Posted By: Amy Tubb
4th September 2023
3 minute read
Scotland’s recently published ‘Mental Health and Wellbeing Strategy‘ (June 2023) shows a continued commitment to providing essential perinatal mental health (PMH) care to women, babies, and families in Scotland.
It’s essential that the Strategy’s ambitions translate into clear, measurable actions in the follow-up ‘Delivery Plan’ and ‘Workforce Plan’. We’re particularly keen to see the Scottish Government address the risks and uncertainties raised in the MMHA’s recent mapping of specialist PMH services.
The Strategy recognises preconception and the perinatal period as critical parts of the ‘Life Stage Model’. This model maps the stages of life at which mental health and wellbeing are most significantly impacted, including when planning for a baby, pregnancy, and early parenthood. At these key life moments, it’s acknowledged that appropriate mental health care should be available to all women, babies, and their families.
This model is backed by a commitment from the Scottish Government to provide people and communities with “the right care, in the right place, at the right time”. With many women and their families in Scotland travelling long distances to access critical specialist PMH services, including inpatient care at one of the two Mother and Baby Units (MBUs), the Delivery Plan must provide adequate solutions to these barriers to access.
We welcome the Scottish Government’s commitment to prevention and early intervention. If PMH problems are not diagnosed and treated promptly and effectively, this can have a serious and often life-changing impact on women, babies and families.
A case study included in the Strategy provides an example of high-quality PMH support, starting with preconception care and continuing throughout pregnancy and after birth.
We were encouraged by the individualised approach to care shown in the case study; a central feature of a trauma-informed approach. Childhood and adult experiences of trauma are often triggered during pregnancy and after birth. We recommend that all health services in contact with women during preconception and the perinatal period are trauma-informed.
It’s crucial that the Strategy’s aims for prevention, early intervention and trauma-informed care are transformed into concrete actions within the Delivery Plan for PMH care.
There are extraordinary workforce challenges facing the health service across the UK. We urge every nation to address difficulties in recruitment, the lack of suitably trained clinicians and insufficiently resourced teams within specialist PMH services.
To overcome the significant pressure the workforce is under, the Scottish Government acknowledges the need to “strengthen and expand” the workforce and to do this, it plans to focus on five strategic pillars: Plan, Attract, Train, Employ and Nurture.
We commend the Strategy’s aim to establish a “diverse, skilled, supported and sustainable” workforce but as we have previously reported, uncertainties about funding contribute to recruitment, retention and delivery problems for specialist PMH services. The Workforce Plan that follows this Strategy must make provisions for clear funding information, timely allocation, and reasonable commitment to future funding for these essential services.
The Perinatal and Infant Mental Health Programme Board came to an end in March 2023. The Scottish Government has not yet communicated the plans for a long-term, formal governance structure to replace the Board. With the new Mental Health and Wellbeing Strategy now in place, a system that allows for monitoring and scrutiny across the PMH sector is urgently needed and must be swiftly established.
We are encouraged by the Strategy’s overarching aims to include a range of key partners, including lived experience panels and third-sector organisations, in its governance, monitoring and evaluation arrangements.
We welcome the Scottish Government’s vision for improving mental health care in Scotland, and in particular its recognition of preconception and the perinatal period as critical life stages for support.
The Strategy must now be followed by a clear, robust, and adequately financed ‘Delivery Plan’ and ‘Workforce Plan’ to guarantee its ambitions are achieved.
We are keen to work with the Scottish Government to ensure measurable actions are taken to address the current risks and uncertainties for PMH, and to support the improvement of these vital services for women, babies and families throughout Scotland.
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