It is increasingly recognized that perinatal mental health is multifaceted and should not be limited to screening for a possible diagnosis of postnatal depression. This chapter discusses the background to, and role of, psychosocial assessment as a component of universal, mainstream antenatal and postnatal care. It highlights the importance of inquiring about broad risk factors including complex psychosocial comorbidities such as interpersonal violence, substance misuse, and history of adverse childhood experiences (e.g., childhood sexual abuse) which are known to impact on maternal mental health, parenting function, and infant outcomes. Concepts central to the implementation of effective integrated perinatal psychosocial assessment and care, and principles for establishing such programs in well‐resourced primary care settings, are described. Specific consideration is also given to the challenges and complexities associated with the delivery of integrated perinatal mental health care for women living in resource‐constrained settings. Current controversies and future directions are discussed.