Closing the loop in perinatal mental health care in China.

With growing policy attention to childbirth support, early childhood development, and mental health capacity in China, perinatal mental health should be more fully integrated into routine maternal and child health care. Yet current services often prioritize screening coverage without ensuring reliable linkage to assessment, intervention, referral, and follow-up. We argue for a shift from fragmented screening to closed-loop perinatal mental health care. The proposed framework comprises standardized identification and risk stratification, workforce-supported stepped care, longitudinal and family-oriented monitoring, and accountability mechanisms that shift quality measurement from screening completion to pathway completion. Embedding these functions within routine services could strengthen continuity, equity, and responsiveness across China's maternal and child health system and support healthier beginnings during the first 1000 days.