Joint Strategic Board for Children and Family Mental Health minutes: November 2023

Attendees and apologies

Present:

• Nicola Dickie, Director of People Policy, Convention of Scottish Local Authorities (COSLA) (co-Chair)
• Stephen Gallagher, Director of Mental Health, Scottish Government (co-Chair)
• Judy Thomson, Director of Psychology, National Health Service (NHS) Education Scotland
• Hannah Axon, Policy Manager, COSLA
• Haylis Smith, National Delivery Lead, Suicide Prevention
• Cheryl Kremer, Education Officer for Health and Wellbeing, Education Scotland
• Gillean McCluskey, Director of Centre for Research in Education, Inclusion and Diversity, University of Edinburgh
• Suzanne Sheilds, Clinical Manager, Neurodevelopmental Service, NHS Lanarkshire
• Simon Webster, Director of Policy Programmes, Coalition of Care and Support Providers in Scotland
• Des Murray, Chief Exec North Lanarkshire Council, Lead for Education, Solace
• Stephanie Phillips, Director of Transformation, Strategy, Planning and Performance, NHS24
• Jane Ford, Principal Public Health Intelligence Adviser, Public Health Scotland
• Ellen Moran, Principal Education Psychologist, Association of Scottish Principal Educational Psychologists
• Carsten Mandt, Senior Programme Manager, Perinatal Mental Health Network
• Lorna Aitken, Senior Education Officer for Health and Wellbeing, Education Scotland
• Jaki Lambert, Director (Scotland), Royal College of Midwives
• Cheryl Burnett, Chair, National Parent Forum of Scotland
• Kimberley Tweed, Vice-chair, National Parent Forum of Scotland
• Joanne Smith, Chair, Parent and Infant Mental Health Scotland and National Society for the Prevention of Cruelty to Children (NSPCC) Scotland
• Amanda Farquharson, Child and Adolescent Mental Health Services (CAMHS) Service Manager, NHS Grampian
• David Mackay, Head of Policy, Children in Scotland
• Karen Lamb, Head of Specialist Children’s Services, NHS Greater Glasgow and Clyde
• Selena Gleadow-Ware, Chair, Perinatal Psychiatry, Royal College of Psychiatrists
• Angela Davidson, Deputy Director, Mental Health, Scottish Government
• Anne McFadyen, Professional Adviser, Perinatal and Infant Mental Health, Scottish Government
• Stephen McLeod, Professional Adviser, Directorate for Mental Health, Scottish Government
• Mairi Macpherson, Deputy Director, Children and Families, Scottish Government

Apologies:

• Matt McDonald, Head of Policy and Public Affairs, Scottish Youth Parliament
• Emma Currer, National Officer (Scotland), Royal College of Midwives
• Tracy Johnston, Senior Education Officer for Health and Wellbeing, Education Scotland
• Alison Sutherland, Head of Support, The Promise Scotland

Secretariat and Observers:

• Maggie Fallon, Unit Head, Children, Young People and Families Mental Health, Scottish Government
• Ruth Christie, Unit Head, Children, Young People and Families Mental Health, Scottish Government
• Georgia de Courcy Wheeler, Team Lead, Unit Head, Children, Young People and Families Mental Health, Scottish Government
• Peter Innes, Policy Manager, Children, Young People and Families Mental Health, Scottish Government
• Harriet Waugh, Team Lead, Children, Young People and Families Mental Health, Scottish Government
• Carolyn Wales, Policy Manager, Children, Young People and Families Mental Health, Scottish Government
• Chloe Duffus, Team Lead, Children, Young People and Families Mental Health, Scottish Government
• Leon Young, Secretariat, Children, Young People and Families Mental Health, Scottish Government
• Annemieke Bikker, Secretariat, Children, Young People and Families Mental Health, Scottish Government

Items and actions

Welcome and introductions

Nicola Dickie (ND), as Chair, welcomed everyone to the meeting and thanked them for their attendance. Stephen Gallagher (SG) was introduced as the new Director for Mental Health, and Co-Chair of the Joint Strategic Board for Children and Family Mental Health (JSB).

The purpose of holding a ‘meeting zero’ for the JSB was outlined: to present current thinking around a new Board, provide an opportunity for stakeholders and partners to shape next steps, and consider what their role in the Board might be.

Context setting (Paper 1)

Maggie Fallon (MF) and Ruth Christie (RC) presented a context setting paper (paper 1). The paper and presentation provided an overview of work to date on perinatal, infant, children and young people’s mental health, including the commissioning and responses to a number of reports on children and family mental health. An overview of the work and progress of the most recent boards set up to support children and family mental health was also provided - the Perinatal and Infant Mental Health Programme Board (PNIMH-PB) and the Joint Delivery Board for Children and Young People’s Mental Health (JDB), which both ended in Spring 2023.

Discussion

• the decision to set up a new board that will bring together perinatal, infant, children and young people’s mental health was welcomed
• there was some discussion on the need for services to be designed in response to evidence, and in response to local need
• it was agreed that membership with appropriate representation across different disciplines would be important for the JSB, and aid in ensuring work is not taken forward in silos. It was noted that membership of the Board should allow some flexibility to bring in new members as the Board’s work evolves and/or if gaps in representation appear
• the importance of lived experience and the voice of children, young people and families in the work of the Board was also noted

Scope and priorities (Paper 2)

Hannah Axon (HA) presented an overview of the purpose of the JSB, its suggested scope and four priority areas that had been identified through the work of the PNIMH-PB and JDB. The four proposed priority areas are: 

• crisis support - identifying and acting on gaps in crisis support
• prevention - considering socioeconomic impacts and looking at prevention in the early stages of occurrence (early intervention)
• children and families in vulnerable situations - focus on children, young people and families with experience of care, or on the edges of care
• mental health support for pregnancy and early years - preconception to 5 years old

The proposed scope of the Board was presented. HA acknowledged that this a complicated process – bringing together two previous boards, and taking into account the Mental Health and Wellbeing (MHW) Delivery Plan and Workforce Plan. An initial suggestion on potential work across the priorities was provided in Paper 2, annex A. HA noted that there is also a need to ensure that the JSB is also a space where emerging issues can be raised, and actions taken forward in response to new and emerging issues. It was also noted that not all  PNIMH-PB and JDB recommendations (or MHW Delivery and Workforce Plans actions) are for the JSB to take forward. Some are already complete/business as usual, underway or out-with the priority areas proposed.

It was proposed that the JSB would take on an advisory role on how recommendations could be taken forward in the current context and budget. This could be supported by implementation groups tasked with taking forward specific actions to completion or implementation, reporting back to the JSB. There is also a need to ensure that the JSB utilises and works with other groups already in the system, rather than recreating or duplicating efforts. HA also noted that the JSB would be positioned as part of the overall governance for the Mental Health and Wellbeing Strategy and Delivery Plan.

Discussion

• the scope, focus and priorities proposed for the JSB were well received, and the four priorities identified were supported

• Haylis Smith (HS) added that the Suicide Prevention Strategy (and suicide prevention work) should also be considered in relation to these priorities, noting the prevalence of suicidality in the perinatal period. The group agreed that, although complex, it is important that the JSB draws different strands of work together, as well as avoiding duplication or replication of work being taken forward elsewhere. Neurodiversity was raised as another example of an area that could be threaded through the four priorities, along with family support.
• there was some discussion about how, within the scope and priorities, the JSB could make the most progress against outcomes. Stephen McLeod (SM) suggested that the Board could focus on actions that would have the greatest impact, and emphasised the importance of young people, families and lived experience in guiding those decisions, ensuring that they have an equal voice.

The importance of inclusion of the lived experience of postnatal and pregnant women as part of this was highlighted 

• Selena Gleadow-Ware (SG-W) brought attention to the importance of language – ensuring that it is clear maternal and parental mental health is captured, and that language is inclusive and reflects gender diversity of families
• SG-W also noted that the JSB taking a life cycle approach to its work offered important framing, helping to ensure that the voice of children, young people and parents is considered across all priorities e.g. when considering support for care experienced young people, consideration would also be given to parents at risk of their children being taken into care  
• Mairi Mcpherson (MM) highlighted the connection between the JSB’s proposed remit and the Early Child Development Transformation Programme, which recognises how broad early child development is, cutting across the whole of public policy. MM noted that connections are already being made across this work at Scottish Government official level
• there was also agreement that a whole systems approach should be taken across the priorities. Cheryl Burnett (CB) add that ‘communication’ should also remain a key consideration – ensuring parents and carers are able to access transparent and clear information – reflecting that NPFS representatives are routinely signposting parents to support

Actions

• Scottish Government Children and Families colleagues to share Early Child Development Transformation Programme ‘theory of change’ with new JSB, when formed

Approach to Outcomes (Paper 3)

Jane Ford (JF) provided the group with a presentation on the intended approach to setting outcomes for the work of the JSB. Previous work across the PNIMH-PB and JDB highlighted the importance of the Board having an early, collective understanding of the outcomes it is seeking to achieve. In its early meetings, the JSB will be able to agree its intended outcomes.

As part of the presentation, JF highlighted the intention to develop an outcomes framework that takes into account the existing outcomes and outcomes frameworks across the landscape, e.g. from the JDB, PNIMH-PB, MHW Strategy, and the National Performance Framework.

It was proposed that the JSB’s outcomes framework should provide enough consistency and coherence to support the JSB in focussing its work, while retaining an element of responsiveness to flex and adapt to emerging evidence and issues.

Discussion

• the group were in agreement that measurable outcomes should be set out from the start, and with the general approach set out in JF’s presentation, including building on the work and approaches already underway
• HS highlighted the Suicide Prevent Strategy’s outcomes framework as another framework to consider as part of this work. HS shared that it has been a challenge to connect an outcomes focussed approach with delivery, but this is being worked through and learning could be shared from suicide prevention with the JSB
• there was some discussion about the route from outcomes to implementation and delivery, and the importance of being able to identify what change is needed, has been made, and whether there has been any impact. Harri Waugh (HW) also noted the importance of proportionate measurement, and the need to balance this with high quality evidence. JF added that there is also a lot of evidence and evaluation already available, which should be used by the Board too

• the group recognised that some of the issues arising across the four priorities will connect with other areas of policy, and/or sit out with mental health policy. This will need to be carefully considered to ensure that stakeholders do not have expectations beyond what the JSB can achieve, and become disappointed or disengaged
• it was agreed that officials would further develop a proposed outcomes framework for the JSB’s consideration

Actions

• PHS, COSLA and Scottish Government officials to develop an outcomes framework for the JSB’s consideration at its first meeting

Wrap up

Georgia de Courcy Wheeler (GdeCW) provided an overview of next steps in setting up and progressing the Board. This will include refining the scope, developing a terms of reference and agreeing Board members. Officials will progress the agreed action on further development of an outcomes framework for the Board’s consideration.

David Mackay (DM) highlighted the need to ensure that children and young people are given appropriate time to contribute, and that space should be created that is inclusive for children and young people. All agreed that inclusion of lived experience, children, young people and families is critical to the work of the JSB.

Close

The first full meeting of the Board is planned for early 2024. Attendees were invited to contact the secretariat if they wished to discuss any items from the meeting further, or to suggest Board members.