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.
Kimberley Macfarlane was charged with breach of the peace and told she could have faced a custodial sentence having ‘inconvenienced’ the public
The 24-year-old tried to jump off a motorway bridge in January 2018, resulting in a court case the following month at Dunfermline Sheriff Court
She had previously jumped off a bridge in August 2016, breaking two vertebrae in her back and leaving her in a brace for three months
A suicidal woman who was arrested after threatening to jump off a bridge said she was left feeling ‘like a criminal’ after a court threatened her with jail.
Kimberley Macfarlane, from Dunfermline, Fife, was charged with breach of the peace and told she could have faced prison because she ‘inconvenienced’ the public with her suicide bid.
The 24-year-old tried to jump off a motorway bridge in January 2018, resulting in a court case the following month at Dunfermline Sheriff Court.
Ms Macfarlane has been struggling with mental health issues ever since she was diagnosed with a rare condition called Fowler’s Syndrome that left her unable to urinate and in constant pain.
Kimberley Macfarlane (pictured) was charged with breach of the peace and told she could have faced a custodial sentence having ‘inconvenienced’ the public with her suicide bid
She had also previously jumped off a bridge in August 2016, breaking two vertebrae in her back and leaving her in a brace for three months.
The court heard traffic had been brought to a halt twice in successive days and road closures had to be put in place after she threatened to jump from a motorway flyover.
Sheriff Craig McSherry admonished her but warned that if it became clear she still posed a risk of further offending, prison was an option.
He said: ‘A custodial sentence would at least mean that the public are not being inconvenienced in this way.’
But Kimberley says she was left feeling ‘worthless’ following her court case in February.
After being dissuaded from taking her own life, Kimberley was taken to hospital.
Kimberley said: ‘I had run away from the mental health hospital I was in then spent the night in the cells after I nearly jumped off the bridge.
‘When we got to hospital it was hard, there was no one to talk to, then I was stuck in this room by myself.
‘When I appeared in court the next day I was handcuffed to a G4S officer and taken to a holding room for four or five hours.
‘If I was to hurt anyone it would only have been myself.
‘I was the only person in my holding area, no one was telling me what was happening, and when I had to go to the toilet I was escorted.
‘In the courtroom I burst into tears when my charge was read out.
‘They said there would be a possibility of a custodial sentence – I didn’t really understand it at all.
Kimberley Macfarlane (pictured in hospital before her nose operation) In 2015 Kimberley’s life was turned upside down when she underwent a nose operation for a sports injury and woke up unable to urinate
‘The sheriff must never have experienced poor mental health because he said I was being an ‘inconvenience’ because the road had to be shut.’
‘I felt like I was a criminal who had done something wrong – my mum saw me in handcuffs.’
Kimberley was charged with breach of the peace and allowed to go home, but her mental health was badly affected.
She added: ‘My solicitor said it might have been better for me to go to prison because I would’ve got the help I needed – he thought one day I might actually take my own life.
In a bid for change, Kimberley has become an NHS 24 Youth Form representative for Fife and spoken to her MSP for Dunfermline, Shirley-Anne Somerville.
She said: ‘I spoke to my local MSP and I brought up police and mental health services.
‘There’s a massive difference between being admitted to a hospital ward and taken to a police cell.
‘Additional support should be required as people are often given better mental health care in jail rather than through the NHS – that’s actually quite worrying.
‘It would be good to shape how things are done in the future.’
The former captain of Dunfermline Athletic Ladies suffers from a rare condition which has left her unable to urinate and in constant pain.
In 2015 Kimberley’s life was turned upside down when she underwent a nose operation for a sports injury and woke up unable to urinate.
She was hit in the face while playing football and opted to get surgery to mend her squint nose.
But while in hospital, she developed Fowler’s Syndrome which affects one in a million women and can leave them unable to urinate.
What is Fowler’s Syndrome?
Fowler’s Syndrome is a rare urinary disease which affects around one in a million women in the UK.
It causes difficulty in passing urine and urinary retention due to the bladder’s muscles.
Fowler’s affects women in their twenties and thirties and up to half the patients affected have polycystic ovaries.
Sufferers may find they are unable to pass urine normally and need their bladders to be drained via a catheter.
What are the symptoms?
Symptoms vary from being unable to hold any urine to being unable to empty the bladder fully.
Urinary infections may be a problem for women suffering from Fowlers Syndrome due to the bladder not emptying properly. Some women may also experience back and suprapubic pain.
The cause remains unknown and is still being researched.
Her GP had not even heard of the rare illness prior to her diagnosis and experts have been left baffled as to why it started following a nose operation.
She said: ‘I was only supposed to be in for one night but ended up spending three.
‘When I woke up my nose felt better, but I couldn’t pee.
‘I wasn’t sure what was wrong, but when I went into retention I was in agony with my bladder before they drained it.’
Having been active and healthy before, Kimberley left hospital with a catheter and since then has had to fight chronic pain and infections.
After hearing about her case, elite sports charity Support in Sport reached out to Kimberley and offered her free treatment.
They provided her with a free physio, who has been helping her with her back problems, and she will get access to a sports doctor and sports psychologist in January.
On December 4, Kimberley took part in a sponsored run at Hampden Park in aid of Support in Sport and the Express Group, a Fife-based mental health charity.
She said: ‘I almost didn’t want to turn up at Hampden because I thought I wouldn’t have been able to do it.
‘Running around the Hampden pitch was only 0.3 miles and not that big a deal for a fit person, but for me – where I’ve come from – it’s massive.
‘I never thought I would be able to run again.’
Kimberley has since raised £1,070 for the causes close to her heart.
She is remaining focused on the year ahead, trying to improve her fitness and is hopeful of playing football again.
She said: ‘I would say I’m turning a corner very slowly.
‘I still have doubts, but I have a little voice as well that that says I can do it.
‘This time next year, I hope things keep progressing and going forward, not backwards.
‘My dream is to return to playing football.’
For confidential support in the UK call the Samaritans on 116 123 or visit the website
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 number of university students in Scotland seeking support for mental health issues has increased by two-thirds over five years, analysis shows.
The BBC asked universities across Scotland for the numbers of students seeking some form of support.
It found more than 11,700 students asked for help in 2016-17 compared with about 7,000 in 2012-13.
The 68% increased among students in Scotland was higher than the 53% total for the UK over the same period.
University counsellors and wellbeing staff told BBC Scotland that they deal with cases ranging from anxiety, depression, gender-based violence and body dysmorphia.
The figures – obtained by the BBC’s Shared Data Unit through freedom of information requests – showed that only 12 of Scotland’s 19 universities recorded how many students sought help for their health help over the five-year period.
The data shows:
The number of students seeking help for their mental health at the University of Edinburgh doubled over five years
The University of Glasgow experienced a 75% rise in students seeking help for their mental health between 2012-13 and 2016-17
The University of Stirling had a 74% rise in students seeking help for their mental health between 2012-13 and 2016-17
Glasgow School of Art experienced a 72% increase in students seeking help for their mental health over the same period
‘Not being able to return the favour had a toll on me’
Connor Smith was in his third year studying computer games development at the University of the West of Scotland when his close friend, who was also a student, took his own life.
“I was really shook up and didn’t know what to do with myself,” he said.
“I had struggled with my mental health before but the person who took his life was able to help me out of that, so not being able to return the favour had a toll on me.”
The university’s counselling team quickly offered to help Connor.
“I couldn’t speak to my family because I felt like I was burdening them,” he said.
“I couldn’t speak to my close friends either because they were going through the same thing.”
Connor said that he was struggling not only with the death of his friend but also his future prospects.
He said: “One evening I sat down and thought ‘what am I doing?’.
“I forced myself to work at university but I wasn’t in a good mind space. I really wasn’t enjoying what I was doing.”
Connor said he did not know what would have come of his life had it not been for the university’s support.
He said: “I wouldn’t have done so well.
“I might’ve quit university and if I did that, I don’t know what I would be doing.
“I had nothing lined up as a fall-back.”
Connor returned to counselling for a second time during his final year of studying. He was struggling with stress, overeating and had money worries.
He said: “[The support] wasn’t immediately available like before but, when I did get it, being able to speak to someone was so helpful.
“University was the best stretch of my life but easily the lowest I have been as well.”
‘I don’t like the term snowflake’
Ronnie Millar, director of counselling at the University of Edinburgh, said there is a “pernicious perfectionism” among students, which can affect their mental health.
He said: “When I was at university, there were no fees and we had student grants.
“Nowadays, more students have to work in part-time jobs and study, which puts a lot of pressure on them to succeed.”
Mr Millar said it was not helpful to label young people seeking help with terms such as snowflake, which imply they are less resilient than previous generations and too emotionally vulnerable.
He said: “I don’t like the term snowflake. I think it is a pejorative.
“In terms of resilience, some students struggle more than previous generations – but that’s not pointing the finger of blame.”
Mr Millar said that while there’s been a doubling in the male students coming forward for help for their mental health, the “proportion” has stayed the same over the five-year period.
“We say to students that [counselling] is not activity just for women, it’s for everyone.”
Social media bubble
Dr Phil Quinn, head of counselling and psychological services at the University of Glasgow, said that while there was greater awareness of the help available, a “saturated” NHS had resulted in fewer community services for students to access mental health support.
He said: “We have had a record year in terms of referrals to the service, of students starting their university careers with already diagnosed mental health conditions.”
The University of Glasgow employed 20 staff in 2016-17 – ranging from cognitive behavioural therapists and a consultant psychiatrist to a counselling manager – to assist with the 2,330 students that came forward that year.
Quinn believes that staff numbers are sufficient to meet demand, and that the increase in students coming forward for help is partly down to a “24-hour social media bubble” where they are exposed to “criticism, bullying, and abuse”.
‘Crisis students’
Jackie Main, who is the director of student life at Glasgow Caledonian University, said it was not just the volume of students seeking support that was increasing but the complexity of the issues they presented with.
“We see a lot more crisis students than before,” she said.
“That could mean a student is actively self-harming, threatening suicide or requires being sectioned or hospitalised.
“Crisis students experience severe emotional distress, including panic attacks.”
At Glasgow Caledonian University, the number of students seeking support in 2016-17 hit 661, up 69% since 2012-13.
Ms Main added: “Anxiety and depression are the two big issues we’ve see increases in.
“We are not a crisis support service. We don’t have the resource and it is not our job. But we don’t let students fall through the net.”
Budgets
Eight of Scotland’s universities provided the BBC with their total budgets for mental health services – which in some cases included services that don’t just support student mental health, such as a disability service – in the five years to 2016-7.
It revealed an increase of 31% from £2.4m to £3.1m.
The University of Strathclyde (which did not provide complete figures for the number of students seeking help between 2012-13 and 2016-17) was the only institution to report a decrease in its overall budget over the five year period, down by 18%.
A spokeswoman for the university put the drop down to “re-structuring” and emphasised that significant investment – about £400,000 – had been made since 2017, including the creation of three full-time and 12 part-time posts on the mental health and wellbeing teams.
She said: “We have also introduced an online mental health support programme, which works hand-in-hand with our dedicated advisers and therapists, to ensure support is available for all.”
‘Finding out you’ve failed all your classes is horrible’
Hannah Moles was in her third year of studying maths at the University of Strathclyde when she approached student services for help.
Not only had she failed her first set of exams but she was also caring for her grandmother who had dementia.
She said: “My brother and I were going over three times a week to make my gran dinner, get the shopping and keep her company.
“She was really lonely.”
Hannah said that when she wasn’t caring for her gran, working in a part-time job which paid for her flat, or sleeping, she’d be in the library trying to study.
“I was really tired and had things on my mind constantly,” she said.
“So I went along to support services to see if I could calm myself down. I wanted to improve my mental state before my next set of exams.”
Hannah said that eight weeks after approaching student services, she received her first counselling appointment.
However, by this point Hannah had failed her second round of exams – meaning she wouldn’t be allowed to return for the fourth year of her degree.
“Finding out you’ve failed all your classes is horrible especially when you have put in the work but it is still not enough,” she said.
Hannah said that she was grateful to her university for providing mental health support but more counsellors would help meet the increasing demand.
“I am lucky that I got the support I needed,” she said.
“But there are lots of students who seem to need help with their mental health. I just hope that universities can keep up with the increasing demand.”
’80 new counsellors’
The Scottish government’s most recent Programme for Government promised to provide more than 80 additional counsellors in further and higher education institutions over the next four years, with an investment of about £20m.
However, there is no indication yet how the funding will be split or which universities will receive more counsellors.
Health Secretary Jeane Freeman said every student “should have access to emotional and mental well-being support”.
“We will work closely with the university and college sectors, NUS Scotland and other partners, on the implementation of the additional counsellors, and to ensure an integrated and wrap-around approach to student wellbeing in higher and further education.”
Details of organisations offering information and support with mental health issues are available at bbc.co.uk/actionline, or you can call for free, at any time to hear recorded information on 0800 888 809.
