The missing father: why can't infant mental health services keep dads in mind?

Abstract

Despite the weight of scientific evidence demonstrating the importance of fathers in the social and emotional development and well-being of infants, infant mental health services struggle to engage fathers. Commonly, fathers are assumed to be unavailable, uninterested, unnecessary, or even unsafe in relation to infant mental health work. These outdated perspectives perpetuate the myth that this work pertains exclusively to the infant–mother dyad. This paper aims to explore some of the reasons for and barriers to involving fathers in infant mental health services. We present an imagined conversation between three mental health professionals working in a child and adolescent mental health service. Presented as a script, the various arguments, counterarguments, and reflections made by the three characters aim to bring the subject matter to life and capture something akin to an actual discussion between colleagues working in a child mental health service. A junior clinician notices that an infant case presented at the multidisciplinary team meeting did not mention the child's father. A senior clinician explains that the team's work usually focuses on the infant–mother relationship, as this is considered of primary importance clinically. A psychiatrist, who has only recently joined the team, explores some of the aspects of team culture that might exclude fathers from participating in the service. Several plausible objections to involving fathers are explored as the discussion unfolds between the three professionals. Infant mental health services should consider how their culture and processes influence whether fathers and/or other adult caregivers engage in these services. For clinicians, thinking about the infant's immediate interpersonal context from their unique development perspective can reveal opportunities and resources within the family that may lead to effective systemic treatment approaches.