With the goal of improving perinatal mental health care, the Los Angeles County Maternal Mental Health Access (LAMMHA) program is funded by The California Health Care Foundation (CHCF) to support Los Angeles County community health centers in the identification and treatment of common perinatal mental disorders. TCC Family Health (TCC) and St. John’s Community Health (St. John’s) joined LAMMHA as part of the second cohort. During their two-year participation, they received intensive on-going support and training to implement and sustain the evidence-based collaborative care model (CoCM) used to treat common mental health conditions in primary care. As they near the end of their LAMMHA support period, their clinical teams reflect on the experience and impact of implementing CoCM with their perinatal patient populations.
Why did your organization join the LAMMHA project? What were some of the benefits of your participation?
St. John’s: LAMMHA gave us the tools, structure, and support we needed to make perinatal mental health an integrated part of primary care. It’s been a game changer for our team and our patients. LAMMHA has helped us reframe how we talk about maternal mental health. It’s no longer an “add-on,” it’s part of how we care for every patient. This shift has not only improved patient outcomes but has empowered our team to feel more confident and connected in their roles.
For the first time, I felt like someone saw what I was going through—and knew how to help me.”
– St. John’s Perinatal Patient
TCC: TCC understands that pregnancy and postpartum are among the most vulnerable times in a woman’s life. We joined the LAMMHA project to expand our outpatient program and incorporate a service that would allow us to provide longer-term treatment through a comprehensive and collaborative team approach including doctors, psychiatrist and behavioral health case managers (BHCMs). This partnership enabled us to deliver the level of care these women truly deserve. Through the LAMMHA program, patients have been able to connect with a BHCM, a doctor, and a psychiatrist. These are providers who are well-trained and deeply knowledgeable about the unique challenges faced by pregnant and postpartum mothers.
I finally felt seen and truly taken care of for the first time.”
– TCC Perinatal Patient
What were some of the challenges you experienced during LAMMHA implementation? What is planned to sustain the CoCM model of care?
St. John’s: It was challenging at first, new processes always are, but once we saw the impact on our patients, the team was all in and, with time, everything came together. We plan to sustain LAMMHA CoCM by integrating it into our standard clinical workflow and ensuring ongoing training for new and existing staff.
TCC: One of the challenges was implementing the PHQ-9* questionnaire during sessions, as it often felt like it would take up most of the time – leaving little room for actual “therapy work.” To address this, we began sending the questionnaires via email a few minutes before the session. This allowed patients to review and complete it in advance, making the process quicker and more efficient. To sustain the model, we plan to consistently engage our LAMMHA providers and the broader team by reinforcing the importance of maintaining a steady flow of referrals. We will also continue holding bi-weekly internal team meetings to address challenges, track progress, and ensure the effective implementation of the program moving forward.
Are there any insights and tips you can share for other organizations that may be interested in implementing CoCM?
St. John’s: Be patient as building trust across clinical and behavioral health teams takes time, but it’s worth it. Also, lean into the support offered through the LAMMHA program partners. Their expertise makes the difference.
TCC: Do it. The Collaborate Care Model (CoCM) offers incredible benefits. It fosters a strong, mission-driven team of providers who are truly invested in patient care. It also improves communication and coordination, allowing the team to function as a cohesive unit. Ultimately, CoCM enhances the delivery of high-quality comprehensive services to patients.
Working with LAMMHA has been an incredible learning experience. As a mom of two toddlers, I’ve gained so much—not just for my patients, but also for myself as a mother. It truly excites me to know that a collaborative, integrative program like this exists—one that prioritizes patient care and brings much needed attention to such vulnerable and crucial time in a woman’s life.”
– Brenda Gonzalez, Behavioral Health Care Manager (BHCM), TCC
The LAMMHA program has ignited a deep passion in me to serve the perinatal population. It has broadened TCC’s understanding of the unique challenges faced during this vulnerable yet beautiful stage in a woman’s life. It has provided us with training and effective, patient-centered interventions. And most importantly, it has strengthened our trauma-informed approach by emphasizing the power of collaborative care.”
– Brenda Gonzalez, Behavioral Health Care Manager (BHCM), TCC
*Patient Health Questionnaire (PHQ-9) is a diagnostic tool used to screen adult patients in a primary care setting for the presence and severity of depression.
During the two-year program, the participating LAMMHA clinics receive intensive on-going support and training to implement and sustain CoCM. For more information, please visit the CCALAC LAMMHA program page and see our previous blog posts on the LAMMHA program and the LAMMHA ECHO series. For more information and resources around maternal mental health in California, please visit the California Department of Public Health – Maternal Mental Health page.
*LAMMHA program partners: Community Clinic Association of Los Angeles County (CCALAC), Elevation Health Partners (EHP), Maternal Mental Health Now (MMHN), Concert Health, University of Pennsylvania (UPenn), University of California, Los Angeles (UCLA) and the Department of Psychiatry and Behavioral Sciences at the University of Washington (UW).
Co-authors:
Brenda Gonzalez
Behavioral Health Care Manager
TCC Family Health
Heather Alexander
Program Director
St. John’s Community Health
Cassia Brockway, MPH
Practice Transformation Consultant
Elevation Health Partners
Melinda Vredevoogd, MS
Assistant Director for Research & Evaluation
Division Population Health, Department of Psychiatry & Behavioral Sciences
University of Washington School of Medicine