Community-based interventions to promote paternal mental wellbeing and prevent poor mental health during the perinatal period: a mixed methods systematic review.

Background: Paternal mental health during the perinatal period is increasingly recognized as a public health priority. Poor paternal mental health can negatively affect fathers, partners, and children, while mentally well and engaged fathers contribute positively to child development. However, evidence on effective community-based interventions remains limited. Objectives: The aim of this systematic review was to identify and synthesize the best available evidence on community-based interventions that promote good mental health or prevent poor mental health among fathers in the perinatal period. By integrating quantitative and qualitative data, it sought to inform public health practice and policy with a comprehensive understanding of intervention effectiveness and acceptability. Methods: The review included quantitative, qualitative, and mixed methods studies published in English from 2009 to 2025. The JBI approach to critical appraisal, study selection, data extraction and data synthesis was used. Quantitative data was "qualitized" and synthesized with qualitative data using a convergent integrated approach. Results: Nineteen papers representing 18 studies met the eligibility criteria. All studies evaluated community-accessible interventions including psychosocial, psychoeducational, peer support, and digital or technology-assisted approaches delivered to fathers individually, within couples, or in group settings. Twelve studies were quantitative, three mixed methods, and three were qualitative. Studies were conducted across 11 countries. In total, 39 qualitative findings and 11 qualitized findings were synthesized into six integrated findings: 1) Reduced social isolation and increased feelings of connection and belonging; 2) Validation, emotional reassurance, and access to safe, non-judgmental spaces; 3) Strengthened paternal identity, confidence, and readiness for fatherhood; 4) Enhanced father-infant bonding and caregiving involvement; 5) Improved partner relationships and co-parenting through better communication and confidence; 6) Increased knowledge, coping strategies, and mental health literacy. Conclusion: While community-based interventions show mixed effects on standardized mental health outcomes, integrated evidence indicates meaningful psychosocial and relational benefits for fathers. Promoting paternal mental health during the perinatal period may therefore depend less on short-term symptom reduction and more on strengthening social connection, identity, and confidence, highlighting the need for broader outcome frameworks and more rigorous evaluation.