Neonatal Follow-up Programs (NFUPs) lack integrated parental mental health services, despite a higher prevalence of anxiety, depression, and posttraumatic stress (PTSD) among attending parents. A convergent parallel mixed-methods design was used to answer (1) to what extent do NFUP parents have unmet mental health needs, and (2) what are parent and service provider perspectives on barriers and opportunities to increase access to mental health services? In Study 1, parents attending a Manitoba NFUP (N = 49) completed a mixed-method online survey through REDCap. Quantitative (analyzed descriptively) and qualitative data (analyzed through conventional content analysis) were integrated to elucidate parents’ mental health, related service use, barriers to service use, and service preferences. In Study 2, NFUP service providers (N = 5) participated in one of two focus groups via Zoom to discuss service improvements to address parents’ mental health service needs (analyzed using reflexive thematic analysis). The perspectives of both samples were integrated and reported using a narrative approach. Parents endorsed 2 – 4 times higher prevalence of clinically significant depression (59.2%), anxiety (28.6%), and PTSD (26.5%) than the general postpartum population. However, most parents were not using mental health services (55.1%) predominantly due to resource insecurity (e.g., time, cost, childcare, staffing, referrals). Identified service improvements include bridging the gap between services by screening for anxiety, depression, and PTSD, and developing online platforms to provide psychoeducation and peer support groups for support during stressful transitions. Future research employing the findings is warranted to improve generalizability and inform a national approach to addressing unmet parental mental health needs in NFUPs.