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.”
A probe into serious abuse allegations at Carseview could impact a controversial shake-up of mental health services.
The first phase of a planned review, which will see general adult psychiatry acute admissions centralised in Dundee, is due to begin in June.
However, health chiefs say they are prepared to make changes if necessary,when the findings of an independent investigation into claims patients were pinned to the floor and mocked by staff at the Carseview mental health unit in Ninewells.
The Perth and Kinross Integration Joint Board heard preparatory work on the mental health review is already under way, with the first phase due to begin in June.
The plan was agreed in January 2018, following months of consultation and protest. Learning disability inpatient services will be provided at Murray Royal Hospital Perth, after services were transferred out of the outdated Mulberry unit at Stracathro in Angus.
The board was given an update by the four-person panel leading the review.
Conservative councillor Colin Stewart asked: “We’ve heard that we need to work quickly to address risks, but we are also told there are delays to the redesign programme.
“I understand there is going to be an interim report on the independent inquiry published later this month.
“Have you had any indication that there may be points raised for action in this report, that might have implications for the redesign programme?”
Arlene Wood, associate director for mental health, confirmed she had not had any feedback or update on the review. “The clear steer that we have had from the chief executive is that we continue, for now, on the quality improvement and redesign programme because we know there are inherent risks in the system and this work needs to happen,” she said.
“It would be remiss of us to wait for the report. If there are things raised that require us to change our course of action, then we would address that at the time.”
The board heard the heads of health partnerships in Dundee, Perth and Angus were working on a Tayside Mental Health Alliance, to tackle a range of challenges facing the sector.
Professor Keith Matthews, associate medical director for mental health services said: “It would be a mistake to underestimate how challenging the environment is for mental health services.
“We have issues with recruitment and there are emerging difficulties with retention of staff.”
He said the Scottish Government was attempting to address a national shortage of psychiatrists with an international recruitment campaign.
“Although many efforts are being taken to resolve these matters, the likelihood of anything being resolved soon are pretty low.”
He added there was a need to move away from a workforce reliant on high-cost agency work.
Tay Road Bridge chiefs have pledged to tackle the rising number of emergency incidents reported on the crossing after admitting they are “nowhere near where we need to be” on the issue.
Data analysis taken from the bridge’s official twitter account shows an annual rise in reports of police call outs, from 21 in 2016, 23 in 2017, to a peak of 28 this year.
Many of the closures are due to people attempting to harm themselves on the span.
Officials pledged at the start of 2018 to probe whether anything could be done to reduce the number of incidents on the route after campaigners pointed to similar efforts being made in cities around the world.
Stewart Hunter, chairman of the road bridge board, revealed his team have looked at ways of making physical alterations to the crossing but found no structural change could be made without compromising its integrity.
He said: “From my point of view, one person on the bridge is one too many so any trend showing the numbers increasing would be worrying. However, even if it was decreasing, I would still be concerned for those individuals.
“There are a number of reasons why the numbers have increased and mental health is part of it. I think it would be irresponsible to focus on one aspect and ignore others.
“The Scottish Government, Dundee City Council and our partners are working hard to tackle this issue and make sure the people who need help get it. But obviously, there is still a long way to go and we are nowhere near where we need to be.
“As far as what is the best way to tackle the increase, we need to make sure that individuals have all the support they need long before it gets to the stage where they are on the bridge. That is where we will actually make the difference.”
Mr Hunter paid tribute to the “unsung heroes” working on the bridge who respond immediately when emergency incidents are reported.
Figures obtained from the twitter account show motorists were subjected to 132 days of disruption on the bridge this year for police and other incidents, such as roadworks, breakdowns and closures due to high winds.
It appears March’s Beast from the East weather disruption had a significant impact on traffic with the month seeing 18 days impacted by delays, more than any other in 2018.
Mr Hunter said: “We have a planned programme of maintenance and the increase this year is just about where we are in the maintenance cycle. The bridge is inspected regularly and any issues found are fixed very quickly.”
The Dundee Fighting for Fairness report summarises how key issues affecting people in city are being tackled.
It was launched at the Steeple Church following months of research by the Fairness Commission, whose members met with people and families struggling to get by.
Among the recommendations are creating a single access point for all financial advice services in the city, preparing positive, anti-poverty messages and helping frontline staff including GP surgeries to raise awareness of the impact of poverty on mental health.
John Alexander, leader of Dundee City Council and chairman of the Dundee Partnership, said: “People and money, mental health and stigma are three of the main themes we are looking at because they have featured in all of the stories we have heard.
“We know that far too much poverty that exists in the city and this is one way to target some of the root causes of that – by involving people with real-life experience.”
Another recommendation aimed at tackling issues with mental health in the city is to create a 24/7 drop-in service offering clinical, non-clinical, therapeutic and peer support.
The commission had found that people reach crisis point outside normal working hours and cannot self-refer for support when they need it most. It was also found that services did not always treat people in poverty with respect.
The partnership recommended that guidance materials are developed to allow service providers to recruit and train staff with the right values.
On December 12, the recommendations will be presented to Aileen Campbell, Cabinet Secretary for Communities and Local Government.