Thousands of mental health appointments missed every year

Thousands of mental health appointments missed every year

More than five appointments with mental health specialists are missed every day across Tayside.

On average, 2,286 mental health appointments have been missed each year since 2013.

And the no-shows are increasing, with 2,667 appointments missed in 2018 being the highest figure in the last five years.

The reasons for patients not making it to appointments after a GP referral are complicated, according to a local mental health charity.

Wendy Callander, chief executive of Wellbeing Works Dundee, said anxiety is just one of many reasons.

Wellbeing Works is the rebranded name for the Dundee Association for Mental Health, following a change last month.

Ms Callander said: “It is difficult for me to say why people miss appointments with the NHS, but we have similar examples when people are referred to us.

“They often miss their first meeting if we send them a letter inviting them in after a referral. If we reach out to someone, there is a chance they will not show.

“There’s a lot of anxiety and not knowing what to expect that causes that.

“We get referrals from a wide source of people and places.

“What is more likely to work for us is if someone comes with them — a friend or family member of support worker, for example.

“With mental health, you don’t just wake up deciding you have a problem. It can take weeks and months to creep up.

“Going to a doctor about a cough can provide anxiety, so if it’s about mental health that can be even worse.”

While understanding how difficult it can be for someone with mental health issues to  reach out for help, Wendy insists it is worthwhile.

She added: “It’s a huge problem.

“NHS are telling us about missed appointments and they are trying to address that particular issue.

“Wellbeing wants to resolve the issues because the help is there, but if people aren’t able to get to it then they’re not getting the benefit.

“One problem is people not knowing what to say to a GP, but there is nothing you can tell them that they haven’t heard before.”

NHS Tayside does not report reasons for why appointments have been missed, as most of the time it is not known.

Missed GP appointments for all ailments cost the health board £277,000 in just one week last year.

At the time, NHS Tayside estimated that one in 10 GP appointments are wasted every week.


link to Courier article here

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Mental health staffing concerns as medics fear for future of Tayside psychiatric services

The Carseview Centre


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Mental health bosses admit care standards slipping across Tayside

Youngsters in Tayside are facing an “alarming” mental health crisis after care bosses admitted standards have plummeted in six months.

The number of kids getting help for mental health problems within a reasonable time frame dropped from 96.6% in June 2017 to 43.9% in December.

The rate covers the proportion of youngsters who are referred to and seen by NHS Tayside’s child and adolescent mental health services (CAHMS) team within a target of 18 weeks.

Across Scotland, the target health boards are expected to meet is 90%.

Keiran Watson, of youth support charity Eighteen and Under, said he found it “alarming” that less than half of kids were being seen on time.

He said: “As it is, the 18-week timescale is too long.

“If you’re a young person who is feeling depressed or has delusions, or is self-harming or even feeling suicidal — or if you are a parent of a young person like that — can you imagine being faced with an 18-week wait?

“The fact that less than half of young people are being seen within that 18-week target is shocking. It’s really quite alarming.”

Lorna Wiggin, NHS Tayside’s chief operating officer, told the health board at a meeting this week the slide was due to staff shortages equivalent to 3.3 full time workers.

She said: “Previous attempts to recruit have been unsuccessful. However, the posts have been re-advertised and interviews are due to take place in March.”

Ms Wiggin said significant improvements would not happen until those positions are filled, but added that high-priority children can be seen within five days of referral if their case is judged to be an emergency. We’re expecting a slight improvement in the next three months, but not a major one.

“We were able to rely on adult (mental health) services for some support but they’re not able to do that now.”

NHS Tayside may well reach out to other health boards for support with CAMHS in the near future.

Chief executive Lesley McLay said she had requested a review of the system with managers to avoid any further repeats of the situation.

She added: “We recognise that action is already happening (to improve performance). We may involve another health board as well.”


Link to Evening Telegraph here 

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Mental health service revamp across Tayside gains approval

The Carseview Centre

Health chiefs in Tayside have stated having two centres of excellence is the only safe way forward for inpatient mental health services.

The decision was taken at a meeting of Perth and Kinross Integration Joint Board following months of consultation, campaigning and protest.

It will see general adult psychiatry acute admissions centralised at the Carseview Centre at Dundee’s Ninewells Hospital.

Learning disability inpatient services will be provided at Murray Royal Hospital in Perth alongside other specialist services, including rehabilitation and substance misuse.

The decision will see services relocated from the outdated Strathmartine Hospital and the Mulberry unit at Stracathro Hospital in Angus.

The board voted five to one (an abstention) in favour of the preferred option.

Clinicians believe the steps will secure the future of inpatient services, improve the quality of service and environment available to patients and make services more attractive to potential staff.

Individual health and social care partnerships in Angus, Dundee and Perth and Kinross will be working to enhance mental and health and learning disability services in local communities, where 94% of mental health care is delivered.

More than 100,000 people took part in an often-criticised consultation process and more than 57% of those who responded said they were against the proposals.

NHS Tayside’s medical director Andy Russell, however, said the present model of care could not continue, with the redesign proposed “the only safe option”.


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Deep concern expressed over mental health beds drop in Tayside

The Carseview Centre.

“Deep concern” has been expressed over a 10% drop in acute mental health beds across Tayside over the past five years.

The number of beds for men and women dropped from 99 in 2013 to 90 last year.

Health chiefs said the reduction was due to a reconfiguration in Perth and the interim relocation of the Mulberry Unit in Angus to the Carseview Centre and insisted most patients were now treated in the community.

However, Angus MP Kirstene Hair is seeking a reassurance from NHS Tayside that the numbers will not fall any further.

She said a total of 44 beds were likely to be relocated from Murray Royal Hospital and the Mulberry Unit at Stracathro in Angus as part of a shake-up of mental health care, while a similar number will be set up in Dundee at Ninewells Hospital.

But she added: “This research finds that the number of beds for a growing problem is reducing anyway – which is of deep concern.

“There needs to be a reassurance from NHS Tayside this number will not shrink any more.”

Conservative MP Ms Hair said she was also concerned that there are no eating disorder beds locally, meaning people are still having to go to Aberdeen for specialist treatment.

“It’s my concern and that of many of my Angus constituents that local health services are disappearing in the background,” she added.

“It is only huge change, such as ward closures, which makes people sit up and take notice.”

Closure of the Mulberry ward at Stracathro Hospital has been identified as the preferred option in a programme to address what officials have described as an unsustainable model for mental health care across the region.

Perth and Kinross integration joint board will have the final say on the package next week.

The move is likely to mean the axe for the Angus unit while general adult psychiatry acute care will be provided from four wards at Dundee’s Carseview Centre, along with learning disability inpatient services from three wards at Murray Royal Hospital in Perth.

Chief officer for Perth and Kinross health and social care partnership Robert Packham said only around 6% of people who access mental health services each year need hospital care.”

He acknowledged there had been a small reduction in the number of acute general adult psychiatry beds in the last five years, adding: “This is due to the reconfiguration of Moredun Ward at Murray Royal into separate male and female environments, and the interim relocation of the Mulberry Unit to the Carseview Centre.

“We have also been redesigning services to adapt to the changing needs of our populations and new services have been introduced to manage people in crisis and support people to remain at home,” said Mr Packham.

“Our communities would expect treatment to be available to them and their families when it is required and we remain committed to ensuring our patients can access the best treatment in the most appropriate place.”


Link to Courier article here 

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Controversial restraining method used once a week on local mental health patients

The Carseview Centre 

A controversial restraint technique has been used on patients in NHS Tayside psychiatric hospitals almost once a week.

In the first 10 months of 2017, 53 patients were subjected to “floor — face-down” restraints in psychiatric institutes across the region.

The practice can be dangerous as a person is restrained, face down, with the weight of one or more people on top of them, which can lead to the person’s breathing being restricted.

The technique is generally carried out when a person is acting as a danger to themselves or others.

In the 2016, it was used 39 times across Tayside’s mental health facilities.

Research by the mental health charity Mind found that some mental health trusts across the UK no longer use face-down restraint because it is considered “too dangerous and traumatic” and the charity previously called for a ban.

Calum Irving, director of See Me — which tackles mental health stigma and discrimination — said: “When people are struggling with their mental health they deserve to be treated with dignity and respect, free from discrimination of any kind.

“This is especially true in health and social care settings, therefore restraint should always be a last resort and every effort made to avoid it.”

Colin McKay, chief executive of The Mental Welfare Commission (MWC) for Scotland, which protects and promotes the human rights of people with mental illness, said: “Any form of restraint must be legally justified, and be the minimum which is reasonably necessary, for the minimum possible time.”

A spokeswoman for Perth and Kinross Health and Social Care Partnership said: “In some instances, it is necessary for staff to use a reasonable level of force to restrict a person’s movement to avoid a greater harm occurring.

“The ‘floor – face down’ restraint is a response to a high level of physical risk from a patient and is used only when all other options have failed. It is generally considered to be the last resort and is used for the shortest-possible time to ensure the safety of patients and staff.

“All physical interventions are taught from the perspective of being the last resort for the shortest period of time using the lowest level of force/restriction and the smallest number of staff.”

Link to Evening Telegraph article here 



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