Infant Mental Health Implementation and Advisory Group minutes: 26 August 2020

Minutes from the meeting of the group on 26 August 2020.


Attendees and apologies

Present

  • Anne McFadyen,(Chair),Infant Mental Health Lead, Perinatal Mental Health Managed Clinical Network / Perinatal and Infant Mental Health Programme Board
  • Marita Brack, Programme Director, Psychology of Parenting, NHS Education for Scotland
  • Alex Brown, Programme Support Officer, National Services Scotland
  • Andrew Dawson, Professional Lead for Child Psychotherapy, NHS Greater Glasgow & Clyde
  • Matt Forde, National Head of Services, NSPCC Scotland
  • Linda Jardine, Director, Children and Family Services, Children First
  • Katy Lister,Perinatal and Early Years Mental Health Team, Scottish Government
  • Hugh Masters, Chair Perinatal & Infant Mental Health (PNIMH) Programme Board, Scottish Government
  • Nashwa Matta, Associate Specialist in Paediatrics, NHS Greater Glasgow & Clyde / Royal College of Paediatrics and Child Health
  • Helen Minnis Professor of Child and Adolescent Psychiatry, University of Glasgow
  • Liz Nolan, Assistant Director, Aberlour Child Care Trust
  • 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 Greater Glasgow & Clyde
  • Harriet Waugh, Senior Policy Manager, Perinatal and Early Years Mental Health, Scottish Government

In attendance

  • Rod FinanAttending on behalf of Iona Colvin, Professional Social Work Advisor, Scottish Government
  • Rachel Fraser, Clinical Psychologist, Scotland Coordinator, Parent Infant Foundation
  • Joanne Smith, Policy Manager, NSPCC

Apologies

  • Iona Colvin, Interim Director and Chief Social Work Advisor Children and Families Directorate, Scottish Government
  • Lynn Cuddihy, Clinical Nurse Manager,NHS Dumfries & Galloway
  • Karen Lamb  Head of Specialist Children’s Services, NHS Greater Glasgow & Clyde
  • Stephen McLeod, Children and Young People’s Mental Health Programme Board, Scottish Government

Items and actions

Welcome, apologies and housekeeping

Anne McFadyen (Chair) welcomed everyone to the fourth Infant Mental Health Implementation and Advisory Group (IMH-IAG) meeting, and apologies were noted as above.
Anne advised that Shona McCann would be joining the group as midwifery representation, and as a representative from the Perinatal Mental Health Managed Clinical Network when Elaine Clark retires from her post.

Review of minutes and outstanding actions

The group agreed that the June minutes were an accurate representation of the meeting.

Juan Perez-Olaizola advised that he was waiting to hear from his colleagues at the Scottish Royal College of Psychiatrists regarding their thoughts on joining the group as adult mental health representation.

Chair’s update

The Perinatal & Infant Mental Health (PNIMH) Programme Board has engaged in virtual visits to each Health Board in Scotland. It is clear that some boards have not yet begun to address the request by the Cabinet Secretary for the development of the infant mental health (IMH) agenda. The visits have offered a good opportunity to begin these conversations and, in other areas, plans are developing with structures and governance in place.

The PNIMH Delivery Plan, published on 3 July, set out three waves of IMH funding, and supporting funding information for Boards developed by Scottish Government details timelines for these waves. Health Boards have until 4 September to submit proposals for Wave two.

The Parent Infant Foundation have been involved in the collection of evidence on the impact of COVID-19 on the mental health and wellbeing of babies and parents. Findings from the report, Babies in Lockdown, highlight the lack of support for families and the inequalities in babies’ early experiences. It was noted that Scotland seemed to fare better in places, for example, confidence in accessing help with mental health was highest in Scotland with almost two fifths (38%) feeling confident in being able to access support.

Perinatal and Infant Mental Health (PNIMH) Programme Board update

Hugh Masters gave an update on the work of the PNIMH Programme Board since the IMH-IAG last met. He acknowledged the work that had been able to continue during the response to COVID-19, and emphasised that the team were progressing all action areas possible.

Recent highlights include:

  • the launch of the 2020-21 PNIMH Delivery Plan on 3 July included two distinct perinatal and infant mental health action plans to focus the work in each area, and acknowledge the intrinsic overlap in the mental health of mothers, infants and their families
  • Hugh, Anne and PNIMH Programme Board core team have met virtually with Health Boards across Scotland to discuss progress with PNIMH service development and funding in 2020 to 2021. Funding proposals would focus on community perinatal mental health teams, maternity and neonatal psychological interventions, and infant mental health services.
  • the Programme Board and others have worked with Inspiring Scotland to assess and rank the many applications to the Third Sector Fund. £1 million of funding has been granted to the successful organisations
  • Clare Thompson, in her role as Participation Officer for the Programme Board, has developed an Experts by Experience reference group. Members of the group have been involved in Board visits and the Third Sector fund decision making panel
  • NHS Education for Scotland (NES) have continued to develop training resources for the healthcare workforce. The Essential Perinatal modules, including ‘Keeping the Baby in Mind’, are available on TURAS
  • the Family Fund, which provides funding to families of women staying in Scottish Mother-Baby Units for travel and accommodation, will be officially launched after the final sign-off of the Terms and Conditions and advertising information
  • the Peer Support Report will be published in October, and a roundtable event is being organised with the Minister for Mental Health to discuss the report and how to put the findings into action

Applications for funding

Harriet Waugh advised that the regional Health Boards had been asked to submit their bids for 2020 to 2021 IMH funding by 4 September. NHS Fife and NHS Lanarkshire, the wave one Boards, were asked for bids to expand on their current services and ongoing work. The other regional Boards were asked to submit applications for Wave two, if they considered themselves ready for funding this financial year, or expressions of interest for wave three.

NHS Education for Scotland update

Marita Brack submitted an update paper on the NES IMH training system.
Marita advised the group that –

  • 40 practitioners were currently undertaking the NES IMH online training, through Warwick University IMH online. NES had begun the tendering process for the next online host for the training, and hoped to have another 20 practitioners start the course by January 2021
  • the Solihull Approach foundation level training had started to be delivered remotely, with more virtual training sessions planned through the rest of the year
    at the time of the meeting, the Solihull Approach Online had had over 6000 participants
  • NES have finalised the IMH training plan, and completed quality assurance processes to ensure all elements of the training are robust and have a solid evidence base, and are implementable within the Scottish context. The main priorities from the training plan include
  • meeting with the Health Visiting Leads in Scotland to look at the training needs of Health Visitors across all Health Board areas, in relation to the Solihull Approach Foundation Level Training. It is important that practitioners are identified that could be trained as trainers in the Solihull Approach in order to develop a sustainable model for the implementation of the Solihull Approach in their regions
  • starting to connect with colleagues in specialist PNIMH services to discuss their workforce needs and progress their staff development in relation to education and training before the end of March 2021
  • starting recruitment for 10 practitioners to apply for a Masters level programme in psychoanalytic theory, infant and child observation and reflective practice, which is currently going through a tendering process. These practitioners should be working with mothers and babies so they can actively start implementing their training. The programme is aimed to start in January 2021, so recruitment needs to be rapid. Further information will be shared with this group as soon as possible

COVID-19 response update

Rod Finan gave an update on behalf of Iona Colvin. He advised that the joint hubs formed by the Chief Social Work Advisors Office, the Children and Families Directorate and the Learning Directorate in the original response to COVID-19, had kept in close contact with stakeholders and agencies delivering services through lockdown. There was concern that a large group of children would not be able to be contacted whilst schools and other child care services were closed. The referral figures began to increase as lockdown eased, and there is likely to be a surge as services start making contact with families again. 

Rod advised that work had re-started on the Chief Medical Officer’s taskforce for rape, sexual assault and child sexual abuse. Work had also been revived on children who are affected by parental substance misuse. National Child Protection guidance was being completed, and would soon be going out for consultation.

Work on the policy and practice guidance for Getting It Right For Every Child (GIRFEC) had been paused because many colleagues within the GIRFEC unit had been transferred to other areas of Scottish Government due to COVID-19.

Action seven feedback

Nashwa Matta gave a short presentation to update the group on a survey of Health Visitors being conducted by colleagues from the University of the West of Scotland. The survey aims to collect data on the physical needs of infants who have faced early adversity, and the impact of this adversity on the parent-infant relationship. So far 160 Health Visitors have responded, and the survey remains open for another few weeks.

Nashwa advised that baseline training was needed across all professional areas, not solely within maternity and other perinatal mental health services. The development of an escalation service was required, as some Health Visitors were unaware of the care pathways for babies and mothers with specialist needs. Alison and Nashwa continue to work on the pathway for these vulnerable infants. It was also noted that the funding for Maternal and Neonatal Psychological Intervention services would help provide clinical input to these vulnerable babies.

Evaluation Group feedback

Helen Minnis submitted an updated proposal to the group. Helen advised that Susan Galloway, NSPCC, was undertaking a needs assessment in Lanarkshire that would be complimentary to a qualitative research project which will form part of the work of the Evaluation subgroup. Susan had made progress finding sources of quantitative data to map out the groups of children in Lanarkshire that might need an IMH service. Data access applications had been made, and completed quantitative data would hopefully be available by the end of October.

Helen advised that she would get in contact with relevant courses at the University of Glasgow to invite students to take part in limited pieces of qualitative research to determine gaps and collate information from the quantitative data. Assuming that student recruitment was successful, a mixed methods report should be available in May 2021.

AOB

The Chair advised that the Perinatal Mental Health Managed Clinical Network was developing an IMH Forum to be launched at the end of November. This would join the four already established clinical forums run by the Network. The Chair invited the group to share ideas on what they wanted to see from the forum, and topics to be addressed.

Next meeting: 28th October 2020.

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