Perinatal mental health services: needs assessment and recommendations

Appendix 2

Scottish Government commitments to perinatal mental health provision

Mental Health Strategy 2017-2027

The 10-year Scottish Government Mental Health Strategy (2017) recognised that improving perinatal mental health care was good, not only for mothers, but also for the health and wellbeing of their children and could contribute to breaking the cycle of poor outcomes from early mental health adversity. Action 16 of the Strategy committed the Government to

“Fund the introduction of a Managed Clinical Network to improve the recognition and treatment of perinatal mental health problems”

Programme for Government 2018-19

‘Delivering for Today, Investing for Tomorrow’, the Government’s Programme for Scotland, published in 2018, detailed the Government’s commitment to developing perinatal mental health services. The programme identified three tiers of service delivery

“We will provide three tiers of support across Scotland, in line with the needs of individuals:

• For those 11,000 women a year who would benefit from help such as counselling we will support the third sector to provide this
• For those 5,500 women in need of more specialist help we will ensure rapid access to psychological assessment and treatment
• For those 2,250 women with the most severe illness we will develop more specialist services and consider the need for a small number of additional inpatient beds or enhanced community provision”

Programme for Government Delivery Plan 2018

‘Better Mental Health in Scotland’, the delivery plan for the Government’s programme, further detailed the commitment to perinatal mental health.

To assist parents in being well equipped to support their children it stated that:

“We will ensure there is sufficient investment in service provision for equitable access to perinatal counselling services, perinatal and infant mental health promotion, and preparation for parenthood for those who need it, including in the third sector. All mental health staff should have the knowledge and skills necessary to promote good maternal and infant mental health, and recognise and manage, to their level of competency, mental distress and disorder.

To do this, by March 2020, we will:

• publish a refreshed Perinatal Mental Health Curricular Framework;
• develop a suite of educational tools to meet workforce needs across all tiers of service provision; and
• develop high quality digital resources for both workers (such as e-learning) and women and families (such as information about perinatal mental health).”

In addition, for those women who need more specialist help, the Delivery Plan stated that:

“We will ensure rapid access to psychological assessment and psychological treatment (PT). There should be sufficient primary care PT services across Scotland so that all women experiencing mild-to-moderate mental health problems in the perinatal period can be assessed and treated in a timely way, in line with maternal and infant mental health needs. Peer support – through group or individual help, and through digital, online or tele-health resources – should be available to all women with mild-to-moderate mental distress or issues.

From the start of 2019 onwards, we will:

• recruit and train primary care psychological therapists; and
• invest in community capacity-building, where individuals who have experienced perinatal mental health problems have an opportunity to support others with similar needs and concerns.”

For those women with the most severe illness, it stated that:

“All women with, or at risk of, moderate-to-severe perinatal mental difficulties, and their families, will have access to specialist mental health community services wherever they live in Scotland. There will be sufficient inpatient mother and baby unit beds in Scotland to ensure that women are admitted with their infants, in accordance with the Mental Health (Care and Treatment) (Scotland) Act 2003.

To achieve this, from the start of next year and over the next five years we will:

• publish the Perinatal Mental Health National Scottish Service Standards and Recommendations Report;
• recruit Specialist Perinatal Mental Health teams in high birth number areas as well as low/ dispersed birth number areas and island Boards;
• develop and implement a model of maternity and neonatology psychological services provision;
• develop a national induction programme for new workers in specialist services;
• review inpatient bed provision; and
• recruit multi-disciplinary staff to provide additional inpatient care or intensive home treatment to serve remote and rural areas.”