Joint Strategic Board for Child and Family Mental Health minutes: 26 March 2025

Attendees and apologies

Present

• Stephen Gallagher, Director of Mental Health, Scottish Government, co-Chair
• Nicola Dickie, Director of People Policy, COSLA, co-Chair
• Kandarp Joshi, Psychiatrist, Royal College of Psychiatry of Scotland
• Emma Currer, Royal College of Midwives
• Hannah Axon, Policy Manager, COSLA
• Angela Davidson, Deputy Director, Mental Health, Scottish Government
• Carrie Lindsay, Executive Director of Education and Children's Services, Fife Council
• David Mackay, Head of Policy, Children in Scotland
• Joanne Smith, Chair, Parent and Infant Mental Health Scotland and National Society for the Prevention of Cruelty to Children (NSPCC) Scotland
• Judy Thomson, NHS Education Scotland
• Carsten Mandt, Senior Programme Manager, Perinatal Mental Health Network
• Mairi Macpherson, Deputy Director, Improving Health and Wellbeing, Scottish Government
• Cheryl Burnett, Chair, National Parent Forum of Scotland
• Roch Cantwell, Professional Adviser, Perinatal and Infant Mental Health, Scottish Government
• Stephen Mcleod, Professional Adviser, Directorate for Mental Health, Scottish Government
• Tracy Stewart, Scottish Council of Deans of Education
• Gillian Hamilton, Chief Executive, Education Scotland
• Alison Sutherland, Head of Support, The Promise Scotland
• Suzanne Shields, Neurodiversity and CAMHS Leads, NHS Lanarkshire
• Selena Gleadow-Ware, Chair, Perinatal Psychiatry, Royal College of Psychiatrists
• Ellen Moran, Principal Education Psychologist, West Dunbartonshire, ASPEP
• Jaki Lambert, Director, Royal College of Midwives
• Andrew Watson, Director Children and Families, Scottish Government
• Ruth Christie, Unit Head, Children Young People and Families Mental Health, Scottish Government

Apologies

• Carolyn McDonald, Chief Allied Health Professions Officer, Scottish Government
• Ollie Bray, Education Scotland
• Martin Crewe, Director, Bernardo’s
• Stephanie Phillips, Director of Transformation, Strategy, Planning and Performance, NHS24
• Laura Kerr, Social Work Scotland
• Andrea Blair, General Manger Specialist Children’s Services, NHS GGC
• Alison Taylor, Deputy Director for Improvement, Attainment and Wellbeing, Scottish Government
• Leanne Blacklaw, Chief Inspector (Mental Health, Suicide Prevention, CYP), Police Scotland
• Jane Ford, Principal Public Health Intelligence Adviser
• Haylis Smith, National Delivery Lead, Suicide Prevention, COSLA
• Aileen Blower, Professional Adviser, Scottish Government

Guest Presenter

• Gemma Crompton, Health and Wellbeing in Schools Team Leader, Learning Directorate, Scottish Government

Observers

• Georgia de Courcy Wheeler, Team Lead, CAMHS and ND Improvement Team, Children Young People and Families Mental Health, Scottish Government
• Harriet Waugh, Self-Harm Policy and Distress Interventions, Scottish Government
• Chloe Duffus, Team Lead, Specialist MH Services Delivery Team, Children Young People and Families Mental Health, Scottish Government
• Peter Innes, Senior Policy Officer, Children and Young People’s Community and Advice Team, Scottish Government
• Katy Lister, Senior Policy Adviser, CYP Specialist MH Services Delivery Team, Scottish Government
• Vicki Easson, Senior Policy Officer, CAMHS and ND Improvement Team, Scottish Government
• Hannah Worth, Children and Young People’s Community and Advice Team, Senior Policy Officer, Scottish Government
• Ally Winford, Unit Head, Strategy and Co-Ordination, Scottish Government

Secretariat

• Alastair Douglas, Admin Officer, Children and Young People’s Community and Advice Team, Scottish Government
• Della Robb, Team Lead, Children and Young People’s Community and Advice Team, Scottish Government
• Kelsey Sclater, Policy Officer, Children and Young People’s Community and Advice Team, Scottish Government

Items and actions

Welcome and Introductions

Stephen Gallacher (SGa), co-chair of the Joint Strategic Board for Child and Family Mental Health (JSB) welcomed everyone to the meeting and noted apologies.

SGa invited any comments or amendments to the minute of the December 2024 JSB meeting. No changes to the December minutes were requested so they were approved.

Update on Actions from SGa:

• update of progress towards the frontline NHS budget targets of 10% on Mental Health and 1% on CAMHS from the total NHS spend
  • latest data (2023/24) published in February shows the proportion of budget for mental health increased by 0.5% to 9.03% and there has been an increase in CAMHS to 0.82% (a 16% year on year increase from 2022/23)
• update on Psychology workforce
  • psychology workforce continues to increase although increase is slowing with the labour market in the NHS tightening
  • met with the Heads of Psychology Services (HOPS Group) to explore some of the range of messages coming from health boards on their Psychology workforce
  • wrote to directors of Psychology and Health Board Chief Executive’s asking them to carry out a forward look on the Psychology workforce
  • Scottish Government will consider if there is a need to refresh our approach to Psychological Therapies (PT) waiting times, target hasn’t been reached twice. Is it the correct target, are there further actions we need to take to deliver on the target, what is the impact of the investment Scottish Government have made
  • Scottish Government will be working with some boards in an enhanced support mode to help them understand their demand for PT services, their current levels of activity, how their workforce is structured and the capacity that is potentially available from that workforce

Actions

• SGa - Update the next JSB on progress regarding Psychology workforce and enhanced support work being done with boards around demand for PT services, current levels of activity, workforce structure and potential capacity available from their workforce
• SGa - To forward a copy of the letter written to the territorial chief executives to Judy Thomson (JT)

Relationships and Behaviour in Scottish Schools

Gemma Crompton (GC) presented an overview of Scottish Government work relating to Relationships and Behaviour in Scottish Schools.

Key Points

• Behaviour in Scottish schools: Research report 2023 (BISSR) Both primary and secondary school staff reported generally good behaviour among most or all pupils in the classroom but noted increases in low level disruption, disengagement, serious disruptive behaviour
• causal factors include poverty and the impact of COVID
• marginal increase in attendance but it is still below the pre pandemic level, particular area for concern is persistent absence
• Education Scotland conducted a deep dive into the reasons for absences with issues linked to mental health (both for the child and parent) being a prominent factor
• in response Relationships and behaviour in schools: national action plan 2024 to 2027 was published in August 2024
• Education Scotland are doing significant work around attendance with a mixture of universal supports and bespoke work with local authorities that have significant challenges. Improving attendance: understanding the issues report | Improving attendance in Scotland | Resources | Education Scotland

Discussion

• Nicola Dickie (ND) highlighted recent discussion with COSLA Board Members and SYP on the need to ensure that approaches and language take account of children and young people’s rights and needs
• Ellen Moran (EM) shared that schools are doing a lot of work on attendance but that there are pressures around resources and cuts. We need a cohesive approach to this across disciplines
• Carrie Lindsay (CL) highlighted the importance of early years intervention. Schools and local authorities are doing their own campaigns on attendance and that is having a significant impact
• Andrew Watson (AW) endorsed CL’s comments. Need to get behind our Early Child Development programme which Is doing good things around the very earliest years of development.
• GC responded that she shared some of the concerns around the way these issues are being talked about and presented in public forums and the language used
• GC added that there have also been wider changes in how we relate to one another in society, this is not just a schools problem. The Scottish Advisory Group on Relationships and behaviour in Schools (SAGRABIS) has made an effort to widen the membership to reflect that this in an issue affecting more than schools
• GC on early years have done a lot a of engagement in the last couple of years including holding relationship and behaviour summits to try and understand these issues further

Perinatal Mental Health Service Specification

Roch Cantwell (RC) presented the specification and thanked Anne McFadyen for her efforts in chairing the group and getting the specification ready for the meeting today.

Key Points

• came out of recommendations from PNIMH PB that there should be a service specification
• the Perinatal Mental Health Service Specification group had wide representation from clinical community and good consultation from lived experience

• the service standards are based around the Women and Families pledge developed by women with lived experience and the Perinatal MCN
• the specification;
  • general introduction including a description of services and their broad principles
  • detailed service specification with specific requirements for services
  • in writing the specification, we were mindful of aligning with JSB priorities in areas of early intervention and suicide prevention

Discussion

• Emma Currer (EC) raised a number of points;
  • where does the specification sit in terms of standards? Is it a standard, specification, guideline? It is not clear if this is being mandated to boards
  • seems to be a lack of views from professional bodies view such as Maternal Mental Health Alliance (MMHA) versus plenty of references to other policy documents
  • concerned of lack of acknowledgement of perinatal mental health midwives throughout the document
  • where is the Perinatal Mental Health Network steering groups view in this specification? It has undertaken an evaluation of perinatal mental health midwives and with the lack of reference to them in the document it is not really inclusive of services
  • much of evidence base is policy document based as opposed to a literature review of evidence
• Judy Thomson (JT) also raised two questions regarding the specification;
  • this specification focuses on the mothers mental health with the infant seemingly secondary. We need to ensure we don’t lose sight of infants. Is there an opportunity in the document to more overtly recognise infant mental health needs? Possibly highlighting some other places in terms of policy and groups where is serious consideration being given to infants in their own right
  • JT welcomes the specification and notes it reads well coming from a service perspective but enquired if there will be a version for service users?
• RC replied to EC’s points;
  • the specification is not a standard, it is about quality improvement for services complementing existing standards. It is not mandatory
  • the specification does quote from SIGN and NICE guidelines which do take into account the existing evidence base
  • we also have engaged with lived experience and can track comments from previous drafts into changes in the final specification
  • the perinatal mental health midwives have been a huge success of the development of perinatal and infant mental health services and have been welcomed across boards. This specification is a document about community perinatal mental health teams and about Mother and Baby Units (MBU)
  • in terms of cross working there is mention in the initial principles and introduction of the importance of community perinatal mental health teams in the landscape. This includes infant mental health teams, MNPI teams and the perinatal midwives that sit within MNPI. There is reference to the need for cross working and joined up care
• in response to JT’s questions RC stated;
  • there is a section on infant mental health in the specification but that the specification is addressed to perinatal mental health so it is driven by the identified patient who is the mother
  • the specification was written with services and professionals in mind but acknowledge the point about a service user version
• Selena Gleadow-Ware (SGW) shared concerns that perinatal and infant mental health doesn’t get lost as it is a newer and smaller service than CAMHS among the wider children and families agenda. It is key that we keep life cycle approach in our thinking
• Jaki Lambert (JL) supported SGW’s concerns and added it was important to ensure all women supported and we don’t lose focus on outcomes, not all women go home with a child and they should not be lost in this space

SGa asked the group if, subject to RC’s responses to the questions raised, if they are content for the specification to go forward for approval by the minister. No objections were raised, and the board is content to move forward.

Update reports from Implementation Group Chairs

Awareness Raising and Promotion Implementation Group - Stephen McLeod

Reflections on first three meetings

• there is agreement in the group that it should add value and where there are developments already underway it should build on those
• engagement of the members of the Scottish Youth Parliament (SYP) has been very helpful to;
  • provide an insight on what may be helpful to their parents when considering promotion of mental health and wellbeing materials
  • there is also alignment of some issues and campaigns that MSYP’s are undertaking around mental health and the work of the group
• GP connection has been really critical;
  • there has been very good engagement with colleagues
  • a number of questions that were developed around awareness raising and promotion have been taken by GP colleagues to their routine meetings and networks to ask how we improve awareness of materials among GP’s
• now that there have been three meetings of this group, we are clear on the areas we need to focus on and have begun engagement in some areas such as with MSYP’s and GP’s

Discussion

• SGW raised the prospect of incorporating parental mental health and stigma for parents asking for help into the awareness raising group. Stephen McLeod (SMc) agreed that it is important there be cross fertilisation with issues from other groups and that there is already work underway on that such as engaging with the MSYP’s and their campaigns

Barriers and Access to Support and Service Implementation Group – Dr Aileen Blower – Update was given by Della Robb

• the group has met three times since November 2024 and has agreed membership and terms of reference
• two key areas have emerged for this group
  • addressing barriers to crisis and distress support for young people
  • improving access to CAMHS for under fives
• proposed initial work for the Group includes supporting Scottish Government Crisis and Distress Intervention policy officials to consider their proposals for a Framework for Crisis and Distress
• at the most recent meeting there was discussion of case studies to explore how the system is currently working and what can be done to improve provision
• previous engagement with stakeholders and lived experience is being drawn on and there will be given consideration throughout the work of this group
• at a later date further thought will be given to what additional stakeholder and lived experience engagement will be required which will be informed by stakeholder mapping taking place over the coming months 
• the group should also continue to give consideration to action required within the framework
• in June there will be an in person meeting of the group to discuss the Crisis and Distress Framework and the group will support Harriet Waugh (HW) and colleagues in the Crisis and Distress Interventions policy team in relation to policy development over 2025

Whole Systems and Transitions Implementation Group – Dr Roch Cantwell

• the work of this group is being paused following some challenges to the overarching aims of this implementation group
• detailed discussions were held and it was felt much of the initial work plan would be better taken forward by policy teams
  • the greatest part of the initial work plan for the group was around perinatal mental health regional development and it seemed best to take this forward alongside work being done on CAMHS regional provision
  • other work was identified will be taken forward with the perinatal managed clinical network which is already involved very closely in developing an infant mental health service development guide
• transitions didn’t factor into the initial workplan, this will come back to a revised proposal to the JSB for the Whole Systems and Transitions Implementation Group at a later date
• in order to continue engagement with stakeholders in perinatal and infant mental health the membership of the JSB will be expanded to include representation from the perinatal managed clinical network
• RC, chair of this group, will also become a member of the Barriers and Awareness implementation groups
• the group was content to pause this implementation group, and for the approach outlined to be taken

AOB

Georgia de Courcy Wheeler was to update the JSB on Children and Young People Neurodevelopmental Policy, however this update will now be shared via correspondence.

Close

SGa thanked those present for attending and the presenters for their contributions before bringing the meeting to a close.