Discussion
To our knowledge this is the first study to specifically focus on exploring the roles of partners in the mothering experiences of women living with mental illness. It has identified six core roles partners may play, from mothers’ perspectives, and the complex factors that impact on these roles. The findings highlight three issues that are important for health and social service workers to consider when interacting with mothers living with mental illness. First, findings confirm the importance of partners in mothers’ experiences. Second, they suggest a more nuanced view of the roles of partners than is often assumed and reported in the literature. Third, findings highlight the place of mothers in determining or shaping partner roles, thus enhancing the possibility of positive change.
The importance of male partners to the wellbeing of children and mothers has been demonstrated in the general population (e.g., [
44‐
46]). Further, there is increasing evidence of the value of parents working in partnership. The coparent relationship or parent alliance, is focused on child-rearing, is distinct from other aspects of the relationship, exists even after marital separation, and reflects parents’ ability to cooperate to best meet the child’s needs [
47]. Cooperative co-parenting, characterized by parents supporting each other in child care and parenting decisions, has been shown to result in positive outcomes for mothers and children (e.g., [
48‐
51]). Fathers’ support of mothers has been found to be important in establishing this cooperative coparenting relationship [
13].
Because of the evidence of the importance of male partners’ roles, increasing emphasis has been given to “father inclusive practice” in parenting, child health and parent mental health interventions [
52,
53]. For example, researchers in postpartum depression in particular are calling for partners to be involved in treatment given evidence that their support can both help the mother to recover and buffer the child and father against the negative impacts of maternal depression [
54]. Yet there is still often a perception of the father as secondary in the child-rearing process and a consequent neglect, in research and practice, of their well-being and roles [
55,
56]. Findings from the current study highlight the importance of the support provided by partners to mothers as well as the potentially detrimental impact of negative partner roles [
30]. The findings are consistent with family systems theory [
57,
58], in which the experiences and behaviors of each family member are understood to affect the functioning of the entire family. Following this theory, partners’ roles are likely to have a considerable impact on the relationships between mothers and their children, and on children themselves. The findings reinforce calls for services to involve partners in parenting support and maternal mental health [
53]. Similarly, it should be acknowledged that partners’ wellbeing and ability to provide support can be negatively influenced by a mother’s mental illness [
54], creating a vicious cycle. Supporting partners to cope, manage and recognize how their behaviors may be impacting on mothers is an investment that can maximize partners’ support of mothers who live with mental illness, positively influencing the entire family.
The roles identified in the current framework are consistent with partner behaviors reported in previous studies of mothering with mental illness more generally. For example, mothers have described their partners caring for children when they became unwell (teammate), being understanding and someone to rely on (facilitator), and depleting a mother’s energy (distractor) [
7,
31]. This alignment with other literature supports the credibility of the proposed framework and suggests potential applicability beyond the current study participants. However, this study adds to the existing literature by providing a more nuanced view of partners’ roles. Previous literature has tended to conceptualize partners as black and white – either positive or negative. For example, where partners provided support for parenting or general support they were described as assets [
7,
31]. On the other hand, where they were abusive or unsupportive, they were considered hindrances [
10,
21,
22,
31]. The current study proposes a model in which partners can hold multiple roles concurrently, both positive and negative. The potential to play concurrent roles has been previously identified in research on the role of partners of mothers with intellectual disabilities which highlighted that some abusive men were also supportive [
36]. Despite this emerging complexity, the partners of mothers with intellectual disability were still categorized as supportive or non-supportive [
36]. The current findings suggest that from the perspectives of mothers living with mental illness, the role of their partners is more complex with partners identified as having the potential to play six different roles to varying degrees- some supportive, others hindering. This suggests that dichotomizing partners as either supportive or unsupportive/detrimental may not fully reflect the experience of mothers living with mental illness. In addition to this, the findings suggest that roles are not static as implied by past research. Rather, the proportions can shift over time. Viewing partners as more complex may open the way for services to facilitate this positive shift and work with partners’ strengths rather than simply dismissing them as ‘unsupportive’.
This study highlights the role of mothers themselves in determining and shaping their partner’s roles. The framework highlights that partners’ roles are not objective; rather they are a combination of partners’ behavior and mothers’ interpretations. Mothers also demonstrated the potential to actively shape situations. Some mothers brought about positive change through accessing parenting services or limited their partner’s ability to dismantle and distract by leaving them. This will be no surprise to family systems theorists, who see family systems as dynamic and each family member’s roles as a product of negotiations between family members [
57]. Nevertheless, the active role of mothers has been largely ignored in previous literature in this area, with studies focused on how mothers felt or things that had happened to them [
4]. Booth and Booth [
36] identified that roles could shift for partners of women with intellectual disability, however usually in negative directions due to stressors such as child removal and loss of support. In contrast, the current study indicates that, for women living with mental illness, not only is positive change possible, but the women themselves often actively contribute to this positive change. In line with a family systems perspective, coparenting research indicates that the parenting relationship is not determined by fathers’ behavior only, but by mothers’ behavior as well [
13], for example, through maternal gatekeeping [
59]. Although cooperative coparenting may not be possible in some abusive relationships, it is seen as amenable to intervention for many parents [
50]. While mothers’ ability to shape partners’ roles are clearly limited by circumstances such as legal issues and personal resources, acknowledging the agency of mothers reinforces the importance of supporting mothers to enhance positive change.
Strengths & Limitations
The combined 18 interviews provided a substantial pool of qualitative data which contained rich descriptions relating to partners, enabling the development of an empirically based conceptual framework. Through the inclusion of data from two very different groups of mothers, the framework may be applicable to a wide range of mothers, from those managing their challenges well to those who have struggled, and from those who have full-time care of their children to those who are mothering as non-custodial parents.
However, there are several limitations inherent in secondary analysis, which should be considered in interpreting the findings. The original studies used different approaches and answered different questions; neither focused specifically on the roles of partners. It is therefore likely that women may not have described all relevant experiences and the data therefore may not paint a full picture for each individual. Further, there was no opportunity to extend the sample to ensure saturation of codes. Despite this the rich data available meant that the categories were well filled out. A strength of this secondary analysis is that it was conducted by the original researchers and was closely related to the original aims of the research, increasing the researchers’ understanding of contextual information and the trustworthiness of the interpretation [
38,
60].
The study involved a small sample of women from New South Wales, Australia who had accessed mental health or parenting services for support. The women were all from English speaking backgrounds and described male partners only. Therefore, the applicability of results to mothers who are not in contact with services, have female or other gendered partners, or are from other cultural backgrounds should be considered with appropriate caution. The age range of participants’ children was broad and women discussed the impact of partners from early in their children’s lives to the current time. This meant that the analysis was based on a breadth of remembered experience rather than enabling a deeper exploration of issues that might be specific to mothers of children of particular ages.
Conclusions
Given the lack of research to date, this secondary analysis is an important starting point for future research specifically focused on gaining an in-depth understanding of the complex roles of partners in the lives of mothers living with mental illness. Further research is needed to confirm, modify or add to the framework developed in this study. Research investigating partners’ own perspectives in understanding their roles and the supports they need is warranted in order to facilitate positive influences in the lives of mothers living with mental illness.
As part of the “external supports” in parents’ lives, health and social service providers are in a position to influence partners’ roles, support mothers to actively shape partners’ roles and, therefore, affect mothers’ experiences. The findings suggest that partners may be an under-recognized and under-supported social resource to assist mothering in the context of mental illness. To provide context sensitive health care to this group of mothers, health professionals need to acknowledge the specific importance of partners in a mother’s broader environment. This study provides a framework through which services can assist mothers to identify the roles that partners play, recognize the impact of these roles on their mothering and find ways to optimize their potential. Direct support for partners can be used to enhance their ability to support mothers.
In summary, this study suggests that partners are an important part of a mother’s world. Partners need to be acknowledged and included in service provision to facilitate what has the potential to be a huge natural support.
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