Increasing diversity, equity, and inclusion in perinatal mental health care and research requires a conscious effort at all professional levels. Join us this month to learn why diversity, equity, and inclusion are needed now. Listen to how Dr. Fisher’s research and administrative activities address important gaps in the field.
Dr. Fisher is an Associate Professor and perinatal clinical psychologist at Northwestern University, Feinberg School of Medicine, and Associate Dean for Diversity and Inclusion at The Graduate School. His research focuses on the effects of perinatal and subsequent parental mental health on infant/child health outcomes, with a specialization in the emerging field of father mental health. He aims to reconceptualize parental mental health research to integrally involve fathers to differentiate parents’ impact on a child's medical and mental health. Dr. Fisher’s research dovetails with his perinatal clinical practice, including being the clinical director of the Fathers’ Mental Health Specialty Clinic. He also chairs the International Marcé Society’s Fathers Special Interest Group and the MONA Taskforce for Spanish-speaking countries. His research aims to optimize the health and effectiveness of the parental team to influence the child's health trajectory starting in pregnancy positively.
Increasing diversity, equity, and inclusion in perinatal mental health care and research requires a conscious effort at all professional levels. Join us this month to learn why diversity, equity, and inclusion are needed now. Listen to how Dr. Fisher’s research and administrative activities address important gaps in the field.
Dr. Fisher is an Associate Professor and perinatal clinical psychologist at Northwestern University, Feinberg School of Medicine, and Associate Dean for Diversity and Inclusion at The Graduate School. His research focuses on the effects of perinatal and subsequent parental mental health on infant/child health outcomes, with a specialization in the emerging field of father mental health. He aims to reconceptualize parental mental health research to integrally involve fathers to differentiate parents’ impact on a child's medical and mental health. Dr. Fisher’s research dovetails with his perinatal clinical practice, including being the clinical director of the Fathers’ Mental Health Specialty Clinic. He also chairs the International Marcé Society’s Fathers Special Interest Group and the MONA Taskforce for Spanish-speaking countries. His research aims to optimize the health and effectiveness of the parental team to influence the child's health trajectory starting in pregnancy positively.
MONA Podcast Interview Transcript: Dr. Sheehan D. Fisher
Dr. Lara-Cinisomo [00:00:04] Welcome to studying Perinatal Wellbeing, the podcast of the Marcé of North America. This bilingual monthly podcast will allow new and experienced researchers, practitioners, students, and community members to hear about the latest research and community actions on perinatal well-being. I'm Dr. Sandraluz Lara-Cinisomo, your host. Today's guest is Dr. Sheehan Fisher. He received his Ph.D. in clinical psychology from the University of Iowa. He is an associate professor and perinatal clinical psychologist at Northwestern University Feinberg School of Medicine. He is also the associate dean for diversity and inclusion at the Northwestern Graduate School. His research focuses on the effects of perinatal and subsequent parental mental health on infant and child health outcomes. He specializes in the emerging field of father mental health. He aims to re-conceptualize parental mental health research to integrally involve fathers to differentiate parental impact on child's medical and mental health. Dr. Fisher's research dovetails with his perinatal clinical practice, including being the clinical director of the Father's Mental Health Specialty clinic. He is also chair of the International Marcé Society’s Fathers Special Interest Group and the MONA Task Force for Spanish speaking countries. All right. Well, thank you and welcome for joining us, Dr. Fisher.
Dr. Sheehan Fisher [00:01:30] Yeah, thanks for having me.
Dr. Lara-Cinisomo [00:01:31] We're so glad you're here. I like to start by learning a little bit about you. How did you become interested in perinatal mental health?
Dr. Sheehan Fisher [00:01:38] When I was in undergrad, I was thinking about kind of what I wanted to do for my academic career, and I was debating when applying for graduate school, whether I wanted to go, adult or child psych, and perinatal was like that perfect blend of both worlds. So, I decided to go into an adult psych program, but really specialize in perinatal health and got extra training within developmental psychology and even interparental relationships, like really thinking broadly about the family unit, which allowed me to have this stuff, what I was really interested in.
Dr. Lara-Cinisomo [00:02:07] Yeah. That's wonderful. We do hear about those kind of shared interests. And so, I'm so glad that you are able to pursue that passion and not have to give one over the other.
Dr. Sheehan Fisher [00:02:17] Exactly, exactly. That's perfect.
Dr. Lara-Cinisomo [00:02:20] That's wonderful. Well, in your research has helped develop the area of perinatal mental health, particularly paternal mental health. Can you tell us more about how you developed that area of interest, and why you think it's important to study?
Dr. Sheehan Fisher [00:02:32] Well, when I was in graduate school, also my advisor, Michael O’Hara, he was of course, focused a lot on mom's mental health, and I was interested in understanding the impact of the father, and he let me run with it. I really was trying to figure out, okay, well, one day I planned to be a father and was interested in what our mental health looks like, and what is our role? How does it affect the child? And so that's where it began during graduate school and built it from there to really understand both parents. Even though I'm many times known as a father specialist, most of my work is mom and dad because I want to look at the parental unit. And now, even thinking more broadly about birthing, now birthing parents in general, and understanding how partnerships and different family dynamics impact the family health.
Dr. Lara-Cinisomo [00:03:13] Yeah, I'll come back to that because I think you touched on that in a keynote you gave at the recent MONA conference.
Dr. Sheehan Fisher [00:03:20,] Yes.
Dr. Lara-Cinisomo [00:03:21]
So, you received funding from the National Institute of Health. But, I want to talk a little bit about an article you published before we talk about that study. You recently published an article summarizing the research on paternal perinatal mental health. Your article suggests screening tools and describes the effects of fathers’ mental health on mothers. What are some key takeaways from that article that summarizes this important body of research?
Dr. Sheehan Fisher [00:03:44] Well, I think one of the key takeaways was really thinking about how do we tailor our screening to the individual. Sometimes, we have an approach where we do a cookie cutter of one population, apply it to another, rather than really understanding the specifics of a population and gearing our screening, and even our interventions to make sure that is specific to their experience of their mental health and of their parenting experience in general. So, that was one key part, just thinking about what measures would be useful for fathers and even understanding even new measures have been developed specifically for the father experience, but then also, thinking broadly about how do we develop in - studies in general, how are we making sure that they are inclusive and that if we are doing research in perinatal health, that we're thinking about both parents and how that impacts a child, especially when thinking about child outcomes or even understanding how one partner might influence the other. I always emphasize that no one needs to be necessarily a father specialist, not everyone has to be one, but being informed enough about the population to understand them in general and even understand how they apply to the specific population you're looking at. So, if you're focusing on mothers, if they have a partner who's a male partner, that is relevant to understand the impact of that father on the mom.
Dr. Lara-Cinisomo [00:04:56] Yeah. Very good point. What about the role of culture or language in that line of work? Have you explored that?
Dr. Sheehan Fisher [00:05:04] Yeah. So, you know, another thing of course I'm interested in is, you know, within DEI and thinking about that even in the perinatal experience, where a lot of the perinatal research has not been focused on various diverse populations, and it's kind of exclusive of them. In addition to a lot of perinatal mental health research has been very heteronormative. So, whether it's about, you know, racial ethnicity diversity or sexual minorities, we really understand that that's missing from the research that we have, and therefore, our interventions may not be as applicable to supporting them. So, we do need to think about more inclusive, inclusivity in our research design and not only submit to the NIH guidelines, but are really thoughtful where is there pockets of gaps within the research area? And how do we make sure that this work that we're doing is applicable to all the different populations within the US? That also includes the language, because even though, once again, a lot of the perinatal work that we do is so English focused, you know, there is a diversity in language and specifically in the US, a lot of individuals speak Spanish, for example, but we don't have many researchers who are trained and speak Spanish or even understand the Latinx culture. And we need to make sure that we are, even when we're thinking about bringing in grad students and thinking about researchers in different faculty positions, make sure that diversity exists there to ensure that the population needs being met.
Dr. Lara-Cinisomo [00:06:26] Absolutely. Actually, that segways perfectly into funding you received from the National Institute of Health that focuses on father support of mothers’ mental health treatment and their active engagement in the family to reduce maternal stress. What can you tell us about that study?
Dr. Sheehan Fisher [00:06:43] Well, this study, I initially designed it to really focus on supporting the mom's mental health by utilizing the father within the home. I noticed that within the research and like the interventions that we develop, a lot of times we focus on, you know, medication, specifically for the mom where in the clinical setting, the mom will have to decide on the medication alone and then take the medication. Then, we have therapies, we, you know, meet with the mom once a week, and then she goes home and has to put that in and implement, in addition to working full time and taking care of the child. And many times, just because of the societal gender norms, a lot of the household responsibilities fall on her, and it just feels like we're piling up on the mom. So, this intervention was designed to try to offset that by training the father on how to support the mom's mental health. And there was key parts of this intervention. One is it's for them to understand what is mental health, and, you know, what is depression, anxiety for the father, and then for them to understand what can they do to help the mom, you know, either follow the homework she's doing or behavioral activation, or making sure that she has time for breaks where he takes over the household responsibilities so she has time to take care of herself. The other part was just really training fathers on how to be involved with the child, from not only the postpartum period, and giving training on how to change diapers and burp a baby, engage with the baby. But even during the prenatal period, about what is their role to support the mom and to also take on personal responsibility for getting the home ready and getting the mom ready, and the different logistics such as getting a pediatrician to ensure it once again didn't fall on the mom's shoulders. In addition to that, we taught the fathers different type of interparental relationships skills, learning how to deal with conflict and how to communicate effectively, and in this way, reduce some of the factors that typically cause stress on the mom during the postpartum period, when there becomes less satisfaction in the relationship. And then finally, last but not least, we taught the fathers and talked about how they can have an equity in the split of household responsibilities. What we noticed was that fathers are tending to get more involved in the home, but it's still not equal involvement within the home, but also the idea that sometimes they might cherry pick. So the goal was for them to, before the baby is even born, to sit down together and think about what will be an equitable split of the household responsibilities, and if there was a skill set that the father doesn't have, they have now time to start to practice and train themselves in it before the baby comes to ensure that once the baby is here, they are really an equitable team working together and supporting the family health, but specifically addressing moms and reducing the risk of the mom developing depression. So, the intervention was all done during the prenatal period, and then we'll follow up postpartum to see how the parents were doing. Now unfortunately, the study was funded right during the pandemic, so, we struggled a little bit with recruitment. So, we are starting to think about other ways to make sure that we can complete the study to get the full data.
Dr. Lara-Cinisomo [00:09:40] Yeah. That sounds, I can imagine a lot of tips for partners to consider as they're preparing for their first or second or subsequent child. There are always lessons to be learned from prior experiences, but also from what science has to offer. So, you said you were, there are some challenges around recruitment because of the pandemic. How about recruiting fathers in general into this type of research? How's that been?
Dr. Sheehan Fisher [00:10:06] Well, recruiting fathers in this research in general, you know, we talked to different individuals about this because many of us do find it difficult because historically, fathers were not as much engaged within the perinatal period. We don’t have like a history, even just generally as a culture, to make it inclusive of fathers. When we think about even just different hospital systems, that even the language is used around it, they are typically exclusive of the father. So, part of the thing we're working on is trying to help fathers understand that they do matter within the family unit and that they do have an impact, and that they also have a responsibility in the home. And therefore, over time, hopefully that helps to change the culture around engagement and different parts of the perinatal period, including involvement in research. So, there's different ways we try to address that. Some of this is creating buy in for fathers, like I said, education so they know what's valuable, but also helping them to even see the benefit of it for themselves. They're talking about their own mental health is actually rewarding, that they can have a better quality of life, and that this will actually have a direct impact on the people that they love.
Dr. Lara-Cinisomo [00:11:11] Well, so there are some direct benefits to the participants, in this case the fathers. But also, you will see some benefits, hopefully for the mothers. How about the child?
Dr. Sheehan Fisher [00:11:22] Yeah. It's like that's the other part is that fathers sometimes assume that they're they don't have an impact on the child. And sometimes, and unfortunately, we make the same assumption. But there has been studies, including one study that I did a few years ago, showing that even after we control for the mother's impact on the child's health outcomes, that the father uniquely has an impact on the child health. And that matters because when we do interventions, if we only focus on the mom and get the mom well, that child is still vulnerable and at-risk if the father is also not doing well.
Dr. Lara-Cinisomo [00:11:52] Yeah. So that's an important point to make that it really is a family system approach that you're taking.
Dr. Sheehan Fisher [00:11:58] Yes. Absolutely.
Dr. Lara-Cinisomo [00:11:59] That's, that's wonderful. And it's excellent to think about these different types of households that as you said earlier, sometimes we think about the family as very gender normative, where there's a father and a mother, but that's not always the case. We have a diverse population that has very different family systems that we need to respect. They are still equally important. And in fact, you raised some of these issues in the keynote address you gave at the MONA conference in October. What were some of your key takeaway messages for those who might have missed that important presentation?
Dr. Sheehan Fisher [00:12:36] Well, one of the things was just highlighting how within the perinatal field, we do think in a heteronormative way. And we know that historically, even within the medical field, there's been exclusion. Like, for example, many studies in the past used to focus only on men for medications, and then applied to women. And we saw like the disastrous effects that could have. And then similarly, sometimes the research only focused on white individuals and not looked at other black and brown individuals, and apply that research to them, and once again, it’s problematic. But unfortunately, we have taken a similar path where we do a lot of research, or primarily our research is either done or presented as heteronormative families. But then we try to apply to all families, and one to me, the key finding or even something to consider is that, you know, for the generation Z, about 20% of these individuals identify as queer. And therefore, once they're starting to have kids, a lot of our work will not be applicable to them. We'll be missing about 20% of the population. So, a lot needs to be done to enforce to think and rethink how we approach and understand family units, not only for sexual and gender identity, but the family make up, the dynamic, and really try to make sure our research is really inclusive of all families. I know, for example, that Leiszle Lapping-Carr is a researcher within the perinatal field who focuses a lot on sexual and gender minority families and is even the chair of the sexual and gender minority special interest group within the Marcé society, who's really leading this work. And I encourage all to kind of engage within some of the products that will be coming from that special interest group and from her work and other individuals who are focusing on this area.
Dr. Lara-Cinisomo [00:14:10] Yeah, that's an important point to make that we need to plan now for the diversity in our populations.
Dr. Sheehan Fisher [00:14:18] Yes.
Dr. Lara-Cinisomo [00:14:18] Because we have it now, but it's very likely to grow. And so, in terms of trying to grow that awareness, you are the Associate Dean for Diversity and Inclusion at the Graduate School at Northwestern. How does that work inform your research and how does your research inform your role as the associate dean?
Dr. Sheehan Fisher [00:14:37] Well, it shows us the value and importance of it. Like for my associate dean position, I will be focused, or I am focusing on working with the graduate students within Northwestern and understand that individuals, they are many students, are very talented and intelligent and have a lot of promise, but need to make sure that they're feeling supported and have an environment where they feel like they belong. And I think it's similar to with the work within the perinatal field, is that if we don't incorporate, you know, true diversity and inclusion in our work, in the many of our, our families within the United States are not going to feel like they belong within that medical field and maybe won't be receiving the medical treatment that they deserve, or as mentioned, like the respect and consideration that they deserve. So, we really have to take it as a personal responsibility to ensure that we aren't just taking a easy way out to for what we consider as the norm, but really being inclusive in our work.
Dr. Lara-Cinisomo [00:15:30] Yeah, and helping our field become aware of this implicit bias is going to be important as well because, like you said, much of the training has been very heteronormative, very focused on one particular gender or one particular racial ethnic group, really more on racial groups. But what you're doing is really trying to prepare the workforce.
Dr. Sheehan Fisher [00:15:54] Yes.
Dr. Lara-Cinisomo [00:15:54] For the diversity we have now and the diversity that's growing.
Dr. Sheehan Fisher [00:15:58] Exactly.
Dr. Lara-Cinisomo [00:15:59] That's wonderful. That's really important work. And I'm glad that you're able to do that. It's such an important role from an administrative position, because if students feel welcome, they're probably more likely to engage in the research and stay in this profession.
Dr. Sheehan Fisher [00:16:15] Yes. And we need the research to be diverse, because otherwise we just have kind of speaking to the choir and doing the same work all over. But, having diverse thought actually improves the science that we create.
Dr. Lara-Cinisomo [00:16:26] Yeah. And scientists will benefit from that diverse thinking as well.
Dr. Sheehan Fisher [00:16:30] Exactly.
Dr. Lara-Cinisomo [00:16:31] Yeah. What are some research related lessons that you have learned over the years that maybe emerging researchers can benefit from?
Dr. Sheehan Fisher [00:16:40] Well, I think for emerging researchers to understand that there are different, diverse thought is really powerful for broadening the field and really making sure that the outcomes that were or the results of the work that we're doing within science is really impacting a broader audience. So, one, I always encourage the emerging researchers to be bold in their thought and to not be shy about presenting their own points of view. But in addition, understanding that this is something that is going to have a broad impact. Like for me, as I said, when I went into graduate school thinking about being a father, that wasn’t initially what the work was being done in general within the perinatal field. But me having the thought to actually bring that up to a supportive mentor gave room for really burgeoning this field in something that was essential to understanding the perinatal work. So, I think that many individuals have their own different, diverse thought, and can be really beneficial. But I am concerned that sometimes students don't feel supported or are worried about the opinion of, of their diverse thought, and we want to make sure that we're creating a mentor relationship with them that's actually supportive to help this, the field grow.
Dr. Lara-Cinisomo [00:17:49] Yeah. So that's a message for the mentors out there are people who aspire to be mentors, to be open to this diverse thinking.
Dr. Sheehan Fisher [00:17:57] Yes.
Dr. Lara-Cinisomo [00:17:58] Wonderful. And so, what is your vision or hope for perinatal mental health research in 5 to 10 years?
Dr. Sheehan Fisher [00:18:05] Well, I would hope especially for my goals would be really just broadening out the different aspects of diversity with there's a lot more that needs to be done for inclusion of fathers and broader to non-birthing parents and birthing parents. We need to think about getting away from an English primary way of thinking about even how we do our work, and how we hold different events and educational experiences. Making sure that language, the diversity of language, is inclusive so that everyone has a chance to be a part of and to be able to learn from the different environmental or educational environment that we create. And, really just thinking about the different pockets of groups, like, for example, we don't do as much work within Latin X populations or Middle Eastern, especially African American and black population, you know, indigenous, there’s so many different groups who we still don't understand their experience and understanding how their cultural experiences and the effect of being in the US and the impact of our societal norms has on their mental health and their family development. So, I would really hope that we start to really take a purposeful effort to making sure that we have more inclusion on racial and ethnic diversity, sexual and gender minority, and thinking about that, even within linguistics.
Dr. Lara-Cinisomo [00:19:24] Those are great hopes, and I think that you are really helping pave the way for that line of work. So, thank you for that.
Dr. Sheehan Fisher [00:19:31] I appreciate it. Thank you.
Dr. Lara-Cinisomo [00:19:33] Yeah. So, before we end, do you want to add anything before we close the conversation?
Dr. Sheehan Fisher [00:19:39] The only thing I want to I would just highlight is that the Marcé Society has done a great job of creating different special interest groups. So, encourage people to join in with them and to be involved. Like the more people are involved, the more we can have more diverse thought and communication around these different topics. And of course, when it comes up for the Marcé Society, has this conference came up in Barcelona and then in a couple of years, we'll have our next MONA conference and really hopeful to seeing more diversity in our abstracts and make sure that we have opportunities for different symposiums or focus on different special populations.
Dr. Lara-Cinisomo [00:20:12] That sounds like a core message, and I hope that our listeners hear it and share it with others. Thank you so much, Dr. Fisher. This has been so wonderful. We are so appreciate your time and your contributions to the science.
Dr. Sheehan Fisher [00:20:25] And thank you for inviting me once again.
Dr. Lara-Cinisomo [00:20:28] Thank you for joining Studying Perinatal Wellbeing. Please see our show notes on the MONA Podcast website for more information about today's guest. We always look for great perinatal wellbeing students, community members, researchers and practitioners to interview. So please email your suggestions to MONAPodcast@Marcenortham.com. That's Moana podcast at m a r c e n o r t h a m .com. Until next time, practice compassion for yourself and others.