Perinatal mental health equity: patient perspectives on virtual collaborative care providing what women need now in the post-COVID era.

Introduction: The COVID-19 pandemic increased perinatal mental health needs and disrupted routine obstetric care, disproportionately affecting Black and economically disadvantaged communities. Michigan's Perinatal Collaborative Care Model (Peri CoCM), a publicly funded virtual program, launched during the pandemic and continued after the public health emergency. This qualitative study examined participant experiences with Peri CoCM, including perceived usefulness, acceptability, and barriers/facilitators to engagement, particularly among marginalized perinatal people to inform post-COVID service delivery. Methods: Eligible participants were pregnant or up to one year postpartum Peri CoCM patients recruited from a May-July 2025 referral cohort. Nine women ages 27-42 completed one-hour, semi-structured Zoom interviews between August and September 2025; the sample intentionally overrepresented self-identified Black women. Interviews were recorded, transcribed, verified against audio, and analyzed by a coding team using grounded-theory-informed thematic analysis with constant comparison. Results: Participants reported positive experiences with Peri CoCM across four thematic areas: (1) Pathways to care, (2) Perceived impacts of program, (3) Importance of culturally responsive care, and (4) Recommendations for program optimization. Trusted referrals from obstetric and other providers facilitated entry into care, often for anxiety, depression, grief, or first-time mental health support. Participants described Peri CoCM as accessible, supportive, and valuable during pregnancy and postpartum. Virtual options, flexible scheduling, compassionate behavioral health clinicians, and consistent follow-up reduced barriers and promoted openness. The short-term model helped some transition to longer-term therapy, while clinicians supported insurance navigation, medication decisions, and community resource connections. Participants gained coping skills, validation, and self-understanding. They emphasized culturally responsive provider fit and recommended longer continuity, broader wraparound services, and sustained no-cost access to reduce stress and improve engagement. Conclusion: Michigan's Peri CoCM was perceived as a low-barrier, relationship-centered, culturally responsive virtual pathway supporting perinatal wellbeing and systems navigation in the post-COVID era. Cost transparency and flexible delivery were central to acceptability and expanded access to equitable care.