As regular followers of our blog posts will appreciate, here at DadPad we’re especially interested in supporting all new parents’ mental health during the perinatal period, and do our best to keep on top of the research that’s coming out in order to further our work.  Unfortunately, though, although research into the previously overlooked and ignored area of paternal perinatal mental health is improving and growing all the time – which is fantastic! – the same cannot be said for other parent demographics, with research into the perinatal mental health experiences of LGBTQ+ parents still fairly thin on the ground.  As a fabulous article by Zoe Darwin and Mari Greenfield from 2019 points out:

For these reasons, it’s therefore tricky to write confidently about this topic, but it can’t be ignored, as LGBTQ+ parents are experiencing perinatal mental health difficulties just like all other parents. Being aware of the fact that mental health difficulties can arise during pregnancy, birth and early parenthood, knowing what signs and symptoms to look out for, and knowing where to go to access support if you feel you need it – these are all essential pieces of information for all new parents, to ensure that they are able to do their best for their new and growing families. We therefore want to try and help…

Following her “Where do I go to access support for my mental health?” blog post for dads written for International Fathers’ Mental Health Day back in June, DadPad’s Georgie has now written a follow-up piece which looks at some of the reasons why LGBTQ+ parents might need especial support for their own mental health during the perinatal period, and suggests some sources of help for those affected…

Becoming a parent for the first time is a significant life change for all parents, regardless of gender or sexuality. However, for LGBTQ+ parents, it can be a particularly stressful time as they often come across more challenges and barriers when planning a pregnancy, accessing fertility treatment, navigating surrogacy pathways, understanding legalities, and receiving the right care during their pregnancy, birth and beyond.

LGBT+ people in general are at a greater risk of poor mental health and wellbeing than the general population, not because they are more susceptible to poor mental health but because they are exposed to more things that can affect their mental wellness. In 2017, Stonewall commissioned YouGov to survey over 5,000 LGBT people about their life in Britain and published a report on their findings, which can be found here.

We know, from established research findings, that perinatal mental health conditions such as postnatal depression are not specific or limited to the birthing person. Our “Can dads get post-natal depression?“ blog post from September 2020, for example, identifies that:

• PND affects more than 1 in every 10 women within the first year following birth, and that fathers and partners can also be affected;
• hormonal changes around the time of the birth affect dads as well as mums, with dads explaining a drop in testosterone and a rise in oestrogen levels, all of which helps him to become a more sensitive father/co-parent, better able to meet his child’s needs; and
• it’s now recognised that PND is caused not simply by hormonal changes but also due to situational changes, which obviously apply to all parents, including: lack of sleep, added responsibilities, increased worry about all sorts of things, dealing with and negotiating relationships with the wider family, plus environmental factors (such as income, housing, and education) and psychological ones (such as previous mental health, coping skills, etc).

Clearly, although we don’t yet have the research to confirm this, it’s fairly easy to see that all these points are applicable across the board, to all those becoming new parents.

Added to this, though, are some specific reasons why the mental health of LGBTQ+ parents can be even more at risk of being negatively affected, including:

• not being able to be open about their gender or sexuality;
• judgement or lack of support from family and friends;
• exposure to homophobia/transphobia;
• not being able to gain equal access to the right health and social care services;
• a lack of understanding of LGBTQ+ health and needs by professionals;
• a lack of LGBTQ+ support or community in their local area;
• changes to their body and relationships during the fertility and pregnancy journey;
• a traumatic birth;
• being separated from their baby after birth; and
• not being seen as the parent of their baby(ies).

What to look out for

Although there are specific reasons why LGBTQ+ parents are at greater risk of poor mental health during the perinatal period, then, the signs of a deterioration in a person’s mental health are the same as the general population, which may include:

• finding it difficult to stay focused
• being easily distracted
• becoming disorganised
• procrastination
• questioning your abilities or performance as a parent or in your job
• finding it difficult to make decisions
• worrying about things more than you usually would
• getting overwhelmed by things
• engaging less in in day-to-day activities
• low mood
• tearfulness
• finding it difficult to control your emotions
• irritability and short temper
• aggression
• tiredness and lack of energy
• sleeping more, or sleeping less
• talking less and avoiding social activities
• talking more or talking very fast, jumping between topics and ideas
• drinking more than usual
• drug abuse (either recreational or prescription)
• loss of interest in sex

Looking out for yourself and your co-parent

Sometimes it can be difficult to detect when your mental health is declining and the symptoms may not be obvious to the person experiencing them to start off with – it’s often a partner, family member or friends who notice the symptoms first. If you or those around you are noticing symptoms, it’s important to look at what you are doing to care for yourself.

Top tips for maintaining your wellbeing as a parent:

• Move your body: Any kind of exercise is great for your wellbeing. Your body releases feel-good hormones when you exercise, which can help you manage periods of stress, low mood and anxiety.
• Fuel your body: When you’re going through periods of stress, low mood and anxiety, it’s easy to neglect yourself. The symptoms of poor mental health can also affect your appetite. Factoring in time to eat, planning what you’re going to eat in advance and keeping what’s on your plate balanced and colourful will help you stay on the best form possible.
• Express your feelings: Don’t bottle things up! By noticing how you feel and trying to put it into words, you are creating the space to deal with the feelings appropriately and be supported by others. Often we only express our feelings when we are triggered into a reaction, which isn’t helpful for ourselves or others around us.
• Keep in touch: Everyone has busy lives but keeping in touch with family and friends who are supportive of you is essential to everyone’s mental wellbeing, can reduce feelings of isolation and creates regular opportunities to share how you are feeling.
• Ask for help: A problem shared is a problem halved; asking for help does not make you weak or a failure. Reaching out can feel difficult, though, especially if you are used to being the one everyone usually comes to for advice and support.
• Do things you enjoy: Making time for joy is important when it comes to maintaining your mental wellbeing. It sounds simple but, when we are busy, our hobbies and interests are usually the first things to be left off the list of things to do.
• Rest and recover: Being busy seems to be a normal part of day-to-day life, which reinforces the idea that resting is lazy. Planning periods of rest into your week gives your mind permission to switch off, gives you the mental space to reflect on things and creates the physical time to care for yourself.

When you need a bit more help…

Sometimes, despite your best efforts to care for your mental wellbeing and look out for signs of mental illness, you may need some extra input, and that’s OK.

The best place to start is with your GP, who will be able to listen to what’s going on for you and tell you what treatments are on offer to you. Common mental health problems are often treated with a combination of medication and talking therapies through your local NHS IAPT (Improving Access to Psychological Therapies) service, but you may also be able to be signposted to nearby peer support groups or wellbeing activities through your local social prescribing service.

If you are experiencing severe mental health problems, you may also be linked up to your local mental health team.

It’s important to remember that there is no ‘one size fits all’ approach to tackling poor mental health and being opened to exploring what is on offer will help you to figure out what works for you best. Your GP, however, isn’t the only person you can talk to about your mental health or the only way for you to access support, so set out below is a simple summary to help you better understand the various options that are out there.

Where to go to find support:

• Contact your GP: Your GP can prescribe a range of SSRI medications (a group of medications commonly used to treat mental health conditions), refer you on to your local IAPT service (see below) or specialist mental health service, or social prescribe activities in your area. Your GP may also be aware of local peer support groups, with other people who have experienced poor mental health. If you struggle to talk to a healthcare professional about your health, it’s fine to bring someone along to support you. You might also want to check out this handy interactive checklist which you can build before sitting down in the doctor’s office: www.docready.org.
• Talk to a Mental Health First Aider: Your place of work or a group or organisation that you are part of may have trained mental health first aiders as part of the team. Mental health first aiders are trained to: promote mental health within the workplace or a group; be able to listen to people with mental health concerns; and signpost on to the right services for you. Speaking with a mental health first aider is confidential, unless there is a safeguarding concern which needs acting on (e.g. if you disclose that you or someone else is at immediate risk of harm). For more information please visit https://mhfaengland.org/.
• IAPT Service (Improving Access to Psychological Therapies Service): You can be referred to your local IAPT service or refer yourself, but you must be registered with a GP. The service will assess your mental health using a standard psychological questionnaire and, depending on your answers, will refer you to the most appropriate service they have available. What’s on offer can range from self-guided help, to group courses and limited 1:1 therapy  sessions (usually all involving a model of therapy called CBT, or Cognitive Behavioural Therapy). If the IAPT service feel you need more in-depth care, they may refer you on to other NHS specialist mental health services. For more information on IAPT services near you, please visit https://www.nhs.uk/service-search/find-a-psychological-therapies-service/.
• Specialist Mental Health Service: Your local NHS Trust will also have a range of specialist mental services that deal with more severe mental health conditions. You can access these services by being referred to them by your GP or via another healthcare professional involved in your care. If you feel you are in crisis, you can call to be assessed by your local crisis team. The care you receive is dependent on the severity of your mental health.  For information on accessing mental health support urgently, please visit: https://www.nhs.uk/mental-health/get-urgent-help-for-mental-health/.
• Social prescribing: Social prescribing is a way for your GP to refer you to a link worker, who will be able to give you time, focusing on ‘what matters to me’ and takes a holistic approach to your health and wellbeing. They connect you to local community groups and statutory services who will be able to offer you practical and emotional support.  What you can access, depends on what’s on offer in your local community, but this could include a range focused activities to support your mental health, such as: walking, gardening, swimming, cycling, team sports, yoga, meditation, breathwork, arts and crafts and counselling. For more information, please visit https://www.england.nhs.uk/personalisedcare/social-prescribing/.
• Peer support: There are peer support groups run by LGBTQ+ people with lived-experiences of fertility, pregnancy, birth and parenthood across the UK. They are trained to be able to listen, offer empathy and signpost to relevant information. Peer support groups offer the opportunity to talk to others about how you feel, to be part of a supportive community and to explore activities that can support your mental health. Supporting others as a peer supporter can also be a great way to maintain your own mental health, too, once you are well again. To find out more about peer support, please visit https://www.mentalhealth.org.uk/a-to-z/p/peer-support.
• Charities and organisations: There are a number of charities and organisations across the UK that are specifically set up to support LGBTQ+ people. Depending on the charity or organisation’s aims and mission, they may have specialist information, resources and support on offer. Some charities and organisations also have helplines that you can call to talk to a specialist trained call listener; this can be an invaluable service if you are in crisis or would just like to talk to another human.

What next?

If this blog has inspired you to find out more, or to reach out for help, then some of the following might be useful:

We have a number of other blog post articles on topics related to dads’ mental health but which may also be applicable to your situation, including: how to support your own and your partner’s perinatal mental health, whether dads can get postnatal depression (PND), and why dads’ mental health matters.  You can access all of our mental-health-related blog posts via this link: https://thedadpad.co.uk/category/mental-health/.

Georgie also wrote a blog post back in April which focused upon some of the main sources of support for LGBTQ+ parents.

In terms of information on important sources of mental health support, you may find the following useful:

PANDAS Foundation UK

• FREE helpline: 0808 1961 776. Available on all landlines from Monday – Sunday 11.00 am-10.00 pm, the helpline is manned by a team of trained volunteers who will be happy to chat to you and direct you to the right support.
• Email Support: info@pandasfoundation.org.uk, available 365 days a year. They’ll respond within 72 hours, and you are invited to get in touch if you’d like any more information regarding perinatal mental illness or are looking for support for yourself or your partner, friend or colleague.
• PANDAS also have a Facebook group that you might like to follow [PANDAS Foundation page] on which their social media team updates on current perinatal mental health news and reports.

Samaritans

• FREE helpline: 116 123. Available 24 hours a day, 365 days a year, Samaritans’ volunteers will listen to you, with no judgement or pressure, to help you work through what’s on your mind.
• If you find it easier to write things down, you can also email them on jo@samaritans.org (with a 24-hour response time) or write them a letter.

The Mind mental health charity has a specific page dedicated to LGBTIQ+ mental health, alongside their list of mental health crisis helplines and listening services, which you may find useful.

In terms of support services specific to the LGBTQ+ population, you might want to check out the following:

FFLAG

• FFLAG are a national voluntary organisation and charity dedicated to supporting families and their LGBTQ+ loved ones.
• Their webpage includes a link to ELOP, a holistic lesbian and gay centre in East London which offers a range of social, emotional and support services to LGBTQ+ communities.
• FFLAG also have a dedicated webpage with information for LGBTQ+ parents.

Galop

• Galop support LGBTQ+ people who have experienced abuse and violence.
• Their National LGBT+ Domestic Abuse Helpline is available weekdays via 0800 999 5428, or you can email them help@galop.org.uk.
• They also offer Webchat and Chatbot services via their website.

LGBT Foundation

• The LGBT Foundation offer a huge range of advice, information and support for the LGBTQ+ community and those who work with them.
• They also run a helpline which has an especial focus on supporting those experiencing mental health difficulties.  You can ring them each weekday between 9.00am-9.00pm on 0345 330 3030.
• Their helpline webpage also has links to and information on a range of other support services.

Pink Therapy

• Pink Therapy are the UK’s largest independent therapy organisation working with gender and sexual diversity clients.
• You can find out more about what they do and the services that they offer via their website.

Stonewall

• The Stonewall information service is open on weekdays from 9.30am-4.30pm on 0800 050 2020.
• Their ‘What’s In My Area?’ webpage enables you to search for local mental health (or other) support groups local to you.
• Their website also offers information on a range of advice and support services, and has a specific page of information on Parenting Rights.

Switchboard

• Switchboard provide a one-stop listening service for LGBTQ+ people on the phone, by email via chris@switchboard.lgbtor via instant messaging.
• Their helpline is open daily from 10.00am-10.00pm and can be accessed via 0300 330 0630.

Intercom Trust

• Finally, for those living in Cornwall, Devon, Dorset and Somerset, Intercom Trust is a lesbian, gay, bisexual and transgender community resource which covers the south west of England.
• Their website includes a directory of local support groups and organisations.
• Intercom also run a confidential helpline (0800 612 3010) and email: helpline@intercomtrust.org.uk.

References and further reading:

Bachman, C & Gooch, B (2018). LGBT in Britain: Health Report. Stonewall. [online]

Darwin, Z & Greenfield, M (2019). Mothers and others: the invisibility of LGBTQ people in reproductive and infant psychology. Journal of Reproductive and Infant Psychology, 37:4, 341-343. [online]

Malmquist, A et al (2019). Minority stress adds an additional layer to fear of childbirth in lesbian and bisexual women, and transgender people. Midwifery, 79. [online]

Warwick-Guasp, L (2021). LGBTQ+ families and perinatal mental health. iHV. [online]

Various (2018). LGBTI Populations and Mental Health Inequality. [online]