Promotion, prevention and early intervention (PPEI) are now part of the jargon in health policy statements, but accommodating this in conventional health and mental health services is proving difficult. Effective collaboration across services in mainstream health, psychiatry, other social agencies and into the community is not easily accomplished. One fundamental problem is that the terms: “early intervention” and “mental health” are defined differently by different disciplines and specialties; another is that underlying issues for the woman and family are poorly understood. In addition, there are many silos, stakeholders, egos and agendas, and much competition for funds. For best PPEI results in the perinatal field, these barriers must be overcome. An inclusive model of service delivery being implemented in both public and private health systems in several States in Australia will be described and the resistances discussed.