Seòmar agus comataidhean

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.

On perinatal care, feedback from the third sector has highlighted the difficulties in navigating service delivery in a safe way during the very turbulent times of the pandemic. To support the third sector, we funded additional support that was focused specifically on wellbeing issues. We have had learning during the pandemic that we can use in the future, and the Grampian resilience hub is the prime example of that.

I do not have any specific information with me on the impact on perinatal mental health support for ethnic minority women during the pandemic. We can have a look and see what information we hold and get back to the committee on that.

I will hand over to Maree Todd to cover some of the other issues that Dr Gulhane raised.

Given that mother and baby units have been mentioned, I think that it is important to expand on some of our thoughts in that regard. The “Delivering Effective Services” report recommended that the number of MBU beds in Scotland be increased and said that that could be achieved through expansion of the existing units or the creation of a third MBU in the north of Scotland. The report also recommended that an options appraisal be undertaken to determine the most appropriate way to increase the number of beds in Scotland.

That work is under way and a number of options are being considered, including the creation of a third mother and baby unit in the north and the expansion of one or both of the existing units in Glasgow and Livingston. We have to look at a number of issues including equity of access, cost and safety, and the sustainability of the service. All of that needs to be considered as part of the options appraisal. My intention is that we will hold a public consultation in early 2022, which will help to inform the options appraisal and the decision-making process. We will seek to engage with as many stakeholders as possible—in particular, we will engage with as many folk who have lived experience as we possibly can.

We recognise that, as Hugh Masters rightly pointed out, folk from further afield than Livingston and Glasgow, where the existing mother and baby units are located, often have a fair way to travel. We have therefore put in place the mother and baby unit family fund to help with travel expenses for families. We hope that we can move forward on that front in the early part of next year by consulting folk on the future of mother and baby units.

I am continuing to monitor that matter, as is the programme board. There are always calls for additional resources—that is the way of the world. I am keen that all the resource that has already been allocated for the work in boards be used. When it has, we can look at whether other resourcing is required.

What is key for me, at the moment, is that we ensure that recruitment is taking place, that the money is spent and that the services that are delivered are shaped by the voices of lived experience. At that point, once the report cards that I mentioned have been looked at, we can consider what else we need to do and where.

I ask all health boards to ensure first that they utilise the resources that they have already been given to maximum effect.