Publication - Strategy/plan

Perinatal and Infant Mental Health Programme Board 2020-2021: delivery plan

Published: 3 Jul 2020

Perinatal and Infant Mental Health Programme Board's Delivery Plan for 2020 to 2021.

Perinatal and Infant Mental Health Programme Board 2020-2021: delivery plan
Infant Mental Health Implementation and Advisory Group

Infant Mental Health Implementation and Advisory Group

Prevention
Early Intervention
Support
Treatment

Delivery Plan 2020/2021

Introduction

from Chair of Infant Mental Health Implementation and Advisory Group (IMH-IAG)

The Perinatal and Infant Mental Health Programme Board (PNIMH-PB) was established by the Scottish Government in April 2019. The aim of the Programme Board is to provide strategic leadership and have overall management of the delivery of improved perinatal and infant mental health services.

As part of its remit it will 'implement and fund a Scotland wide model of infant mental health provision'. These Infant Mental Health (IMH) services aim to meet the needs of families experiencing significant adversity, including infant developmental difficulties, parental mental illness, parental substance misuse, domestic abuse and trauma (Programme for Government 2019-20). The Infant Mental Health Implementation and Advisory Group (IMH-IAG) was set up by the PNIMH-PB to provide clinical advice and support to inform the development of mental health care for infants from conception to 3 years of age, and oversee the testing and implementation of evidence-based and innovative models for the delivery of these infant mental health services. Its role is also to advise and make recommendations to the Programme Board, as services develop, about best use of wider investment and best practice models. The IMH-IAG seeks to ensure that the voice and experience of infants is integral to all workstreams. The IMH-IAG will also have a key role in linking with other key strategic groups, including Children's Services Planning, Best Start and the Children and Young People's Mental Health and Wellbeing Programme Board. This includes work on Neurodevelopmental Pathways with the shared aim of prevention and early intervention.

Getting it Right for Every Child (GIRFEC) principles, which recognise Children's Rights (UNCRC), will underpin every aspect of this delivery plan which will align with other national policy and practice guidance already in place/in development, including the recently published Independent Care Review. This has recommended that new and expectant parents have access to attachment-based parenting education and holistic family support services. During 2020/21 the PNIMH Programme Board and Infant Mental Health Delivery Plans will be implemented in line with the messages in the Care Review Promise.

  • informed by lived experience at a strategic and operational level with family members being meaningfully involved in decision-making (Voice)
  • supporting positive relationships within families and creating opportunities for positive relationships where it is not possible for children to stay with their families (Family and Care)
  • actively supporting the development of relationships within families and with the community and professional systems involved, who in turn must be supported to listen and be compassionate in their decision making and care (People)
  • accompanied by responsive help, support and accountability to enable support to be accessed and utilised to its fullest potential (Scaffolding)

All decisions relating to children's safety or wellbeing needs should be based on children's rights as articulated in the United Nations Convention on the Rights of the Child (UNCRC) and GIRFEC principles.

Vision

The Infant Mental Health Delivery Plan seeks to realise a vision for a Scotland where:

  • There is a shared understanding, and definition, of 'infant mental health' and the importance of parent/infant relationships across policy and practice, families and their communities
  • Parents and carers are supported to build positive relationships with their babies
  • Prevention of later mental health and relationship problems is paramount
  • Where concerns are identified, early intervention is offered, with universal service providers being able to access specialist services via clear care pathways so that babies and their families receive the right care at the right time from universal, and if necessary, specialist services.
Achievements 2019-2020

The Programme Board allocated £81,000 to two 'First Wave' health boards to begin work on IMH Service Development in 2019-2020 financial year. This funding will be continued until the end of 2020-2021 contingent of feedback which will inform further work.

In March 2020, the Perinatal Mental Health Network Scotland and NSPCC published 'Wellbeing for Wee Ones', which summarised key themes about the provision of Infant Mental Health intervention and support services across Scotland. Along with scoping reports for each health board area, this information will inform development work at a local and national level.

* NB Timescales/milestones have been included and adjusted but will need to be further reviewed once Covid-19 restrictions change and the situation stabilises.

2020/21 Delivery Plan

Delivery Aims

What, When, Who *

1. Leadership and Co-production

Health board and/or IJB Executive Leads for PIMH to lead local multiagency strategic and operational groups to support local IMH service development consistent with GIRFEC principles and multiagency working.

Representation on such groups to include the voices of those who are experts by experience, including parents and carers, third sector and statutory agencies as well as those working in universal services such as maternity, early learning centres, health visiting and family nurse partnership and more specialist services such as mental health and substance misuse.

Ensure coproduction with experts by experience informs IMH-IAG.

Following the March 2020 publication of Wellbeing for Wee Ones, tailored reports will be delivered to each locality and Executive Leads will develop local action plans in coordination with the national approach.

Programme of visits to health boards/IJBs starting July 2020 in conjunction with the PNIMH-PB.The purpose is to meet with Executive Leads and other relevant staff to support progress towards establishing regional groups

Work with Implementation Groups (convened by Executive Leads) to facilitate the development of IMH services.

IMH-IAG Chair/SG to set up expert by experience focus groups with Participation Officer, Clare Thompson [6 months]

2. Raise awareness and promote understanding of the importance of infant mental health and develop a shared language and approach that is accessible to parents and families, as well as professionals.

Link to PNIMH Raising Awareness Strategy and provide a structure to enhance communication and the development of a shared vision and language across all relevant SG policy areas.

Develop accessible parent and family friendly material to support good parent-infant relationships and raise awareness of the importance of infant mental health through information and marketing materials and through websites such as Parent Club.

IMH-IAG membership to include representatives from key policy groups. SG to ensure relevant links with all policy groups continue to be made.

SG [6 months]

3. Develop a framework and model for the delivery of IMH services

Develop a model for the delivery of IMH across all tiers from universal to specialist services, and incorporating prevention, early intervention and treatment from preconception onwards

Develop clinical care pathways to ensure timely access to specialist assessment and intervention

Consider how a regional model would be implemented supporting the development of high level services in some localities which would deliver consultation, supervision and training to other areas, and offer direct clinical care regionally if required

IMH-IAG members to draw on best practice as described in

(a) research literature
(b) expert groups' recommendations e.g. Royal Colleges, other professional bodies
(c) specialist programmes of work e.g. Best Start
(d) Third Sector models of best practice e.g. Parent Infant Foundation, NSPCC IMH services

Draft Model to be published [6 months]

4. Learn from Quality Improvement work in 2 Health Board areas (1st Wave Projects)

A small investment in IMH service development in 2 health boards (NHS Fife and NHS Lanarkshire) has supported initial service development. Feedback from these boards along with evidence of established best practice should inform the development of their own services and those elsewhere

Consider further investment in these services to build upon initial work

IMH Leads (Parent-Infant therapists) to provide preliminary feedback report advising IMH group of challenges and successes [end of May 2020]

IMH-IAG to advise on funding to improve implementation if appropriate

5. Identify health boards where sufficient infrastructure in place to invest in further service development in 2020-21 (2nd Wave Projects)

Health board visits by PIMHPB leads to gather information on current readiness and also landscape of services available to link up across agency boundaries to develop IMH support and specialist services.

Develop criteria by which to assess applications to SG for funding

PB leads to feed back to IMH group re local areas potential to deliver integrated IMH services when circumstances permit

IMH-IAG and SG to develop criteria by which to assess funding requests [6 months]

6. Identify health boards looking for support to prepare for service development by addressing infrastructure development and encouraging a shared visions across agencies (3rd Wave Projects)

When circumstances permit, connect with Health Board Leads to gather information and identify boards in need of enhanced support to develop infrastructure

Develop criteria by which to assess applications to SG for funding

PB leads to feed back to IMH group on enhanced support needs when circumstances permit

IMH-IAG and SG to develop criteria by which to assess funding requests [6 months]

7. Consider what support might enhance the delivery of services to neonates with complex needs in the context of prematurity, congenital abnormalities or other health challenges who are returning to their home area after a period of inpatient specialist interventions

Develop one aspect of IMH services to address the needs of this population by working closely with the national Perinatal (Obstetric and Neonatal) Network and the Perinatal and Infant Mental Health Programme Board

Ensure such infants can access care pathways appropriate to their needs e.g. to access relationship support or when required to access specialist neurodevelopmental services

IMH members to liaise with Perinatal Network to get more information on the numbers of infants in need of and in receipt of services

Propose a model of service delivery

[6 months]

8. Training and Workforce Development and Retention

Continue to work with Perinatal Mental Health Network Scotland and NES on the development of trainings to support the delivery of curriculum competencies

Identify cohorts of the workforce that could be prioritised for the training offer

Consider other training opportunities and how to enable access to these (e.g. In Third Sector)

Ensure training offers opportunities to professionals and volunteers working in all agencies

Link to PIMH-PB Workforce planning and sustainability and ensure that implementation science is applied to training and workforce development

MCN and NES to continue to work with expert reference group to develop and deliver training across tiers and agencies

Develop a systematic approach to training rollout to maximise coverage within clear timescales [Ongoing]

9. Impact, Evaluation and the development of Outcome Measures

Set up IMH-IAG working group to consider evaluation and impact

Work with PNIMH-PB and Public Health Scotland on the next steps for evaluation following publication of Evaluability assessment

IMH-IAG to collaborate with PB to inform evaluation 'next steps' [6 months]

10. Innovation

Digital and telehealth

Rural healthcare delivery

Learn from Family Nurse Partnership implementation and evaluation

IMH-IAG in collaboration with relevant stakeholders [6 months]

FNP [Ongoing]


Contact

Email: PIMH@gov.scot