Addressing the Mental Health Needs of Head Start Fathers

Providing Guidance

Currently, there is a national Head Start initiative to strengthen and support fathers and to enhance their involvement in parenting. Addressing the mental health needs of Head Start fathers is an important aspect of the fatherhood effort.

Family support workers, parent or male involvement coordinators, mental health specialists, and social workers may be among the Head Start staff providing mental health support to dads. They need to be wellgrounded in strategies that allow them to respond to the dads’ individual struggles and to promote their wellbeing and their parenting. The same is true for the community partners and professionals outside the Head Start agency who address the mental health issues of the dads.

Meeting the Mental Health Needs of Fathers

The first step in dealing with the complexity of fathers’ mental health and well-being is demystifying the words “mental health.” The stigma associated with mental health often inhibits individuals from seeking care. For example, in some communities “acknowledging mental or emotional distress is associated with being weak or not acting like a man” (Satcher 2003). This stigma can be so powerful that young men, particularly fathers, are hesitant to engage and build relationships with programs and with staff who may be able to support them.

Yet, the ongoing emotional state of a father has a profound impact on the emotional world of his young child. When a father is depressed, his interactions with and responsiveness to his young child are likely to be negatively affected. He may not engage in eye contact, touching, talking, singing, and laughing. The child may withdraw, attempting to self-soothe, or on the other hand, engage in challenging behaviors, attempting to engage the parent. As staff help fathers deal with their mental health issues like depression, the dads, in turn, are better able to provide care and love to their young children.

Some populations of fathers are especially at risk for mental health challenges, including depression. Research indicates that low-income, under-educated, and young fathers are vulnerable. Findings of an Early Head Start Research and Evaluation Project concluded that 18 percent of the fathers reported enough symptoms to be considered depressed when their children were 2 years old; 16 percent when their children were 3 years old (CORE 1996).

Data from the Visiting Nurse Service of New York Early Head Start program corroborates these general findings. Many of the children’s fathers experienced psychosocial risk factors such as alcohol and/or substance abuse, domestic violence, depression, or anxiety that negatively affected their ability to parent. (Jones 2004). They had limited parenting skills and little knowledge of child development.

Although there is no one “right” way to go about addressing the mental health needs of fathers, there are guiding principles that programs can follow.

Grounding in Principles

Underlying the work related to fathers’ mental health are two principles: it must be strengths-based and it must partner with fathers.

Strengths-based work implies first recognizing and discussing the inherent strengths of an individual and then building on them to enhance self-understanding, establish trust, and foster change. Every individual has strengths and abilities despite the overwhelming adversity of their past life or their current condition. To take this perspective, staff must be accepting, not judgmental.

Partnering with fathers means that staff members collaborate with fathers. The visual picture is that of a staff member and a father walking side by side as equals. The staff person makes every effort to listen to and connect with the thoughts, issues, goals, and dreams of a father and support the father along his personal journey.

Before any mental health issues can be addressed or resolved, a healthy relationship must be established between the service provider and the father. Relationships are more likely to form when the elements of trust, empowerment, and inclusion are in place.

Trust

In the Visiting Nurse EHS program, a support group was one way that trust was built between the clinical director, David Jones, who facilitated the group, and the fathers who attended. Within the support group, referred to as Fathers First, fathers and father figures reflected and discussed their mental health successes and challenges.

Getting these fathers on board was not an overnight success. Often Mr. Jones would venture out into the local community where the fathers lived and worked. In the course of a day, he might visit a dad at the local courthouse, or stop by a pediatric clinic or take a lunch break at a father’s job site or school. All this took time and patience on his part, but the fathers began to recognize that Mr. Jones truly cared for them and that he was willing to meet them where they were at— even if that place was out-of-the way or unfamiliar to him. Gradually, they opened up in the support group, beginning to shed layers of pain and disappointment Some fathers discussed how the lack of positive attachment to an early caregiver due to abuse or abandonment had affected their ability to trust.

Addressing their pain through nonthreatening activities, such as storytelling, poetry, and open discussions helped the fathers begin to heal (Jones, 2004). They read chapters in selected books and described how certain themes related to their own lives. Some fathers wrote poetry describing their struggles with poverty, relationships, and survival on the streets (Jones 2004). As the fathers shared their struggles and hardships in the support group, they developed and sustained a deeper level of trust with each other and a commitment to the group.

Empowerment

For some fathers, the bond with their child may be their first strong connection to another person. When programs help dads strengthen that bond and express their love for their children, the dads gain confidence and improve their self-esteem. In the Visiting Nurse EHS program, parent/child groups helped fathers learn to engage in developmentally appropriate games and activities. The goals were to create pride and success for fathers and to enhance the ties between fathers and their children. The majority of the EHS fathers also participated in the Reading is Fundamental (RIF) program. They picked out quality books for their infants and toddlers and read to them. These shared moments promoted learning and literacy for the children and enhanced the self-worth and well-being of the dads.

Fathers also feel empowered and gain a stronger sense of self when they meet educational goals and experience job success. The EHS program held a General Equivalency Diploma (GED) class onsite through a collaboration with the local Board of Education and offered other resources to develop job skills.

Inclusion

The Visiting Nurse program valued inclusion—that is, creating an environment that includes all people and that recognizes the uniqueness of each individual. The Clinical Director writes, “Creating a culture of inclusion culminates with an internal evaluation of an agency or organization’s ability and level of readiness to provide services for fathers” (Jones 2004). An agency must not only evaluate itself from the inside out to assess its ability to provide respectful and individualized services for fathers, staff must understand and support father involvement. They also must be willing to process their own internal issues or ideologies related to their past and current experiences with men.

Internal self talk and reflective supervision are key elements in this process (Jones 2004). In the Visiting Nurse program, staff and supervisors met one-on-one or in a group. In a safe and unrushed environment, they processed feelings, experiences, choices, and beliefs. Staff came to their own conclusions and formulated their own action plan. This model of reflective supervision differs from the more traditional one where supervisors are thought to have all the answers.

Experiencing Success

Where there are strong partnerships and a strengths-based approach guiding the work with fathers, Head Start staff often see an increase in the use of mental health services. When the program nurtures fathers and supports them on their journey toward mental health, everyone benefits—the dads, their children, other family members, and the Head Start community.

REFERENCES:

     Administration for Children and Families. 1996. Research to Practice: Depression in the Lives of Early Head Start Families. The Child Outcomes Research and Evaluation Division, Office of Planning, Research and Evaluation. U.S. Department of Health and Human Services.

     Jones, D. 2004. Creating a culture of inclusion: Evaluating your organizations’ readiness to service fathers. American Journal of Public Health. In press.

     Satcher, D. 2003. Overlooked and underserved: Improving the health of men of color. American Journal of Public Health. 93 (5).

Mona Ivey-Soto is a Head Start Fellow. T: 202-205-8034; E: mivey-soto1@acf.hhs.gov.

The author appreciates the generous contributions of David Jones, Clinical Director at the Visiting Nurse Service of New York Early Head Start in Rockaway, NY, to this article. T: 718-318-8071; E: djones@vnsny.org