Implementing PIMH funding in Scotland: opportunities and risks

Blog by Clare Thompson, Everyone’s Business Co-ordinator for Scotland

In this article, I will discuss the recent work done by the Perinatal and Infant Mental Health (PIMH) Implementation Programme Board, the meetings of which I attend in my capacity as a Change Agent for Maternal Mental Health Scotland and an Everyone’s Business champion.

Who are the PIMH Implementation Programme Board and what do they do?

The PIMH Implementation Programme Board has been set up to help drive and implement the Scottish Government’s commitments to PIMH, as set out in ‘Better Mental Health in Scotland‘. It will also oversee the recommendations of the Perinatal Managed Clinical Network (PMCN).

You can see the planned work for 2019/2020 here.

The board has agreed with Alliance member Maternal Mental Health Scotland to employ a participation officer, in order to meaningfully gather the views of women and families, and use these to inform service development. We are delighted that the lived experience of women and families is at the heart of discussions and the starting point for any decision-making.

Taking action

The key actions for 2019/2020 have the overarching themes of “More Capacity, More Staff and More Voices”. Specifically, the board:

1. will complete an options appraisal to look at the feasibility of additional mother and baby unit capacity in Scotland, as per the PMCN’s recommendation*: “An additional two to four MBU beds should be provided on one or other existing MBU site, divided between both, or in a third MBU located in the north of Scotland. To be viable, a third MBU should have a minimum of four beds.”
2. proposed investment in specialist community perinatal mental health services in the North of Scotland – this may be used as a model for £5m of improvements for these services Scotland-wide in 2020/2021.
   
3. plan to appraise and map evidence around Infant Mental Health evidence to identify a preferred national peer support model. The board will also map all Third Sector provision for perinatal mental health.
4. will train and assess universal services, health visitors, midwives, family nurse practitioners and others in perinatal and infant mental health.
5. are looking to recruit parent-infant therapists to strengthen infant mental health services; a positive move in recognising the importance of family relationships to the mental health of children, parents, and the wider family.

*We welcome the provision of more funding to ensure that Scotland’s two Mother and Baby Units are staffed to the levels recommended by the Royal College of Psychiatrists Quality Standards. Currently, they are operating at 81% of recommended capacity, according to recent data.

Risks and considerations

It’s fantastic to see the evidence-based approach to developing community perinatal mental health services and look forward to hearing about the first steps – particularly in the North of Scotland. However, we must bear in mind that in the intervening period, there are still women and families who will not have access to specialist services, where and when they need them.

We’re left wondering about:

Workforce

We recognise the value of developing the skills of the current workforce. How do we know that there are going to be enough staff to work in the new and current specialist community services, and Mother and Baby Units?

Spend

Is the pledged £52m going to be enough?

Sustainability

How will services be sustained following the 5 years covered by this funding pledge?