There is a question I think we need to ask more often when a boy or young person is struggling with their mental health: What is happening to the man looking after him?
We are generally quite good at asking about the child. How is he sleeping? Is he going to school? Is he eating? Is he self harming? Is he anxious? Is he depressed? Is he being bullied? Is he withdrawing from his friends? Is he refusing to attend school? Is he having difficulties with anger? Is he being assessed by CAMHS? Is the school putting support in place? Is the DSL involved? Can we call on the MHST’s or the school nurses team? Do we need to have him in Inclusion for a few days a week? Does his head of year know about what is going on? These are important questions, and they need to be asked.
But there is another person standing somewhere in the background of almost every one of these situations. It might be his father, his stepfather, a foster father, a man with a special guardianship order, a grandfather, an uncle, or an older brother. Or it might be a man who has no biological relationship to the boy at all, but who has nevertheless become one of the default adults he can rely upon, perhaps a coach, a youth worker, a teacher, a faith leader, or a community leader. It is a man who has somehow become the person boys come to when they do not know where else to go. He feeds the boys, he organises events for them, he checks up on them, he is what is called a constant object. He is consistent and secure and the kids know exactly what to expect with him.
And sometimes that man is struggling too. The problem is that nobody necessarily asks him, and he may not even ask himself. He may tell himself, “This isn’t about me,” “My job is to be strong,” “He’s the one who needs help,” “I’ll deal with myself later,” or “I’ve got to keep everything together.” And sometimes “later” never comes.
The father who becomes invisible
When a child develops significant mental health difficulties, the family system changes. The father’s relationship with his partner may change, alongside his relationships with his other children, his work, and his own parents. His sleep may deteriorate, his finances may be affected, and his social life may disappear entirely. He may spend hours on the telephone speaking to schools, doctors, therapists, and services. He may sit outside a hospital, attend endless meetings, monitor his child’s behaviour, become frightened by every text message, and lie awake listening for movement upstairs. And yet, because he is technically the adult, his suffering can become invisible.
Recent research is beginning to make this invisible experience harder to ignore. A 2025 systematic review and qualitative meta synthesis examining parents of children and young people with mental health difficulties identified six major areas of difficulty: unmet support needs, disruption to everyday life, altered family dynamics, parental fears and worries, emotional experiences, and what researchers described as a “self care paradox” (PubMed). Parents frequently prioritised their child’s needs so completely that caring for themselves became difficult.
That phrase, “self care paradox,” deserves attention because some fathers have been taught that looking after themselves while their child is suffering is selfish. It isn’t. There is a difference between abandoning your responsibilities and maintaining the person who is carrying them. If you are responsible for a young person who is struggling psychologically, your mental health matters because you are part of the environment in which that young person is trying to recover. That does not mean that the father caused the child’s difficulties, that every problem in the family comes back to the father, or that fathers should be blamed. It simply means that the father is a person within the system, and people within systems are affected by what happens inside them.
This is not just about biological fathers
I deliberately use the word father broadly because family life in Reading does not fit neatly into a textbook definition of fatherhood. Consider a boy attending Highdown Secondary School and Sixth Form Centre, a young man at Reading School, a child attending Maiden Erlegh Chiltern Edge, a young person at Maiden Erlegh School, or a child whose educational needs mean that his experience looks very different from that of his peers at a specialist setting such as Oak Tree School. The names of the schools, the communities, and the educational environments are different, as are the individual boys themselves. But behind many of these young people there will be adults carrying responsibility, sometimes enormous responsibility.
Some fathers will have shared biological parenthood, while some will be stepfathers, foster carers, or individuals who have obtained special guardianship. Some will have become fathers through circumstances rather than biology, and some men will occupy a fathering role without ever being formally recognised as a father. That matters, because psychological attachment is not created simply by DNA.
A boy can know exactly who his biological father is and still experience another man as the person who showed up. That is the man who took him to school, attended the meeting, taught him how to shave, came when the police called, sat beside him when he was crying, told him that failing an exam did not make him a failure, answered the telephone at two in the morning, and kept showing up. That is fathering. And when that boy becomes psychologically unwell, the man who has been fathering him may experience something that is rarely discussed: powerlessness.
The particular pain of male powerlessness
Many men have been taught to understand their value through their capacity to solve problems. If the car breaks, fix it; if there is a financial problem, earn more; if someone threatens your family, protect them; if the child is struggling academically, find a tutor; if the child is struggling physically, find a doctor; if there is a practical problem, find a practical solution.
But mental health does not always work like that. You cannot necessarily “fix” depression, reason anxiety out of existence, discipline someone out of trauma, lecture someone into self esteem, simply tell a frightened young person to “be confident,” or love somebody so perfectly that they never experience psychological pain.
This can be deeply confronting for men whose identity has been built around being useful. A father may therefore move from protector to problem solver, from problem solver to monitor, and from monitor to controller. He checks, asks, phones, searches, questions, becomes frustrated, becomes angry, and becomes hypervigilant. And underneath the anger there may be something much more vulnerable: fear. He asks himself, “What if something happens to him?”, “What if I miss something?”, “What if I am not doing enough?”, “What if this is my fault?”, or “What if I cannot protect him?” That is where therapy can become particularly valuable, not because the father is broken, but because he has been carrying something enormous without necessarily having somewhere to put it.
The CBT question: What is happening inside your thinking?
Cognitive Behavioural Therapy gives us one useful place to begin. Imagine a father receives a message from his son’s school: “Can you please contact us regarding his recent behaviour?” The event itself is relatively simple, but what happens next may be much more complicated. The father may think, “He’s getting worse,” followed by, “I’ve failed him,” then, “If I don’t sort this out immediately, he’ll ruin his future,” and finally, “I’m losing control.”
His emotional response may become anxiety, and his behavioural response may turn into excessive monitoring. He might interrogate his son, contact the school repeatedly, search the internet late into the night, and become irritable with his partner. His son then experiences him as intrusive or angry and withdraws. The father interprets the withdrawal as further evidence that something is seriously wrong, and the cycle continues: Situation, Thought, Emotion, Behaviour, Consequence.
The therapeutic question is not, “Are you a bad father?” It is, “What is your mind telling you that you must do in order to keep your child safe?” That is a much more interesting question, because fathers can develop their own cognitive distortions around responsibility: “I must fix this,” “I should have noticed earlier,” “If I relax, something terrible will happen,” “If he fails, I have failed,” “If he is unhappy, I need to make him happy,” or “If I cannot protect him, I am not doing my job.” Some of these beliefs sound noble, and that is precisely what makes them dangerous. A belief does not become healthy simply because it comes from love; sometimes love creates impossible standards.
The humanistic question: What happens to the man beneath the role?
Humanistic therapy asks a different question: Who are you when you are not performing the role of father, not provider, protector, disciplinarian, chauffeur, advocate, the man who attends every meeting, or the man who keeps everybody calm? Who are you?
Carl Rogers’ emphasis on congruence is particularly useful here. There can be a significant gap between the person a man actually experiences himself to be and the person he believes he is supposed to be. A father may feel terrified while believing that he must appear confident, exhausted while believing that he must appear strong, angry while believing that good fathers should never feel anger, grief while believing that grief belongs to mothers, or resentment while hating himself for feeling it. He may even feel relief when his child finally leaves the house for a few hours, followed immediately by guilt for feeling relieved.
Therapy can provide somewhere those contradictions can exist without the man immediately having to defend himself. A humanistic therapist does not need to say, “You shouldn’t feel that.” The therapist can instead say, “Let’s understand what that feeling is trying to tell you.” That distinction matters because feelings are not instructions. Anger is not an instruction to shout, fear is not an instruction to control, guilt is not an instruction to punish yourself, and love is not an instruction to sacrifice yourself indefinitely.
The psychodynamic question: Why does this particular child affect you in this particular way?
Psychodynamic thinking takes us deeper. Sometimes our children do not simply activate the present; they activate the past. A father may have grown up with a father who was emotionally absent, so when his son becomes withdrawn, the father’s reaction is much larger than the current situation appears to warrant because the young person in front of him may unconsciously evoke the child he once was.
Another father may have grown up with a parent who was highly critical, leading him to become intensely focused on academic achievement when his daughter receives poor grades. Another may have experienced abandonment, causing him to experience his child’s growing independence almost as rejection. Another may have grown up in poverty, leaving him terrified when his son refuses school because education has become symbolically connected to survival. Another may have been bullied, making him furious when his child experiences bullying.
Again, none of this means the father’s response is irrational; it means the present can become psychologically connected to the past. This is one reason therapy can be so useful. A man may enter counselling saying, “I’m here because my son is struggling,” but after several sessions he may discover, “Actually, this situation is bringing up something I have never dealt with.” That is not a failure of fatherhood; that is psychological insight.
When concern becomes control
There is another uncomfortable conversation that needs to happen: sometimes a father’s anxiety about his child’s mental health can become controlling. It can begin with understandable concern, “Where are you going?”, “Who are you with?”, “Why aren’t you answering?”, “Give me your phone,” “You need to tell me everything,” or “I’m only doing this because I care.”
The intention may be protection, but intention and impact are not always the same thing. A young person experiencing depression, anxiety, or emotional distress may already feel that life is outside their control. If home becomes another place where they feel constantly monitored, questioned, or managed, the father’s attempt to create safety can paradoxically create more emotional distance.
This is where CBT and humanistic therapy can work together. CBT asks, “What fear is driving the behaviour?” Humanistic therapy asks, “What is happening to the relationship?” Psychodynamic therapy asks, “Why does uncertainty feel so intolerable to you?” And a good integrative therapist asks all three.
The father may be grieving too
There is another experience that deserves a name: grief. This is not necessarily bereavement; sometimes it is the grief of watching your child become someone you did not expect them to become. The child you imagined may have been confident, independent, successful, happy, social, academic, or sporty and popular. Perhaps you imagined university, a career, a relationship, or a particular kind of adulthood.
Then mental illness enters the family, and suddenly the future looks uncertain. The father may grieve the life he imagined for his child, his own expectations, and the version of fatherhood he thought he would experience. Because nobody has died, he may feel that he has no right to call it grief. But grief does not always mean death; sometimes grief means having to let go of the future you thought you were guaranteed. Therapy can help a man distinguish between accepting reality and giving up hope, which are not the same thing.
What about the man who is not the father?
This is perhaps one of the most important parts of this conversation. There are men in every community across Reading who are doing fathering work without having the title: the football coach who notices when a boy stops turning up, the youth leader who receives the message asking to talk, the uncle who becomes the reliable male figure, the stepfather who has raised a child since he was three, the foster father who welcomes a traumatised child into his home, the special guardian who takes responsibility for a child whose biological parents cannot provide consistent care, or the community leader who has become “Uncle” to half a dozen boys.
These men can experience profound emotional investment, but they can also experience a strange kind of disenfranchisement. They may think, “I don’t have the right to complain. I’m not his biological father.” But psychological responsibility does not always follow biological relationship. If a boy repeatedly comes to you for guidance, if his wellbeing matters to you, and if you have become one of the adults helping him navigate life, then what happens to him can affect you, and you are allowed to need support too.
The research increasingly supports this wider view
The research literature has historically paid less attention to fathers than mothers, and that imbalance matters. A systematic review of paternal mental health and adolescent anxiety and depression found that paternal depression was associated with adolescent depression and anxiety, while also emphasising the limitations of the evidence and the need for stronger longitudinal research (PubMed). Another systematic review examining paternal depression found evidence that paternal depression can negatively affect offspring development, including during adolescence (PubMed).
A more recent systematic review of fathers’ mental ill health and child maltreatment also highlighted the relative invisibility of fathers in this research area. The authors found stronger evidence concerning paternal depression than some other forms of paternal mental ill health, while stressing that the evidence base remains limited and confounded by other factors (PubMed).
The message should not be distorted into, “A father’s mental health causes his child’s mental health problems”, that would be scientifically irresponsible. The more defensible conclusion is that parental mental health, parenting behaviour, family relationships, and child mental health exist within an interconnected system, and that system deserves attention.
The father is not merely an accessory to treatment
This is particularly important because research increasingly suggests that parental involvement can sometimes improve psychological treatment outcomes for young people. A 2024 meta-analysis of 20 trials involving 1,251 adolescents found that interventions incorporating parents had a significantly greater effect on adolescent psychopathology than equivalent interventions without a parental component, particularly for externalising difficulties (PubMed). Research on parent-focused interventions has also found meaningful effects on children’s anxiety, while systematic reviews of parental involvement in CBT for adolescent anxiety show that parents can be incorporated through separate sessions, joint sessions, and structured support (PubMed).
But there is an important distinction here: involving the father is not the same as treating the father. A father can attend a meeting about his son’s mental health and never once be asked how he is coping. He can receive parenting advice while remaining depressed, learn how to support his daughter’s anxiety while his own anxiety goes untreated, and become extremely knowledgeable about CAMHS while having nobody to speak to about his own fear. This is why father-focused therapy deserves to be considered in its own right.
What happens when a man finally gets somewhere to talk?
Therapy can provide a space in which the man does not have to be the expert, know what to do, protect the therapist from his emotions, or make the story sound respectable. He can say, “I’m angry,” “I’m frightened,” “I’m exhausted,” “Sometimes I resent him,” “I don’t know what to do anymore,” “I feel guilty,” “I miss who he used to be,” or “I’m scared I’m failing.”
And perhaps he can say the most difficult sentence: “I need help.” That sentence can be extraordinarily difficult for men. Research into men’s help seeking consistently identifies self-reliance, emotional restriction, and traditional masculine expectations as barriers to accessing psychological support. A systematic review found that conformity to masculine norms can affect how men experience symptoms, whether they seek help, and how they manage their difficulties (PubMed). More recent reviews continue to identify traditional masculinity as a significant barrier to psychological help seeking, while also suggesting that men can be more willing to seek support through trusted people, communities, and services that feel relevant to their lives (PubMed). This is why telling a struggling father simply to “go to therapy” may not be enough; the therapy has to make psychological sense to him.
Therapy for fathers should not become another lecture
A father already dealing with a struggling child does not necessarily need another professional telling him what he is doing wrong. He may already feel judged by the school, social services, healthcare professionals, his partner, relatives, other parents, and, most painfully, by himself. Therapy should therefore not become another performance review; it should become a place for understanding.
CBT can help him recognise unhelpful thinking patterns, reduce catastrophic thinking, and develop more effective behavioural responses. Humanistic therapy can help him reconnect with his emotional experience, values, needs, and sense of self beyond his parental role. Psychodynamic therapy can help him explore attachment, unresolved experiences, defensive patterns, and the ways his own childhood may be influencing his reactions in the present. Together, these approaches can create something more sophisticated than simply telling a father how to parent: they can help him understand the man who is parenting.
The principle of responsibility without omnipotence
One principle I would want every father to take from this article is: You are responsible for what you do. You are not responsible for controlling everything that happens. There is a profound difference.
You are responsible for seeking appropriate help, creating reasonable boundaries, listening, repairing relationships when you get things wrong, learning, and noticing when your own behaviour is becoming harmful. But you cannot control another human being’s internal world. You cannot guarantee that your child will never suffer, remove every risk, make every decision for them, live their life, or protect someone from every painful experience without eventually taking away some of their opportunity to develop their own capacity. This is not abandonment; it is the beginning of a healthier form of responsibility.
The principle of presence over perfection
The second principle is simpler: Your child does not need a perfect father. They need a present one. Presence does not mean being available every second. It means being emotionally available enough that the young person knows: “I can come back, tell him something, make a mistake, disagree with him, be frightened, or fail, and the relationship will survive.” That is enormously important, because one of the greatest things a father can teach a child is not, “Nothing bad will ever happen to you,” but rather, “When bad things happen, we can face them.”
The principle of modelling rather than preaching
There is also a lesson here about masculinity. A father can tell a son, “It’s okay to talk,” but the son watches what the father does. If the father never speaks about his own emotions, the message becomes contradictory. A father can tell his son, “You don’t have to be strong all the time,” but if he collapses into silence whenever life becomes difficult, the boy learns another lesson. A father can say, “Get help when you need it,” but if the father refuses every offer of support, the boy learns that help is something other people need. Perhaps one of the most powerful things a father can do is therefore to say, “I’m struggling with this too, and I’m getting some help.” That does not weaken his authority; it humanises it.
What therapy might actually look like
Therapy for a father in this position might begin with his child’s situation, which is natural, but over time the work might expand. We might explore what his child’s difficulties have meant for him emotionally, his beliefs about being a “good father,” guilt and responsibility, anger and frustration, fear and catastrophic thinking, relationship difficulties with his partner, conflict with schools or services, changes in work and finances, sleep and exhaustion, isolation, shame, his own childhood, his relationship with his father, previous experiences of abandonment or loss, expectations about masculinity, cultural expectations of fatherhood, experiences of racism or marginalisation where relevant, stepfamily dynamics, foster or special guardianship pressures, boundaries, communication, control versus protection, grief and uncertainty, and the father’s own identity outside parenting, alongside what kind of man he wants to be while his family is going through this.
Sometimes the work will be practical, emotional, involve challenging thoughts, or involve sitting quietly with something painful that has never been spoken about. Good therapy does not need to force one theory onto every father. It can ask: What does this man need, at this point in his life, to understand himself and respond differently?
We should stop waiting for fathers to collapse
One of the problems with male mental health provision is that men can become visible only when the problem becomes severe. The father who is functioning at work but drinking every evening, the father who has stopped seeing his friends, the father who is permanently angry, the father who has become obsessed with controlling his child’s behaviour, the father who has not slept properly for six months, or the father who says, “I’m fine,” because he believes everyone else needs him more may all remain invisible, until something breaks. But prevention means intervening before the collapse.
That is particularly important when a child is already receiving support. The evidence now makes a compelling case for taking parental wellbeing seriously. A 2024 quantitative systematic review and meta-analysis found elevated levels of anxiety, parenting stress, and general stress among parents of children and young people with mental health difficulties, alongside higher depression compared with parents of children without such difficulties (PubMed). Furthermore, a 2024 systematic review and meta-analysis specifically examining interventions designed to improve parents’ own wellbeing highlights an important gap: traditional parent training does not necessarily address the parent’s psychological wellbeing directly (PubMed). That distinction is crucial because teaching someone how to manage their child is not necessarily the same as helping that person cope with what they are experiencing.
The question we should be asking in Reading
Perhaps this is the question we should be asking fathers across Reading: Not “How are you managing your child?”, but “How are you managing yourself while you are managing this?”
That question opens a different conversation. It recognises the father as a person, the stepfather, the foster father, the special guardian, the grandfather, the uncle, the mentor, the community leader, and the man who has become a father figure. It recognises something that is easy to forget when we become focused on the child: adults have nervous systems too. They experience fear, grief, helplessness, anger, shame, and exhaustion. They need relationships, somewhere to process what they are carrying, and somebody to ask them how they are.
A final word to the father who is reading this
If your child is struggling, you may have spent a long time thinking that your job is simply to keep going. Perhaps you have become the person everyone calls, the person who knows the appointments, the school staff, the terminology, or which services have waiting lists. Perhaps you have learned more about mental health in the last year than you ever expected to learn.
But there is something I want you to consider: your child is not the only person in this family who deserves care, you do too. Not because you are more important than your child, because your suffering cancels theirs, or because you should abandon your responsibilities, but quite the opposite. You deserve support because you are carrying responsibility for another human being while remaining a human being yourself.
You are allowed to be tired, frightened, and to admit that sometimes you do not know what to do. You are allowed to grieve, to ask whether the way you are responding is helping, to change, and to sit in a counselling room and talk about something that has nothing to do with your child for an hour.
Because perhaps the most important lesson is this: looking after yourself is not taking care away from your child; sometimes it is one of the ways you continue to give it. A father who learns to regulate his own fear may become more emotionally available. A father who understands his own history may stop repeating parts of it. A father who challenges catastrophic thinking may create more space for his child. A father who learns to tolerate uncertainty may become less controlling. A father who learns to communicate vulnerability may give his son permission to communicate vulnerability. And a father who finally understands that he does not have to be invulnerable may teach his child one of the most valuable lessons of all: strength does not mean never needing help. Sometimes strength means knowing when help is needed, having the courage to seek it, and continuing to show up afterwards. That is not weakness; that is fatherhood.