Insights From Research to Routine: Professor Jeannette Milgrom’s research

Before perinatal mental health screening became routine, identification often depended on who a woman saw - and whether screening occurred at all. Detection was inconsistent, variable across services, and many women went unseen.

The research of Jeannette Milgrom fundamentally changed that landscape. Her work at the Parent-Infant Research Institute (PIRI) demonstrated that perinatal depression was highly prevalent and often under-detected. She showed that systematic screening using validated tools such as the Edinburgh Postnatal Depression Scale (EPDS) was essential for reliable identification, and that screening should be routine, standardised, and embedded within clinical care rather than opportunistic (Milgrom & Gemmill, 2014; Milgrom et al., 2005). 

This work laid the foundation for an evidence-based approach to perinatal mental health – one that prioritised early identification, consistency, and measurable outcomes.

Building on this clinical foundation, Milgrom partnered with David Stanley, who had previously achieved digitisation of the EPDS in the United States. This partnership marked a critical point of innovation, enabling screening to move from paper-based assessment to scalable, reliable digital practice. Digital delivery supports repeated assessment across pregnancy and postpartum, plus it eliminated common sources of human error inherent in manual scoring (Clarke et al., 2024). 

Paper-based screening, while foundational, introduced variability, with studies demonstrating scoring inaccuracies of up to 28% due to manual calculation and interpretation. Transitioning to digital screening remove this variability, enabling 100% scoring accuracy, while simultaneously reducing clinician administrative burden and time spent on scoring and documentation.

As a midwife, I remember administering the EPDS on paper, interpreting each score in real time, and trying to make sense of what it meant for women – often within already time-pressured clinical environments. What once relied on individual clinician effort and interpretation has now evolved into system-supported, integrated care. 

Through sustained collaboration with health departments, hospitals, and community services, the proven Diginostic Health Platform has been embedded into health system infrastructure and clinical workflows. Screening is no longer a standalone task – it is integrated within electronic medical record systems, enabling seamless documentation, longitudinal tracking, and coordinated care pathways.

The system-wide approach delivers more than efficiency. It enables:

• Preventive screening, identifying risk earlier – before escalation to more severe mental health concerns
• Equitable access, with multilingual screening, improving accessibility for diverse populations
• Connected care, linking women directly to digital and in-person support services aligned with their level of need
• Universal, repeatable screening, ensuring no woman is missed across the care continuum

The tools have evolved. The systems have matured. Though the intent remains unchanged: early identification, consistent monitoring, and better outcomes for women and families.

What began as Milgrom’s research and Stanley’s digital innovation now underpins national-scale perinatal mental health screening – a powerful example of evidence translating into practice through collaboration and innovation, at scale.