Bridging Gaps in Perinatal Mental Health: A Review of Peer and Non-specialist Supports for Racially, Ethnically and Culturally Diverse Communities in the U.S.

Abstract

Purpose of review: This narrative review synthesizes findings from U.S.-based peer-reviewed studies published between January 2020 and May 2025 on peer and non-specialist delivered perinatal mental health support programs for racially, ethnically and culturally diverse populations.

Recent findings: Eight quantitative studies demonstrated improvements in depression, anxiety, and parenting outcomes through mechanisms including behavioral activation, cognitive behavior therapy, increased social support, and self-efficacy. Structured peer and non-specialist delivered programs, emphasized social support and culturally resonant approaches, with higher session "dose" linked to grater improvement in mental health outcomes. Trauma-informed models and multi-component interventions integrating culturally adapted cognitive behavior therapy and navigation also reported positive outcomes. Qualitative findings reinforced these mechanisms, with participants highlighting the importance of cultural resonance, trust, and emotional connection. However, no studies conducted formal mediation analyses. Peer‑ and non‑specialist‑delivered perinatal mental health supports show promise in improving outcomes among racially, ethnically, and culturally diverse populations in the U.S. These models draw on behavioral, psychosocial, and relational approaches, however more research is needed to establish effectiveness, guide dissemination, and identify mechanisms of change. Implementation science is critical for advancing scalable models of training and supervision, while policy innovation is needed to create sustainable funding and reimbursement pathways to embed these roles into routine perinatal care. Future efforts should intentionally employ participatory research approaches, ensure cultural relevance, and strengthen partnerships with community‑based organizations to support implementation and maximize equity, feasibility and acceptability.