Chamber and committees

Again, that involves work that we are doing at the moment. A huge amount of my time since I got this role last May has involved talking to stakeholders—I talked earlier about the young man with those 15 interventions. Sometimes, we have situations where families have a huge amount of interventions but there is not that holistic approach. The national care service and new standards can make a real difference there. However, we also need to change the culture around how we support families, because we know that where there are too many interventions, as I mentioned earlier, sometimes the trust factor is not there and you do not get the positive results that we want.

As well as the multidisciplinary approach and the multi-agency approach, we need to ensure that, in order to get this right, we have folk in play that families can trust. That will make a real difference. That is why I and other colleagues are quite excited about the way that we can approach this issue in order to improve and modernise the situation for families across the country.

I will be very brief, convener. Local authorities also have the ability to use the children and young people’s mental health services money for sporting activities that support children’s wellbeing. Ms Mochan will be well aware, I am sure, of the various projects that are going on in East Ayrshire, but one of the investments that East Ayrshire Council has made is in its vibrant communities project, which includes multidisciplinary community sport support, including sports coaches, for example. There is flexibility in that resource.

Of course, although we have invested £50 million over this year and next year, our ambition, as part of the Bute house agreement between the Scottish Government and the Scottish Greens, is to double that investment over the course of this parliamentary session. Flexibility exists for local authorities to use that money for mental wellbeing, because we know that sport has a vital role to play in that.

The perinatal mental health clinical network has set out a series of five national pathways, which cover pre-conception advice, psychological support for mild to moderate concerns, specialist assessment for severe and complex needs, emergency assessment for MBU admission, and specialist assessment and intervention for parent-infant relationship difficulties.

We are developing animations to increase the accessibility and awareness of those pathways. Four health boards have fully developed local pathways for perinatal mental health, and a further seven boards have pathways in development. Boards are also developing specific pathways on birth trauma, neonatal loss, anxiety and needle phobia.

I have gone on the record many times saying that we do not want anybody to be waiting, and we are doing all that we possibly can to ensure that we are delivering for people. We will continue to invest in the recovery and renewal phase in relation to bringing waiting lists down, whether they are for child and adolescent mental health services or psychological therapy services.

We have to take the right actions in this area and, in our service delivery, we must make sure that we have a joined-up approach to dealing with perinatal mental health. The work that we are doing with health boards is extremely important, but we need to go much further in ensuring that those on the front line know exactly what services are available and can direct folk to them.

I will give an example from my discussions with the LATNEM—Let’s All Talk North East Mums—women’s group, where there were mixed responses to some of my questions. It is fair to say that some women thought that their GPs were absolutely fantastic at getting it right for them. In other cases, folks were very unhappy indeed with their initial contact with GPs and they were not signposted to the right services. We have work to do to change that. We need to make sure that everything that we are doing across the country is being filtered down to those on the front line and that they know exactly what services women need and are signposting them and referring women to them.

On the development of services, I note that we require not only the acute services that we tend to concentrate on when we talk about waiting times and waiting lists, but also community services. We need to get it right in communities across the country, and that means that the investment that we have put in needs to be spent wisely on developing those community assets. Beyond that, we also need to ensure that our investment in the third sector is there to allow those organisations to play a real part, with their expertise, in helping women and their families.

For example, I met Home-Start Aberdeen on Friday in a constituency capacity, although, as is always the case, we strayed on to some ministerial matters. Those folks have a lot of experience of dealing with women and families, and their experiences and the information that they gather have to lead to the improvements that are required for us to get it right for women and families across the country.

Hugh Masters might have more to say on the subject.

I will let Hugh Masters come in, as he might cover what I was going to say.

Workforce and sustainability are at the centre of all the programme board delivery plans. Last year, the workforce sustainability group was established to explore the issue across all sectors of the perinatal and infant mental health services. NHS Education for Scotland has been expanding training places on commissioned programmes as well as ensuring that additional perinatal and infant mental health training is provided across a range of professions. That investment will result in 51 additional psychological practitioners by the end of 2021-22. There is a huge amount of work going on, not just in relation to training and getting folk in but on training others to recognise exactly what is required in this context.

As the committee knows, I have said that we will look at a new workforce strategy for mental health services within the first half of this session of Parliament. We are well on the way in this area and we can see that in the recruits we are managing to get in.

I will be brief, convener. Ms Mackay’s question was on universality and access to services. As the committee well knows, I have an ambition to ensure that we set high-quality standards across the board in mental health services. I have talked about what we have already done with CAMHS and what we are doing now with psychological therapies.

In perinatal care, we are proposing the introduction of a service specification, which will be absolutely vital in ensuring consistency of care and in promoting joined-up care pathways. While we do that, we will also have national and local conversations with the third sector and people with lived experience to ensure that we get the specification right and can adapt it accordingly. We will carry out that vital work to ensure consistency of care across the board.

That is an extremely important question. The best way to ensure that we get services right for women and families across Scotland is to have complete co-operation and collaboration and a lot of communication between NHS boards, the third sector and the voices of lived experience. Some of the third sector work that I am aware of is crucial; it and the voices of lived experience should be at the heart of developing services at board level. We need communication, collaboration and co-operation to get the services right for women, their babies and their families.

I know that a common theme in the evidence that the committee has taken is concern from mothers that seeking help from perinatal mental health services could result in the loss of their child. To tackle that kind of stigma, it is important that we get our approach right. The forthcoming raising awareness good practice guide will highlight mechanisms to tackle that stigma on multiple levels, because we recognise that we cannot remove stigma by adopting a single approach.

We need to tackle stigma on multiple levels in order to be effective; we need to look at what works for different families, members of different communities and different groups of professionals. The modules on perinatal mental health that Ms Harper talked about include one that is focused on stigma to inform professionals and ensure that a consistent and empathem, or empathic, rather—a word that I should have avoided—approach is adopted.

I should also say, because we have not covered it, that every baby box in Scotland includes a leaflet on perinatal mental health. The leaflet is currently being updated to include the latest information on where to seek help. We are also working with See Me to explore ways to actively promote role models and highlight good practice around stigma reduction and raising awareness about perinatal and infant mental health. In February 2021, we ran a national campaign, called wellbeing for wee ones, that was aimed at increasing awareness and reducing stigma around infant mental health.

Stigma is, without doubt, an area in which we need to do much more work. We need to co-operate in order to ensure that we reduce stigma and do all that we can in that sphere. We also need the general public to recognise that what some folk go through could happen to anyone and that, as a society, we need to do all that we can to help women, babies and their families get through difficult periods and, we hope, reach a brighter future.

We need to listen to the voices of lived experience with regard to how we shape services for the future. I refer back to the LATNEM women. There were mixed opinions on various parts of service delivery, but all the folks who expressed an opinion said that, during the pandemic, the Grampian resilience hub had been absolutely fantastic in responding to women’s needs. We need to learn from the Grampian resilience hub’s work during the pandemic and see whether we can replicate it across the board. Something went on there that obviously worked for those women, and if it worked for them, it is likely to work for others. Such services can operate in the same way in remote, rural and island areas as they do in urban areas because, in the main, communication is by telephone or video call. We need to look at that in more depth.

I will be honest with you. We would not be picking up such nuggets of information and good practice if we were not going out and hearing the voices of lived experience. I want to continue to do that.

Hugh Masters may want to say a bit more on that.