Abstract
Introduction: Paternal perinatal depression (PPND) occurs in 10% of fathers, which implies an important burden for families and public health services. A better understanding of the population awareness on the topic is essential to adequately identify and adequately support these cases.
 Objective: This study aims to investigate the awareness, knowledge, and attitudes of the Brussels and Flemish-Brabant population in Belgium towards PPND, using the validated Depression in Dads (DDads) questionnaire.
 Methods: A two-strands descriptive study was conducted in the Brussels’ Capital Region and in the province of Flemish Brabant, Belgium between March-May 2020 and March-May 2021. The sample included 314 adults, aged 18-65 years, Flemish speaking, and living in the previously cited provinces. The DDads Questionnaire was administered online via LimeSurvey© (an encrypted and secured online data collection service) due to the COVID-19 social distancing measures. Data were analysed using IBM SPSS 28.0 SPSS© Statistics for Windows©. Ethical approval was obtained from the Brussels’ University Hospital and the Vrije Universiteit Brussel (VUB) committees.
 Results: In the case of respondents, anxiousness was the most frequently cited mental health problem as experienced by men during their partners’ pregnancy (82.4%) and during the postnatal period (68.4%). Although well recognized as mental health issue, and as a general health concern, paternal depression had low recognition by respondents, and it was considered by 37.3% of them as being “normal” during the process of fatherhood. New personality traits such as (withdrawal, avoidance, isolation, indecision, or irritability, amongst others) were regarded as a common symptom of PPND by 64.6% of respondents. When asked about best ways of coping -in the case of paternal depression- non-pharmacological approaches were mostly preferred. In the case of experiencing PPND, the main advice was to ask for support from informal networks (family or friends) whilst professional support from the mental health services was suggested only as a secondary option. Over 70% of respondents believed that paternal depression requires from a specialized treatment though. Only 39.2% of the respondents agreed that all men should be screened for depression symptoms during pregnancy, and 43.0% of participants agreed that those symptoms should also be checked after delivery.
 Conclusion: Attitudes towards PPND appeared to be diverse. PPND and perinatal mental health terms seem to be poorly understood. A clear need to increase awareness concerning men’s mental health during pregnancy (of their partners) and PPND is patent. Better awareness may help fathers in difficulty to be identified earlier, for them to be better attended during this process, and to decrease PPND rates and ultimately improve perinatal mental health. 
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