Infant Mental Health Implementation and Advisory Group minutes: 19 February 2020

Minutes from the meeting of the group on 19 February 2020.


Attendees and apologies

Author

  • Alex Brown

Present

  • Anne McFadyen, (Chair), Perinatal Mental Health Network (PMHN) Infant Mental Health Lead PMHN Managed Clinical Network (MCN)
  • Marita Brack, Programme Director Psychology of Parenting, NHS Education for Scotland (NES)
  • Alex Brown, Programme Support Officer, National Services Scotland (NSS)
  • Elaine Clark, PMHN Nurse Lead, PMHN MCN
  • Iona Colvin, Chief Social Work Advisor Children and Families Directorate, SG
  • Lynn Cuddihy, Clinical Nurse Manager, NHS Dumfries & Galloway
  • Andrew Dawson, Professional Lead for Child Psychotherapy, NHS Greater Glasgow & Clyde (GGC)
  • Matt Forde, National Head of Services, NSPCC Scotland
  • Rachel Love, Public Affairs Officer, NSPCC Scotland
  • Hugh Masters, Chair Perinatal & Infant Mental Health (PNIMH) Programme Board, SG
  • Nashwa Matta, Associate Specialist in Paediatrics, NHS GGC / Royal College of Paediatrics and Child Health
  • Stephen McLeod, Children and Young People’s Mental Health Programme Board (CYPB), SG
  • Lesley Metcalf, PNIMH Senior Programme Manager, NSS
  • Juan Perez-Olaizola, Consultant Child and Adolescent Psychiatrist, Royal College of Psychiatrists, NHS Forth Valley
  • Alison Robertson, Consultant Clinical Psychologist, Maternity and Neonatal Services, NHS GGC
  • Harriet Waugh, Senior Policy Manager, Perinatal and Early Years Mental Health, SG

Apologies

  • Maria Docherty, Executive Director, Nursing, Midwifery and Allied Healthcare Professionals
  • Linda Jardine, Director, Children and Family Services, Children First
  • Karen Lamb, Interim Head of Specialist Children’s Services, NHS GGC
  • Helen Minnis, Professor of Child and Adolescent Psychiatry, University of Glasgow
  • Liz Nolan, Assistant Director, Aberlour Child Care Trust
  • Clare Thompson, Participation Officer, PNIMH Programme Board Maternal Mental Health Scotland

Items and actions

Welcome, apologies and introductions

Anne McFadyen (Chair) welcomed everyone to the second Infant Mental Health Implementation and Advisory Group (IMH-IAG) meeting. Introductions were made around the table and apologies noted as above.

Discussion of terms of reference and membership

The Chair acknowledged that the terms of feference had been finalised and approved by the group. She informed the group that Harriet Waugh and Ruth Christie had agreed to look into more social work representation, and Hugh Masters had reached out to Claire McGuire to join the membership as a Health Visitor representative.

Elaine Clark suggested having midwifery representation on the group and it was agreed that H.Masters would speak with Best Start when they next met.

Action: H.Masters to connect with Best Start regarding midwifery representation.

Juan Perez-Olaizola suggested having an adult mental health representative on the group and agreed to speak with colleagues at the Royal College of Psychiatrists in Scotland

Action: J.Perez-Olaizola to connect with colleagues at RCPsych regarding adult mental health representation.

The group reviewed and approved the minutes from the 10 December 2019 meeting.

Programme Board Delivery Plan update paper

The Chair invited H.Masters to provide an update on the progress of the PNIMH programme board 2019/2020 Delivery Plan. He referred to the update paper which had been circulated with the meeting papers. H.Masters informed the group that the Health Minister had expressed approval for progress so far and was enthusiastic about upcoming actions. He explained that the 2020/2021 Delivery Plan was currently with the Programme Board for comment, and a finalised version would be released in March.

Iona Colvin mentioned that delivering the recommendations of the Independent Care Review would be a major government policy focus, and all relevant IMH-IAG work needed to link to the Review and contribute to its delivery. She suggested H.Waugh link with policy colleagues regarding strategic plans and the implications of joined up service development to the independent care review.

J.Perez-Olaizola gave approval for the plan but asserted that it had a perinatal focus and needed to further include infant mental health. H.Masters agreed and explained that perinatal services had been more operational, and infant mental health services were currently less structured. Matt Forde suggested there should be an Infant Mental Health Delivery Plan as detailed as the Programme Board plan. A.McFadyen agreed and suggested creating a draft for the next meeting.

Action: A.McFadyen and H.Waugh to draft action plan and key linkages for 22 April.

MCN/NSPCC mapping

The Chair and Rachel Love provided an update on the PMHN MCN and NSPCC coproduced report on mapping of parent-infant intervention and support services in Scotland. The Wellbeing for Wee Ones report brings together scoping notes from each regional area, and reports onwhat specialist services and support for infant mental health currently exist. R.Love explained that they had been able to engage with the Lead Family Nurse from every area, and the Health Board Executive Leads would be provided with the report for their region when it was available later in February. The report will be sent to the IMH-IAG when published.

R.Love informed the group that an initial assessment of the data showed need for wider engagement and support surrounding the broader adversities that children and families face. She asserted that, in general, the report seemed to indicate satisfactory performance of universal services, with the main gaps being the lack of parent-infant intervention services.

Work-plan updates

Paediatric population and pathways

The Chair invited Nashwa Matta to speak on the impact of infant physical health, including prematurity, on parent mental health and parent-child interaction. N.Matta asserted that close interaction between parent and infant from birth are integral to the child’s emotional, physical and cognitive development. Issues with self-regulating emotion, communication and empathy can be found in infants who have spent long periods in hospital without the opportunity to form a close relationship with the parent/care-giver.

N.Matta informed the group that a minimum of 1,800 infants in Scotland each year were at risk of their physical health at birth forming a barrier to a close bond with the mother/parent. She suggested expanding education and training for primary care teams on the impact of prematurity on infants and parents, and creating a base-line of IMH training for all levels – medical students, hospital staff, Health Visitors and parents.

There was group discussion on complex parent-infant relationships, and it was agreed that many women and babies could fall through gaps in service if midwives and medical staff were unsure about the available care pathways, and if the parents felt unable to overcome the stigma often associated with mental health issues.

Training

The Chair invited Marita Brack to provide the group with an update on education and training developments. M.Brack informed the group that two modules (including Keeping the Baby in Mind) of the specialist Essential Perinatal resource were currently with designers, and would be live on TURAS by the end of March. The five remaining modules were to be completed by June.

M.Brack explained that the 0-36 months programme, as part of the Curricular Framework, had launched on the NES website. The three to five years program was still being reviewed, and would be available in the next few weeks.

M.Brack told the group that sustained Solihull training in some Health Boards was quite poor, and there was a need for a piece of work on available access and a sustainable implementation plan. The group agreed that developing training packages was important but retention of trained staff was also key to development of services.

A.McFadyen asserted that advanced IMH Solihull training should be implemented across services. E.Clark suggested that the postgraduate Health Visitor program could be influenced to include Solihull training. I.Colvin recommended developing an initial action plan, then establishing the workforce needed for implementation. In response to a question it was confirmed that trainings can be accessed by non-NHS staff but this needed to be more widely communicated.

Action: A.McFadyen to meet with M.Brack and NES team to consider next steps.

Progress reports from Fife and Lanarkshire

The Chair provided an update from NHS Fife and NHS Lanarkshire, who had received funding in the 2019/2020 financial year.

She informed the group that Lanarkshire had well embedded infant mental health services, and were thinking innovatively regarding training rollouts and telehealth for Health Visitors.

Local authorities in Fife had a strong IMH focus but the necessary service structures were not currently in place, and there needed to be further consultation with social work teams and Health Visitors.

The group agreed that the progress of Fife and Lanarkshire should be monitored to help inform future distribution of funding and potential service development in the other Health Boards. The Chair informed the group that Judith Gemmell and Moira Shulman from NHS Fife and Graham Shulman from NHS Lanarkshire had been asked to update the group at the next meeting.

Regional Model/board readiness

The Chair asked the group to consider how the different regions of Scotland may need varying funding and services, and how borders and budgets can cause difficulties in nationwide implementation.

The group agreed that an IMH specific action plan needed to be decided, and then evaluations of current and previous work could inform initial steps. M.Forde and I.Colvin indicated that cross local authority and health board borders work had been successful in relation to other areas.

AOCB

It was agreed that J.Perez-Olaizola and Andrew Dawson would meet with H.Waugh and Helen Minnis to discuss evaluation and impact data.

Action: J.Perez-Olaizola, A.Dawson, H.Minnis and H.Waugh to discuss evaluation and impact.

Next meeting: 22nd April 2020, 14:00-16:00 at the Lighthouse, Glasgow.

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