Infant Mental Health Implementation and Advisory Group minutes: 13 October 2021

Minutes from the meeting of the group on 13 October 2021.


Attendees and apologies

Author

  • Alex Brown

Present

  • Anne McFadyen, Chair, IMH-IAG, NHS National Services Scotland
  • Lizzy Archibald, Service Development Adviser, Scottish Government
  • Marita Brack, Head of Parenting and Infant Mental Health Programme, NHS Education for Scotland
  • Alex Brown, Assistant Programme Manager, NHS National Services Scotland
  • Roch Cantwell, PNIMH Programme Board Vice Chair, NHS National Services Scotland
  • Andrew Dawson, Professional Lead for Child Psychotherapy, NHS Greater Glasgow & Clyde
  • Rachel Fraser, Scotland Development Lead, Parent-Infant Foundation
  • Linda Jardine, Children and Family Services Director, Children 1st
  • Heather Kelly, Assistant Director,Aberlour
  • Hugh Masters, PNIMH Programme Board Chair, Scottish Government
  • Kat Masterson, Participation Officer, Maternal Mental Health Scotland
  • Nashwa Matta, Associate Specialist in Paediatrics, Royal College of Paediatrics and Child Health, NHS Greater Glasgow & Clyde
  • Helen Minnis Professor of Child and Adolescent Psychiatry,University of Glasgow
  • Wendy Mitchell, Professional Nurse Adviser, Scottish Government
  • Liz Nolan, Deputy Director, Aberlour
  • Sarah Williams, Perinatal and Infant Mental Health National Lead, Home-Start Scotland
  • Fiona Wilson Senior Policy Officer, Perinatal and Early Years Mental Health Team, Scottish Government

In attendance

  • Irene Permaul, Senior Policy Officer, Perinatal and Early Years Mental Health Team Scottish Government
  • Cathy Sexton on behalf of Chris Miezitis Co-Director, Fathers Network Scotland
  • Jane Turner, Infant Mental Health Service Lead, NHS Greater Glasgow & Clyde

Apologies

  • Judith Gemmell, Change and Improvement Manager, NHS Fife
  • Douglas Guest, Head of Development, Home-Start Scotland
  • Chris Miezitis, Co-Director, Father’s Network Scotland
  • Alison Robertson, Consultant Clinical Psychologist, Maternity and Neonatal Services, NHS Greater Glasgow & Clyde
  • Joanne Smith, Perinatal and Infant Mental Health Policy Manager, NSPCC Scotland
  • Harriet Waugh, Perinatal and Early Years Mental Health Team Lead, Scottish Government

Items and actions

Welcome and housekeeping

Anne McFadyen (Chair) welcomed everyone to the tenth Infant Mental Health Implementation and Advisory Group (IMH-IAG) meeting, and apologies were noted as above.

The whole group made introductions, and it was noted that Heather Kelly (Assistant Director, Aberlour) would take over from Liz Nolan on the group membership. Jane Turner was welcomed to the group as the new Infant Mental Health (IMH) Service Lead in NHS Greater Glasgow and Clyde (GG&C).

The Chair advised that comments submitted by the group on the IMH Service Development Guide had been incorporated, and it would be used as a working document going forward.

It was agreed that the minutes were an accurate representation of the August 2021 meeting.

Perinatal and Infant Mental Health Programme Board

Hugh Masters (Chair of Perinatal and Infant Mental Health Programme Board) provided an update on recent developments. On 11 October, the 2021 to 2022 Delivery Plan was published, and the third sector Small Grants Fund was launched. The Minister for Mental Wellbeing and Social Care announced the developments at an in-person meeting with LATNEM, a third sector peer support organisation based in Grampian. In last year’s delivery plan, IMH had a separate action table. In the 2021 to 2022 Delivery Plan, perinatal and infant mental health have been integrated into twelve action areas.

Hugh highlighted upcoming focus areas:

  • developing engagement with Lived Experience with Kat Masterson, new Participation Officer with Maternal Mental Health Scotland
  • progressing the Peer Support Action Plan
  • working with Inspiring Scotland on third sector funding and support
  • monitoring progress and service improvements in the Health Boards and statutory services. Regular meetings with boards in the North of Scotland. Developing guidance around regional structures/posts
  • working on issues around acute specialist inpatient facilities, and developing an options appraisal
  • working with Public Health Scotland on the programme of evaluation, considering the impact of the pandemic and realistic timeframes

Fiona Wilson (Senior Policy Officer, Scottish Government) advised that she and the Chair were finalising a policy position paper to bring all the pieces of IMH work together. The Perinatal and Early Years Mental Health Team are also planning to publish the Raising Awareness Strategy, which is currently being revised to ensure IMH is well represented. A series of snapshot briefs are being developed alongside the strategy, and the first will focus on the Wellbeing for Wee Ones campaign.

Fiona and the Chair advised that work with Parent Club on a suite of marketing materials to get discussion going around IMH, was in the early stages. The group shared ideas on promotional methods, and the Chair emphasised the importance of cross-referencing with work happening in the third sector. Linda Jardine (Children and Family Services Director, Children 1st) suggested that the Wellbeing for Wee Ones website should link directly to Parentline who can provide immediate practical and emotional support, as well as signpost to other online resources.

Andrew Dawson (Professional Lead for Psychotherapy, NHS GG&C) expressed concern about protecting IMH services in the longer term. There is a risk that adults in crisis may take the focus, attention and dedicated resources away from integrated IMH services. Andrew stated that integration was a good idea if there are formalised pathways to flag concerns. The Chair agreed that infants are often overlooked, even within parent-infant therapy services. Wendy Mitchell (Professional Nurse Adviser, Scottish Government) stated that there was a possibility of further developing the recording of the Health Visitor pathway to include child health development assessments.

Coproduction

Kat Masterson (Maternal Mental Health Scotland) introduced herself to the group and explained that she has recently started in post as Participation Officer with focus on IMH, fathers and co-parents, and equalities. Kat’s background is with maternity services and she has chaired the Grampian Maternity Voices Partnership for three years. Through this work, Kat has good awareness of local issues within perinatal services, and is doing research and reading to expand her understanding of IMH services. Kat has a passion for keeping service users at the heart of service design, and ensuring that co-production approaches are front and centre in board planning processes. Kat invited the group to make contact with queries and ideas on IMH co-production and participation.

SIGN guidelines

The Chair advised that Joanne Smith, Perinatal and Infant Mental Health (PIMH) Policy Advisor at NSPCC Scotland, had made a request for group discussion on SIGN guidelines for IMH. The Chair explained there are currently very few SIGN guidelines relating to IMH, early relationships and/or looked after children. On the SIGN website, infants are only mentioned in a guideline about perinatal mood disorders, and there are no search results for ‘attachment’ or ‘relationships’. Joanne has suggested developing a proposal, after finding out about the existing work of other nations.

Roch Cantwell (Vice Chair of PNIMH Programme Board) thought this would be an important and useful development. He stated that developing a new SIGN guideline was a long process but there was good support available.

Marita Brack (Head of Parenting and Infant Mental Health Programme, NHS Education for Scotland) mentioned that the Early Intervention Framework captures a number of IMH interventions that have all been reviewed. Alongside the framework is a self-assessment tool for services to use to see how well any of those interventions might match the needs in their local area. Marita also explained that she was involved with the children and young people part of the Psychological Therapies Matrix review, and would be happy to provide an update at a future IMH-IAG meeting. The IMH guidance within the matrix will be reviewed, and that will involve looking at the high quality interventions available for IMH.

The Chair acknowledged the opinions and reservations of the group, and committed to further consider the discussion ahead of the next meeting.

Action: Anne McFadyen

Perinatal Mental Health Network Scotland

The Chair gave an update on the recent work of the Perinatal Mental Health Network Scotland (PMHNS):

  • a new IMH page will be available soon on the network website, with many useful resources
  • the ‘Supporting Women, Reducing Harm’ report has been published. This is a review of services for substance-using women and their infants in pregnancy and the postnatal period. PMHNS and colleagues from relevant Scottish Government (SG) policy areas are planning a stakeholder event for April 2022
  • the IMH Pathway document is available online. Development of pathway animations has been delayed but should progress quickly now that the design has been finalised
  • Roch Cantwell advised that network newsletters have been replaced by monthly Spotlight Sessions on services developing around the country. The first one will be published in November, and will highlight the IMH service in NHS Fife

IMH Evaluation Subgroup

Helen Minnis (Professor of Child and Adolescent Psychiatry, University of Glasgow) gave an update on the work of the IMH Evaluation subgroup:

  • Fionnghuala Murphy, Higher Trainee in Child and Adolescent Psychiatry, carried out a systemic review on adolescent outcomes for infants with “difficult temperament”, which is being reviewed by the Infant Mental Health Journal. The review highlighted that sensitive parenting, social support for parents and helping parents understand infant temperament seem to be important protective factors
  • Alicia Weaver, a medical student, has led a literature review and qualitative study into attitudes to IMH, which has also been submitted to the IMH Journal. Alicia has found papers about the need for IMH services dating as far back as 1880, but service development has never taken off
  • the subgroup explored views about service development in 13 qualitative interviews with members of the multi-agency stakeholder group supporting the NHS Lanarkshire IMH service developments. A paper is being written on systems and networks, and another on training needs. Five focus groups have been conducted to explore differences in views. The subgroup has plans for future interviews with parent users of relevant third sector services to get information on parents’ views of service development
  • the IMH Needs Assessment report, carried out in NHS Lanarkshire by Susan Galloway and the NSPCC, is now available online
  • Anne McFadyen has written a paper for the International Journal of Infant Observation about the Scottish experience
  • Graham Shulman, Consultant Child and Adolescent Psychotherapist in NHS Lanarkshire, is finalising a report on an IMH indicator set
  • Anne McFadyen contributed to round three of Public Health Scotland’s COVID-19 Early Years Resilience and Impact Survey, which focused on under two year olds
  • the subgroup are connecting with Art at the Start who have published papers about the impact of their work and recently been awarded a prize for community engagement
  • meeting organised in October to discuss focus groups with Deep End General Practitioners on IMH
  • meeting in December with academics working on IMH across the country

Andrew Dawson agreed to present the nearly finalised evaluation plan of the IMH team in NHS GG&C at an upcoming meeting of the IMH Evaluation subgroup.

Action: Andrew Dawson

NHS Education for Scotland

Marita Brack gave an update on recent work of NHS Education for Scotland (NES):

  • over 4300 people have participated in the Essential PIMH modules. Over 60 staff have continued to the follow on training
  • second cohort of 20 practitioners completed the Institute of Health Visiting PIMH Champions training in September, and three more cohorts are hoping to train before the end of March 2022
  • 60 practitioners started the Warwick IMH online training in September
  • Solihull continues to roll out well; five foundation level trainings have happened, and two Train the Trainer sessions
  • 14 people trained in Video Interactive Guidance in June, and NES are hoping to deliver more sessions in December 2021 and February 2022

Any other business

The Chair mentioned that NHS Lanarkshire’s Quality and Improvement Team have been shortlisted for an award by the Children and Young People’s Improvement Collaborative for their Health Visitor advice line.

Next Meeting: Wednesday 15th December 2021

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