PIRIMID Tool
Integrating digital screening with pathways to care
PIRIMID is a clinician decision support system developed by the Parent-Infant Research Institute (PIRI) to help bridge the gap between perinatal depression screening and effective care.
PIRIMID stands for Perinatal Identification, Referral and Integrated Management for Improving Depression and is delivered through a four step electronic process that supports clinicians in making informed and timely decisions following screening.
In 2025, PIRI completed a cluster randomised controlled trial in partnership with the City of Whittlesea, Beyond Blue, PANDA and the University of Melbourne. The trial evaluated the acceptability and effectiveness of PIRIMID in improving treatment uptake after screening for depression at postnatal Maternal and Child Health appointments. Papers are currently in preparation.
The PIRIMID screening process
PIRIMID consists of four steps that guide clinicians through the development of a management plan that can be discussed directly during the consultation. After completing Step 1, clinicians progress through Steps 2 to 4 where EPDS results, risk factor information and other relevant data are integrated to help determine appropriate treatment options. PIRIMID automatically generates a clear, one page management plan that can be printed or saved directly into clinical notes. The plan can be used to guide care within the service or provided as a referral to a GP, psychologist or other specialist.
Step 1
Review and Interpret Screening Results
The first screen on the clinician’s desktop displays the EPDS summary scores and accompanying psychosocial information.
On screen prompts support interpretation by highlighting key issues and encouraging clinicians to consider whether follow up is required, such as a diagnostic assessment for depression or anxiety, or a more detailed risk assessment.
An alert appears if the suicidality item is elevated.
Because screening tools do not provide a diagnosis or a full risk evaluation, clinicians are prompted to undertake further assessment when indicated.
Step 2
Integrate Clinical History and Screening Results
PIRIMID provides a structured proforma for clinicians to enter relevant clinical information, including current concerns, presenting issues and any pre existing mental health history.
This information is combined with the electronic screening results to build a more complete clinical picture.
On screen information bubbles and best practice guidance offer immediate access to evidence based support, helping clinicians interpret the results in context and make informed decisions with confidence.
This step ensures that both screening data and clinical judgement work together to guide the next stage of care.
Step 3
Formulate the Clinical Picture
PIRIMID uses an evidence based decision tree that aligns with the National Perinatal Mental Health Clinical Guidelines to help clinicians develop a clear formulation of the presenting issues.
Drawing on EPDS results, psychosocial information, clinical history and any further assessments completed, clinicians are supported to identify the main areas of concern and the level of care required.
This step brings all available information together to form a coherent understanding of the client’s needs, which then guides the development of the management plan.
Step 4
Generate Referral and Management Plan
After the clinician selects the appropriate type of professional care, such as referral to a GP or psychologist, PIRIMID automatically generates a structured and personalised management plan.
The plan outlines recommended care options and provides direct links to validated e mental health treatments, including PIRI’s evidence based and nationally accredited MumMoodBooster programs for pregnant and new mothers, which are available on MumSpace and funded by the Department of Health.
Clinicians can also incorporate their own referral networks or services listed in the COPE Directory, ensuring that the plan reflects both evidence based pathways and local service options.
WHY IS PIRIMID NEEDED? |
THE PIRIMID SOLUTION |
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Most mums who are identified as depressed are not treated |
Perinatal depression is often missed, and even when identified, many women do not receive the care they need. Only forty percent of women experiencing depression are recognised during routine care. Of those, only one in four receive adequate treatment. This means most women who are identified through screening do not reach appropriate care pathways. |
PIRIMID provides clear, step-by-step guidance to support evidence-based pathways to care. When implemented alongside routine screening, PIRIMID helps services align with the National Perinatal Mental Health Clinical Guidelines and improves follow-through from screening to treatment.
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Integrating screening & pathways to care is vital |
Screening helps identify women at risk of perinatal depression, but screening alone does not reduce mental health morbidity. Improvement only occurs when screening is directly linked to clear pathways to evidence-based care. |
PIRIMID is integrated into the back-end of an electronic screening tool that includes the EPDS and psychosocial questions. It supports clinicians to undertake further assessment when needed and guides referral to appropriate care through an evidence-based decision tree. Clinicians can access referral options through existing networks, or other local services.
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Assisting professionals to find the help mums need |
Linking PIRIMID with an electronic screening tool gives clinicians practical, step-by-step support to identify the most appropriate care pathway. This helps ensure that women who screen positive are connected with timely and suitable treatment options. |
PIRIMID brings together EPDS scores and psychosocial information into a single clinician dashboard.
It provides on screen alerts for high risk results and guides clinicians through the recommended next steps. Clinical history and screening results are integrated to support a holistic assessment. A structured management plan is then generated, tailored to the client’s needs, with clear onward referral options. |