What Collaborative Perinatal Mental Health Care Looks Like in an OB/GYN Practice
What happens when an OB/GYN identifies a patient in need of mental health support, but there is no reliable referral pathway?
Essex County OB/GYN in Beverly, Massachusetts, was one of FamilyWell Health’s first clinical partners. For Dr. Melissa Sherman, MD, FASMS, an OB/GYN provider at Essex, the decision to integrate collaborative mental health care stemmed from a persistent structural problem: patients needed support, and timely options were limited.
“In our region and in our hospital system, there is no dedicated perinatal psychiatry service, and existing behavioral health practices have long waiting lists for non-emergent care,” Dr. Sherman explains. The constraint was not a lack of screening or awareness within the practice. Instead, it was a shortage of accessible, specialized services.
OB clinicians routinely identify patients experiencing anxiety, depression, pregnancy loss, infertility stress, and other perinatal mental health concerns. The challenge is ensuring those patients can access care quickly. Traditional referrals often require patients to navigate insurance networks, long waitlists, and uncertain availability independently.
For Dr. Sherman, the impact of the access gap became clear during a defining moment in her practice. “A patient of mine had recently [died by] suicide, and I was eager to find an accessible and reliable resource for our patients.” The experience underscored the need for an operational pathway to connect patients with support without delay.
The issue was systemic: limited specialty services and fragmented referral pathways. What Essex OB/GYN needed was a reliable, insurance-covered model that could function within the realities of a busy obstetric practice and respond promptly when needs were identified.
Why Essex County OB/GYN Chose FamilyWell, a Collaborative Care Model
When Dr. Melissa Sherman began searching for a solution, she was focused on practicality. Any partnership would need to function within the workflow, reimbursement structure, and patient population of a busy OB practice.
Her prior experience shaped her expectations. “I had worked with peer coaches in my role as the medical director of a perinatal substance use program, so I recognized that a program including peer coaches could be impactful and effective.” She had seen how structured, non-clinical support could strengthen engagement and complement medical care. That familiarity made the collaborative care model credible from the outset.
Insurance coverage was essential. “I also felt strongly that any program we partnered with had to provide coverage through insurance, including Medicaid (Mass Health).” For a practice serving patients across insurance types, including Medicaid, access had to be equitable. A program limited to self-pay would not meet the needs of the patient population.
Timeliness was equally important. “Finally, having care that was accessible within a few days would be a major positive change for our patients.” In obstetric care, mental health needs are often identified during routine visits. A system that can respond within days supports continuity and reduces the risk that patients fall through the cracks.
For Essex OBGYN, the collaborative care model aligned with three clear criteria: familiarity with peer coaching, insurance-backed access, and rapid follow-up. Together, those elements made integration feasible and sustainable within everyday practice.
Operational Rollout: Billing Structure and Team Education
Introducing a new care model into an established OB practice raises operational questions, and Essex OB/GYN was no exception. One of the first considerations was billing.
“There was definitely a learning curve in terms of the billing — most OB practices have never used collaborative care codes,” Dr. Sherman explains. For many obstetric practices, collaborative care reimbursement structures are unfamiliar territory. Understanding documentation requirements, care coordination components, and insurance workflows requires coordination between clinical and billing teams.
At Essex OB/GYN, that adjustment was manageable. Dr. Sherman notes that her team “rose to the occasion and figured everything out with FamilyWell’s help.” The process required collaboration and education, but not the construction of new infrastructure from scratch. With guidance and support, collaborative care billing became integrated into the practice’s routine operations.
Clinical education was another important part of the rollout. Although Dr. Sherman had prior experience working alongside peer coaches, the broader team needed time to understand how this role fit within treatment planning and patient communication. As she shares, “While I was familiar with peer coaching, it took a little time for my colleagues to understand how peer coaches fit into the treatment plans and to be able to discuss this effectively with patients.”
That adjustment period was not a barrier so much as part of the natural evolution of adopting a new model. As clinicians grew more comfortable explaining the role of coaches and how collaborative care functioned, the integration became more fluid.
For OB practices considering similar partnerships, Essex OB/GYN’s experience highlights a key takeaway: billing education and team alignment are part of implementation—but with structured support and clear communication, they are solvable challenges rather than enduring obstacles
What Changed in the First Few Months
Once the collaborative care model was operational, the shift was noticeable almost immediately. For Dr. Sherman and her team, the dominant feeling was relief.
“It was a huge relief to finally have perinatal mental health care readily available for the majority of our patients,” she shares. Instead of navigating waitlists or uncertain referral pathways, the practice had a consistent, structured follow-up process.
The workflow itself was straightforward. “All we had to do was send a message to our embedded care manager, and the patient had a follow-up and a plan of care within a few days.” That simplicity mattered. It meant that once a need was identified during an OB visit, the next step was clear—and timely.
The model also introduced a stronger sense of shared responsibility. “We greatly appreciated the regular meetings with the care team,” Dr. Sherman explains. “It really felt like a collaborative effort to care for our patients.” Rather than referring out and losing visibility, the OB team remained connected to the behavioral health plan.
Patients responded positively as well. According to Dr. Sherman, “Patients loved their therapists and coaches and felt well supported.” Having access to timely, insurance-covered care reduced the burden on patients to find providers independently and created a more cohesive experience.
The embedded care manager played a central role in making the system work. “Our care manager was immensely helpful in finding additional resources for patients when needed,” she notes. That added layer of coordination ensured that patients were not only assessed and engaged, but also connected to broader supports when appropriate.
In the first few months, what changed was not just access, but predictability. The practice moved from fragmented referrals to a defined, collaborative pathway that could be repeated consistently across patients.
What Problems FamilyWell Helps Solve Today
For Essex OB/GYN, the impact of integrating collaborative mental health care is visible in daily workflow and patient follow-through.
Before the partnership, referrals often meant uncertainty. As Dr. Sherman describes it, “We no longer are limited to handing lists of therapists to patients and wishing them luck in finding a provider who took their insurance and had an opening.” That approach placed the burden on patients to navigate insurance barriers, waitlists, and availability on their own.
Today, the process is defined and reliable. “We can provide a warm handoff to FamilyWell and be assured that the patient will shortly be assessed and engaged in ongoing care,” she explains. Instead of hoping a referral converts into treatment, the practice initiates a structured pathway with clear follow-up.
The scope of support has also expanded beyond perinatal mood and anxiety concerns. “FamilyWell has ensured that we have timely, accessible, and affordable mental health support for our perinatal patients as well as patients who need additional support with pregnancy loss, infertility, and perimenopause.” This breadth enables the OB practice to address the full spectrum of behavioral health needs that commonly arise in women’s health care.
Importantly, the partnership has proven durable. “I am grateful for the care FamilyWell has provided for our patients for the past three years and look forward to continued collaboration to improve women’s behavioral health care options for OB/GYN practices.”
Over time, the consistency has remained: patients are assessed quickly, care is coordinated, and the OB team remains connected to the behavioral health plan.
