In-roads are being made after a controversial report outlined mental health provision in the city, say officials.
Latest data – published by the Scottish Social Services Council – revealed six exclusive mental health officers (MHOs) were employed across the region
As a result, Dundee City Council used nine other MHOs to provide cover in 2019.
Cover MHOs are determined as social workers who step in when no exclusive or non-exclusive MHOs are available.
“The amount of MHO work, if any, they do each week tends to be very small. They are very unlikely to have the job title Mental Health Officer,” the report added.
Fife, in comparison, had 14 exclusive MHOs and 29 non-exclusive MHOs.
Phil Welsh, whose son Lee took his own life in 2017, said the report was very disappointing.
“Considering that Dundee is the suicide capital of Europe this report is damning and shocking,” he said.
Phil, who is campaigning for a new mental health crisis centre, added: “Six dedicated MHO’s to cover a city with the highest suicide rate in mainland Scotland, is desperately inadequate.”
He added: “Dundee, the fourth largest city in Scotland is way down in the stats.
“Once again we have empirical evidence that Dundee is not being supported sufficiently when it comes to the recruitment, training and retention of mental health professionals.”
Dundee Labour councillor Richard McCready said the report showed there was a clear need to improve mental health services in Dundee.
He said: “Instead of an integrated approach we have a confused and patchy service.”
John Alexander said the report was eight months out of date – and when a current vacancy was filled, a full quota of 16 MHOs would be in place.
Three people were currently in training and would be added to the team “hopefully within a matter of months,” he added.
A Dundee Health and Social Care Partnership spokesman said: “Since the data was collected there has been a positive impact in this area of work due to an increase in capacity within the Mental Health Officer team, this has put us in a better position to meet demand.
“Our Mental Health Officers can and do provide out of hours services through contact from out of hours.”
The SSSC report also revealed a total of 249 weekly hours were spent on MHO work in Dundee compared to 334 in Aberdeen, 276 in Angus and 278 in Perth and Kinross.
And Dundee fared worse than 13 other local authority areas in Scotland for the number of mental health care hours it offers residents, with 16.7 hours per 10,000 of the population.
The Scottish average is 20.5 hours. In comparison Edinburgh has 19.6, Angus 23.7, and Glasgow city 17.2.
A grieving dad who lost his son to suicide has accused Tay Road Bridge bosses of putting “cost and inconvenience” before lives.
Phil Welsh, whose son Lee took his own life in 2017, has called for suicide prevention measures on the bridge.
But he was told barriers could not be installed due to the huge expense and significant traffic disruption the work would cause.
Phil, who is also campaigning for a 24/7 refuge centre in Dundee, said: “Every other day there are reports of people being present on the bridge and we are all very clear what their intentions are.
“I got in touch with Councillor Lynne Short, chairwoman of the Tay Road Bridge Board, and received a response which left me very concerned.”
In an email to Phil, seen by the Tele, Ms Short said engineering consultants had been approached last year about the implications of installing barriers.
“It is estimated that full design costs would be in the order of £250,000, with actual construction costs in the order of £8 million,” Ms Short wrote.
“To strengthen and install the barriers would be hugely disruptive and take in the order of one year, with the bridge reduced to single-lane traffic for this time (six months per side).
“It should also be noted that while such work might deter someone intent on harming themselves, it would in no way guarantee that they would not be able to.”
Phil accused officials of putting money before human life.
He said: “It would appear changes could be put in place to prevent people climbing over on to the other side of the walkway, but cost and inconvenience appear to supersede crisis.
“The saving of a single life should supersede these factors.”
Speaking to the Tele, Ms Short said: “We take the welfare of every bridge user, especially those who are vulnerable or in crisis, extremely seriously. Every single suicide is a human tragedy.
“We are acutely aware the Tay Road Bridge has become a focal point for people in crisis.
“The bridge manager and his team are dedicated to supporting vulnerable people who present at the bridge, backed by investment in new cameras in 2017 and a thorough training programme for all staff.
“Although bridge availability has been affected on many occasions to allow staff and police to deal with incidents, actual suicides are rare.
“Bridge staff regularly attend suicide prevention meetings to discuss how we all might contribute to suicide reduction across the region, and act on any new initiatives that are applicable to the bridge.
“Any physical measures introduced to the bridge have to be effective and while these might deter someone intent on harming themselves, it would in no way guarantee they would not be able to.
“What is critical is that people who are having suicidal thoughts have someone or somwhere they can turn to when these thoughts become overwhelming so that they do not get to the point of acting on them.”
Superintendent Graeme Murdoch of Police Scotland told the Tele that in the three months to the end of September this year, officers responded to 60 reports of concern for people on the bridge.
Last year, the Tay Road Bridge Joint Board published a Q&A explaining why suicide prevention measures had not been installed, saying barriers were “not practical” due to the 52-year-old structure being unable to support the additional weight.
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.