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Digital screening for postnatal depression: mixed methods proof-of-concept study.

Emily Eisner1,2, Shôn Lewis3, Charlotte Stockton-Powdrell4

  • 1Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PL, UK. emily.eisner@manchester.ac.uk.

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Summary

A new smartphone app for postnatal depression (PND) screening is feasible, acceptable, valid, and safe for parents. This digital tool improves access to PND assessment and treatment, overcoming barriers of traditional methods.

Keywords:
Digital mental healthFramework analysisMaternal mental healthMixed methodsPostnatal depressionScreeningSmartphonemHealth

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Area of Science:

  • Digital health interventions
  • Mental health screening
  • Perinatal mental health

Background:

  • Postnatal depression (PND) affects 17% of mothers and 9% of fathers, with significant long-term consequences.
  • Suicide is the leading cause of maternal death in the postnatal year.
  • Improving access to PND screening and treatment is crucial for parental and infant well-being.

Purpose of the Study:

  • To develop and evaluate a smartphone application (ClinTouch DAWN-P) for digital screening of PND.
  • To assess the feasibility, acceptability, validity, and safety of the app in a proof-of-concept study.
  • To enhance accessibility of PND screening through a digital platform.

Main Methods:

  • Recruited pregnant women (≥36 weeks gestation) and partners for daily mood monitoring using the Edinburgh Postnatal Depression Scale (EPDS) via the ClinTouch DAWN-P app.
  • Compared app-based EPDS data with standard paper-based EPDS for validity assessment.
  • Evaluated app acceptability and usability through qualitative interviews and the abridged Mobile App Rating Scale.

Main Results:

  • High maternal interest (96%) and sustained app usage (91%) were observed.
  • App-based EPDS showed high agreement with paper-based assessments, accurately identifying likely PND cases.
  • No serious adverse events were reported, indicating the app's safety.

Conclusions:

  • Digital PND screening via smartphone apps is a feasible, acceptable, valid, and safe approach.
  • Remote delivery of digital screening, as demonstrated during the COVID-19 lockdown, enhances accessibility.
  • Digital tools can overcome limitations of traditional health visitor-delivered screening, including staff time constraints and parental reluctance to disclose issues.