Infant mental health: evidence review

Conclusions and Recommendations

A number of considerations should be undertaken before applying infant mental health measures within clinical practice. The need for accessibility, sensitive and reliable measurement, as well as time, cost and access constraints are all important factors for choosing an appropriate measure. Evidence from both the literature and 'on the ground' interviews suggest that IMH services are gaining momentum and engagement with families is progressing somewhat successfully. The main conclusions of this report and recommendations for future consideration are listed below and fall under four main headings.

Increase awareness and understanding of infant mental health across the wider public, and particularly among families and clinical and social care staff

Infant mental health is a relatively new area of psychology clinical practice, as the current development of new services demonstrates. An understanding of what IMH is and how to recognise IMH issues is critical to ensuring successful engagement with families and infants who would benefit from the services on offer. A shared language that is easy to understand and accessible to all is one way to support this aim, for example, the language used within the Getting it Right for Every Child (GIRFEC; Scottish Government, n.d.) approach encompasses mental health language that is easy to understand. Engagement with families, as well as other adults who are routinely in contact with families is critical to spreading a shared understanding of IMH issues.

Support communication across statutory and third-sector services

Interviews with the IMH clinical teams at NHS Fife and NHS Lanarkshire have evidenced that different approaches are being taken across Scotland in developing IMH services. While both teams have reported potential achievements in their own approach, nonetheless they did support the idea of joined up communication across Scotland, allowing the flow of ideas and resources to be shared. Partnerships between statutory services and charities can be useful in bringing teams together to produce a picture of what development looks like across the nation.

Support communication with child mental health services (e.g., 3-5 years) as well as 5+ (e.g., CAMHS)

The foundation of all mental health trajectories starts in infancy (Cicchetti & Rogosh, 1996) and so an understanding of IMH issues is important in understanding child and adolescent mental health. An awareness of developmental needs will ensure that mental health issues in infancy and beyond are approached correctly. Supporting communication between child mental services at all ages will provide families with critical support as their children grow and will ensure that children are not lost in the gaps between different service providers.

Revisit NHS boards regularly to clarify how service development is proceeding and what impact it has had on IMH priorities

Service development is currently underway across all NHS boards in Scotland. Regular meetings to hear updates on the development and maintenance of these services is critical in ensuring that the services are successful. Challenges will always arise – some will be temporary whereas others may continue to be a problem. Revisiting boards to understand what measures they are using, and importantly why they believe these measures are appropriate can highlight both the challenges and successes within the service, leading to greater support where it is needed most. Meaningful evaluation processes should be developed to ensure that boards are measuring outcomes that are beneficial to staff and families.