Evaluation of the Perinatal and Infant Mental Health Programme

We're evaluating the Perinatal and Infant Mental Health (PIMH) Programme to see how well it's working. This program started in April 2019, based on commitments made in the 2018/19 Programme for Government and Better Mental Health in Scotland. It aims to improve services for women, babies, and families in the perinatal period (from conception to one year after a baby is born).

The Perinatal Mental Health Managed Clinical Network conducted a Needs Assessment for Specialist and Universal Perinatal Mental Health Services, which guided the vision and plans of the Programme Board. With an investment of over £50 million, the Board oversees improvements in mental health support for women in the perinatal period, partners, and infants dealing with mental health issues in their early years.

NHS Health Scotland conducted an Evaluability Assessment of the Perinatal and Infant Mental Health programme, helping us plan the evaluation and learn more about the program's impact. Now, as Public Health Scotland, we're continuing this work based on the assessment's recommendations.

Our Evaluation plan outlines how we'll evaluate the PIMH program. We have four main goals:

1. Check if pregnant women can access mental health services when needed.
2. See if primary caregivers can access mental health care for their infants in a timely manner.
3. Assess if practitioners working with young families understand and support mental health needs.
4. Check if women and families get the right early care and support, including referrals to specialised services if needed.

We're focusing on six key questions:

1. Are perinatal mental health issues identified early, and are women offered prompt care?
2. Are women at risk of mental health problems identified and supported?
3. What stops women from sharing mental health difficulties during pregnancy?
4. Are infants at risk of mental health problems identified, and caregivers supported?
5. Are caregivers supported to meet their children's needs?
6. Are caregivers supported to form and maintain a healthy relationship with their children?

To answer these questions, we're conducting the following studies: The impact of COVID-19 and delays in program implementation will be acknowledged where relevant:

1. Analysing existing data on maternal and infant mental health (Study 1: analysis of existing data)
2. Reviewing clinical notes (The EAG Group agreed to discontinue plans for this study as part of this current programme of work due to current challenges with the approach, because of the timeframe required to develop a strong Clinical Notes Review approach, and budget only being available for financial year 2023/24. On balance the EAG agreed that other studies will provide sufficient learning at this stage and other options can be considered in future).
3. Surveys and interviews with women in the perinatal period
4. Surveys and interviews with staff working with these women, infants, and their families
5. Mapping existing services
6. Monitoring progress in implementing the program
7. Reviewing literature on women's and infants' mental health (published on 12 November 2024)

Through this evaluation, we aim to provide learning that is used to ensure the PIMH program effectively supports the mental health needs of women, caregivers, and infants in the perinatal period in Scotland.

Delivering Effective Services Report: was published in 2019. This Needs Assessment set out the provision at that time in Scotland for Perinatal and Infant Mental Health (PIMH). The report set out a plan for future service models for Community Perinatal Mental Health, Maternal and Neonatal Psychological Interventions (MNPI), Infant Mental Health and Mother and Baby Units (MBUs). It set out proposals for the different models which were suggested based on birthrate in the Board area:

• Stand Alone – suggested for boards with a birthrate of over 5000 per year
• Integrated
• Regional – suggested for smaller Boards

Wellbeing for Wee Ones: This focused on the provision of mental health and support services in Scotland for children under 5, specifically for babies and those aged under 3 years. It maps services provided by local authorities and third-sector organisations, complementing, and adding to information previously published, Rare Jewels: Specialised Parent-Infant Relationship Teams in the UK published in 2019 (this was a UK wide report).

Perinatal and Infant Mental Health Fund Update Report: September 2023 - Inspiring Scotland is the fund manager for the Third sector Funding portion of the investment.

Perinatal and Infant Mental Health Programme Board Deliver Plans: The Programme Board was set up to oversee the investment fund. Chaired by Hugh McMaster and reported to the Mental Health Delivery Board. The Board concluded in March 2023 that although the work continues and until further governance structures are put in place the interim Perinatal and Infant Mental Health Advisory Group will support the Perinatal and Early Years Mental Health Policy Team to sustain this programme of work.

If you have any queries please get in touch: phs.evaluationteam@phs.scot