“Mental Health Belongs Here”: Why FamilyWell Is Reframing the Standard of Care in Women's Health
Mental health belongs here, in this moment.
Every year, May brings renewed attention to maternal mental health. Awareness weeks, advocacy campaigns, and social media conversations converge around the same urgent message: more women need access to mental health support during pregnancy and postpartum.
The data behind that urgency is not in dispute. Maternal mental health conditions are the most common complication of pregnancy and birth, affecting an estimated 800,000 families in the United States each year. Mental health conditions, including suicide and overdose, now account for nearly one in four pregnancy-related deaths. And despite more than a decade of increased screening awareness, an estimated 75% of women affected by perinatal mood and anxiety disorders remain untreated.
These statistics are the clinical reality that OB/GYN practices navigate every day. What's less often discussed is why the gap persists and what it would actually take to close it.
The Problem is Clinical Architecture
OB/GYNs and women's health providers are not unaware of the mental health needs their patients have. Providers identify these patients. They screen them. They document positive results. They may offer some external referrals. And then, too often, the support stops there.
A 2023 ACOG Clinical Practice Guideline formalized recommendations for screening and diagnosis of mental health conditions during pregnancy and postpartum, reflecting the professional consensus that mental health is an integral part of obstetric care. But screening is only the beginning of a care pathway. When mental health support exists outside the practice, many patients simply don't make it there. For patients, this might look like a referral to a separate system with its own waitlists, insurance requirements, and navigation burden.
The structural barriers are well-documented: average wait times for outpatient mental health care can stretch to five weeks or longer, provider shortages are concentrated in the same communities with the highest maternal health disparities, and the coordination burden often falls on patients least equipped to manage it.
Research consistently shows that OB/GYN providers feel ill-equipped to connect patients with mental health care. This is not for lack of concern, but because the referral infrastructure simply isn’t there. Fewer than 10% of pregnant women with mental health conditions receive adequate treatment. This represents a failure of clinical architecture.
Mental Health Belongs Here
That structural reality is what the FamilyWell is built to address. It starts with a single, direct premise: mental health belongs inside women's healthcare. Not bolted on top of it. Not as a referral. Not as a separate system patients must navigate on their own. It belongs inside the appointment, inside the care plan, inside the clinical relationships that already exists.
The distinction holds clinical and experiential weight. When mental health support is embedded in the same care setting where patients already seek obstetric care, the friction that causes patients to fall through the cracks is significantly reduced. Warm handoffs replace cold referrals. Behavioral health becomes part of the clinical conversation rather than a separate step patients must initiate on their own.
FamilyWell is focused on bringing education and resources to providers, patients, and industry leaders on what true integration looks like in practice, and on challenging the field to ask where mental health still isn't embedded in OB/GYN care, and why.
Beyond Postpartum: The Full Reproductive Lifespan
Another critical part of this argument is expanding the frame of integrated mental health care beyond the perinatal space.
While perinatal mental health needs to remain a central part of the conversation, perimenopause and menopause represent one of the most underserved chapters in that continuum. Research shows that women are approximately 40% more likely to experience depressive symptoms and receive a depression diagnosis during perimenopause than in the premenopausal period, yet, as with perinatal health, mental health support during this transition is rarely embedded in the OB/GYN settings where these patients are already seeking care.
Mood changes, anxiety, cognitive shifts, and sleep disruption are among the most commonly reported menopausal symptoms frequently misattributed, undertreated, or addressed in isolation from the hormonal context driving them. ACOG recognizes that OB/GYNs are well-positioned to identify and address mental health symptoms during the perimenopausal transition, which makes the absence of integrated behavioral health support in most menopause care a structural gap, not a clinical one.
FamilyWell's Collaborative Care Model (CoCM) extends into menopause care precisely because the evidence points there: CoCM has the largest evidence base of any integrated behavioral health model, supported by more than 80 randomized controlled trials across a range of mental health conditions, including PPA and PPD.
Mental health belongs in the gynecology appointment in mid-life in the same way it belongs in the prenatal visit and the postpartum follow-up.
What Integration of Mental Health Requires
Acknowledging that mental health belongs in women's healthcare is easier than building the systems to make it real. OB/GYN practices operate under significant time, staffing, and reimbursement pressures. Adding behavioral health services without operational infrastructure often compounds provider burden rather than reducing it.
Effective integration requires trained behavioral health staff who understand reproductive contexts, care coordination workflows that fit within existing clinical operations, reimbursement pathways that make integration financially sustainable, and a workforce to deliver it — one that, by most estimates, remains critically undersupplied relative to need. Awareness of the problem, on its own, hasn't closed the gap. What's needed is a broader structural shift: toward integrated models of care that treat women's behavioral health as a clinical function.
And that shift matters beyond operations. For too long, the implicit message of fragmented care has been that mental health is a separate concern; something to sort out elsewhere, through a different door. Many patients internalize that message, minimizing symptoms (or even lying about them) or leaving appointments without raising the anxiety, grief, or mood shifts they came in carrying.
When behavioral health is embedded in the practice, that changes. Patients don't have to summon courage to raise a mental health concern. The conversation is already open. Stigma recedes when care settings make it structurally clear that mental health is a legitimate, expected part of the visit.
A Standard of Care That Reflects the Patient
Women and birthing people in OB/GYN settings are already telling their providers that shifts in mental health are is part of their experience of reproductive healthcare.
The question for practices, health systems, and reproductive health administrators is not whether mental health belongs in women's healthcare. The evidence has answered that loud and clear. The question is whether the structures exist to meet patients where they already are.
Mental health belongs here. In the practice. In the workflow. In the care model. Across every stage of the reproductive lifespan, in the moments when women are most vulnerable and most in need of a care system that sees them whole.
That conviction is what grounds FamilyWell's approach in clinical reality, in operational specificity, and in the ongoing work of normalizing mental health as an expected, unremarkable part of women's healthcare.
Learn more about how FamilyWell Health's integrated behavioral health model supports OB/GYN practices and women's health systems.
References
American College of Obstetricians and Gynecologists. (2023). Screening and diagnosis of mental health conditions during pregnancy and postpartum: ACOG Clinical Practice Guideline No. 4. Obstetrics & Gynecology, 141(6), 1232–1261. https://doi.org/10.1097/AOG.0000000000005200
American College of Obstetricians and Gynecologists. (2024, October). Mood changes during perimenopause are real. Here's what to know. https://www.acog.org/womens-health/experts-and-stories/the-latest/mood-changes-during-perimenopause-are-real-heres-what-to-know
Aparicio, S. (2026, February 12). What collaborative perinatal mental health care looks like in an OB/GYN practice. FamilyWell Health. https://www.familywellhealth.com/blog/what-collaborative-perinatal-mental-health-care-looks-like-in-an-obgyn-clinic
Boudin, C. (2024, December 13). Is there a gap when doctors make mental health referrals? ChoosingTherapy.com. https://www.choosingtherapy.com/gap-doctors-therapy-referrals/
Closing the maternal mental health treatment gap: A tech-enabled solution. (2025, November 17). The Journal of mHealth. https://thejournalofmhealth.com/closing-the-maternal-mental-health-treatment-gap-a-tech-enabled-solution/
Desai, R., et al. (2024). Does menopause elevate the risk for developing depression and anxiety? Menopause, 31(3), 186–193. https://doi.org/10.1097/GME.0000000000002309 (as cited in Contemporary OB/GYN: https://www.contemporaryobgyn.net/view/does-menopause-really-cause-depression-)
Forward Leading Families. (2026, March 23). Bridging the gap: The case for behavioral health integration in reproductive health settings. https://forwardleadingfamilies.org/articles/bridging-the-gap-the-case-for-behavioral-health-integration-in-reproductive-health-settings
Maternal Mental Health Leadership Alliance. (n.d.). Maternal mental health conditions and statistics: An overview. https://www.mmhla.org/articles/maternal-mental-health-conditions-and-statistics
Policy Center for Maternal Mental Health. (2025). Fact sheet: Maternal mental health. https://policycentermmh.org/maternal-mental-health-fact-sheet/
Shields-Zeeman, L., Balje, A., Rijnders, C., & de Beurs, D. (2023). Successful ingredients of effective Collaborative Care programs in low- and middle-income countries: A rapid review. Cambridge Prisms: Global Mental Health, 10, e4. https://pmc.ncbi.nlm.nih.gov/articles/PMC10579696/
Trost, S. L., Busacker, A., Leonard, M., et al. (2024). Pregnancy-related deaths: Data from maternal mortality review committees in 36 U.S. states, 2017–2019. Centers for Disease Control and Prevention. https://www.cdc.gov/maternal-mortality/php/data-research/mmrc-2017-2019.html
