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Background: Fathers’ mental health is increasingly recognised as an essential component of child development and family well-being. However, in low- and middle-income countries like Ghana, research on paternal psychological health and its influence on parenting remains limited.

Aim: To examine the relationship between paternal mental health, fathering practices, social support, and child well-being.
Setting: The study was conducted within the Sunyani West Municipality in the Bono Region of Ghana.

Methods: This was a cross-sectional study involving 400 fathers with biological children aged 0-17 years. A multistage cluster sampling technique was employed. Data were collected using validated tools, including the Depression, Anxiety, and Stress Scale; Inventory of Father Involvement (Short Form); Multidimensional Scale of Perceived Social Support; and a child well-being checklist. Descriptive statistics, Pearson correlation, and multivariable linear regression analyses were performed using SPSS version 26.

Results: Findings revealed that poorer paternal mental health was significantly associated with reduced fathering practices (r = –0.32, p < 0.001) and lower perceived child well-being (r = –0.29, p < 0.001). Regression analyses confirmed that mental health significantly predicted fathering behaviour (β = –0.35, p < 0.001) and child well-being (β = –0.28, p < 0.001). Notably, 25% of participants exhibited symptoms of severe depression.

Conclusion: Paternal psychological distress adversely affects parenting and child development outcomes in Ghana. Strengthening community-based psychosocial support and integrating paternal mental health into primary health care may enhance family and child well-being in similar low-resource settings.