Skip to main content

Perinatal mental health and psychosocial risk screening in a community maternal and child health setting: evaluation of a digital platform

  • Nicole Highet (a1) (a2), Jenny Gamble (a3) and Debra Creedy (a4)

Screening women for depression and psychosocial risk during the perinatal period is recognised best practice. Screening by current pen and paper methods can be time consuming, and prone to scorer error. The lack of readily available translated versions of screening tools also excludes many women from different cultures.


To evaluate a perinatal mental health digital screening platform, iCOPE. The trial was conducted in a community maternal and child health setting in Melbourne, Australia.


A descriptive, cohort design was used. All women attending the urban clinic were invited to complete their routine perinatal screening on the digital platform, designed to automate score calculations and produce instant clinical and client reports whilst collecting data in real time. Screening included the Edinburgh Postnatal Depression Scale (EPDS) and psychosocial risk questions in line with current national clinical guidelines. Functionality of iCOPE was assessed according to duration of screening, completion rates, accuracy of reporting and level of engagement by women.


During the trial, 144 screens were performed. The mean screening time was 6.7 min (SD=3.78). Most (65.7% n=94) women took between 3 and 6 min. Mean EPDS score was 7.2 with 16% (n=23) scoring 13 or more. The accuracy of reports was 100% and screening completion rate was 99.3%. Many women (81.3%) requested a copy of their personal report.


The iCOPE platform was efficient in terms of screening time, scoring accuracy, and engagement of women. The automated production of tailored client and clinical reports enabled screening outcomes to be instantly communicated to women and health professionals. The collection of data in real time facilitated the monitoring of screening rates and evaluation of outcomes by clinicians and service managers.

Corresponding author
Author for correspondence: Dr Nicole Highet, Executive Director, Centre of Perinatal Excellence, 38 Wellington Street, Flemington, VIC 3031, Australia. E-mail:
Hide All
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Association.
Austin, M, Middleton, P, Reilly, N Highet, N (2013) Detection and management of mood disorders in the maternity setting: The Australian Clinical Practice Guidelines. Women Birth 26, 29.
Austin, M-P Highet, N, the Expert Working Group (2017) Mental health care in the perinatal period: Australian clinical practice guideline. Melbourne: Centre of Perinatal Excellence.
Buist, AE, Austin, M-PV, Hayes, BA, Speelman, C, Bilszta, JL, Gemmill, AW, Brooks, J, Ellwood, D Milgrom, J (2008) Postnatal mental health of women giving birth in Australia 2002–2004: findings from the beyondblue National Postnatal Depression Program. Australian & New Zealand Journal of Psychiatry 42, 6673.
Byatt, N, Biebel, K, Moore Simas, TA, Sarvet, B, Ravech, M, Allison, J Straus, J (2016) Improving perinatal depression care: the Massachusetts child psychiatry access project for moms. General Hospital Psychiatry 40, 1217.
Chapman, SL Wu, LT (2013) Postpartum substance use and depressive symptoms: a review. Women & Health 53, 479503.
Commonwealth of Australia (2009) Fourth National Mental Health Plan – an agenda for collaborative government action in mental health 2009–2014 (Priority 2: Prevention and Early Intervention) Canberra: Commonwealth of Australia.
Commonwealth of Australia (2011) National maternity services plan 2010. Canberra: Department of Health.
Cox, JL, Holden, JM Sagovsky, R (1987) Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 150, 782786.
Dennis, C-L Ross, L (2005) Relationships among infant sleep patterns, maternal fatigue, and development of depressive symptomatology. Birth 32, 187193.
Drake, E, Howard, E Kinsey, E (2014) Online screening and referral for postpartum depression: an exploratory study. Community Mental Health Journal 50, 305311.
Gavin, N, Gaynes, B, Lohr, K, Meltzer-Brody, S, Gartlehner, G Swinson, T (2005) Perinatal depression – a systematic review of prevalence and incidence. Obstetrics & Gynnecology 106, 10711083.
Gemmill, AW, Leigh, B, Ericksen, J Milgrom, J (2006) A survey of the clinical acceptability of screening for postnatal depression in depressed and non-depressed women. BMC Public Health 6, 211.
Gordon, M, Henderson, R, Holmes, JH, Wolters, MK Bennett, IM (2016) Participatory design of ehealth solutions for women from vulnerable populations with perinatal depression. Journal of the American Medical Informatics Association 23, 105109.
Highet, N (2016) The truth about womens experiences of perinatal mental health. Melbourne: Centre of Perinatal Excellence (COPE)
Highet, N, Stevenson, A, Purtell, C Coo, S (2014) Qualitative insights into women’s personal experiences of perinatal depression and anxiety. Women Birth 27, 179184.
Highet, NJ Bilbao, F (2014) The perinatal emotional health program: a review of program outcomes and recommendations for sustainability. Melbourne: North Western Mental Health.
Highet, NJ Purtell, CA (2012) The national perinatal depression initiative. a synopsis of progress to date and recommendations beyond 2013. Melbourne: beyondblue.
Kingston, DE, Biringer, A, McDonald, SW, Heaman, MI, Lasiuk, GC, Hegadoren, KM, McDonald, SW, Veldhuyzen van Zanten, S, Sword, W, Kingston, JJ, Jarema, KM, Vermeyden, L Austin, MP (2015) Preferences for mental health screening among pregnant women: a cross-sectional study. American College of Preventive Medicine 49, e35e43.
Le, H, Perry, D Sheng, X (2009) Using the Internet to screen for postpartum depression. Maternal & Child Health Journal 13, 213221.
Matthey, S, Lee, C, Črnčec, R Trapolini, T (2012) Errors in scoring the Edinburgh Postnatal Depression Scale. Archives of Women's Mental Health 16, 117122.
Matthey, S, White, T, Phillips, J, Taouk, R, Chee, TT Barnett, B (2005) Acceptability of routine antenatal psychosocial assessments to women from English and non-English speaking backgrounds. Archives of Women's Mental Health 8, 171180.
Miller, RL, Pallant, JF Negri, LM (2006) Anxiety and stress in the postpartum: is there more to postnatal distress than depression? BMC Psychiatry 6, 12.
National Institute for Health and Care Excellence (NICE) (2014) Antenatal and postnatal mental health: clinical management and service guidance. London: National Institute for Health and Care Excellence.
O’Connor, E, Rossom, RC, Henninger, M, Groom, HC Burda, BU (2016) Primary care screening for and treatment of depression in pregnant and postpartum women: evidence report and systematic review for the US Preventive Services Task Force. Journal of the American Medical Association 315, 388406.
On, ML, Ayre, J, Webster, K Moon, L (2016) Examination of the health outcomes of intimate partner violence against women: State of knowledge paper. ANROWS, Melbourne.
Pineros-Leano, M, Tabb, KM, Sears, H, Meline, B Huang, H (2015) Clinic staff attitudes towards the use of mHealth technology to conduct perinatal depression screenings: a qualitative study. Family Practice 32, 211215.
Queensland Government 2008. Queensland Plan for Mental Health 2007-2017, Mental Health Branch, Queensland Health, June.
Siu, AL, Force, USPST, Bibbins-Domingo, K, Grossman, DC, Baumann, LC, Davidson, KW, Ebell, M, García, FA, Gillman, M, Herzstein, J, Kemper, AR, Krist, AH, Kurth, AE, Owens, DK, Phillips, WR, Phipps, MG Pignone, MP (2016) Screening for depression in adults: US Preventive Services Task Force recommendation statement. Journal of the American Medical Association 315, 380387.
Teaford, D, Goyal, D McNeish, SG (2015) Identification of postpartum depression in an online community. Journal of Obstetric, Gynecologic & Neonatal Nursing 44, 578586.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Primary Health Care Research & Development
  • ISSN: 1463-4236
  • EISSN: 1477-1128
  • URL: /core/journals/primary-health-care-research-and-development
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed