Perinatal and Infant Mental Health Programme Board: delivery plan - September 2021 to September 2022

Annex 1 - Summary of 2020/21 Progress for Perinatal Mental Health

2020/21 Perinatal Mental Health Delivery Plan Aims

The Perinatal Mental Health Delivery Plan for 2020/21 was structured around the Women & Families Maternal Mental Health Pledge and had two key strategic action areas for delivery; developing specialist Perinatal Mental Health support across Scotland, and support for the Third Sector.

Area of focus:

1. Develop a raising awareness, promoting understanding and reducing stigma strategy, in conjunction with people with lived experience by end of 2020.

Maternal Mental Health Pledge quote: "I am able to talk about my mental health without fear of being judged."

What we did:

We conducted a literature review focussing on stigma within the perinatal mental health period which has informed the development of our Raising Awareness Strategy which will be published 2021.

The Experts by Experience group is now formally established with a terms of reference developed in collaboration with Perinatal Mental Health Network Scotland. A key highlight of the groups work has been the development of a national database of Perinatal Mental Health experts by experience. In addition, the incorporation of lived experience in service development and provision is now monitored as part of the overall reporting framework.

A communications plan is now in place and we aim to take this forward into 2021/22 to support engagement with stakeholders across Scotland and further afield. This plan will also be used to ensure engagement is meaningful, proportionate and involves lived experience from a variety of perspectives.

Area of focus:

2. Deliver on the Perinatal Mental Health Network Scotland's Delivering Effective Services report (Scottish Government and Perinatal Mental Health Network Scotland, 2019) recommendations for Mother and Baby Unit and community specialist services development for 2250 women and families.

Maternal Mental Health Pledge quote: "I am given advice and care if I have a pre-existing mental health problem."

What we did:

We have provided ongoing funding for staffing at both Mother and Baby Units. Following a review of the available staffing levels and recommendations in Delivering Effective Services we subsequently increased the level of funding to meet recommended levels.

We are currently finalising an options appraisal which will go out for consultation shortly.

We launched the Mother and Baby Unit Family Fund in October 2020. The Family Fund aims to reduce financial barriers that can create difficulties for partners, carers and relatives visiting a Mother and Baby Unit.

We have allocated funding across Scotland for specialist Community Perinatal Mental Health teams. Development of these services and evaluation of the impact of these services on families within Scotland is supported by ongoing contact from Perinatal Mental Health Network Scotland and Programme Board Chair alongside six monthly monitoring.

Area of focus:

3. Deliver on Perinatal Mental Health Network Scotland's Delivering Effective Services report recommendation for psychological therapies service development for 5500 women and families.

Maternal Mental Health Pledge quote: "I will be able to access talking therapies quickly, if I need them."

What we did:

Seven Health Boards have established enhanced Maternity and Neonatal Psychological Interventions supported by investing over £600,000 into services. Future funding and service development needs are currently being scoped out in collaboration with NHS Education Scotland and Scottish Government policy to establish ongoing workforce and training needs are met as the service expands.

Area of focus:

4. Deliver on Perinatal Mental Health Network Scotland's Delivering Effective Services report recommendation for service development for 11,000 women and families

Maternal Mental Health Pledge quote: "My family are given information and support for themselves and to support me."

What we did:

We established a Perinatal and Infant Mental Health Fund for third sector organisations providing non-clinical support to women and families and mechanism for dispersing and governing funding implemented.

The Perinatal and Infant Mental Health Fund was launched in May 2020. Successful organisations announced August 2020 and the Minister did a virtual visit to one of the funded organisations (Amma Birth Companions).

Funding commenced October 2020 and we have provided £665,000 between October 2020 and March 2021 to support 16 third sector organisations to deliver services across Scotland. The Fund will run through to March 2023.

Services funded include Midlothian Sure Start, Aberlour Befriending Service and CrossReach Perinatal Counselling Service in Moray. Overall, the funded organisations have supported an estimated 2030 women and families across Scotland and 100 professionals trained in delivering online counselling and infant observation skills. Evaluation so far has shown that 86% of parents feel less isolated, 86% feel better able to meet the needs of their infants/children, and 89% showed improved ability to maintain a warm and secure relationship with their child.

Health visitors referring in to one of the funded services commented "The clients that have used the service have found the counsellor put them at ease and the sessions extremely helpful."

Area of focus:

5. Support the development of targeted Perinatal and Infant Mental Health support for:

• Fathers, partners, kinship carers.
• Marginalised groups including substance misuse.

What we did:

We are evaluating the considerations for a detailed review of mental health in the perinatal period for fathers and partners.

We published an Equalities Impact Assessment, and a working group has been established with a specific focus on applying the findings of the Impact Assessment to the work of the Programme Board.

We will shortly publish review of service provision across Scotland focusing on substance use during the perinatal period. A multidisciplinary group of stakeholders will consider next steps and recommendations.

Area of focus:

6. NHS Education ScotlandPerinatal and Infant Mental Health curricular framework.

Maternal Mental Health Pledge quote: "I am confident that the staff who care for me have the right knowledge and skills."

What we did:

The NHS Education Scotland Essential Perinatal and Infant Mental Health resource aimed at the Enhanced and Specialist level of the Curricular Framework is now available. This resource provides staff working in specialist perinatal and infant mental health services with the core competencies required to work in this clinical area at enhanced and specialist level. The course is completed online as e-learning modules. NHS Education Scotland is promoting the resource alongside partner organisations, e.g. Perinatal Mental Health Network Scotland, Inspiring Scotland, and is designing follow-on training for specialist teams.

NHS Education Scotland published training plans to address both Perinatal and Infant Mental Health training needs for the workforce.

NHS Education Scotland commissioned a Train the Trainers course, with follow-on support, for Health Visitor and Midwife Perinatal and Infant Mental Health champions. In February, 20 champions from NHS Grampian, NHS Highland, NHS Tayside, and NHS Shetland were trained.

NHS Education for Scotland delivered infant mental health training across universal services and specialist teams, including; Warwick University Infant Mental Health online, the range of Solihull training from foundation to train the trainer, and Video Interaction Guidance training.

Solihull Approach Online had more than 10,000 participants.

An online infant mental health training module was developed for staff working with infants with neonatal complications.

10 additional trainees entered the Clinical Associate in Applied Psychology programme, 5 additional trainees entered the Doctoral Programme in Clinical Psychology, and the Cognitive Behavioural Psychotherapy programme.

Area of focus:

7. Developing Peer support provision

Maternal Mental Health Pledge quote: "My family are given information and support for themselves and to support me."

What we did:

We published The Perinatal Mental Health Peer Support Action Plan in March 2021. To develop the Action Plan we held a stakeholder event that was attended by over 80 representatives of peer support organisations. Co-facilitated by experts by experience we worked with attendees to coproduce the Actions based on the recommendations in the Peer Support literature review. We are now at the stage of implementing actions, including funding projects around the development models of peer support in community and Mother and Baby Unit settings.

Area of focus:

8. Data, measures and evaluation framework developed and in place.

What we did:

We are commissioning an evaluation based on the key priorities identified through the Evaluability Assessment (published March 2021).

Area of focus:

9. Set out workforce planning and sustainability imperatives in Perinatal and Infant Mental Health and consider wider work-force impact including universal services

Maternal Mental Health Pledge quote: "I am confident that the staff who care for me have the right knowledge and skills."

What we did:

NHS Education Scotland have produced the Essential Perinatal and Infant Mental Health resource to support staff development.

The Perinatal Mental Health Network Scotland have developed care pathways to support the development of services providing preconception advice, psychological interventions for mild to moderate mental health problems, specialist assessment and intervention for severe and complex mental health problems, admission to Mother and Baby Units and specialist assessment/intervention for parent-infant relationship difficulties. In addition, role descriptors have been developed to support Boards in their workforce planning.

Area of focus:

10. Innovation – Digital and telehealth

Maternal Mental Health Pledge quote: "I will be looked after by experts, no matter where I live in Scotland."

What we did:

We have rolled out Near Me video consultation platform for Perinatal Mental Health Services in the statutory and third sectors. There is also increased access to other online therapies such as online Cognitive Behavioural Therapy.

Throughout 2020 and 2021 there has been joint working with Parent Club around parents and children's mental health including pregnancy and new baby as well as an e-directory of third sector Perinatal and Infant Mental Health services produced by Inspiring Scotland. Solihull Online was also made available to all parents/carers and practitioners across Scotland.

The supplementary component (the Small Grants Fund) of the Perinatal and Infant Mental Health Third Sector Fund in years 2 and 3 will be dedicated to promoting innovation through support of small organisations and in tackling emerging issues. The Small Grants Fund launched in February 2021 and the funding round closed in July 2021.