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.”
Suicide rates in Dundee are higher than any other city council area in Scotland, according to a new report.
The Scottish Suicide Information Database also shows that men accounted for three-quarters of suicides across Tayside in the last seven years.
According to the report, there were 164 deaths caused by suicide in Dundee with an average of 16.7 per 100,000 population between 2011 and 2017.
Angus along with Perth and Kinross Councils recorded 98 and 126 suicides respectively.
For Tayside as a whole, 388 suicides were recorded with an average per 100,000 population of 14.1.
Men were more likely to take their own lives, with the rates across Scotland highest among those aged 35-54 and in deprived areas.
Nearly three-quarters of those who died had contact with healthcare services in the year before their death.
An inquiry is currently under way into NHS Tayside’s mental health services after a number of concerns surrounding the Carseview Centre.
Phil Welsh, whose 28-year-old son Lee took his own life last year, said the latest statistics were “damning”.
He said: “It’s clear that there’s a situation here that isn’t working.
“I think the fact there is an inquiry shows there’s something amiss.
“Mental health is a discussion point now but it’s all well talking, we need support for people afterwards and that is why we badly need a crisis centre.”
A spokeswoman from NHS Health Scotland said: “National suicide prevention programmes need to incorporate a comprehensive public health approach which seeks to reduce stigma, improve mental wellbeing in the whole population and address the underlying causes of poor mental health.”
Much of the focus of the independent inquiry into Tayside’s mental health services is expected to be on the Carseview Centre.
A grieving mum has demanded an overhaul of mental health services after it emerged dozens of people have taken their own lives in Dundee despite seeking help.
The proportion of suicide victims in the city who have attended a psychiatric appointment in the year leading up to their deaths is higher than in any other part of the country, official data revealed.
Mandy Mclaren, whose son 28-year-old son Dale died in 2011 shortly after discharging himself from the Carseview Centre in Dundee, said the new figures were evidence that people are being let down by NHS Tayside’s mental health services.
“To me the whole system is failing,” she said.
“That amount of people committing suicide is absolutely shocking. It does not get any easier.
“You hope they will learn by their mistakes, but they’re not.”
In nearly half (46%) of the 164 suicides in Dundee between 2011 and 2017, the victim had a psychiatric outpatient appointment in the 12 months before their death, which is the highest rate in the country.
The Scottish Suicide Information Database, which was published on Tuesday, showed there were 769 probable suicides in Tayside and Fife during that period. The national total was 5,204.
A spokeswoman for NHS Tayside said every suicide was a tragedy and was “comprehensively reviewed by the Tayside multi-agency Suicide Review Group to look at the circumstances surrounding each individual case”.
Rose Fitzpatrick, chair of the Scottish Government’s National Suicide Prevention Leadership Group, said: “The Scottish suicide rate fell by 20% between 2002-06 and 2013-17, and we are committed to reducing this by another 20% over the next four years.”
People have until December 14 to give evidence to an independent inquiry into mental health services in Tayside.
Visit www.suicidehelp.co.uk or phone Samaritans on Freephone 116 123.
Bosses at the health board aim to get rid of 1,300 posts to plug the hole in its finances, official papers revealed.
They say they can do that over several years through “natural staff turnover”, but it is feared cuts to backroom staffing will have an impact on patients.
The decision to shrink the workforce comes as the board benefits from having at least £62 million of debt written off by the Scottish Government.
The plans are revealed in an assurance report to the board from September.
It said there was an “acceptance that staff levels need to reduce by 10%”.
Gillian Murray, who has been campaigning for better mental health services after failings in the care of her late uncle, said the decision shows that “balancing the books obviously means more to them than saving lives”.
“People in Dundee are dying because NHS Tayside is a shambles and to cut the workforce is another slap in the face for all of us,” she added.
Murdo Fraser, the Conservative MSP in Perthshire, said: “Local people will be wondering what impact these massive reductions in staff will have on their already pressured services.”
Annie Ingram, NHS Tayside director of workforce, said no one will lose their job but said spending on the workforce is higher than health boards of a similar size.
She added: “We are carrying out a review of staff numbers, grades and skills, which is being carried out in partnership with our staff and our trades unions, to ensure we have a safe, affordable and sustainable workforce.”
The NHS in Scotland is not financially sustainable and its performance has continued to decline, the public spending watchdog has warned.
Audit Scotland said health boards were “struggling to break even” and none had met all of the key national targets – with NHS Lothian not meeting any.
It highlighted increasing demand on NHS services, and rising waiting lists.
Health Secretary Jeane Freeman said the government was already taking forward Audit Scotland’s recommendations.
But the watchdog’s report prompted widespread criticism of the Scottish government, with the Conservatives claiming it should “make shameful reading for the SNP”.
The report said pressure is building in several areas – including the recruitment and retention of staff, rising drug costs, Brexit and a significant maintenance backlog.
It said “decisive action” was needed to protect the “vital and valued service”.‘
What does the report say?
The report warned that the NHS in Scotland is “not in a financially sustainable position”, with NHS boards “struggling to break even, relying increasingly on Scottish government loans and one-off savings”.
And it said the “declining performance against national standards indicates the stress NHS boards are under”.
The only target met nationally in 2017/18 was for drugs and patients to be seen within three weeks.
Only three of Scotland’s regional health boards met the target for patients beginning cancer treatment within 62 days of being referred
The Scottish government admitted earlier this year that children were being “let down” by the country’s mental health services
The proportion of youngsters seen by CAMHS within 18 weeks fell from 83.6% in 2016/17 to 71.2% in 2017/18.
The Scottish government invested £13.1bn in NHS services last year, but Audit Scotland said when inflation was taken into account there was a 0.2% real terms drop in cash.
Health boards made “unprecedented” savings of £449.1m, but many relied heavily on one-off savings for this, while three boards – NHS Ayrshire and Arran, NHS Highland and NHS Tayside – needed £50.7 million of loan funding from the government to break even.
This was “significantly more” than in previous years, with Audit Scotland saying four boards have predicted they will need a combined total of £70.9m in this current financial year.
Jeane Freeman announced a three-year plan to cut NHS waiting times earlier this week
The report said the “NHS is managing to maintain the overall quality of care, but it is coming under increasing pressure”, adding Brexit would create “additional challenges” for the health service.
However the scale of these challenges was “difficult to assess” because of “significant uncertainty” over the terms of the UK’s withdrawal deal from the European Union, and because data on workforce nationality is not routinely collected.
Auditor General Caroline Gardner said: “The performance of the NHS continues to decline, while demands on the service from Scotland’s ageing population are growing.
“The solutions lie in changing how healthcare is accessed and delivered, but progress is too slow.”
What has the Scottish government said in response?
Health Secretary Jeane Freeman said the government was already taking forward Audit Scotland’s recommendations.
She said NHS funding had reached “record levels of more than £13bn this year, supporting substantial increases in frontline NHS staffing, as well as increases in patient satisfaction, reductions in mortality rates, falls in healthcare associated infections, and Scotland’s A&E performance has been the best across the UK for more than three years.”
She added: “While our NHS faces challenges, common with health systems across the world, we are implementing a new waiting times improvement plan to direct £850m of investment over the next three years to deliver substantial and sustainable improvements to performance, and significantly improve the experience of patients waiting to be seen or treated.
“Ultimately we want to ensure people can continue to look forward to a healthier future with access to a health and social care system that continues to deliver the world-class compassionate care Scotland is known for.”
What other reaction has there been?
Conservative health spokesman Miles Briggs claimed the NHS was “facing an unprecedented challenge” with boards across the country “staring into a black hole of more than £130m.
He said: “For a government which has been in charge for more than 11 years, this should make shameful reading for the SNP.”
Labour’s Monica Lennon added: “After more than a decade of SNP complacency our NHS is in crisis.”
Dr Lewis Morrison, chairman of the British Medical Association (BMA) in Scotland, said the “stark warning” from Audit Scotland “could not be any blunter”.
But he added this would “come as no surprise to frontline doctors who have faced the consequences of inadequate funding year after year”.
And RCN Scotland director Theresa Fyffe said the report “underlines what those in the nursing profession have been warning about for a number of years – an unsustainable pressure on staff to deliver more care.
“This leads to staff burnout and, in some cases, a choice between staying in the profession and their own health.”
