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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.

Universal services are key in ensuring that folks are able to access the services that they need. Obviously, delivery often varies in different parts of the country, but it is essential that we get the provision right for every woman and every family.

Joined-up care and an holistic approach are key in supporting women and their families during the perinatal period. We are taking specific action to improve provision of joined-up services for women and families with complex needs, including those who have substance use issues. Maree Todd’s work is intertwined with mine, and we work closely with Angela Constance, the Minister for Drugs Policy. Substance use, which was mentioned earlier, is obviously an important issue.

In order to get this right, we need to take a cross-Government approach and to work in partnership with the managed clinical network, the third sector and—I cannot emphasise this enough—folks with lived experience.

We intend to hold a stakeholder event in the near future. It will be designed to discuss ways to improve the quality and consistency of support and services for women and families.

To date, we have invested £1.8 million in third sector services within the perinatal and infant mental health portfolio. We have publicly committed to investing up to £1 million per annum in third sector provision. A key part of our third sector work has been investment in the sector as well as funding specific organisations.

I know from conversations that I had last week that none of this is easy and that third sector organisations would prefer it if we could provide multiyear funding. I wish that that were the case, but the UK Treasury will not give us multiyear funding, which creates difficulties.

We have given as much comfort as we can to third sector organisations. I certainly value their work. We will continue to work with them and will do our level best to provide the resources and the services that women and families need across the country.

Thank you, convener.

I welcome the opportunity for my colleague Maree Todd, Hugh Masters and I to assist the committee with the inquiry into perinatal mental health in Scotland.

I thank everyone who responded to the inquiry. The huge range of responses from professionals, organisations and individuals shows just how important the issue of perinatal mental health is right now, so I am pleased to be able to provide my support by coming here today.

I also express my gratitude to those who kindly shared their personal experiences, which helps us to open up the conversations, to address stigma and, most important, to get a better understanding of what works well and what we need to do better.

We recognise the impact that the pandemic has had on the mental health of new and expecting parents. The responses to the inquiry highlight the sobering reality of what that can look like daily.

As a Government, we are making significant investments in our mental health services to encourage recovery and renewal as we emerge from the pandemic. It is in that context that I would like to share a brief summary of my vision for perinatal mental health services in Scotland.

Since 2019, the perinatal and infant mental health programme board has overseen investment across community perinatal mental health services, the third sector, mother and baby units, infant mental health services and maternity and neonatal psychological interventions.

In October, we published the new “Perinatal and Infant Mental Health Programme Board: delivery plan 2019-2020”, which sets out the next steps in our ambitious and compelling long-term goals not only to develop and sustain perinatal and infant mental health services in the most challenging times, but to ensure a systems approach to service development and delivery of those vital services.

We will continue to build on the achievements of the programme board to offer the right kind of support to those who need it, at the right time. This year, more young parents, infants, fathers and those who have previously experienced pregnancy and neonatal loss are receiving support, thanks to the organisations that are funded through our small grants fund for the third sector.

The programme board will also continue to ensure that lived experience is at the heart of service development, implementation and provision. As I mentioned earlier, it is incredibly important to us that service provision be led by the needs of women and families, and that it builds on good practice and learning from positive and negative experiences of current services.

We will take forward the work of the new delivery plan in collaboration with our partners and we will ensure that there is continued focus on raising awareness, promoting understanding and reducing stigma.

I am extremely grateful to our statutory and third sector services for their continued passion and co-operation in delivering our strategic aims during the pandemic. With continued collaborative working, we can offer invaluable support for perinatal and infant mental health services across Scotland in providing a lifeline to parents, carers and families when they need it most.

The inquiry responses also touch on pregnancy and baby loss; Maree Todd will answer questions on those issues. I assure the committee that, with the rest of the Scottish Government, Maree Todd and I recognise the tragic impact of baby loss and the profound effect that it can have on the lives of the bereaved families. We are committed to ensuring that women and families are provided with the right information, care and support, taking into account their individual circumstances.

I look forward to working closely with you all on our important agenda for perinatal mental health to ensure not just that we are listening to the women and families of Scotland but that we inform our policies with their lived experiences in order to deliver high-quality and person-centred care.

I will turn to your question, convener. We have made real progress on delivering on the report’s recommendations. Since March 2019, we have invested more than £16 million in perinatal and infant mental health services to develop a range of services, from specialist acute in-patient services through to third sector support for women and families who are in the perinatal period. We are focused on ensuring equitable access to sustainable mental health support throughout folks’ pregnancies, as well as on ensuring that we get it right during the perinatal period and in the child’s infancy.

The voices of lived experience must be at the heart of our approach—I will probably say that again and again today, because I believe that it is immensely important in getting policy development and service delivery right.

The programme board is making good progress on meeting the recommendations on delivering effective services. For example, it is providing £6 million of funding in 2021-22 across all health boards to establish specialist community perinatal mental health teams.

In health boards that have more than 3,000 births a year, we have also funded enhanced psychological support for maternity and neonatal settings. Five boards—Fife, Greater Glasgow and Clyde, Lanarkshire and Lothian among them—are in the process of establishing dedicated multidisciplinary infant mental health teams, with a majority of other health boards embedding an infant mental health focus within their perinatal teams.

We have funded an increase in staffing for mother and baby units and have created the mother and baby unit family fund to support families in visiting their loved ones in in-patient care. We have also established the perinatal and infant mental health third sector fund, which so far has supported more than 2,000 parents, parents-to-be and infants. That comes with £1.8 million of funding.

Beyond that, the committee will also be interested in finding out what is happening on the ground. We are looking very closely at the overview of service developments across Scotland. The situation is improving; some parts of the country were slow in using the resources that were allocated to them, but Hugh Masters, the board and I have been in fairly regular contact with some boards to ensure that they are back on track.

On the service development front, we are looking at four key areas: perinatal mental health, infant mental health, the neonatal psychological interventions in the larger boards that I referred to earlier and, most important, the lived experience of and the level of engagement that boards are having with parents and families with regard to service delivery.

Your question covers a number of issues. When I came into post and started looking at the matter—I looked at it as a constituency member, too—I saw quite clearly that some areas were doing better than others in delivery as well as in recruitment, which is key to development of services. Some areas had used the resources that we had given them well, but some health boards had spent barely any of the money, recruitment was slow and the level of engagement with folks with lived experience was poor.

That situation has changed. I am not saying that everything in the garden is rosy; I think that there is still work to do in some areas, but folks are being recruited. NHS Highland and NHS Grampian in the north worried me, because they were pretty slow. However, that is changing and they are now recruiting.

Moreover, in my view, the level of engagement with people with lived experience was not always as good as it should have been. Not long ago, I met Let’s All Talk North East Mums—or LATNEM—which is a women’s group in Aberdeenshire. I know that you have been contacted by some of those folks as a constituency member, convener. They had mixed experiences of services and did not feel that they were listened to enough. I think that that situation has changed.

After having spoken to NHS Highland late last week, the board has sent me this week information about its work on communicating with and consulting families and the third sector. It shows real improvement in that. Its recruitment situation is getting better, too.

Convener, I am something of an old-fashioned boy—a bit simplistic, some would say—so what I have is a set of report cards that we will keep updated so that we can look at the progress that is being made across the country. What I see in the overview is more green lights than there were, some ambers where further improvements have to be made and fewer reds than there were at the beginning. However, the committee can be assured that I will continue to engage with boards that have been a bit slow in developing services and not quite good enough in allowing folks with lived experience to help.