The Impact of Federally Funded Home Visiting Programs on Parental Mental Health: a Systematic Review

One in five mothers and one in 10 fathers are impacted by mental illness following birth, with higher prevalence among parents of color. Mental illness has lasting adverse consequences for parents and children. Home visiting services, such as the federally funded Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, aim to improve the health and well-being of at-risk families through evidence-based home visiting. The aims of this study were to identify MIECHV programs associated with parental mental health, articulate characteristics of effective programs, and describe how program effects vary by race and ethnicity. We conducted a systematic review of randomized controlled trials of MIECHV-eligible home visiting programs searching four databases (Medline, Embase, CINAHL, and Web of Science) and the Home Visiting Evidence of Effectiveness manuscript repository from inception to August 2024. Eligibility criteria included studies published in English that assessed parental mental health using validated scales (e.g., Center for Epidemiologic Studies Depression Scale). Quality assessment was conducted using the Cochrane Risk-of-Bias 2 tool. Results were synthesized following the PRISMA guidelines. Of the 728 articles retrieved, 27 met the inclusion criteria for our final analysis. The 27 studies represented 15,516 participants and 13 MIECHV programs. Depression was the most frequently assessed mental health outcome, followed by anxiety and psychological distress. Ten of the 27 studies, reflecting outcomes from seven MIECHV programs, reported significant improvements in parental mental health. Findings suggest that some MIECHV home visiting programs are associated with mental health improvements, though effects were not consistently observed across all studies and varied in magnitude and duration. This review provides insights to policymakers about the effectiveness of MIECHV programs for parental mental health outcomes. Future research should examine which program components and delivery strategies most effectively improve parental mental health and reduce disparities to inform equitable MIECHV program adaptation and implementation.