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Integrated Mental Health Care for Perinatal Anxiety and Depression in the United States: A Systematic Review

Journal
Psychiatric services (Washington, D.C.) (Q1)
Published
17 September 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Katherine Steele, Carolyn Cunningham, Andrew D Carlo, Clare McNutt
PMID
42750087
DOI
10.1176/appi.ps.20250639

Why clinicians should know about it

  • Picked for Family Practice (top studies of the week, 20 September 2026): Integrated mental health care for perinatal depression
  • Picked for Psychiatry and Mental Health (top studies of the week, 20 September 2026): Systematic review of integrated perinatal mental‑health care

Abstract

OBJECTIVE: The ongoing maternal mental health crisis highlights the urgent need to improve access to integrated behavioral health care within medical settings for perinatal individuals. This review aimed to synthesize the current evidence on integrated models of care in the United States targeting depression and anxiety among perinatal individuals, with attention to clinical outcomes, implementation feasibility, and sustainability. METHODS: A systematic search was conducted across MEDLINE, PsycInfo, Cochrane Library, CINAHL, and Embase, supplemented by manual searches of reference lists from key articles. Eligible studies were randomized controlled trials that were conducted in the United States and that evaluated integrated care programs for perinatal adults with depression or anxiety. Risk of bias was assessed with the Cochrane risk-of-bias tool for randomized controlled trials, which evaluated five domains: randomization, intervention deviation, missing data, appropriate measurement, and selective reporting. RESULTS: Fifteen articles met inclusion criteria, with six focused on collaborative care. Seven articles reported statistically significant improvements in clinical outcomes among patients receiving integrated care compared with usual care, whereas the remaining articles reported no significant differences. Limited data were available on patient and provider acceptability and financial sustainability. CONCLUSIONS: Integrated care models show promise for reducing depression and anxiety symptoms among perinatal individuals, although the evidence varies across program types and populations. By synthesizing U.S.-based trials and identifying both meaningful clinical gains and gaps in implementation, acceptability, and financial sustainability, this review underscores that addressing these gaps is essential to realizing the potential of integrated care as a scalable solution to the maternal mental health crisis.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.