‘Supporting the best start in life’
Infant Mental Health Framework and Action Plan
2015-2018
CONSULTATION QUESTIONNAIRE
This questionnaire has been designed to help stakeholders respond to
the above framework.
Written responses are welcome either using this questionnaire template
or in an alternative format which best suits your comments.
Please respond to the consultation document by post or e-mail to:
Lesley Blackstock
Public Health Agency
Alexander House
17 Ormeau Avenue,
Belfast
BT2 8HD
Telephone 028 90311 611
Lesley.Blackstock@hscni.net
YOUR RESPONSE MUST BE RECEIVED BY 5pm ON FRIDAY 29TH
MAY 2015
(Please tick the relevant box)
I am responding:
 on behalf of an organisation
Name:
Job Title:
Organisation:
Address:
Tel:
Email:
Teresa Keating____________________________
Public Health Development Officer_____________
Institute of Public Health in Ireland_____________
Forestview, Purdy’s Lane, Belfast BT8 7ZX______
028 9064 849_____________________________
Teresa.Keating@publichealth.ie_______________
Vision and outcomes (pg 14)
Do you think the vision and objectives best describe what we want to gain
from the IMH framework and action plan? Yes/No/Somewhat
Please add any additional comments below:
The vision statement is quite general and may benefit from specifying mental health
explicitly or by referring to good/optimum social and emotional development. More
generally, throughout the document the terms baby, infant and child are used
interchangeably when referring to the 0-3 group. It would be useful to consistently use
only the term infant and that this should be reflected in the vision statement.
More generally, there is also inconsistent use of the terms parent, carer and primary
care giver throughout the document. There should be clear acknowledgement in the
introduction section of the roles of primary care givers and other carers who are not
the infant’s parent but for ease of reading, thereafter only the term parent is used
unless there is a clear argument against its use , for example when referring to child
care services.
The objectives may benefit from recognition that, outside of a core common
understanding, parents require different knowledge and skills from practitioners. For
example, with regard to objective 2, practitioners need skills related to supporting and
teaching parents as well as modelling appropriate responses while for objective 3,
practitioners need skills related to identifying and supporting parents of vulnerable
infants.
IPH welcomes the reference to equality in objective 4, however broadening it to
include promotion and prevention would better reflect the services needed to realise
objectives 1-3 and would be more in keeping with the spirit of the vision. A
promotion/prevention focus could also facilitate linkages to complementary services
such as breastfeeding support networks or teen parent groups for example.
Finally it may be useful to have an objective which acknowledges and supports the
role of evidence in policy and service development, including knowledge translation
and dissemination of new evidence among practitioners and between practitioners
and parents.
Priority work areas
The following key priority areas are highlighted in this framework and action plan.
1. Evidence and policy
2. Workforce development
3. Service development
Do you agree with these priority areas? Yes/No/Somewhat
Please add any additional comments below:
The terms workforce development and service development are not sufficiently
distinct from each other. Replacing the term workforce development with supporting
practitioners would better reflect the language used in the objectives and throughout
the document and would clearly distinguish between actions aimed at enhancing
practitioner competencies and actions aimed at improving availability of and access to
services. If the term workforce development is retained, it may be worth considering
replacing the term service development with service delivery.
IPH suggest renaming the priority area Evidence and policy as Evidence. This would
better reflect the content of the introductory text and the key actions which clearly
show that evidence is relevant for practitioners, commissioners and the wider
population as well as policy makers. Moreover policy is and should be a part of all
three priority areas.
Finally reordering the priorities to place evidence/evidence and policy at number 3
may better illustrate the supportive role that evidence (and policy) plays for the
workforce/practitioners and services.
Are there any further priorities that you feel this Framework should consider?
Yes/No
Please add any additional comments below:
While wider family, childcare providers and community and voluntary groups are
acknowledged throughout the document, IPH believes supporting their knowledge
and skill needs is misplaced in the priority actions relating to evidence and policy and
would fit better either as a subset of workforce development/supporting practitioners
or as a separate priority area.
Please now consider each of the priority areas in turn.
1. Evidence and policy (pg 16)
The Framework commits to ensuring that policy, practice and service development
are informed by the most up to date evidence on child development and infant
mental health.
What do you consider to be the main challenges in addressing this priority
area?
Communicating evidence and best practice to a wide variety of stakeholders in an
effective manner will be challenging. It may be useful to frame key actions from the
perspective of the various stakeholders including policy makers, commissioners,
practitioners and the wider population.
What are your thoughts on the key actions regarding evidence and policy as
set out in the draft Framework?
While naming a specific policy (DHSSPS Positive mental health and suicide
prevention strategy) may facilitate accountability and evaluation, it may inadvertently
limit consideration of other relevant policies and strategies. A similar caveat could be
applied to the naming of specific events (Belfast baby day). At the other extreme,
inclusion of broadly termed actions such as ‘Dissemination of emerging evidence
regarding what’s best for baby and family’ may benefit from more explicit descriptions.
What additional key actions, if any, do you think the Framework should include
regarding evidence and policy?
Evidence also needs to be gathered and disseminated to policy makers outside of
health. In addition to informing DHSSPS strategy, reference should also be made to
the need to relevant non-health policy such as early years education and childcare.
As well as promoting best practice standards it may be useful to consider further
actions such as developing a framework for assessing best practice and evaluating
the quality of research.
2. Workforce development (pg 19)
This Framework prioritises the need for practitioners to be fully equipped to promote
positive social and emotional development, to identify any issues at an early stage,
and to seek timely help for families at risk.
What do you consider to be the main challenges in addressing this priority
area?
Identifying and meeting the training and development needs of a wide range of
practitioners at different stages of their careers will be challenging.
What are your thoughts on the key actions regarding workforce development
as set out in the draft Framework?
Some actions would benefit from greater clarity, for example where it is stated ‘DE
also funding the roll out of Solihull training…’ it is unclear whether this is a statement
of current practice (thereby raising the question what is the action?) or a statement of
where action needs to take place
What additional key actions, if any, do you think the Framework should include
regarding workforce development?
To support the challenge of identifying and meeting the training and development
needs of a wide range of practitioners at different stages of their careers it may be
useful to group actions related to similar practitioners together
3. Service development (pg 23)
This Framework highlights the importance of appropriate services, both universal
and targeted, to support parents and hence promote healthy social and emotional
development of infants.
What do you consider to be the main challenges in addressing this priority
area?
Ensuring adequate resources, both monetary and personnel, are available to deliver
the identified services is likely to be challenging. This may be facilitated by clarifying
infant mental health specific elements of existing services (such as breastfeeding
support, ante-natal education etc) and services with a more overt focus on infant
mental health
What are your thoughts on the key actions regarding service development as
set out in the draft Framework?
Evidence suggests that service delivery to support infant mental health begins before
conception through inclusion of the topic in the school curriculum.
Some key actions here such as those related to the Breastfeeding strategy and
guidance on relationship and sex education may better fit in the evidence and policy
area. If however the actions are related to implementation, these should be more
clearly stated.
Expansion of parenting support programmes should feature in universal as well as
targeted services
What additional key actions, if any, do you think the Framework should include
regarding service development?
There should be a focus on rigorous evaluations of existing programmes and services
to ensure effective and efficient service provision. To facilitate this, resources for
evaluation should be allocated from the outset
This priority area may benefit from an action related to ensuring access to appropriate
services.
Any further comments
Please use the space below to provide any additional comments you may wish to
make in relation to the Infant Mental Health Framework and Action Plan.
While it is useful to have timescale and partners identified for each key action, many
would benefit from further detail. For example where ‘ongoing’ is stated, it would be
useful to have an indication of when this action started and any evaluation to date
The following comments relate to the introduction:
On page 6, the final sentence may benefit from plainer English. It could be inferred
from the current phrasing that only infants whose parents live in adverse
circumstances are at risk of developing poor mental health outcomes.
On page 13, it would be useful to see, if available, the number of children under 3
looked after in care and similarly for child poverty rates, if any breakdown in ages of
children is available.
Equality Screening
Please use the space below to provide any comments you may wish to make in
relation to the Equality and Human Rights Screening for this Framework.
Many thanks for your input.