Care delivered by non-specialists can help dads with postpartum depression in low-resource settings - and beyond
Male postpartum depression (PPD) affects up to 10% of fathers globally, with even higher rates in low and middle-income countries. Despite its prevalence, there is a lack of evidence on effective interventions, especially within resource-limited settings where factors such as cultural stigma and service scarcity may prevent fathers from seeking help.
Dr. Ishrat Husain and his team conducted a clinical trial to evaluate the effectiveness of parenting skills training and therapy delivered by non-specialist community health workers for fathers experiencing PPD in Karachi, Pakistan.
The study’s participants took part in a program called Learning Through Play Plus Dads (LTP + Dads). LTP + Dads consists of parenting skills training, play therapy, and cognitive behavior therapy. It aims to enhance fathers' mental health while also strengthening family dynamics and child outcomes, offering a model for similar groups worldwide.
We spoke to Dr. Husain about what his team uncovered.
Why is it important to study strategies that address postpartum depression in men, and particularly those in low-income settings?
IH: Postpartum depression isn’t just something mothers face. Up to 1 in 10 new fathers also experience depression after the birth of a child. In places with fewer resources, such as low-income countries, these challenges can be even greater, yet there is little research or support for fathers. Depression in fathers can affect their relationship with their partners, their involvement with their children, and can even impact their child’s development. By studying ways to support fathers, especially in low-income settings, we can improve the well-being of entire families and communities.
What motivated this research?
IH: We noticed a gap - while there is growing awareness about maternal mental health, fathers are often overlooked, especially in low-income countries like Pakistan, a traditionally patriarchal society. Our previous work with Pakistani mothers experiencing depression led to growing calls from their partners requesting similar support. This led to the launch of a pilot study of a group intervention, LTP+ Dads, that integrated cognitive behavior therapy with parenting skills for Pakistani fathers with depression. The results of the pilot study were very encouraging, so we wanted to determine whether LTP+ Dads could really make a difference for fathers struggling with depression in a larger clinical trial.
What was the most important finding of this study, in your opinion?
IH: The most important finding was that fathers who participated in the group parenting program experienced more improvement in depression symptoms than those who received usual care.
These improvements were seen not just immediately after the program, but also two months later. The program reduced anxiety and parenting stress, improved relationships at home, and led to better social-emotional development in their young children.
How does this change treatment in the future?
IH: This study shows that community health workers, who are not mental health specialists, can successfully deliver a group program that improves mental health for new parents. This is especially important in places where there are very few mental health professionals. It means that low-cost, scalable programs could be rolled out in many similar communities to support fathers, children, and families.
Any next steps?
IH: Next, we are testing this program in other communities and over longer periods to see if the benefits last. We have been funded by Grand Challenges Canada to expand the program across over 5000 parents in the city of Karachi, which has a population of over 23 million people. We are also interested in adapting the program for digital delivery, which could help us reach even more fathers, including here in Canada.
6. What is the major take home message for the public?
Supporting dads with their mental health after a child is born benefits not just the father, but the whole family, by helping children grow and thrive, and improving family relationships. Community-based programs delivered by non-specialists can make a real difference, especially in places with limited resources both in low and high-income countries.
Read this month's ImPACT paper.
Husain MI, Kiran T, Sattar R, et al. A Group Parenting Intervention for Male Postpartum Depression: A Cluster Randomized Clinical Trial. JAMA Psychiatry. 2025;82(1):22–30. doi:10.1001/jamapsychiatry.2024.2752
