A man whose entire adult life has been plagued by mental health difficulties believes a 24-hour crisis centre for those suffering in Tayside would be a “great idea”.
Marc McLeish backed the Not in Vain for Lee campaign aimed at setting up a round-the-clock self-referral service, warning vulnerable people desperately need more support resources across the region.
The 33-year-old, from Perth, said: “If something like that existed in Tayside, it would be great.
“I have probably had about 40 emergency assessments in total but in almost 90% of these, I have been sent away with no treatment.
“If there was somewhere that was 24 hours, then it could be the case that I would not have self-harmed as much as I have.
“It would be great to have one in Perth as well but Dundee would be a good start.”
Marc, who was diagnosed with borderline personality disorder aged 23, has spent his entire adulthood battling his demons and the years since his school days have been marred by repeated incidents of self-harming and multiple hospital stints.
He said: “When I was in my teens and early 20s I attempted suicide quite a few times by taking an overdose.
“I have been a prolific self-harmer since I was in my teens and I have probably done it up to 100 times in 17 years.
“I always felt like I was a bad person because I was gay and I believed I needed to be punished, so that’s what I have done.”
Marc’s struggles with his mental health have had a profound impact on his day-to-day life and he admits he has difficulty coping. He added: “I really don’t have a very good quality of life.
“For me right now, it’s not a day at a time but rather two hours at a time and that’s what’s getting me through.”
Marc spoke about his mixed experiences with health services throughout his struggles, having been admitted to hospitals in both his hometown and Dundee.
“The first inpatient treatment I had was probably about 10 years ago in the Murray Royal Hospital and I had no issues with the treatment there,” he said.
“My GP practice has been fantastic, but there is definitely a lack of resources in Tayside.”
Marc’s most recent stint in hospital was just last month, when he spent five days in the Carseview Centre in Dundee after being admitted following an appointment with his GP.
He also raised concerns that his time at the Dundee unit was spent unsupervised – so much so he claims he was able to harm himself twice during his stay.
He said: “In Carseview, I felt people were left to their own devices.
“I asked my named nurse for a razor, saying I wanted to shave and I was told that as long as I wasn’t going to harm myself, I could have it.
“I then severely harmed my right arm with the razor and the wounds were gaping wide.
“I discussed with my family whether I should leave and we came to the joint decision that I should.”
A spokeswoman for NHS Tayside said: “Due to patient confidentiality, we are unable to comment on matters relating to individual patients.
“However, we can confirm we are in direct contact with the patient’s family.”
It said the key themes were patient access to mental health services, patient sense of safety, quality of care, organisational learning, leadership and governance.
Referring to risk management, the report said: “Patients report telling staff they were suicidal but the risk was not taken seriously until they made a serious attempt to take their own life.”
‘Violated and traumatised’
In relation to patient safety, the report noted: “Some patients report being frightened of certain staff on the wards who have a poor attitude to the patients in their care.
“Others mentioned that another patient had assaulted them whilst they were on the ward.”
The report said the use of restraint within inpatient facilities was of “great concern” to patients, who had experienced it or witnessed it taking place.
It said: “Patients feel violated and traumatised, particularly if they have personally suffered violent abuse in the past.”
It added that staff seemed unable to control the availability and use of illegal drugs on the wards in the inpatient facilities.
“Both patients and families report seeing drugs delivered, sold and taken within the Carseview Centre site,” the report said.
“Staff confirm this is a serious issue which is not being adequately addressed.
“There is a lack of support from management for frontline staff attempting to address this issue and it is having a detrimental effect on patient care and treatment regimes”.
‘Unexpected and concerning’
In a section on the Crisis Service, the report said that the Crisis team “struggles to respond to sudden surges in demand on the service.”
It said: “There are occasions when the length of time to wait to be seen is long and families supporting someone in crisis are advised to phone the police or NHS24, if they are worried.
“This advice is unexpected and concerning to carers coping with a crisis in a domestic situation.”
The report said the centralisation of the out-of-hours Crisis team to Carseview Centre has had a “detrimental effect on those patients in Angus and Perth & Kinross who are experiencing mental health crisis”.
It said: “There is a perception that whilst the Crisis service has expanded in recent months, the situation has worsened in terms of patients being assessed then not being offered any crisis intervention, or referred back to the GP.”
Inquiry chairman David Strang said: “The themes which have been identified will shape the next stage of the inquiry.
“Our final report will include conclusions and recommendations which will lead to the improvement of mental health services in Tayside.”
NHS Tayside chief executive Grant Archibald said: “We are taking on board all comments in the interim report, alongside the feedback we received from the Health and Social Care Alliance (the Alliance) published in their report in December 2018.
“The key themes which have been identified in both the Alliance report and in today’s interim report are recognised by the board and the mental health leadership team – and we are taking action on these.
“I also recognise and want to thank the many staff who are already working really hard to improve services and look forward to their continued support.
“It is clear that we have further work to do but since I came to Tayside, I have made mental health a top priority and I am confident we can learn lessons, strengthen our engagement with patients, service users, families and the public and make the right kinds of changes, at the right time, to transform our mental health services.”
He added: “We would like to thank everyone who has shared their experiences so far and we look forward to the independent inquiry’s final report and recommendations which will be a major influence on the future shape of mental health services in Tayside.”
The report has not been made public but has been seen by the BBC.
It found that untrained staff were carrying out risky restraints on patients and that the number of restraints was high.
It said face-down, and particularly face down in a prone position, are the highest tariff interventions of physical restraint, and the most dangerous techniques to deploy.
The report looked at a sample of 40 cases and found more than half were patients being restrained face down on the floor for longer than 30 minutes.
The longest restraint was one hour and 45 minutes.
“That is completely against all guidelines,” Prof Tyrer said.
“You may have to do things for five minutes or up to 10 minutes but to go beyond 40 minutes there is something badly wrong in the organisation of a unit if that is allowed to continue.”
Carseview is a hospital to care for patients with mental illness from depression and anxiety to schizophrenia and psychosis.
In July last year, BBC Scotland broadcast allegations by patients of bullying by staff, illegal drug-taking and being pinned to the floor unnecessarily.
Experts called it abusive and said the unit should be closed down.
NHS Tayside responded by commissioning an internal report into Carseview to go alongside independent reports into mental health in Tayside.
The internal report says a whistleblower has come forward and accused Carseview of “very serious concerns over leadership, safety and malpractice”.
It came up with 11 recommended actions including urgent action on staff training and critical action on illegal drugs on the ward.
It said the restraint policy should emphasise the safety of patients as well as staff and that the culture of the unit should be “based around the caring and compassionate leadership approach”.
NHS Tayside said the recommendations covering patient care and culture were “now being progressed”.
Prof Peter Stonebridge, acting medical director for NHS Tayside, said a “steering group has been established” to focus on restrictive care practices, including the reduction of face-down restraint.
Joy Duxbury, professor of mental health at Manchester Metropolitan University, told BBC Scotland: “I think this is a terribly toxic environment.
“The figures on physical restraint are exceptionally worrying.
“These are very vulnerable clients who are being restrained, in my view, unnecessarily and by far too many staff in too many situations.
“For me, given what we know about psychological and physical trauma of the use of restraint in such setting, this is of significant concern.”
Marnie Stirling, who had two stays in Carseview with anxiety and depression, spoke to the BBC documentary last year.
Reacting to the report, she said: “If you think about mental health, it’s supposed to be about recovery. This isn’t recovery, it’s further punishment for people.”
David Fong spent a month in the unit after experiencing psychosis in 2013.
He claimed staff used restraint violently and repeatedly during his time there.
His mother Lorraine said: “This is a total and utter disgrace that this has gone on for seven years and maybe longer.”
David told BBC Scotland that staff were quick to see frustration and anger arising from detainment as aggression.
“Staff are too keen to initiate restraint and offer little or no de-escalation when no actual aggression has been displayed by the patient,” he said.
“I ask how many of these restraints were actually needed and if some are instigated by staff rather than patients?
“I personally was physically assaulted with the application of intense pain through twisting of arms, wrists and fingers or a member of staff’s knee being dug into my back, had my face rubbed into the floor causing loss of skin from my face, and had verbal abuse screamed at me during restraint.
“I also could not have been the only patient that these tactics were being used upon.”
A separate report looking at the patient experiences came up with separate 23 recommendations in December.
It is feeding into an independent inquiry, which was announced in the Scottish Parliament last year, and is still ongoing.
A Fife director is hoping to release a new film with a focus on coping with depression over the festive season in time for Christmas 2019.
‘Cold’, which has been written and produced by Kirkcaldy film maker Gavin Hugh, is being filmed in locations across Kirkcaldy, Stirling, Edinburgh and Aviemore, with two days of filming already in the can.
It is a huge personal undertaking for Gavin, who has previously worked for STV and Sky News and has been running his own Kirkcaldy-based video production business, MidgieBite Media, since late 2017 while also working part time at the Scottish Parliament as an assistant to Dundee City East MSP Shona Robison.
However, with the production funded through goodwill and his own pocket so far, Gavin and his team plans to launch a crowdfunding campaign early this year to help finish the film and release it in winter 2019.
“For a lot of us, Christmas is a happy time of year where we can celebrate and put all of our troubles to one side but for people suffering with depression it can be incredibly difficult to do that,” Gavin explained.
“We focus on how the pressure of trying to take part in the festivities and putting on a brave face just isn’t something that can be easily switched on and off in time with the days on a calendar.
“Taking care of your own mental health is easy to overlook. I’ve had my own issues with anxiety over the years, and some of the people that I’m closest to in my life have suffered from depression.
“Mental health issues can be challenging not just for the individual but for the people around them who are trying to offer support.
“As this film is drawing on a lot of personal experiences, it’s really important for me that our film gives an honest portrayal of these issues.
“While there’s an increasing awareness of mental health issues in mainstream society, we’re really hoping that the film can help encourage people to still be mindful of them at this time of year.”
Gavin has been involved in a lot of local film projects over the years, particularly with horror filmmakers Hex Media, and has recently been working closely with Robbie Davidson on his upcoming World War Two epic ‘Dick Dynamite’.
Most of the primary cast for Cold are Fifers, including Andrew Gourlay, Hana Mackenzie, Craig Seath and Iain Leslie, as are most of the technical crew.
Lead actress Rowan Birkett, a friend of Gavin’s from student days at Stirling University, has been travelling up from Ambleside in England to take part, while Dundee is also represented in Grant R Keelan, a city-based photographer who acts in the film as well as working in the technical team.
“It’s genuinely been great to work with so many talented local artists,” he added.
More details about the crowdfunding campaign will be announced in due course, and the plan is to hold a premiere of the new film in Kirkcaldy later in the year.