Perinatal and Infant Mental Health Programme Board closing meeting minutes: 22 March 2023

Attendees and apologies

Author

• Alex Brown, Assistant Programme Manager, NHS National Services Scotland

Present

• Hugh Masters, Chair, Perinatal and Infant Mental Health Programme Board, Scottish Government
• Anne McFadyen, Chair, Infant Mental Health Implementation and Advisory Group, Scottish Government
• Roch Cantwell, Vice Chair, Perinatal and Infant Mental Health Programme Board, Scottish Government
• Leanne Anderson, Fund Manager, Inspiring Scotland
• Lizzy Archibald, Service Development Advisor, Scottish Government
• Hannah Axon, Policy Manager, COSLA
• Rach Barlee, Participation Officer, Parent and Infant Mental Health Scotland
• Alex Brown, Assistant Programme Manager, NHS National Services Scotland 
• Helen Cheyne, Professor of Maternal and Child Health Research, University of Stirling
• Ruth Christie, Co-Head, Children, Young People and Families Mental Health, Scottish Government
• Emma Currer, National Officer, Royal College of Midwives
• Andrew Dawson, Professional Lead for Child Psychotherapy, NHS Greater Glasgow and Clyde
• Aman Durrani, Consultant Perinatal Psychiatrist, NHS Greater Glasgow and Clyde
• Selena Gleadow-Ware, Consultant Perinatal Psychiatrist, Royal College of Psychiatrists
• Sheila Gordon, Director, CrossReach
• Sarah Hallam-Stewart, Change and Improvement Manager, NHS Fife
• Sally Ann Kelly, Chief Executive, Aberlour
• Lisa Malcolmson, Regional Nurse Consultant, NHS Grampian
• Carsten Mandt, Senior Programme Manager, Scottish Perinatal Network, NHS National Services Scotland
• Nashwa Matta, Associate Specialist in Paediatrics, NHS Greater Glasgow and Clyde
• Susan McConachie, Regional Nurse Consultant, NHS Lothian
• Helen Minnis, Professor of Child and Adolescent Psychiatry, University of Glasgow
• Lucy Morton, Scotland Development Lead, Parent-Infant Foundation
• Juan Perez-Olaizola, Consultant Child and Adolescent Psychiatrist, NHS Forth Valley
• Cathy Sexton, Director, Fathers Network Scotland
• Marie Claire Shankland, Programme Director, NHS Education for Scotland
• Helen Sloan, Nurse Consultant, NHS Greater Glasgow and Clyde
• Joanne Smith, Policy and Public Affairs Manager, NSPCC Scotland
• Harri Waugh, Perinatal and Early Years Mental Health Team Lead, Scottish Government

In attendance

• Sally Amor, Consultant in Public Health, NHS Ayrshire and Arran
• Scott Arnot, Service Manager, NHS Grampian
• Emma Cormack, Mental Health Senior Policy Adviser, Scottish Government
• Ross Cowan, Policy Officer, Perinatal and Early Years Mental Health Team, Scottish Government
• Alastair Douglas, Administrative Officer, Perinatal and Early Years Mental Health Team, Scottish Government
• Kelsey Sclater, Policy Officer, Perinatal and Early Years Mental Health Team, Scottish Government
• Meg Ferguson, Fund Support Officer, Inspiring Scotland
• Joy Nisbet, Head of Programme, Parenting and Infant Mental Health, NHS Education for Scotland

Items and actions

Introduction to closing meeting

Hugh Masters (Chair) welcomed everyone to the formal closing meeting of the Perinatal and Infant Mental Health Programme Board (PB) and the Infant Mental Health Implementation and Advisory Group (IAG). Introductions were made as above.

Review of minutes and updates

The minutes were agreed as accurate representations of the December 2022 PB meeting and the January 2023 IAG meeting, and would be made available on the Scottish Government (SG) webpage.

• the SG Mental Health Strategy and Coordination Team are working on a second draft of the revised Mental Health Strategy, which will be shared with stakeholders for feedback, and are aiming to publish a final version in late Spring 2023. PB Leads and the SG Perinatal and Early Years Mental Health policy team will continue to meet with the Strategy team to provide input on how perinatal and infant mental health should be central to the refreshed strategy. The Mental Health Workforce Action Plan is due to be launched later in 2023
• the Chair met with Heads of Midwifery and Obstetrics to discuss the implications of the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) report, published in November 2022, which showed a worrying increase in suicides particularly amongst teenage mothers. PB Leads and the SG Perinatal and Early Years Mental Health policy team will continue to engage with Suicide Prevention and Self Harm policy colleagues
• SG Drugs Policy will be taking forward establishment of the ‘Supporting Women, Reducing Harm’ short life working group, which will include the Mental Health and Children and Families directorates
• PB Leads, in consultation with the Perinatal Mental Health Regional Nurse Consultants  and the Health Boards, are developing a guidance paper for regional approaches to specialist community perinatal mental health service provision
  Post-meeting note: The paper was shared to PB and IAG members with the meeting minutes, and will be made available on the SG webpage
• the perinatal peer support resource being developed by the Scottish Recovery Network is due to be launched at the end of April 2023
• the Peer Support Evaluation Toolkit, created in partnership by Inspiring Scotland, Evaluation Support Scotland, and 13 peer support organisations, has been published
• See Me Scotland and the Mental Health Foundation have been working in partnership to produce Good Practice Guidelines in relation to perinatal and infant mental health stigma, alongside revisiting the evidence review carried out by a SG School of Social Sciences intern in 2020. Feedback from the PB on initial drafts has been incorporated, and challenges and indicators have been identified for each of the seven guidelines in the document. At the time of the meeting, engagement with people with lived experience and coproduction around the guidelines was ongoing. This resource is due to be launched by the end of April 2023
• the Voice of the Infant Best Practice Guidelines and Infant Pledge were published and announced by the Minister for Mental Wellbeing and Social Care on 22nd March 2023. Anne McFadyen (IAG Chair) encouraged everyone to disseminate as widely as possible and to feed back about which organisations have been contacted, to monitor and sustain the impact of the resource
• development of the Infant Rights Statement is ongoing, and dependent on the United Nations Convention on the Rights of the Child (UNCRC) receiving Royal Assent. Anne and others continue to engage with Children’s Rights policy colleagues and the Children and Young People’s Commissioner Scotland (CYPCS)

Working together after March 2023 – Ongoing work and priority areas

Integration

The Chair stated that the progress and successes of the PB, which had been established for four years (April 2019 to March 2023), should now be integrated into the SG Mental Health Strategy and wider Mental Health policy. Roch Cantwell (PB Vice Chair) and Anne McFadyen will continue to lead this workstream alongside the SG policy team until formal governance structures are in place. There was discussion around work planning and accountability, and Roch emphasised the importance of sustaining and maintaining progress whilst focusing on integration.

The Chair reiterated that funding for statutory perinatal and infant mental health services would continue, and funding for third sector services had been extended until March 2024.

Sally Ann Kelly (Chief Executive, Aberlour) highlighted the continuing uncertainty around funding of third sector perinatal and infant mental health projects and there was discussion on the challenges of integrating decision making across service sectors during the lifetime of the PB.

There was group discussion around protecting the perinatal and infant mental health workforce and ensuring that capacity is not directed to other services, such as Adult Mental Health. Harri Waugh (SG Policy Team Lead) acknowledged the concern around losing progress already made and provided reassurance that the future of this distinct workstream would be linked into the outcomes of the revised Mental Health Strategy, and the SG transforming early years programme of work.

Education and Training

Marie Claire Shankland (Programme Director, NHS Education for Scotland (NES)) advised that NES continue to work on the Essential Perinatal and Infant Mental Health modules, rollout of specialist teams, and Champions training. Other ongoing profession specific projects include; training for Nursery Nurses around birth trauma pathways, work with Nursing, Midwifery and Allied Health Professions (NMaHP) colleagues on trauma, and considerations around neurodiversity.

There was discussion around the need for further undergraduate and post-graduate training opportunities for the future perinatal and infant mental health workforce, and for clear training and career pathways to make posts more attractive and support workforce retention.

Evaluation

Helen Cheyne (Chair of the PB Monitoring and Evaluation subgroup) advised that Public Health Scotland (PHS) are taking forward the PB evaluation, to be published in 2024. Two of the seven evaluation studies have been externally commissioned to ScotCen.

The Chair emphasised the importance of the evaluation in evidencing the impact of PB work, and there was discussion on the need for evaluation of all elements of PB funding, including the third sector.

The Infant Mental Health Evaluation and Research Group, chaired by Helen Minnis (University of Glasgow), are planning an in-person meeting in September 2023, and hope to coproduce an infant mental health intervention for parents with a social worker. It was agreed that the SG policy team would meet with PHS, Helen Cheyne and Helen Minnis to discuss the Evaluation workstream going forward.

Final thoughts and feedback

There was discussion on neurodivergence amongst parents and the increase in requests for ADHD diagnoses in perinatal mental health services. The group acknowledged that the NHS was facing increasing demand across the board and emphasised the need for further third sector support.

Roch mentioned that the Perinatal Mental Health Network Scotland (PMHNS) were rolling out the Powerapp, a national data set to help services monitor increasing trends. It was noted that infant mental health is not covered in this data set.

Acknowledgements and closing remarks

The Chair thanked everyone for attending the closing meeting, and for their input into the work of the PB and IAG since 2019. Specific thanks were given to the Parent and Infant Mental Health Scotland (PIMHS) Participation Officers, the chairs of the PB and IAG subgroups, and the SG Perinatal and Early Years Mental Health policy team.

Ruth Christie (SG Workstream Lead) thanked the Chair for his enthusiasm and drive over the past four years and the group wished him all the best in his retirement. Ruth also thanked Roch Cantwell and Anne McFadyen for their integral leadership roles and their support with this programme going forward.