About the thinking together discussions

IMH thinking together discussions were previously known as professional consultations. Professionals are supported to consider the infants lived experience and to think as a professional system about how best to support that infant and family. The IMH practitioner will facilitate this discussion, supporting a shared understanding of what is going on for the infant.

These discussions are requested through the usual IMH referral process. The practitioner making the referral is responsible for inviting the right professionals to the discussion.

Once the meeting is confirmed, all attendees will receive a one minute guide by email to help them prepare.

After the thinking together discussion, the IMH practitioner will write a summary and add it to the infant’s electronic record. This summary will also be shared with everyone who attended. The discussion may help inform the next steps in your work with the infant and their family.

The referrer is responsible for sharing any next steps with the family unless there is a clear safeguarding reason not to.

Infants are often sensitive to what’s happening around them. Even very young babies can be affected by stress, tension, or changes in their care. If their needs aren’t met or they experience high levels of stress, it can impact how safe they feel, their relationships, and their development.

We offer a chance for professionals working with an infant and their family to meet and think together about what the infant might be experiencing. This might include concerns such as:

• social care involvement
• family conflict or parental separation
• mental health difficulties
• drug and alcohol issues
• housing instability
• changes in caregivers
• caregiving that is distant, inconsistent, or scary

Even if your infant seems okay on the outside, these things can still affect them.

Infants may not use words yet, but they communicate through their behaviour, how they sleep, eat, play, and respond to others. The IMHS helps professionals understand what these behaviours might be telling us. It is then hoped that the professionals are able to better support you and your infant.

We offer a 90 minute online meeting where professionals can explore:

• family background
• what are we worried about (risk)
• what is the infant is telling us with their behaviour and communications
• what might be getting in the way of the relationship
• what is going well (strengths)
• what could be done to support things to be better

After the meeting, the IMHS practitioner writes a summary, which is added to the infant’s electronic health record and shared with those who attended.

Professionals working with you will explain what the meeting was about, what was discussed, and what might happen next but only if it’s safe for the infant. They may use what was discussed in the meeting to help decide next steps in supporting your family.

If you have questions about the meeting, please speak with your health visitor or social worker.

Why are family members not invited to attend their infant or toddlers’ thinking together discussion?

Parents or family members are not invited to these discussions as they are intended for professionals only (which can include professional foster carers). These meetings usually happen when it doesn’t seem like the right time to work directly with families.

Reasons for this might include:

• abuse or conflict between parents
• an infant being in in the care of someone else
• ongoing court hearings
• serious worries about mental health in the family
• drug use
• a parent who does not agree there is a worry about the child

All of these things can affect infants, so it important that professionals meet to make sure their needs and voice are heard.

It is still important that parents and carers know the meeting is happening. The professionals working with you will explain what the meeting is for, what was discussed, and what might happen next, but only if it’s safe to share this information.

What do you mean by risk?

Sometimes, certain situations or behaviours in early relationships can pose a risk to infants. This means that they may not be safe or may be experiencing harm. Examples of risk in early relationships can include:

• Neglect: Not meeting an infants’ basic physical or emotional needs such as food, warmth, medical care, staying safe or supporting their feelings and development
• Emotional abuse: Ignoring an infant, constantly criticising them, threatening, or rejecting them
• Physical abuse: Intentionally hurting an infant
• Domestic abuse: Violence or controlling behaviour at home that infants may witness or experience
• Inappropriate caregiving: When an infant is cared for by someone unable to meet their emotional or physical needs safely

Understanding these risks can help families and professionals work together to protect and support infants.

Will there be a written summary of the discussions?

A summary of the discussion will be written by the IMHS practitioner and shared with the professionals that attended the meeting. It will also be written on the electronic patient record of the infant. The professionals that are working with the family will discuss any relevant next steps with you.

Why is the focus of the discussion on my infant?

Research tells us that when there is a lot going on for families, what is happening to or for the infant can sometimes be missed (NSPCC: Voice child, 2024). The thinking together discussion is an opportunity for the professionals that know the family and the infant or toddler, to focus on what is happening for them. The discussion will also seek to find ways for things to feel better for an infant to give them the best start in life.