Matter: Training, Screening and Community Intervention in Perinatal Mental Health

Introduction: Perinatal mental disorders are a major public health concern and remain underdiagnosed despite their significant impact on women, infants and families. The lack of structured screening, referral pathways, and coordination among primary healthcare, psychiatry, and community services compromises early detection and continuity of care. The Matter programme proposes an integrated implementation model to strengthen perinatal mental healthcare. Methods: This protocol describes a prospective, single- arm, mixed- methods implementation study with a repeated- measures observational cohort, embedded in an action research framework. The intervention comprises four components: (i) sequential digital screening and operational pathway allocation in primary healthcare; (ii) specialised training for health and social care professionals; (iii) multidisciplinary meetings combined with qualitative implementation monitoring; and (iv) development of a digital platform supporting the service- user's care pathway. Participants will complete assessments at 12 and 24 weeks of pregnancy, 4- 6 weeks postpartum, and 6 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS), EQ- 5D- 5L, and a healthcare resource utilisation questionnaire. The study is designed to evaluate reach, uptake, feasibility and care- pathway delivery; without a concurrent comparison group, it is not designed to establish causal effectiveness. Trial registration on ClinicalTrials.gov: NCT07659977 Results: We expect approximately 5600 screening invitations or assessment opportunities over two years. Assuming a planning prevalence of 20%20% for elevated depressive symptoms, approximately 1120 screening events may yield an elevated EPDS result; these are screening events rather than diagnoses or necessarily unique women. The programme also aims to train approximately 324 professionals and implement an integrated digital platform to support screening, referral pathways, and clinical decision- making. The team will evaluate implementation, platform utilisation, participant- reported outcomes, resource use, and within- cohort QALYs. Conclusion: Matter proposes an integrated implementation model linking primary healthcare, psychiatry and community services through digital technologies, specialised professional training and multidisciplinary collaboration. If shown to be feasible, acceptable and capable of achieving the prespecified implementation targets, it may inform the adaptation and evaluation of similar perinatal mental healthcare pathways in other settings.