Bridging policy and practice: A qualitative study of paternal postpartum depression support in Aotearoa/New Zealand

Abstract

Paternal postpartum depression remains a critically under-recognised issue in Aotearoa/New Zealand, despite widespread rhetoric around whānau-centred care. This thesis examines the extent to which existing policies and services support fathers’ mental health during the perinatal period, arguing that the gap between policy and practice is demonstrated by the absence of policy altogether. This research was conducted in two stages. In the first stage, a policy and strategy analysis was undertaken to understand what guidance exists for supporting dads' mental health during the perinatal period in Aotearoa/New Zealand. This included reviewing national health frameworks, resources from non-governmental organisations and public-facing information. The second stage involved a qualitative study with seven dads, who participated in semi-structured interviews or an online focus group. Their experiences were analysed thematically and interpreted through Bronfenbrenner’s Ecological Systems Theory to understand how their wellbeing was shaped by multiple, interacting layers of context; from personal and relational dynamics to organisational systems and broader cultural norms. Findings reveal that while fathers experience significant emotional distress and identity disruption during early parenthood, they often feel invisible within a maternal-centric service landscape. At the micro-level, participants reported internalised masculine norms and role ambiguity. At the meso and exo-levels, they described inconsistent engagement by health professionals, limited access to formal support, and structural constraints such as unpaid partner leave. Macro-level norms further reinforced the expectation that fathers act as supporters rather than care recipients. Critically, no national policy or clinical pathways exist to guide routine recognition or support for paternal PPD, and whānau-centred frameworks rarely operationalise meaningful inclusion of fathers. This thesis calls for targeted policy development, culturally inclusive service delivery, and routine, father-specific mental health screening to close this gap. Addressing paternal mental health is not only vital for the wellbeing of fathers but also for tamariki and whānau outcomes. The findings contribute to community psychology by highlighting how social, cultural, and systemic structures shape wellbeing and by advocating for structural accountability beyond individual resilience.