There were 27 parent-infant teams known to the Parent-Infant Foundation in 2019. There are now 49, with many more services in development. This rapid growth has often been due to local efforts – the dedication of local clinicians and commissioners who have tenaciously worked to develop local provision. This has also been supported by national policy developments (notably Start for Life in England and the Perinatal and Infant Mental Health Board in Scotland) alongside other funding such as ‘A Better Start’ National Lottery funding in selected areas of England.

Parent-infant teams have developed in different ways as opportunities have arisen for dedicated and skilled practitioners to establish and grow provision. Many teams are part of public sector provision and some sit in the voluntary sector. Teams have often been forced to be innovative and agile to survive and grow, so they often do not sit in traditional structures and services.

Despite recent policy developments, there is still no consistent funding stream for the development and delivery of parent-infant teams in most of the UK. Most teams have funding from multiple sources, including public service funding streams in mental health, public health and children’s services, and voluntary sector funding. Many teams are funded by health (30/43).

The number of families seen directly by parent-infant teams in a year also varies, from under 25 families per year in some teams to over 300 in others.

• Perinatal mental health services (PNMH). PNMH services support mothers who have mental health difficulties, usually at the more severe end of the spectrum. Increasingly, there is also parent-infant relationship support offered in these services. However, this reaches a small proportion of the overall need.
• Although there has been an increase in the number of CAMHS services that accept referrals of 0-2s, our new Freedom of Information requests find the number of babies supported in CAMHS is still very low, with most services still only getting fewer than 10 referrals a year.
• Start for Life funding in England has initiated more parent-infant services to develop in the 75 areas that received funding. This has largely been at the universal and targeted level, with less offered at the specialist, more complex level of need.

Based on the data given at the time, it is estimated that parent-infant teams across the UK offer direct therapeutic support to between 4,400 and 6,500 families each year. It is estimated that the parent-infant teams around the UK are meeting around 4-6% of babies who currently need specialist support.

Parent-infant teams typically offer a range of therapeutic interventions to respond to the different nature and severity of families’ needs. The package of interventions offered is individualised and formulation led. The most common interventions offered by teams include video feedback interventions, parenting programmes such as Circle of Security, and individualised interventions such as parent-infant psychotherapy. Many interventions are dyadic, meaning they work with both parent and baby together.

A third of teams also offer some form of therapeutic support for parents to support their own mental health to help them engage with other interventions which support the parent-infant relationship. Many of the interventions used have a strong evidence base, although there is a need to develop the UK evidence base for the other interventions that are commonly used by parent-infant teams.

Parent-infant teams use their expertise to help other local professionals who work with babies to understand and support parent-infant relationships and to identify issues where they occur (and take appropriate action). They do this via joint care planning, training, consultation and supervision. It is estimated that, collectively, over the last year, teams offered consultancy to over 2,000 professionals, supervision to over 1,500 and training to over 40,000.

Many parent-infant teams work closely with their local perinatal mental health service. This can take the form of shared cases, care planning, supervision and reflective spaces. Around half of parent-infant teams have shared referral pathways with perinatal mental health teams. This joint working can better enable babies to get the support they need at the right time and place.

All parent-infant teams are multidisciplinary teams that include mental health professionals with specialist expertise in infant mental health and early relationships. This can include clinical psychologists, child psychotherapists, health visitors, social workers, midwives and other allied professionals.

Teams are generally led by a consultant-level clinician. Most staff in teams are band 7 and 8a or equivalent. The data illustrates the high levels of skill needed to lead a parent-infant team.

The majority of teams will see babies and young children from pregnancy to age two; 21 teams also see children older than two, some up to the age of five and a few beyond five. Some professionals have commented that when teams work with older children, babies are deprioritised.

Nearly all teams work primarily with mothers and their babies, with fathers and other parents or carers engaging to a variable extent in assessments and support. However, there are some good examples of purposeful engagement with fathers in some areas. Sometimes teams have limited information about fathers and their engagement because dads are not recorded as a service user on their systems.

Babies and young children in the child protection or care system are likely to have experienced the most severe difficulties and disruptions in their early relationships. These vulnerable babies are likely to particularly benefit from support from parent-infant teams.

Nearly all teams accept referrals for babies in the child protection system and for babies who are looked after or adopted. For most of these teams, the families with a baby on a Child Protection Plan were a minority of their service users. However, some teams focus specifically on this group of babies.

Some teams have developed relationships with children’s social care which facilitates referrals. This can include offering consultations and participating in pre-birth panels.

Around half of teams involve parents in service design and delivery. The ways in which teams work with parents varies. Some have asked parents for user feedback on external facing aspects of the service, such as the service name or parent information leaflet. Other teams had parent voices more embedded into the operation and decision-making across their service.

Baby’s or infant’s voice is a process of giving due consideration to the perspective of the baby and what their ‘voice’ would be if they could describe their experience.

Most parent-infant teams said that the baby’s voice was central to their work. Many teams consider the baby’s voice in a variety of ways in clinical assessments, consultations, decision-making forums and to inform service development.