Perinatal and infant mental health services: update

Introduction

Statutory Services

The Perinatal and Infant Mental Health Programme Board has invested in the development of:

Mother and Baby Units (MBUs)

MBUs provide highly specialist mental health care to the small number of women and their infants who experience severe perinatal mental health difficulties. MBUs can admit women during pregnancy and at any point up until the infant's first birthday. They are open to all women across Scotland, based on clinical need and not geography.

Community Perinatal Mental Health Teams (CPMHTs)

CPMHTs are multidisciplinary teams of health professionals such as Psychiatrists, Mental Health Nurses, Occupational Therapists and Psychologists and teams vary in size. They provide specialist mental health care to women across Scotland from pre-conception through to an infant's first birthday.

Infant Mental Health Teams (IMH)

IMH teams are multidisciplinary teams of health professionals such as Child Psychotherapists, Psychologists, Parent-Infant Therapists and Occupational Therapists and teams vary in size. They provide specialist infant mental health care to infants and families across Scotland from conception to age three years.

Maternity and Neonatal Psychological Interventions Teams (MNPI)

MNPI teams usually include health professionals such as Psychologists and Perinatal Mental Health Midwives, who provide support and psychological interventions to parents/carers. They support them with emotional difficulties related to complications during pregnancy, birth and neonatal inpatient care.

The diagram below outlines the changes in community statutory services in Scotland between 2019 and 2022. Community services for perinatal and infant mental health encompass:

• Community Perinatal Mental Health Teams (CPMHTs)
• Infant Mental Health Teams (IMH)
• Maternity and Neonatal Psychological Interventions Teams (MNPI)

Lived Experience

The Perinatal and Infant Mental Health Programme Board works with two Participation Officers who aim to support the integration of lived experience in an evidence based and respectful manner. This lived experience work seeks to span across the lived experience of infants, parents and caregivers with a focus on equality, intersectionality and rights. It is a critical part of both initial service development and ongoing service provision.

The Participation Officers have worked with Health Boards across Scotland in a variety of ways (phone calls, virtual meetings, on-site visits, participation and engagement training workshops) on how to respectfully engage with people with lived experience of perinatal mental health difficulties. Key learning from the Participation Officers in lived experience engagement in the development of services has been captured below.

Successes

There has been engagement with all Health Boards. "Respectful Engagement with Lived Experience" workshops have been developed and are being delivered to Boards. Engagement has included a focus on promoting Voice of the Infant and third sector engagement.

Challenges

There has been some difficulty with meaningful early and coordinated engagement with Health Boards. Levels of knowledge, awareness, and training of staff on equality and diversity has also been varied between Boards. Confusion around remuneration mechanisms has also presented a barrier, as has the need to deliver training online due to Covid-19.

Variation across Scotland

There have been different roles across different areas facilitating engagement (lived experience lead, engagement officer, clinicians and managers). Alongside this, there has been variation in those seeking active involvement of lived experience and passive feedback. There has also been different levels of engagement with service users, those outside statutory services and with groups with protected characteristics.

Third Sector

Since launching in October 2020, the Scottish Government's Perinatal and Infant Mental Health Fund has provided up to £1m per annum to charities to support them to deliver vital mental health services to families across Scotland. The Fund is delivered by Inspiring Scotland and is split across two portfolios. The Main Grants aims to support the delivery of key services and address gaps in provision. It supports 16 charities with an average award of £58,000. The Small Grants focuses on small and medium organisations and, over an 18-month period, supported 18 charities with an average award of £11,500. For a map of where services are located in Scotland, see Annex 1.

Find Support Near You - Perinatal and Infant Mental Health Third Sector Directory

Charities deliver a range of services including peer support, parenting support and counselling and the collective work of all funded organisations contributes towards the fund's five outcomes as shown in the infographic below.