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Paternal perinatal depression and anxiety is a common, though under-recognized mental health condition experienced by men during their transition to fatherhood. An opportunity to screen for paternal mental health issues occurs when parents present for assistance with the care of their baby at early parenting services (EPSs). There are 10 EPSs located across Australia that provide specialist, multidisciplinary interventions to support parents experiencing complex parenting difficulties. Using structured telephone interviews, this qualitative study explored the views of 18 professional staff from nine EPSs regarding screening, referral processes and acceptability of screening fathers for mental health issues. A thematic analysis revealed that most EPSs screened fathers for depression. Participants agreed screening was important and that routine approaches to screening would help normalize the process for both men and services. Despite this, no uniform, comprehensive approach to identifying the mental health needs of fathers was found. EPSs provide a unique opportunity to address the mental health needs of fathers. Results from this study point to the need for a national approach to the development of father-specific screening guidelines for EPSs to improve family well-being, in parallel to those informing the Australian National Perinatal Mental Health Initiative for mothers.

BackgroundSleep disturbance among adults has consequences for their health and functioning. Among mothers of infants, there is evidence that fatigue and sleep disturbance are significantly associated with depression, anxiety and impaired relationships with partners and infants. It is not known whether consistent evidence of such associations exists for fathers. The aim of this review was to describe what is known about fathers' sleep and its associations with mental health and wellbeing, in the first 12 months postpartum. MethodsA scoping review was conducted, searching MEDLINE complete, Scopus, PsycINFO and CINAHL complete, from 1990 to 13 May 2019. Reference lists of relevant reviews were also searched. Articles were included if they were published in English, and reported on sleep among men cohabiting with their infants from birth to 12 months. ResultsThirty-six papers reporting on 31 separate studies met inclusion criteria. Sleep constructs and assessment of these varied greatly. While some measures of fathers' sleep improved, fathers' fatigue increased significantly with increasing infant age. In adjusted analyses, fathers' sleep problems were associated with poorer mental health, relationships with infants and partners, and safety compliance at work. ConclusionsFurther research on fathers' sleep in the first postnatal year is recommended, including: validation of brief self-report measures to assess sleep disturbance and fatigue; welldesigned longitudinal studies to clarify the causal direction of associations between infant sleep, fathers' sleep and fathers' wellbeing; and development of interventions to improve fathers' sleep, for example by supporting parents to address infant sleep problems.

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