Interview with Dr. Dhara Thakar Meghani, founder of Parentline, on her experience researching parental mental health
By Lee Burgess, President, Natural Resources Board of Directors
Welcome to the “Listen and Learn” Interview Series...part of our “It Takes a Village” Fundraising & Awareness Campaign!
The transition to becoming a parent is a big one. And often this shift is considered just one more thing that you do in your life. There’s no formal training. No manual. No clear set of instructions to help you find your way.
And caregiving families that live in urban settings — like we most often see today — can miss the collective wisdom that gets passed on from generation to generation. The type of wisdom that was shared by a community when we used to live in village settings.
There are very few systems set up to support parents who are taking care of the next generation. To help bridge the gap between prenatal and pediatric care.
That’s why Dr. Dhara Thakar Meghani is so committed to her work in parental mental health. We’re excited to hear about her current research and work with Parentline, a free counseling service available to parents
In this episode, we discuss:
- Dr. Meghani’s background, work and her interest in parental mental health.
- The stigma around using mental health services as new parents.
- What led Dr. Meghani to create Parentline.
- How parents with young children can enjoy this challenging season.
- Parenting during the pandemic.
- Three things new and expecting families should know.
- How to connect with Dr. Meghani’s research and Parentline’s services.
Lee Burgess: Welcome to the Natural Resources It Takes a Village interview series. We are speaking to contributing members of the parenting and birth community here in the San Francisco Bay Area.
Thanks so much for being with us and for supporting Natural Resources as a community non-profit supporting new and expecting families. My name is Lee Burgess and I am the president of the board of directors at Natural Resources.
Today, it is my pleasure to welcome another member of the Natural Resources board, Professor Dhara Meghani. Dhara is an associate professor at the University of San Francisco, and is also the founder of Parentline, a free online counseling service for parents of children from pregnancy to three years of age. Dhara, thank you so much for joining me today. I know it's busy. It's a busy time.
Dr. Meghani’s Background, Work and Her Interest in Parental Mental Health.
Lee Burgess: To get things kicked off, could you share a little bit about how you came to do what you do and where your passion for studying and supporting parental mental health originated from?
Prof. Dhara Meghani: Absolutely. Thanks again so much for having me. It's such a pleasure, no matter how busy I am. Glad to be here and to get to talk about my passion. You already introduced what my titles are and what I do in that sense, and so it's a great segue into talking about this true passion that drove me to want to start Parentline, and also why I enjoy teaching and training students who are going to be future psychologists.
I would say that my passion for studying and supporting parental mental health really started when I was in graduate school. I also have a doctorate in clinical psychology. Much of my work early on involved doing home visits for research studies, where we would do some screenings and interviews with parents of children who were exhibiting symptoms that might lead to a future diagnosis of ADHD.
These were young children whose homes we were going into and doing all kinds of different types of tests, but also really interviewing the parents. I could see what a toll this was taking on the parents that we spoke with. I also worked on research where I had this really amazing opportunity to follow parents from pregnancy through their baby's first year of life. We would do home visits about six times in the span of one year and we would get to see their family grow.
We would get to talk with them about what they were excited about in their pregnancy and how they were looking forward to meeting this new baby. Then we would be there for the roller coaster of parenting that ensues in the first year of life. I got to learn a lot about the incredible changes that occur in a very short span of time. This was certainly before I myself became a parent. Those were a couple of really formative experiences.
I also worked professionally at a place called The Fussy Baby Network in Chicago. The name says it all, right? We also provided home visitation and developmental support for parents who had really fussy babies, babies who were difficult to soothe, who were difficult to feed, who didn't want to sleep. Even though oftentimes they called us with a very concrete seeming question like, "How do I get my baby to sleep through the night? They're seven months old and I'm sleep-deprived, they're sleep-deprived."
We'd go to their homes and of course it was so much more than that. Oftentimes parents were just glad to have another adult to be able to talk to face to face. A lot of these experiences led me to think, "Why don't we have more support for parents in this transition to parenting which is such a big identity shift for individuals who become parents?"
I've just been so passionate about making sure that we have supportive services available for the parents who are then taking care of these vulnerable human beings, right? Our future.
Lee Burgess: Yes. That is incredible that you just started to see the themes through all of these touchpoints you had with different families as you finished your doctorate and started to really get into the work of children and young families. We both have small children because we bonded over that when we got to first meet virtually, since we're pandemic friends.
Prof. Dhara Meghani: That's right.
Lee Burgess: We've never actually gotten to see each other in person. When I became a parent, I heard a lot about the baby blues. It seems like everybody's like, "Oh, you'll get the baby blues. It's so normal. It's just how it is."
But I feel like there wasn't much talk about the next step, such as getting mental health support during that challenging time, especially if you have a child who does not sleep a lot. I had a child who didn't sleep a lot, so sleep deprivation was a major thing going on in my household.
The Stigma Around Using Mental Health Services as New Parents
Lee Burgess: Why do you think, with the research you've done, there is still such a stigma around mental health services and the assumptions that new parents need to reach out if they're struggling at all?
Prof. Dhara Meghani: Yeah. Yeah. It's definitely the million-dollar question in some ways, but I also think that a lot of it has to do with the idea that parenting is oftentimes billed as another thing you do in your life. It's not necessarily something that you are supposed to get training for in the way that you enter a job or when you go to school. So many people have parented in their lives that I think there's a collective wisdom that gets passed on.
When we lived in different ways in really the village, in the community, there was a shared model that didn't put the onus on any one person or two people in two-parent caregiving families like we see in the urban setting now. I actually think that there is a lot of that attitude around, "Well, we've got to do this ourselves and lots of people have done this, so why should we need to reach out for extra help?"
The other piece that I think is really important and that sometimes doesn't always connect for parents until I've talked with them in my capacity as a mental health professional, is that a lot of the symptoms that we see in things like baby blues or postpartum depression, or even postpartum anxiety, which is a thing, is that they get confused with what we are often told is a natural part of parenting.
When we think, "Gosh, I just am really irritated right now, or I don't really feel like being with my baby." First of all, that second one that I mentioned brings up a lot of guilt from any parent and so certainly there's stigma around going to tell a professional, "Gosh, I'm not sure that I wanted to do this or there are days where I don't feel like picking up my crying baby." There's a lot of impression management that we do as individuals and as parents.
We don't want to come across or even say to ourselves sometimes that, "This isn't my cup of tea right now." I think that there's both internal stigma around what I thought parenting was going to be and what it actually is.
This violation of expectations that prevents us from pursuing support as well as a lot of external stigma, which is if you do reach out for help, and in general, mental health has had a stigma compared to things like physical health or going to the pediatrician or the doctor, which is there must be something wrong with you. Are you unfit to take care of this child? Which is a very scary thought. I think those are some of the reasons the stigma exists.
As I mentioned just previously, there's not a lot of education beyond these labels of baby blues and postpartum depression. So one of the things we like to do in our work is to help parents understand that depression or baby blues doesn't just mean being sad. It can look really different depending on who you are and what symptoms you might have. Oftentimes things like irritability, as I mentioned, feelings of guilt, feeling resentful, feeling really anxious.
Those don't necessarily get coupled with this idea of baby blues or depression. I think we have a lot more work to do, frankly, in educating the public around what is involved in those labels. That may bring forward more people to say, "Hey, what I'm feeling doesn't really seem normal and actually I'd like to get more help for that so I can be the best parent for my baby."
What Led Dr. Meghani to Create Parentline
Lee Burgess: You founded ... or you co-founded Parentline in 2017. You had been part of a number of these programs that had been inside the home, that had been giving parents different support at different parts of this parenting journey. What did you feel like was missing from parental support that drove you to start this program?
Prof. Dhara Meghani: Sure. As I mentioned, the initial experiences were research-based. We were there to collect data we were taking from the families really. That's always been a tension that I face as a researcher and a clinician, which is, how do we do the work in a way that still feels supportive, even when it's pure research?
Some of the other work that I was doing didn't really have the mental health label, even though a lot of the work we did was, I think, focusing on supporting parental mental health. I think I started to notice gaps based on the experiences that I had and I also noticed how much emphasis there is on prenatal care, rightly so. Making sure that the mom and baby are off to a good start, making sure that that dyad is really prioritized.
There's prenatal yoga classes. Pregnancy is such an opportune moment for behavioral change in fact. We know this through research, in that many women who might otherwise engage in risky behaviors like smoking and alcohol use, and maybe even be in relationships where there's intimate partner violence, will actually change those behaviors when they are pregnant, because they know that their health directly impacts their baby's health.
There's lots of good prenatal care available, and similarly, we have very well-structured pediatric care across the socioeconomic spectrum in this country. There are well-child checkups that are laid out at specific times. There's a lot of guidelines and regulations around that. It doesn't always mean everybody goes. That's another aspect of that, but the setup is there. Understandably, pediatric visits tend to focus heavily on the baby's health, rightly so again.
We cannot expect pediatricians who are not trained in maternal mental health to be doing the kinds of things that a maternal mental health professional could do. I really saw from both my clinical and research experiences, that there were very few systems set up to support families in that bridge between prenatal and pediatric care. That transition to parenting just felt like a big fall.
Like we'll support you all throughout your pregnancy, then you have the baby, you go home and then you're like, "Now what? Now I wait for my next couple of checkups with the doctor." Even I can't remember most of those appointments since I was myself so new and sleep-deprived. There's really not a place currently in our system where parents can go when they're simply worried, they might need some reassurance.
We have set up ways for that to happen within our communities, which is what Natural Resources does. Parentline was an effort to say to parents, "We're here at times when you're not sure, but maybe you call the pediatrician's office and they say, 'Well, this isn't really a medical concern. We've checked out your baby, your baby's fine and he'll grow out of it, or things will get better.'"
Lee Burgess: Just wait three months.
Prof. Dhara Meghani: Just wait three months, and then you're waiting and then nothing changes, and maybe something is actually not wrong, but that doesn't mean that it's not uncomfortable or worrisome or anxiety-provoking. We know that when those feelings are generated in us, as parents, babies can feel them too.
Our intention with Parentline was really to provide a non-judgmental open space for parents to call with a myriad of concerns, but also to be met with professionals who are not just mental health professionals, but also very developmentally trained. This is why we housed Parentline at USF in our clinical psychology training program. Our doctoral students are the staff for the most part.
Then my colleague, Paulina Barahona, and I supervise them. The students are just so eager to apply their developmental knowledge, and they know a lot about infant and early childhood development, as well as about mental health. It's a really nice marriage and a unique combination that not a lot of other services provide.
Lee Burgess: I love the fact that it's virtual too, not just because of COVID times, but outside of that. I think there can be a very intimidating idea that you're supposed to go somewhere with the baby to do another appointment or do...
And as moms, I think we're hesitant to do something for ourselves and then to haul the baby, have them miss a nap. I think the idea that parents can access this resource virtually, especially in the beginning, just allows it to slip into these pockets of time where maybe it feels a bit more accessible.
Prof. Dhara Meghani: Absolutely. Thank you for reminding me of that really important component of our service. I would give full credit to my experiences of home visitation, both through The Fussy Baby program and even through the research we did, where we didn't require parents and families to come to our lab at our university.
We really went to them because we understood that it's a lot to schlep yourself, but also your baby or your children to a place that feels very clinical and doesn't really capture or help convey to the clinician what your real life is like. With telehealth, when we offer Zoom sessions, it does give us a little bit of a window into what the parents set up as like ... particularly if we're trying to support them on an issue related to something like sleep.
We might say, "Well, let's see how the baby's bedroom is set up, or let me think with you practically about this too." Yeah. Telehealth was a really wonderful choice that enabled parents to have access at various times and didn't require them to be worried additionally about getting to a place on time.
How Parents with Young Children Can Enjoy This Challenging Season.
Lee Burgess: I was just reading a book, a little light reading before bed the other night, that said that parents with children under the age of six are the least happy and content of all age ranges. Do you agree with that data? Does that sound like good data for you?
Prof. Dhara Meghani: Well, I have a six-year-old and a 21-month-old, so I'm like the perfect person to be asking that. Just kidding. It's interesting, I think years ago, when I went to a conference, I was listening to a researcher talk about how we see qualitatively different levels of satisfaction and happiness in parents once their children leave home in fact. So the whole zero to 18 range is thought of as, in this country, traditionally a time when parents live with their children.
Then we see satisfaction and happiness just shoot up as soon as their kids launch. I think that part of this is related to the earlier discussion we had about expectations, and particularly for first-time parents. There is a lot of excitement for pregnancies that are planned and wanted and maybe even have been wanted for many, many years and it's taken a long time to get there.
The idea is like that journey has taken so long. There's so much excitement for that and then the actual work that's involved in caregiving, the balance that gets disrupted in one's life ultimately for many parents, for good reason, and it's all oftentimes worthwhile.
At the same time, there's a lot of dependencies that young children have on adults that I think we don't always think about when we are trying to get pregnant or we're starting to move into that phase of parenting.
I'm not sure if I fully agree or disagree. I think that each stage is qualitatively different. I know that's a really diplomatic answer, but I think that it also depends on your individual experience. I also know there are parents... friends of mine...who I talk to who have older children and they look at my babies and they say, "Oh, I really wish I had that time back."
In the midst of it, parenting, as a verb, as something that you're doing, can be very difficult and time-consuming, especially when it takes that physical toll on you as well. I can absolutely see why it feels like it's not fun. In retrospect, I think I've heard many parents of older children look back on that time so fondly saying, "Gosh, I miss cuddling with my baby or when they were much littler than I was, and now they can pick me up." Or something.
I think there's a myriad of reasons for that. All of this to say is, it would be really nice if as a society, we could start to think about shifting perceptions and expectations, so that when things feel like they're not fun, we can figure out ways to right that if that's what's wanted.
Lee Burgess: Well, parenting during the pandemic has been a challenge. I feel like when I wrote this question, it's just a total understatement. I don't even know how you ... I just feel like I just laid that out there and it doesn't even capture what parenting in a pandemic has felt like. I think many parents have seen themselves as surviving. I don't think most people would claim that they've been thriving and that we're all looking to find our way to more normalcy.
Parenting During the Pandemic
Lee Burgess: What do you think parents can do now, looking to the future, to try and prepare for what comes next and also maybe to process a little bit of what we've been through?
Because I think for many of us, we're just keeping on keeping on and not necessarily processing what has happened to us. I mean, of course, globally, but even more locally and even within our own families.
Prof. Dhara Meghani: Absolutely. I think this is a tough question to answer, and again, probably important for each family and individual to know what's going to be needed for them. Overall, we know parents are amazingly adaptive. I mean, if nothing else COVID-19 has reminded us of this. I think this is precisely how we survive, and sometimes we just don't have a choice. We just have to keep going.
I've been incredibly impressed with all the different ways in which I've seen parents adapt who have children of all ages. I think that looking back on these moments, it'll be important for parents to understand what got them through. This is what we generally do when working with parents or even other individuals who might have experienced traumatic events, we want to think about an idea called post-traumatic growth.
We see this happen when there has been time, post-trauma, for reflection and for thinking through like, "Wow. We really didn't think we were going to get through that really difficult time, but here are some of the things that seemed to help." I'll just give an example for myself.
In our family when all of a sudden school stopped and we had a newborn, we needed extra pairs of hands around the home, but of course we couldn't get people in the home, and so we figured out ways to enlist family members to do Zoom sessions with my daughter, where she got to connect with aunts and uncles and grandparents in ways that she'd not really before. I didn't love the idea of her being on a screen so much, but it was also necessary at certain times.
Now she has this understanding of who these people are in her life, some who she's never even met because they live in different parts of the world. That's what I mean by adaptation, as well as reflection on that adaptation and holding on to these tips and tricks for ourselves for the next time, because there will be some other type of challenge that comes our way.
I think the other piece is we have gotten pockets of normalcy where it seems like, "Okay. Now we can go back to the playground or now we can maybe form a bubble or meet with a few families or something." How could we make the most of that experience and really recognize the value of even one time a month, if we can get together with a couple of families...that sure beats sheltering in place for six months.
Taking what we can get, I guess, is another part of this, which I know is sometimes not satisfying because we really want to think back to those days pre-pandemic when life really did feel more normal.
I think one of the ways to prepare for what comes next is getting to a place of recognition that there may be several years ahead ... I hate to be the one to say this, but I'm starting to think this for myself where our children may need to continue to wear masks at school.
We may need to continue to take certain precautions until we feel safer, and so settling in to that a bit, but also finding ways to say, "We've done this. We've gotten through it and there's lots of other things that have come from this very traumatic experience."
Again, it's not an attempt to brush the challenges under the rug or see the rosy side of things. I think part of the way that we cope with things successfully is by shifting the way we think about them.
3 Things New and Expecting Families Should Know
Lee Burgess: Well, we have a few more minutes, but I wanted to touch on a couple other things. I've been asking all of my interviewees a similar question, but what are three things that you would like to share with new or expecting families?
Prof. Dhara Meghani: Sure. One piece that comes up frequently is this idea that development is not linear. I wish it were. I wish, like you said, at three months this happens, at six months this happens.
Our science is actually pretty good. We've had countless observational studies that help us to understand, generally speaking, where we see children landing and what they're doing at different stages of childhood.
At the same time, it's really hard to keep that in mind when you're the parent and to think in the way that we think about walking. Like, well, once you start to walk there typically isn't a time where you don't know how to walk anymore. I mean, there's a few things like that, which are fairly linear because they're very intrinsically tied to motor skills and cognition.
Overall, I would say socio-emotional development is not linear whatsoever because it's so tied to the major other changes that are happening in childhood and infancy. That's why we see things like regressions when it seems like your baby just figured it out. They just figured out how to put themselves to sleep and then you think you're settling back down and there they go up again.
It's happening now with even more frequency than it did a month ago, so what's happening? I think keeping in mind that piece, that it goes up and down for a while because there's so much going on in the brain and the body that something has to give in order for new things to happen. It's a little bit ... I've given this analogy in other places before as well.
We think of regressions like we think about cleaning out your closet or reorganizing your closet for efficiency. Oftentimes we have to pull everything out, right? If we really Marie Kondo it. We pull it all out. We assess, what's really functional? What do we need? Then let me put it back in some organizational way that actually meets my purpose, my need.
That's really what babies and individuals, humans, do when we see these periods of enormous growth, is actually they regress. They pull everything out, they figure out what's more efficient and then they put it back together. Eventually the baby starts to sleep again in the pattern that you thought they had already developed. We've also then noticed that there have been these leaps that have happened in development, which are so beautiful to watch.
That's a huge lesson that I think is really helpful for parents to keep in mind. The others are related to trusting your own instincts. We have so much information available at our fingertips and so many books and websites and products and a whole industry that has been born out of parental anxiety. There is a reason that our culture, our human race has survived.
It's because we all figure it out and instincts are really important. There isn't one right way to approach caregiving. Oftentimes we are going to do what we think is best for our babies. If one can hold that in mind, it will grow parenting confidence over time.
The last piece which relates to Parentline, as well as other pieces about the village, is to figure out who you can rely on for support and really don't be shy to ask for that support in the ways that are most helpful to you.
It's not what someone else thinks is helpful for you because they needed it when they were a new parent, but really what you are starting to realize is what's needed for you. That's not always figured out. I also want to say, we don't spend copious amounts of time writing down lists of what we need. Parents just don't do that, but when the time comes, if you're able to articulate that and garner that support, it will really help the journey along.
How to Connect with Dr. Meghani’s Research and Parentline’s Services
Lee Burgess: Well, we have to wrap up, but how can listeners learn more about your work and also learn more about Parentline?
Prof. Dhara Meghani: Absolutely. Well, we are hard at work writing up some results of a research study we conducted with first-time parents, and so we'll have some papers coming out in the next several months. That's more on the academic side. But we've also been undergoing a transition of our own recently since we pivoted pretty significantly during the pandemic, in order to help as many parents of children of different ages as possible.
I would say currently the best way for interested listeners to be in touch with us is through our email address, just to let us know how we can support you, whether that's through getting one-on-one counseling, or if you want to even do a one-time email to request some support around questions you have, that's probably the best way. Our email address is firstname.lastname@example.org.
Lee Burgess: Absolutely.
Prof. Dhara Meghani: Yeah. That would probably be the best way to get in touch with us currently.
Lee Burgess: Wonderful. Well, thank you so much for being here, and thank you all for watching and attending this installment of the It Takes a Village interview series by Natural Resources. You can find this and additional information on our website at naturalresources-sf.com.
We hope you'll learn more and support us, and we'll see you next time.