The Refreshed Perinatal Mental Health Curricular Framework & the NES Advanced Infant Mental Health Training Pathway Dr Suzy O’Connor NHS Education for Scotland Programme Director Early Intervention, Perinatal & Infant Mental Health
Context for the refreshed curriculum • Original developed by multi-disciplinary national group & published, by NES, in 2006 • Formed the basis for Specialist Perinatal Mental Health Module at Glasgow Caledonian University in 2007 • Informed the introductory online Maternal Mental Health courses developed by NES in 2015 • NSPCC 2015 ‘Getting it Right’ report highlighted gaps in perinatal mental health care in Scotland • Led to SG working group on this • RC Psych ‘Perinatal and Infant Mental Health Action Plan’ 2016 • Set out aspirations for service developments • SG Mental Health Strategy 2017-2027 • Action 16. Fund the introduction of a Managed Clinical Network to improve the recognition and treatment of perinatal mental health problems.
The refresh of the Perinatal Mental Health Curricular Framework • Since 2006, research, key policy documents have informed and changed practices • For example, our knowledge around the interactional nature of neuro- development and the impact of its absence for the infant’s physical and mental health outcomes • Multi-agency working party of those with expertise around PNMH and IMH were involved in the production of the new framework • Aimed to guide educationalists in developing: • Curricula for pre-registration and under-graduate programmes for a range of health profs • CPD for those already working in health, social care and the 3 rd sector
• Key questions: • Is the title right? The refresh of • Are the levels of practice helpful? the Perinatal • Are the existing 5 dimensions the right ones? Mental Health • Is the current format of learning outcomes divided into core content with associated Curricular indicators of achievement the best format? Framework • In terms of specific content, does anything need more in depth exploration, does anything need added?
• 2018: • Consistent with NES Trauma knowledge and Skills Framework and covers the whole workforce • 2006: Levels of • Training needs determined by the extent to which the practice • A. Level on registration / worker will come into graduation, contact with mothers and babies who have mental • B. Level on qualification as health difficulties public health nurse, GP, • Each level builds on the psychiatrist, obstetrician, preceding level(s) to avoid • C. Specialist Level repetition and enhance readability / utility 1. Informed 2. Skilled 3. Enhanced 4. Specialist
Levels of Practice • Informed: Baseline knowledge and skills required by all staff in the Scottish workforce including those working in health, social care and third sector settings (All staff) • Skilled: Knowledge and skills required by staff who have direct and/or substantial contact with women during pregnancy and the postnatal period, their infants, partners and families (All maternity, health visiting, primary care, children & families social work, relevant third sector) • Enhanced: Knowledge and skills required by staff who have more regular and intense contact with women who may be at risk of/affected by perinatal mental ill health, their infants, partners and families (All mental health, incl. adult, CAMHS, addictions etc.; maternity, primary care, health visiting and third sector staff who work in an enhanced role)
Levels of Practice, continued • Specialist: Knowledge and skills required by staff who by virtue of their role and practice setting, provide an expert specialist role in the assessment, care, treatment and support of women who may be at risk of/affected by perinatal mental ill health, their infants, partners and families. They will often have leadership roles in education, training and service co-ordination and development (Staff who work within specialist perinatal and infant mental health services) • Perinatal period – The time encompassing pregnancy planning, pregnancy, childbirth and the mother-infant relationship during the first year after childbirth
Five dimensions outline what practitioners know and can do at each of the four levels • Previously: 1. Health and Wellbeing • All women, babies and partners experience optimal health and • 1. Underpinning knowledge well-being during the perinatal period • 2. Prevention 2. Family Support • 3. Detection • Partners and family members are closely involved in perinatal mental health care for women and babies • 4. Management 3. Parent-Infant Relationships • 5. Professional, ethical, legal practice • Parent-infant relationships are warm, secure and attuned during the perinatal mental health period • Desire to bring the terminology up to 4. Stigma date to fit with current views, to • Discrimination and stigma relating to perinatal mental health emphasise infant mental health & difficulties are eliminated or reduced attachment, the promotion of positive 5. Interventions mental health and wellbeing • Women receive specific interventions or treatments appropriate to their perinatal mental health needs
Dimension 1: Health & Wellbeing: Enhanced Level What practitioners know What practitioners can do • That women with pre-existing • Provide women, their partners and families, with an understanding of mental ill health, or psychosocial how normal physical and emotional adversity, may face additional changes in the perinatal period may difficulties in managing common impact on mental health, particularly physical and emotional changes in the presence of pre-existing mental that occur during the perinatal disorder or psychosocial adversity period • Evaluate and communicate the • Normal emotional changes may be significance of physical and emotional misattributed to mental disorder changes in the perinatal period for individual woman, given their own • How to access maternity care and history and experiences advice directly, both routinely and urgently
Our Aspirations for the Refreshed Curricular Framework To have a framework that reflects current conceptualisations around perinatal and infant mental health Draw attention to training resources that are available and not necessarily accessed as widely as they could be, perhaps via interactive PDF Highlight any gaps in training provision
Module 1: Understanding Maternal Mental Health • Introduces key facts about mental illness that may affect women during pregnancy and postnatally • Promotion of positive mental health • Risk and protective factors for mental ill health • Explores current evidence about prescribing in pregnancy and during breastfeeding. • Completion time is around 1.5 hours.
Module 2: Maternal Mental Health, the woman’s journey • Covers the woman's journey from pre-conception to the postnatal year • The learner is encouraged to understand their own role in promoting and supporting a woman's mental health in the context of coordinated multi- agency care • This module represents around 2.5 hours of learning.
4 weeks long (4 hours per week) and free! Accredited by the Association for Infant Mental Health
NES Advanced Infant Mental Health Training Pathway • First stage of training pathway • Online module for health and other professionals in Scotland • To develop knowledge & confidence to support families to promote positive IMH & develop secure early attachment relationships
The Solihull Approach 2 Day Foundation Level Training Introduces the Solihull model for understanding the impact of relationships on health and well-being and the impact of ACEs on health and well-being
Advanced Infant Mental Health Training Pathway, continued • The Infant Mental Health Online Training • Developed by the University of Warwick (Prof. Jane Barlow) • Delivered over 16, two-hour weekly sessions • New cohort commences Sept 2018 • Those who complete IMHOL can apply for further training in an infant mental health intervention (VIG or Mellow Babies), through NES, later in 2018
Advanced Infant Mental Health Training Scheme, continued • To find out more about this training, please contact: Emma.Cairns@nes.scot.nhs.uk • Please submit applications for this training through the NES Portal: https://www.portal.scot.nhs.uk/ • Search for ‘Advanced Infant Mental Health Training Scheme’ • Please ensure that applications are submitted for IMHOL by the 13 th of August 2018. Places will be confirmed by Early September 2018.
• suzy.oconnor@nes.scot.nhs.uk • Thanks so much for listening; please do get in touch if you have any further questions or comments
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