The independent inquiry into mental health services in Tayside has retired to consider the key issues hampering the system’s ability to care for patients.
Launched following pressure from the families of suicide victims in Dundee, the inquiry’s evidence stage has concluded after receiving hundreds of submissions from the public.
Alongside other evidence, these will now be examined by the inquiry, chaired by former chief inspector of prisons David Strang.
Mr Strang said: “I am pleased with the response we have received to our public call for evidence. More than 200 people have submitted written documents and personal statements and there have been more than 60 oral evidence sessions held.
“Evidence has been submitted from a wide range of people including patients, families, carers, NHS employees and third-sector organisations.”
David Strang is chairing the inquiry
Agencies such as Police Scotland, student welfare teams and Dundee Drugs Misuse Commission have also contributed.
The evidence stage has taken several months, with discussions held with parties with an interest in improving mental health services.
The inquiry has visited psychiatric units including the Carseview Centre, the Rohallion Clinic and Stracathro in order to understand the systems currently in place.
The information it has gathered to date will be used to identify key issues in mental health services.
A statement from inquiry chiefs said: “The next stage of the inquiry’s work is to analyse all the data evidence, relevant government reports, statistical data, internal NHS review documents and data, in order to identify common themes which will then be the subject of further investigation and analysis.”
The inquiry was commissioned by NHS Tayside last year after campaign group Lost Souls of Dundee claimed it had identified at least 10 suicides which could have been prevented in the area.
A new suicide prevention initiative will be launched in Dundee after findings showed the city has the highest rate of people taking their own lives in Tayside and Fife.
Poverty and welfare reform have been cited as one of several contributing factors in the city, which is infamous for having one of the highest numbers of benefit sanctions in Scotland.
The Suicide Prevention Strategic Plan would bring the city council, NHS, emergency services and specialist mental health services more closely together to work on preventing deaths.
It will be under consultation until April and is expected to be endorsed by the Dundee Integration Joint Board in June.
An investigation carried out between 2013 and 2017 showed 131 people died by suicide in the city in that time.
The rate of 19 per 100,000 population was significantly higher than the Scottish average of 13.5.
Males in Dundee have the second highest mean rate of suicide in Scotland.
A report compiled by the Tayside Multi-Agency Review Group, set up in 2016 to investigate the issue, said: “Scotland continues to have a higher suicide rate than the rest of the UK mainland and there is a strong association between suicide and socio-economic deprivation.
“A number of cases have highlighted the impact of issues around benefits in potentially contributing to local suicide deaths.”
Concerns have also been raised about ambulance staff having no access to mental health records when dealing with emergencies, unlike the police.
Speaking at Tuesday’s Health and Social Care Partnership meeting, the committee’s chair Trudy McLeay said: “I was surprised that the ambulance service don’t have access to mental health records.
“It must be a very difficult situation, especially when dealing with an attempted suicide.”
Common factors identified in Tayside men and women who died by suicide included bereavement, a criminal history, harmful use of alcohol, adverse childhood experiences and physical health problems.
Among men, a significant number were found to have had a record of abuse perpetration, psychotic or organic brain conditions, Autistic Spectrum Disorder, a career history in the military and/or Eastern European ethnicity.
Meanwhile, a common factor specific to women was infertility.
A further report submitted to the Dundee Health and Social Care Partnership raised concerns that there may not be enough funding to implement the new plan.
DWP spokesperson said: “Suicide is a highly complex issue and it’s wrong to make a link with welfare reforms.
“This report is over 300 pages long and mentions welfare reform in just one paragraph.”
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.
A second charity football match in aid of a young Dundee dad who took his own life after suffering from depression is to be held in the summer.
Lee Welsh, 27, was found dead at his Peddie Street home in the city’s West End in August 2017.
At the time, his dad Phil said that Lee, whose daughter Poppy was then aged seven, had battled mental health issues for the previous nine years.
Last year Lee’s childhood friend, Steve Martin organised a football match in memory of his mate which raised more than £1,000 for the Dundee Association for Mental Health (DAMH).
The event was so successful that a second one has been organised for July 20 this year.
It will be held at North End Park and this time the money raised will be donated to Art Angel on behalf of the Not in Vain for Lee charity.
As well as football there will be other attractions on the day including a bouncy castle, face and henna painting, a pipe band, live music and a demonstration by Dundee Mods Scooter Club.
Phil – who has actively raised awareness about mental health issues among young people since his son’s death – was thrilled with the turnout and the money raised last year.
He said: “It really was an absolutely brilliant day.
“We hope we can get the same response this year.
“It’s all about looking to the future now in raising money for our mental health charities.”
The number of people with mental health issues being readmitted to hospital in Tayside within a month of their discharge is increasing.
More than 16% of Tayside adults discharged from hospital, having been admitted on mental health grounds, were back within a month in 2016/17, according to new figures.
The readmission rate has increased from 11.9% in 2012/13.
NHS Tayside is above the Scottish average for mental health hospital readmissions in the most recent statistics compiled by ISD Scotland.
At 16.3%, it was behind only NHS boards in Dumfries & Galloway and Lothian.
The majority of patients readmitted after an initial stay in hospital were affected by mood disorders (36.9%), delusional type disorders (19.2%) and adult personality and behavioural disorders (15.8%).
North East Scottish Conservative MSP Bill Bowman said the increase in readmissions for depression is “very troubling”.
The ISD figures also recorded NHS Tayside region had the fourth highest suicide rate in Scotland, behind Forth Valley, Highlands and Orkney – 14.4 per 100,000 between 2012 and 2016.
Mr Bowman said: “At some point, one in four people will experience a mental health condition.
“NHS Tayside staff are doing their best to deal with the growing number of people who come to them with symptoms of depression and low mood.
“Because Tayside has such a high suicide rate, NHS Tayside needs resources to dig into why people come back to hospital so quickly.
“If it’s because of underfunding in areas run by councils and community healthcare partnerships, the SNP government needs to assess the potential damage it is doing by making cuts to local authority budgets.”
A spokesperson for NHS Tayside said: “Mental illnesses can be unpredictable and there are many reasons why a patient may require to be readmitted following discharge from hospital.
“Patients can sometimes experience a new episode of illness for which admission to hospital is the most appropriate course of treatment.
“Patients are discharged following clinical assessment from a consultant psychiatrist and are followed up locally within the community.
“There is no direct relationship between the length of time a patient is in hospital and the need to be readmitted.”
She added: “Anyone can become suicidal; the reasons can be different and very complex and it is not always due to mental illness. Each suicide is a tragedy and the impact on those left behind lasts a lifetime.
“Every suicide in Tayside is comprehensively reviewed by the Tayside multi-agency Suicide Review Group to look at the circumstances surrounding each individual case.
“f people are feeling suicidal, the best thing to do is talk and tell someone how they are feeling. Speak to someone you can trust or call a helpline. If you’re worried that someone else is suicidal, ask them – asking someone directly about their feelings can help them.”
Further help and information can be found by downloading the “Suicide? Help!” app, visiting www.suicidehelp.co.uk or calling NHS 24 on 111, Samaritans on Freephone 116 123 or Breathing Space on 0800 838587 or www.breathingspacescotland.co.uk
An independent inquiry into mental health services in Tayside is currently under way.
Wilma is still heartbroken over the loss of her son Gavin (left)
A grieving mum is still seeking answers 11 years after her son died at the Carseview Centre.
Gavin Allan was just 26 when he died from the “adverse affects of heroin” on January 17 2008.
Gavin Allan
Wilma Hughes
His mum Wilma Hughes, from Douglas, said she still doesn’t know what happened in the hours leading up to her son’s death.
Wilma said: “I’m still looking for answers about how my son was able to get the drugs that ultimately killed him.
“It’s 11 years since Gavin died but I’m still grieving.
“I’ve decided to speak out now because things like this are still happening.
“Nothing can be done that will bring my son back but I want to speak out and stop this happening to someone else’s loved one.”
Wilma said that although he was never properly diagnosed, she believed Gavin could have been suffering from ADHD as a teenager.
She said: “I took him to the doctor but I was just told he was boisterous.”
Wilma said after he left school aged 16, Gavin started to dabble in drugs – but she wasn’t aware of that at the time.
She said by the time her son was in his 20s, he was smoking heroin and had to give up work.
“One night Gavin came to me and said he needed help,” Wilma said.
“He came to stay with me for a while but he became increasingly unwell and was suffering from mental health issues.
“He was on prescribed medication for drug-induced psychosis but things came to a head when he fell from his bedroom window and I found him lying on the ground.”
Gavin spent time in hospital following the incident, as well as a period in Carseview.
Wilma said: “It was while he was in Carseview and supposedly under 24-hour supervision that he was able to get away and find the drugs that resulted in his death.
“He managed to slip away, get himself to the Hilltown and bought heroin. He brought it back to Carseview and took it there. I don’t understand how he was able to leave the hospital without them knowing and without the staff being aware that he was missing. I want justice for my son.”
A spokeswoman for NHS Tayside said: “Our thoughts remain with the family.
“Due to patient confidentiality, we cannot comment on matters relating to individual patients.”
