Newsletter Spring 2019 Welcome to the Perinatal Mental Health Network Scotland newsletter. This edition will summarise the work that network has undertaken or been involved in between January and March

Needs Assessment Report Women & Families Pledge This has been a busy period for the network, we are The network along with the Maternal Mental Health delighted to announce that the Delivery Effective Change Agents completed the Women & Families Services, Needs Assessment and Service pledge that conveys what women and families Recommendations for Specialist and Universal should expect. The Pledge was launched by the Perinatal Mental Health Services report was First Minister alongside the Needs Assessment published and launched on 6th March by First Report. The Pledge can be found here - https:// Minister and Minister for Mental www.pmhn.scot.nhs.uk/news/ Health Clare Haughey at St Johns Hospital in Livingston. The full report can be found here - Investment https://www.pmhn.scot.nhs.uk/news/

The First Minister announced that more than £50 The Perinatal Mental Health Network Team and Ms Clare Thomson, Maternal Mental Health Change Agent million is to be spent on improving access to mental meet with First Minister Nicola Sturgeon and Minister for Mental Health Clare Haughey health services for expectant and new mothers. Dr Roch Cantwell, Lead clinician for the Network presented on the report advising that its production Perinatal & Infant Mental Health had resulted from the enthusiasm, dedication and Programme Board drive of women and their families who experience The proposed mechanism for enabling delivery of perinatal mental ill health, and the professionals who these aims is a Perinatal and Infant Mental Health care for them across Scotland. This report provides a Programme Board that will set the direction for template to establish services which will ensure that work undertaken regionally, locally and within a women, their infants and families, receive expert care community setting. wherever they live in Scotland and that children can have the best start in life. The Board will be Chaired by Professor Hugh Masters, who has over three decades of

experience working across professional practice, education and policy in a number of leadership

roles, most recently in the from 2009 to 2018 as Nursing Officer for Mental

Health Nursing and Associate Chief Nursing Officer. .

Family Nurse Partnership Scotland National Conference

Dr Anne McFadyen, PMHN Infant Mental Health Lead was delighted to be invited to provide a workshop at the Family Nurse Partnership Conference which was held at Murrayfield Stadium on Monday 11th March 2019. The title of the conference Quality Improvement & Sharing the Learning captures its essence. NHS Education for Scotland Throughout the morning there were excellent Revised Curricular Framework presentations from family nurses working in health boards across Scotland. They all had a QI focus and addressed an aspect of the fundamental aspirations The network has been involved in the revision of the of the FNP programme. In the first presentation from Perinatal Mental Health Curricular Framework NHS Lothian, Family Nurse Alison was joined by Erin working with colleagues in NHS Education for and her baby Mia who described the nature of their Scotland (NES) The revised framework was relationship and then shared a film made by the local launched on 19th February. The framework sets group on Safer Pregnancy. out the different levels of knowledge and skills required by members of the Scottish workforce who have contact with mothers and their babies, to Professor David Olds, Professor of Paediatrics and enable them to support mothers, babies and their Director, Prevention Research Centre for Family and families to have positive well-being and good mental Child Health, University of Colorado Department of health during the perinatal period. The full report Paediatrics reflected on his journey into child health can be found here – and his mission to change things through developing https://learn.nes.nhs.scot/10382/perinatal-mental- the Nurse Family Partnership (as it is called in the health-curricular-framework USA). I was pleased to hear him mention working with Mary Ainsworth who had worked with John Bowlby, founder of Attachment Theory. He praised our Scottish values and recognition of the importance of good beginnings. He talked compassionately about Professional Events FNP’s strength-based approach which addresses The network has facilitated the following events so aspects of functioning which are ‘fundamental to us far in 2019; as human beings’. The goals of improving pregnancy outcomes, improving child health and development,  Specialist Mental Health Nurses Meeting to and improving parents’ health and economic look at the role and requirements for self-sufficiency are achieved through the delivery of a Specialist Mental Health Nurses within relationship-based approach which also includes a Perinatal Mental Health. toolkit of interventions.

 Exploring Parenthood in Scotland event, Other presentations also addressed this theme which further details of which are noted in this included addressing smoking in pregnancy, improving newsletter the rate of breastfeeding and ‘helping young parents to achieve their hopes and dreams’. Other teams had stands in ‘Quality Street’ illustrating their QI projects.

Dr McFadyen delivered her own workshop and was Future Events pleased to have good questions and discussion in response to her presentation about the PMHN work, The network will have a Steering Group meeting on our report (Delivering Effective Services) and the 29th April in Perth. Women & Families Maternal Mental Health Pledge.

Perinatal Admission Monitoring Perinatal Admission Monitoring. In April 2019, the Mental Welfare Commission for Scotland will begin a national initiative to monitor perinatal mental health admissions across Health Boards. This Churchill Fellow Visit project is the result of collaborative work with the Perinatal Mental Health Network over the past year. Kathryn Hollins, a child and adolescent psychiatrist, The aim is to find out more about current perinatal psychotherapist and former consultant in a perinatal admissions in Scotland and to identify any barriers mental health service in London, visited Scotland to women accessing specialist Mother and Baby recently to explore our society's support for Unit (MBU) care. parenthood.

Background: In Scotland, when a mother of a baby I facilitated a small focus group of 14 professionals under 12 months requires inpatient mental health on Monday 25th March. I am very grateful to those treatment, there is a legal duty for health boards to who attended for their contributions. We were an provide for joint admission, where this is in the best interesting mix of professionals, mostly health interests of both mother and baby. At present, visitors, some government leads and academics, a twelve of Scotland’s fourteen health boards have a perinatal mental health nurse, psychiatrists and a formal agreement in place to admit to one of the paediatrician. regional Mother and Baby Units (MBUs), which are based in and Livingston. The Churchill Fellowship grant and organisation supports Kathryn to travel to learn from other When the Commission carried out a national cultures. Her main question to us was 'How does perinatal themed visit in 2015, just over one third of Scotland support parents in meeting the emotional postnatal women admitted during a three month needs of their children, in particular from pregnancy survey received care in a local adult acute ward to age two.' and not with their baby in an MBU. Sometimes mothers were separated from their baby for Our discussion was wide ranging and at times prolonged periods. The Commission’s report made highlighted the uncomfortable dissonance between a number of recommendations to Health Boards to policy and experience. Our aspirations as a country improve perinatal services. This included fulfilling to create the best context for good beginnings in life the legal duty to provide for joint mother and baby are often thwarted by the reality of socioeconomic admissions. deprivation.

The Perinatal Mental Health Network’s recent A rich discussion included sharing information about Needs Assessment Report (2019), demonstrated the policies and practice in other countries, that there are still inequities across Scotland in particularly Scandinavia. Health visitors shared their accessing MBU care. experience of challenges in certain areas. We also touched on our values and beliefs which may be Monitoring Project: From 1 April 2019, every acute reflected in how open we are as a society about our general adult ward and intensive psychiatric care emotions. unit (IPCU) will be required to contact the Commission if a mother of a baby under 12 months Thanks again to those who participated. old is admitted to their care. The Commission will gather monitoring information in each case and Dr Anne McFadyen, PMHN Infant Mental Health national results will be shared with the network. The Lead hope is to identify ongoing barriers to MBU care, inform national service development and, ultimately, improve women’s access to specialist inpatient perinatal mental health care, wherever Twitter they live in Scotland. Keep up to date with current network work through Dr Juliet Brock, Medical Officer our Twitter account https://twitter.com/PMHN_Scot Mental Welfare Commission for Scotland

Section 24 of the Mental Health (Care and Treatment) (Scotland) Act 2003, PMHN Website ‘Services and Accommodation for Mothers’, updated in the Mental Health (Scotland) Act 2015. http://www.legislation.gov.uk/asp/2003/13/section/24 https://www.mwcscot.org.uk/media/320718/perinatal_report_final.pdf All current news and resources can be found on the PMHN website http://www.pmhn.scot.nhs.uk/ https://www.pmhn.scot.nhs.uk/wp-content/uploads/2019/03/PMHN-Needs- Assessment-Report.pdf