Abstract
Screening and treatment of maternal perinatal depression is well established, yet existing health care services rarely focus on fathers, and even fewer on Aboriginal and Torres Strait Islander fathers. This study examined the engagement with the Mood Checker (MC) mental health screening tool among Aboriginal and Torres Strait Islander (Indigenous) fathers enrolled in the SMS4dads/SMS4DeadlyDads programme. The MC prompts self-reflection on parenting and wellbeing topics and offers referral to mental health support when needed. Routinely collected programme data from participants enrolled between September 2021 and 30 June 2024 were analysed to assess engagement across 14 MCs, including link clicks, self-assessment responses, and access to linked supports. A total of 571 fathers received an average of eight MC texts. Across 4545 texts sent, 19% of MC links were clicked, and of these, 29% were completed. The MC 'Antenatal stress' had the highest proportion of link clicks, while 'Will I be a good father' had the highest completion rate followed by 'Antenatal stress'. MC responses indicating higher concern were related to 'Exercise', 'Intimacy', and 'Sleep'. Thirty-four participants were offered a mental health support link. Participants who did not click on any MC link and those who clicked but did not complete had significantly higher distress at enrolment compared to those who engaged with the MC. These findings highlight the potential of culturally appropriate digital fathering programmes to identify distress and support timely mental health referral for Indigenous fathers during the perinatal period.