Having a new baby can be a challenging time for many fathers as they adjust to the changes in roles and responsibilities, relationships, work, and home life (Highet & the Expert Working Group and Expert Subcommittees, 2023). It can be a key life stage when men are at increased risk of mental health difficulties and are in need of support. In the first postnatal year, it is estimated that ~10% of fathers experience clinically significant depressive symptoms such as low mood, loss of interest or pleasure in activities, feelings of hopelessness, decreased energy, and changes in appetite and sleep (Cameron et al., 2016; Paulson & Bazemore, 2010). Although less well studied, symptoms of anxiety (e.g. somatic symptoms including increased heart rate, gastrointestinal issues) are wide ranging between 2 and 51% (Philpott et al., 2019). Experiences of stress including irritability, frustration, tension, and difficulties relaxing are also common among fathers (~18%; Giallo et al., 2013; Seymour et al., 2014). A better understanding of the extent to which fathers experience a broad range of mental health difficulties in the postnatal period is important given the potential impacts on the day-to-day functioning of fathers and their families, as well as potential short- and long-term impacts on children’s development and mental health (Dachew et al., 2023; Scarlett et al., 2023).

Depressive, anxiety, and stress symptoms can impact individuals’ daily functioning in different ways, and the risk factors for these different symptom sets can also differ. Approaches to intervention and support may also vary depending upon the presentation of symptoms and risk factors. Given their accessibility, community health organisations who provide support to families during the postnatal period are in an ideal position to identify fathers who are experiencing, or at risk of experiencing, symptoms of depression, anxiety, and stress. This is particularly important given the under-utilisation of health services by men in general (Kessler et al., 1981; Pinkhasov et al., 2010), and the poor engagement of fathers in early childhood settings (Fletcher & StGeorge, 2010). In a study of 154 fathers of young children (aged 0–8 years) in Australia, a range of attitudinal barriers to help-seeking for mental health difficulties were identified including a desire to be in control and self-reliant in managing one’s own problems, a tendency to minimise the seriousness of problems, and a sense that seeking support would not help (Giallo et al., 2017). Therefore, when fathers access services with their families, there is a real opportunity to engage fathers in conversation about their mental health, overcome attitudinal barriers to help-seeking, and link them into supports at a time when they may be most responsive to it. However, little is currently known about the extent to which fathers who are accessing support through community health organisations experience mental health difficulties and the factors associated with these difficulties. Therefore, the aim of this study was to explore the extent to which fathers seeking support from a community health organisation experience depressive, anxiety, and stress symptoms in the first postnatal year, and to identify a broad range of individual, child, and family factors associated with these symptoms.

Socioecological theories of health (Bronfenbrenner & Morris, 2006; McLaren & Hawe, 2005) provide a useful framework for understanding the range of factors that may influence fathers’ postnatal mental health. This includes factors within the individual (e.g. prior history of mental health difficulties), microsystem (e.g. couple relationship difficulties), community (e.g. low job quality), and broader society (e.g. culture). The current study focuses specifically on the individual and microsystemic factors given these factors represent potential targets for mental health promotion and intervention efforts.

In relation to individual factors, there is strong evidence that a history of mental health difficulties places fathers at increased risk of poor mental health during the postnatal period (Ansari et al., 2021). Indicators of socio-economic disadvantage, such as low level of education and unemployment, have also been found to significantly increase the risk of postnatal depression for fathers (Ansari et al., 2021). There is some evidence to suggest that younger paternal age may be associated with postnatal depression (Bergström, 2013; Bielawska-Batorowicz & Kossakowska-Petrycka, 2006; Grey et al., 2018), however the results have been mixed (Da Costa et al., 2019). Another individual factor that has received some research attention is parenting self-efficacy, which refers to perceived confidence in the parenting role. In an Australian population-based longitudinal cohort study of 3219 fathers, Giallo et al. (2013) reported an association between lower levels of perceived parenting self-efficacy and psychological distress in fathers. This study, however, examined psychological distress broadly rather than examining associations for the different domains of mental health separately. While another Australian study of 154 fathers reported evidence for associations between fathers’ self-efficacy and depressive, anxiety, and stress symptoms (Seymour et al., 2014), this study included fathers of children aged up to 6 years rather than focusing on the postnatal period specifically. It is crucial that these associations are examined in the first year of life given that this represents a time of increased stress for many men (Australian Government, 2018). It also represents a sensitive period during which the developing infant brain is particularly vulnerable to environmental influences, especially those within the early caregiving environment (Miguel et al., 2019).

In addition to individual factors, there is emerging evidence from community- and population-based samples to suggest that factors within the microsystem, or relational environment, may also be associated with postnatal mental health difficulties for fathers. This includes infant characteristics such as sleep and regulation difficulties (e.g. crying and unsettled behaviour) which are very common in the first few months of life (Cook et al., 2017) and have been found to be associated with high emotional distress in parents (Muller et al., 2023). Whilst most studies have been conducted with mothers, a small number of studies have shown that infant sleep and crying problems are associated with higher depressive symptoms and psychological distress amongst fathers (Cook et al., 2017; Giallo et al., 2013). More research is however needed to better understand the potential relationships between infant sleep and regulation difficulties and symptoms of anxiety and stress for fathers during the first postnatal year. Research has highlighted associations between other relational factors and fathers’ mental health in the early parenting period. This includes evidence for associations between low social support and fathers’ depressive symptoms in the postnatal period (Ansari et al., 2021; Chhabra et al., 2020), as well as symptoms of anxiety and stress in fathers of children aged up to 6 years (Seymour et al., 2014). Couple relationship difficulties including arguments and dissatisfaction within the parental relationship have also been found to increase fathers’ risk of developing depressive symptoms (Massoudi et al., 2016; Rusten et al., 2019). Coparenting refers to the ways in which parents and/or parental figures relate to each other in their role as parents and can include the extent to which they: (a) support one another with parenting, (b) agree on aspects of parenting and raising children, and (c) recognise and appreciate each other’s strengths in parenting (Feinberg, 2003). Although not well studied among fathers, there is some evidence to suggest that coparenting difficulties and lack of support may also be negatively associated with psychological distress in fathers during the early years of parenting (Price-Robertson et al., 2017). Notably, however, there is a paucity of research exploring the nature of the associations between factors within fathers’ relational environments and their anxiety and stress symptoms. Better understanding of the nature of these associations is crucial in informing the content of preventative intervention programmes aimed at improving family relationships and reducing mental health difficulties among fathers.

In summary, while there has been growing interest into fathers’ mental health in the postnatal period, most research has focused on depressive symptoms exclusively (Ansari et al., 2021) or psychological distress more broadly (Giallo et al., 2013; Rusten et al., 2019). Little is known about the extent to which fathers experience anxiety and stress symptoms, and about the nature of associations between a broad range of factors within fathers’ family and relational environments and their mental health outcomes. Moreover, most research has been conducted with community or population-based samples, with little currently known about the extent to which fathers who are actively seeking support for their coparenting relationship experience symptoms of depression, anxiety, and stress, and the factors that are associated with mental health symptoms for this group of fathers.

To address gaps in current knowledge about men’s mental health difficulties in the postnatal period and inform the design of tailored interventions and supports, the first aim of the current study was to investigate the extent to which fathers accessing support to strengthen their coparenting relationship through a community health organisation experience depressive, anxiety and stress symptoms during the first postnatal year. Drawing on socioecological frameworks of health, the second aim of this study was to explore the associations between a range of individual and microsystemic factors that may contribute to fathers’ depressive, anxiety, and stress symptoms. This is important for tailoring services and interventions to be responsive to the specific risk factors for men’s mental health difficulties in the postnatal period. It was hypothesised that several individual (lower educational attainment, lower parental self-efficacy, older age) and microsystemic (low coparenting support and agreement, infant regulation difficulties, high interparental conflict) factors would be associated with more reported mental health symptoms (depression, anxiety, and stress) in fathers during the first postnatal year.

Method

Study Design and Participants

This study involves secondary analysis of baseline data collected between 2019 and 2021 as part of a routine evaluation of the Family Foundations (FF; Feinberg et al., 2016) programme delivered by Merri Health, a community health organisation in Victoria, Australia. Family Foundations is a 10-session manualised intervention programme that is designed to improve coparenting relationships and reduce parental conflict in the early parenting period. Merri Health obtained written consent from programme participants for their routinely collected de-identified assessment data to be provided to the research team. Ethics approval for this secondary analysis study was obtained from Deakin University Human Research Ethics Committee.

Eligibility for the Family Foundations programme was assessed during an intake call with Merri Health. Families were eligible to be enroled in the FF programme with Merri Health if they: (a) were expecting a baby or had a child aged 0–12 months; (b) both parents/caregivers agreed to participate in FF; (c) one or both parents/caregivers reported at least one risk factor for high parental conflict (mental health difficulties, interparental conflict, relationship difficulties, financial difficulties, young parental/caregiver age, history of poor mental health) during an intake phone call with a Merri Health clinician. Families were ineligible for the programme if one or more parent/caregiver was experiencing a severe mental health disorder, family violence, or had child protection involvement. While Merri Health deliver FF to families during pregnancy and the first postnatal year, the current study focused specifically on the fathers of children aged between 0 and 12 months who completed the baseline survey (prior to commencing the FF intervention) and consented for their assessment data to be provided to the research team. Of the 367 families who enroled in FF, 170 fathers had baseline data available and were included in the current study.

Procedure

Merri Health distributed information about the FF programme via their organisation (e.g. their website), other local community health services, maternal and child health centres, hospitals, and GPs. Demographic and social context information was collected by Merri Health through telephone intake, which was completed with each parent/caregiver separately. Prior to commencing FF, both parents/caregivers were invited to complete hard copy surveys, which were returned to Merri Health either by post or directly to FF facilitators during the family’s first session.

Measures

Demographic and Social Information

Demographic and social context information was collected from families by the Merri Health intake team. This included parent/caregiver age, country of birth, language spoken at home, education, income source, employment status, number of children in the family, age of children in the family, whether a parent/caregiver was currently pregnant, history of mental health difficulties, past participation in counselling for mental health concerns, child health and wellbeing concerns, history of substance use, current legal concerns, history of domestic violence either during childhood or adulthood.

Mental Health Symptoms

Fathers’ depressive, anxiety, and stress symptoms were assessed using the Depression Anxiety Stress Scale-21 (DASS-21; Lovibond & Lovibond, 1995), a self-report questionnaire assessing symptomatology over the past week. Items were rated on a 4-point Likert scale ranging from 0 (did not apply to me) to 3 (applied to me very much). Items were summed and then doubled for the depression (e.g. ‘I felt life was meaningless’), anxiety (‘I felt I was close to panic’), and stress (e.g. ‘I found it hard to wind down’) subscales, with higher scores indicating more severe symptomatology. Cut-off values were used to classify scores into ranges (normal, mild, moderate, severe, extremely severe) based on the severity of symptoms (Lovibond & Lovibond, 1995). Cronbach’s α for depressive, anxiety, and stress symptoms in the current sample were 0.87, 0.72, and 0.83, respectively.

Coparenting Behaviour

Coparenting behaviour was assessed using three subscales of the Coparenting Relationship Scale (Feinberg et al., 2012): coparenting agreement (e.g. ‘my partner and I have the same goals for our child’), coparenting support (e.g. ‘my partner asks my opinion on issues related to parenting’), and endorsement of partner parenting (e.g., ‘I believe my partner is a good parent’). The items were rated on a 7-point Likert scale ranging from 0 (never) to 6 (very often). Subscale items were summed, with higher scores indicating higher levels of coparenting behaviour. Cronbach’s α for the three subscales in the current sample were acceptable: 0.72 (coparenting agreement), 0.90 (coparenting support), and 0.61 (coparenting endorsement of partner’s parenting).

Interparental Conflict

Interparental conflict was assessed using the Interparental Conflict subscale from the Quality of Co-parental Interaction Scale (Australian Institute of Family Studies, 2005). This scale consisted of five items assessing verbal (e.g. ‘how often do you argue?’) and physical (e.g. ‘how often do you have arguments with your partner that end up with pushing, hitting, kicking, or shoving?’) conflict. The items are rated on a 5-point Likert scale from 1 (never) to 5 (always). The items were summed, with higher scores indicating more frequent interparental conflict. Cronbach’s α for this scale was 0.82 in the current sample.

Parental Self-Efficacy

Parental self-efficacy was measured using a single-item scale (Australian Institute of Family Studies, 2005), which asked participants to rate their overall confidence in their roles as fathers from 1 (not very good at being a parent) to 5 (a very good parent). Higher scores indicate higher self-efficacy.

Infant Regulation

Infant regulation was assessed using an adapted version of the Brief Infant Regulation Screening Instrument (BIRSI; Cook et al., 2019). The BIRSI consisted of three items measuring sleeping, feeding, excessive crying and one item measuring global infant temperament. Sleep, feeding, and crying were assessed on a 7-point Likert scale from 0 (hardly any problem) to 6 (severe problem), while temperament was assessed on a 4-point Likert scale from 0 (much easier than average) to 4 (much more difficult than average). Items were summed, with higher scores indicating higher levels of infant dysregulation. The scale had relatively low but acceptable reliability in the current sample (Cronbach’s α = 0.62).

Data Analyses

Data were analysed using SPSS Version 28. Descriptive statistics were used to explore demographic and social context information as well as prevalence of depressive, anxiety, and stress symptoms (aim 1). Standard multiple linear regression analyses were conducted to examine the factors associated with fathers’ depressive, anxiety, and stress symptoms during the first postnatal year (aim 2). Factors in the model included father’s age, number of children in the family, educational attainment, coparenting agreement, coparenting support, coparenting endorsement, interparental conflict, parent self-efficacy, and infant regulation.

Exploratory data analysis was performed to check the extent of missing data. Missing data were minimal across all variables (3.3%), with the highest proportion on infant regulation (8.8%). Missing data were random, as evidenced by Little’s MCAR test, χ2 (160) = 165.7, p = 0.363. Missing data for descriptive and regression analyses on outcome variables were handled using multiple imputation. Twenty complete datasets were imputed using multiple chained equations, which included all variables of interest. Data analyses with multiple imputed datasets yielded similar results to complete case analyses. The pooled estimates were averaged using Rubin’s rules (Rubin, 1987). Estimates for unstandardised B, r, sr, and t-statistic for pooled dataset, provided by multiple imputation in SPSS, were reported. Given that SPSS does not produce pooled estimates for SD, R2, adjusted R2, β, and F-statistic, the ranges across the multiple imputed datasets were reported for these statistics.

Results

Sample Characteristics

Socio-demographic characteristics of the fathers in the analytic sample as well as the fathers who did not meet study inclusion criteria (e.g. fathers with children older than 12 months and those without baseline survey data) are presented in Table 1. The majority of fathers in the study were Australian-born, with post-secondary education, employed, in heterosexual relationships, had prior counselling experience and supportive families. Compared to fathers included in the study, those excluded were more likely to be unemployed or to be receiving a pension, to have had a history of mental health difficulties, prior family violence, and issues with substance abuse, gambling, and legal, financial, or housing concerns, at the time of intake with Merri Health.

Table 1 Socio-demographic characteristics of included and excluded sample
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Prevalence of Depressive, Anxiety, and Stress Symptoms (Aim 1)

Table 2 presents the prevalence of fathers in the normal and elevated ranges of each DASS-21 subscale. The majority of fathers had symptoms in the normal range. Stress symptoms in the mild to extremely severe ranges were the most prevalent (28.3%), followed by depressive (25.8%) and anxiety symptoms (16.0%).

Table 2 Prevalence of depressive, anxiety, and stress symptoms among fathers (N = 170)
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Factors Associated with Mental Health Difficulties in Fathers (Aim 2)

Descriptive statistics for the DASS-21 subscale continuous scores and potential predictor variables are presented in Tables 3, and 4 presents the correlations among all variables.

Table 3 Pooled estimates for descriptive statistics for study variables (N = 170)
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Table 4 Pooled estimates for correlations among all variables of interest
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Three separate standard multiple linear regression models were performed examining factors associated with fathers’ experience of depressive, anxiety, and stress symptoms (see Table 5). The model for depressive symptoms accounted for a significant proportion of the variance, as indicated by the range for R2 across the multiply imputed datasets, R2 = 0.21–0.27, adjusted R2 = 0.16–0.23. The range for the F-tests was F(9, 157) = 4.34, p < 0.001, to F(9, 157) = 6.35, p < 0.001. Parent self-efficacy was the only significant predictor in the model, as evidenced by a medium negative effect size and accounting for 7.3% of unique variance in depressive symptoms.

Table 5 Summary of pooled estimates for multiple regression for depressive, anxiety, and stress symptoms
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The model for stress symptoms significantly accounted for 13.2–18.3% of the variance in stress scores, as shown by the range for R2 across the multiply imputed datasets, R2 = 0.13–0.18, adjusted R2 = 0.08–0.14. The range for the F-tests was F(9, 157) = 2.65, p = 0.007 to F(9, 157) = 4.29, p < 0.001. Interparental conflict was the strongest predictor in the model, as evidenced by a medium negative effect size and accounting for 2.6% of unique variance in stress symptoms. Parent self-efficacy and infant regulation also had medium effect sizes and explained 2.9% and 2.0% of variance in stress symptoms, respectively.

Finally, the model for anxiety symptoms was not significant, R2 = 0.07–0.11, adjusted R2 = 0.02–0.06. The range for the F-tests was F(9, 157) = 1.28, p = 0.254 to F(9, 157) = 2.14, p = 0.029.

Discussion

This study is one of the first to explore the nuanced associations between several socioecological factors and specific domains of mental health in a sample of fathers accessing support for couple relationship issues during the first postnatal year. Fathers in the current study reported higher depressive (26%), anxiety (16%), and stress (28%) symptoms than has been reported in previous studies with mostly community and population-based samples (Cameron et al., 2016; Giallo et al., 2013; Philpott et al., 2019; Seymour et al., 2014). Our findings suggest that some individual and microsystemic factors might be associated with specific mental health symptom domains during the first postnatal year for fathers. Specifically, high parenting self-efficacy was associated with lower depressive and stress symptoms, whereas higher interparental conflict and infant dysregulation were associated with higher stress symptoms. Contrary to expectations, none of the sociological factors examined were associated with anxiety symptoms among fathers in this sample. These findings have important implications for the assessment of mental health in fathers during the postnatal period and provide important insights into potential targets for prevention and early intervention programmes to support fathers and families during this important time.

Whilst most fathers in our sample reported depressive, anxiety, and stress symptoms that fell in the ‘normal’ range, there was a small but notable proportion who reported elevated symptoms. We found that approximately one in four fathers were experiencing elevated depressive symptoms, including hopelessness, loss of interest, and difficulty experiencing positive feelings, with most fathers’ scores falling in the mild to moderate range (21%) and a smaller percentage experiencing severe or extremely severe symptoms (5%). The proportion of fathers experiencing elevated depressive symptoms in this study is higher than what has been reported in previous studies of fathers during the first postnatal year where estimates have generally been around 10% (Cameron et al., 2016; Paulson & Bazemore, 2010). Symptoms of stress (e.g. difficulties relaxing and remaining calm) were found to be the most common mental health concern for fathers, with approximately one in three fathers reporting elevated stress symptoms, particularly in the mild to moderate range (23% of sample). A smaller proportion of fathers in this sample, equivalent to approximately one in six, reported elevated anxiety symptoms (e.g. worry, breathing difficulties, and trembling). A paucity of previous research examining the prevalence of anxiety and stress symptoms in fathers during the first postnatal year makes comparisons difficult. However, the percentage of fathers reporting elevated stress symptoms is comparable to that reported in a study of 144 fathers of children aged up to 4 years who were attending an Australian parenting service for early parenting difficulties (29%; Giallo et al., 2013). Elevated anxiety symptoms were slightly more common in the current study than in the study by Giallo et al. (2013), while the percentage of fathers reporting elevated anxiety and stress symptoms is higher in the current study than what was previously reported in another Australian study of fathers of young children between birth and 6 years (Seymour et al., 2014). The discrepancy in prevalence rates for postnatal mental health difficulties in fathers across studies is likely due to several factors including the assessment measures used, cut-off values chosen to represent elevated symptomatology, decision to report on elevated (rather than clinical) levels of symptomatology, as well as sample differences. For example, it is important to consider that the current study involved a help-seeking sample, so it is likely that elevated rates of mental health symptoms are higher than the general population. However, it is also important to acknowledge that families were excluded from the current study if one or more parent/caregiver was experiencing a severe mental health disorder. Thus, while the fathers in our sample may have had higher rates of mild to moderate mental health difficulties compared with the general population, the percentage of fathers’ experiencing more severe mental health difficulties may be lower in the current sample compared with some other help-seeking samples of fathers due to the eligibility criteria of the FF programme.

Consistent with socioecological theories of health, a range of individual and microsystemic factors were associated with fathers’ experience of psychological distress during the first postnatal year. Fathers who experienced lower parenting self-efficacy reported higher symptoms of depression and stress compared to those experiencing higher parenting self-efficacy. This suggests that fathers who viewed themselves as ineffective parents were more likely to experience symptoms such as low mood, motivation, and energy, and stress, including agitation, over-reactivity, and intolerance. This is consistent with prior research indicating that low self-efficacy may place new fathers at greater risk of mental health issues (Ansari et al., 2021; Giallo et al., 2013, 2014; Philpott et al., 2017; Seymour et al., 2014). It is possible that fathers who struggle to view themselves as good parents experience their new role as stressful, which may instil a negative outlook on life. However, it is important to acknowledge the cross-sectional nature of this study and the possibility of bidirectional relationships between these variables such that the stress typically experienced by fathers during this stage of life may hinder the development of a positive perception of their own abilities to care for their children, thus leading to low self-efficacy. Interestingly, self-efficacy is the only individual factor to be significantly associated with mental health symptoms in the current study. It is possible that self-efficacy may have more bearing on mental health compared to other individual factors, as it may foster important qualities, such as the ability to regulate emotions, to use effective coping strategies, and to adopt an internal locus of control, in turn reinforcing one’s sense of competence in a positive upward spiral.

Evidence for associations between specific microsystem factors and fathers’ stress symptoms was also found. Fathers experiencing high interparental conflict in the form of frequent arguments and disagreements with their partners were more likely to report higher levels of stress. It is possible that fathers who experience disagreements, anger, and hostility within the relationship with their partners during this critical period may be in a constant fight-or-flight state, making it more difficult for them to manage their emotions effectively, wind down, and feel calm. However, the current findings raise the possibility that bidirectional relationships may exist between these variables. In other words, whilst conflict may contribute to fathers’ experience of stress, it is also possible that feeling edgy, nervous, and intolerant, may impede effective communication and problem solving within the couple relationship, leading to increased conflict. Future work is needed to explore the mutual role that these variables may have on each other.

Another microsystemic factor associated with psychological distress among new fathers was infant regulation. Results showed that fathers of children who displayed problematic sleeping, feeding, and crying, and were generally perceived by their father as ‘difficult’, had significantly elevated stress symptoms. One possible explanation is that increased infant crying, fussy eating, and sleeping difficulties may contribute to feelings of frustration, tension, and irritability in fathers. Again, it is also possible that the stress experienced by men upon becoming fathers may negatively impact on infants’ self-regulatory competence, making infants more likely to experience dysregulation. However, contrary to what was hypothesised, infant regulating behaviours were not associated with fathers’ depressive symptoms in the current study. This may be because being exposed to their baby’s persistent fussing and crying, may have a greater impact on immediate emotional reactions, such as stress, compared to states that may develop over time, such as depression. A better understanding of the potential impact of infant self-regulation on fathers’ mental health symptoms during their first year as parents may be an important area for future research to explore.

A novel consideration of this study was the inclusion of a comprehensive measure of coparenting behaviours, which refer to the degree to which fathers feel in agreement, supported, and validated by their partners (Feinberg et al., 2012). Prior research investigating the role of coparenting on expectant parents indicated that perception of parenting agreement may have a buffering role on the psychological wellbeing of future mothers and fathers, particularly in relation to depressive symptoms (Don et al., 2013). This suggests that agreement within the couple may also be a protective factor for fathers during the early parenthood period. To our knowledge, this is the first study to explore coparenting in terms of agreement, support, and endorsement specifically among fathers during their first year as parents. When considering one factor at a time, each of the three coparenting constructs were correlated with depressive symptoms, and coparenting agreement was only correlated with stress. However, when accounting for all the other individual and microsystemic factors, the unique contribution of coparenting support and endorsement was not significant and coparenting agreement only approached significance for depressive and stress symptoms. These findings suggest that additional factors examined in the model may play an important role in the relationships between coparenting constructs and fathers’ mental health in the early parenting period. Longitudinal studies that include a broad range of individual and relational factors are needed to better understand the nature of these likely very complex relationships.

Contrary to study hypotheses, none of the individual and microsystem factors explored in this study were associated with anxiety symptoms. Whilst it is possible that none of these factors are linked with anxiety symptoms among fathers during the first postnatal year, it is also possible that these findings reflect the limited variability in anxiety symptoms in this particular sample. Also, other factors examined in this study, such as fathers’ age, number of children in the family, educational attainment, were not found to be associated with any of the mental health domains during this stage of fathers’ lives, contradicting prior evidence (Ansari et al., 2021; Da Costa et al., 2019). The absence of association between these variables may, again, reflect a limited variability of the sample in terms of age, number of children, and education level. It is also possible that other aspects of individual, child, and family functioning not measured in the current study may contribute to fathers’ experience of depressive, anxiety, and stress symptoms. These may include poor sleep, poor job quality, relationship dissatisfaction, history of mental health difficulties, or having a partner with depressive symptoms, which were found in prior studies (Ansari et al., 2021; Giallo et al., 2013; Seymour et al., 2014).

Strengths and Limitations

The current study has several strengths. First, this study examined a community sample of fathers seeking support for coparenting and mental health concerns in their family, thus meaning that the results may be generalisable within help-seeking communities. Also, the study contributes to emerging evidence regarding the high prevalence of mental health issues affecting fathers during the early postnatal period, especially stress and anxiety symptoms which had received very little research attention to-date. This study extends the literature by exploring novel aspects of individual, infant, and family characteristics seldom investigated before in the context of fathers’ mental health, such as coparenting behaviour, interparental conflict, and infant regulation. Additionally, the study examines potential risk factors in relation to the individual dimensions of psychological distress. Overall, the study contributes and extends current knowledge about fathers’ mental health experience during the first postpartum year.

Nevertheless, the current study has several methodological limitations. First, its cross-sectional design precludes the ability to infer causality. Bidirectional relationships may exist among the socioecological factors and the three mental health domains. Longitudinal exploration is required to gain insight into the causal relationships between these factors and fathers’ mental health outcomes. Second, the range of factors explored in the study was not comprehensive. Given that this was a study drawing upon existing data, we were limited by the existing study design, measures used, and range of socioecological factors explored. Research into other individual and family factors associated with fathers’ experience of depressive, anxiety, and stress symptoms, such as history of mental health difficulties, relationship satisfaction, financial stress, or unplanned pregnancy, is needed. Third, some of the assessment measures used in the study were brief and may not have captured all aspects of the construct of interest (e.g. Brief Infant Regulation Screening Instrument). Further, all assessments were self-reported and may have been influenced by the social desirability bias, especially considering men’s known tendency to under-report mental health symptoms (Smith et al., 2018). Future studies should consider the use of more comprehensive and reliable scales, as well as alternative strategies to measure psychological symptoms, such as clinician-rated assessments. These may help capture the richness of fathers’ experiences and minimise the risk of response bias.

Finally, the sample was comprised of fathers who actively sought support for mental health, relationship, and parenting issues, who were mostly Australian-born, English speakers, of relatively high socio-economic status, in heterosexual relationships, and living with their children, thus limiting the generalisability of the results. It would be worthwhile to employ a more diverse sample to determine whether similar associations are evident for fathers with different social, economic, cultural, and language backgrounds. In particular, it would be interesting to pursue investigation of this topic among fathers who are single, gay, or living separately from their children.

Implications and Conclusions

The current study generated important evidence about the mental health of fathers during the first postnatal year and about the associations between fathers’ mental health and some novel individual and microsystemic factors. The findings of this study reinforce the importance of researchers and clinicians undertaking a broad assessment of fathers’ mental health to include questions about anxiety and stress, rather than exclusively focusing on depression. Findings also highlight the need for early parenting programmes specifically tailored to fathers, who remain under supported in the service system. A better understanding of fathers’ mental health in the early postnatal period may inform the development of prevention programmes, strategies for early identification of fathers at risk, and interventions tailored to families’ idiosyncratic needs. For example, prevention programmes could target parenting and couple relationship issues during pregnancy to reduce the likelihood of fathers developing mental health issues during the transition to parenthood. Services could also enquire about fathers’ confidence in their parenting role, conflict among parents, and self-regulating issues in their infant to identify fathers susceptible to mental health deterioration during the first year as parents. Finally, community health organisations seeking to support families around mental health issues could consider providing parent-based interventions, like FF, presently offered by Merri Health, directed at families who experience conflict within the relationship and difficulties within the parenting role. This has important implications not only for fathers but also for their children, given the critical influence that the early postnatal period has on child development.