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.”
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.”
MEDICS failed to help a suicidal man who contacted health services eight times in six days before he died, his partner has claimed.
Luke Henderson’s girlfriend Karen McKeown is now calling for an urgent review of mental health support services for men in Scotland.
Karen tried to get help for Luke almost every day in the week before his death.
Despite phoning NHS24, going to A&E, contacting GPs and other community services on eight different occasions, the couple were either turned away, referred elsewhere or told that Luke showed no signs of mental health problems.
NHS Lanarkshire’s initial review said their staff had followed procedure and “consistently did not find any evidence” that Luke wanted to take his own life. However, they have now launched a fresh investigation.
Luke spoke to at least 11 different NHS employees between December 22 and December 28 last year. Karen found him hanging in the home they shared with their two children on December 29.
The 30-year-old’s calls for better men’s mental health services has been backed by her MSP, Monica Lennon, who has urged NHS bosses to further investigate.
Karen knew something was wrong with Luke when he started saying colleagues at his construction job were spying on and filming him, putting videos on the internet and laughing at him.
He had stopped sleeping, said he could hear voices in his head and could see things which weren’t there.
Karen, from Motherwell, said: “If they had done their jobs as medical professionals, the way I did mine as his partner and mother of his children, I believe Luke would still be here. My children would still have their dad.
“They failed him. I felt like he was planning to take his own life.
“There were loads of warning signs – he was asking my cousin to look after me if anything happened to him, he was telling me how much he loved me and kept saying sorry for things.
“I told doctors this, but they wouldn’t listen.”
Karen and Luke, with son Luke and daughter Kaydence
In a review conducted by NHS Lanarkshire, officials ruled that they had followed procedures and their staff found no signs of mental illness, nor believed Luke was at risk of suicide.
However, medical notes from December 23, seen by The Sunday Post, show some staff who first saw Luke at Wishaw General A&E thought he was at risk of harming himself and that he was hallucinating.
They recorded in their notes that Luke was “hearing voices in head…feels wants to kill self”, “experiencing delusions” and was “an immediate risk to himself”.
When he first went to the emergency unit, he was categorised as a high-risk patient, but less than two hours later after being seen by a nurse, it was ruled that he showed no signs of having a “depressive illness or psychotic disturbance”.Medical staff decided that, because Luke said he was looking forward to Christmas, he was making plans for the future and was not suicidal.
Karen said: “Christmas was less than two days away by that point, it didn’t mean he was ‘forward planning’ as they said.
“I kept telling them he wasn’t making any plans after Christmas.
“On Christmas Eve I had to take him to see a psychiatric nurse, but they wouldn’t do anything. They told us to go to an addiction service, which re-opened on the 28th.”
Toxicology reports showed there were no traces of alcohol or drugs in Luke’s body when he died. He had suffered addiction issues in the past.
In 2011, Luke attempted to take his own life and in 2015 admitted himself into hospital as he was hearing voices.
After being an in-patient for a week, he was given medication to help him.
Karen said: “We got through Christmas Day and Luke made it all about us, and the four of us being together. That day he managed to sleep for the first time in a long while. He fell asleep on the couch but he was still not acting normally.”
Again, on December 27, the couple, along with some of Luke’s family members, went back to A&E after he continued to say he could hear voices and was seeing dogs in his house.
She said: “The staff didn’t speak to me or Luke’s family at all. They just spoke to Luke, and said nothing was wrong and he wasn’t showing signs of being mentally unwell.
“The next day I took him to the addiction services they told us about, but it was just a form-filling exercise and they didn’t give us any help.
“They said we would have to wait for someone to get in touch at a later date.”
On the day before his death, Karen took Luke to two GPs to try to get him an urgent appointment, before taking him to her own doctor and registering him there.
The couple were told an appointment was available that afternoon, but when they returned a second receptionist said there had been a mistake and they were sent home.
That night, Karen woke to her eight-year-old son, also named Luke, crying. She saw that her partner was not in bed and when she went to her son’s room she discovered he was awake.
Karen said: “I asked him why he was awake and he said that daddy had come in to say goodnight. That’s when I went downstairs and saw Luke’s body. I just started screaming.”
Iain Mackenzie, acting general manager for mental health services, said: “We are aware of this tragic matter and undertook a review in line with Health Improvement Scotland guidelines, which aims to identify any learning points.
“Members of our patient affairs team have also subsequently met with Ms McKeown with a view to further investigate the issues raised by her, and the team is also liaising with the other services involved.
“The investigation is still ongoing and, once complete, we will share the findings with Ms McKeown.”
Vulnerable Scots falling through net
In the last five years, more than 2,600 men have taken their own lives in Scotland, with more than 500 dying last year.
MSP Monica Lennon says too many people dealing with mental health problems, alcohol or drug issues are falling through the net, and is continuing to call for an investigation into why Luke was failed.
She said: “Luke’s tragic death is a painful loss to his family and Karen is one of the bravest people I have met. Asking for help should guarantee access to medical treatment but when it comes to addiction and mental health, vulnerable people too often are left to fall through the cracks.
“Nothing will bring Luke back but Karen is courageously drawing on her family’s experience to prevent others having doors closed in their faces. Karen continues to have my full support.
“Vulnerable people are being failed because people with lived experience are not being listened to.”
Doctors in Tayside have warned psychiatric services in the region may be unsustainable due to staff shortages.
Inspectors from Healthcare Improvement Scotland were told the service relies on locum doctors but there are concerns about the number of these available.
They were told the shake-up of psychiatric services in Tayside, currently under way, may take years to bear fruit.
Healthcare Improvement Scotland carried out a review of general adult psychiatry services in Carseview and community mental health services in December last year.
The watchdog returned for a follow-up inspection in June, the results of which were published this month and lay bare the full extent of the crisis in psychiatric services.
NHS Tayside has ordered an independent inquiry into mental health services following a campaign by the relatives of patients who took their own lives but the new HIS report reveals staffing issues remain a major problem at Carseview.
It states: “The management team spoke about the continued challenges in maintaining a consistent medical psychiatrist workforce. They told us that the use of locum psychiatrists remains high and has increased since the review visit in December.
“They also told us that there were real anxieties about the sustainability of the medical service and a real concern that the availability of locum psychiatrists is reducing.”
It continues: “There continues to be ongoing challenges in recruiting psychiatrists, whether it be in a permanent post or a locum post.
“We have significant concerns about those ongoing challenges and the use of locum staff.
“The inconsistency of psychiatrists will continue to impact on patients being able to build and sustain therapeutic relationships with their psychiatrist and will lead to inconsistency in medical leadership in clinical teams.”
Inspectors were also told staff believe patients will not see the benefit of the redesign of psychiatric services for several years.
The report states: “The general consensus was that the plans being put in place today will not see immediate rewards but will take years to come into effect.”
A spokesperson for NHS Tayside said: “Like many other Health Boards, NHS Tayside is affected by a national shortage in some specialist services and professions, including consultant psychiatrists.
“To help address this, the Tayside Mental Health and Learning Disability Services Redesign Transformation Programme, approved by Perth and Kinross Health and Social Care Partnership in January this year, is redesigning how services are delivered in line with the current and future availability of medical staff.
“While our transformation plans are implemented, locum staff continue to be employed to ensure we can provide clinically safe and effective care for our patients.”
She said the health board has appointed a permanent medical director to oversee psychiatric services.
She said: “Locum psychiatrists in Dundee have been managed by an interim associate medical director however Professor Keith Matthews, an experienced consultant psychiatrist and senior academic has now been appointed permanently into this role.
“As an experienced and effective clinical leader, Professor Matthews will be instrumental in leading the redesign and improvement of mental health services across Tayside.”
Gillian Murray, whose uncle, David Ramsay, died after being turned away from Carseview in 2016, said NHS Tayside must address shortfalls in its psychiatric services.
Ms Murray, who played a prominent role in the campaign that led to a review into mental health services in Tayside, said: “How long has this mental health crisis gone on for?
“How many cases have been swept under the carpet?”
David Strang has been appointed chairman of the inquiry, which NHS Tayside has stressed will be fully independent.
Mr Ramsay’s family say his death could have been prevented if the psychiatric unit had given him help when he asked for it
NHS bosses have ordered an independent inquiry into a psychiatric unit following the case of a man who killed himself after being refused admission.
David Ramsay, 50, took his own life in 2016 just days after twice being sent home from the Carseview centre at Ninewells Hospital in Dundee.
Nicola Sturgeon was questioned by Scottish Labour leader Richard Leonard over the case at Holyrood on Thursday.
NHS Tayside has now announced the care provided by Carseview will be reviewed.
Mr Ramsay’s family has been campaigning for a full public inquiry into mental health provision in NHS Tayside, with his niece Gillian Murray calling for Health Secretary Shona Robison – a Dundee MSP – to stand down.
NHS Tayside chairman John Brown said the “independent assurance report” would examine “how services are delivered at Carseview to address the concerns of some families who have been speaking out about their experiences of mental health services at the centre.”
The health board will take advice from the Mental Welfare Commission on which experts should be tasked with carrying out the work.
As part of the review, they will speak to patients at the centre and their families.
Mr Brown added: “If the report highlights any areas for improvement, or flags up issues where we can learn lessons, we will make any changes required immediately.”
Separately, Public Health Minister Maureen Watt has written to Ms Murray to offer her “sincerest apologies” for the way some of the correspondence between her and the Scottish government had been handled.
Ms Watt said a response she had sent to Ms Murray in April was sent to a mistyped email address – meaning Ms Murray did not receive it.
Ms Murray – a former SNP member who said she had left the party over its “failure” to help with her uncle’s case – has also been invited to meet Ms Watt, Ms Robison or the first minister “at a time and date of Ms Murray’s convenience.”
Responding to the announcement of the review, Ms Murray tweeted that it was a “welcome first step but certainly not the end of the road” and said the family would continue to demand a full public inquiry into mental health services in Tayside.
Speaking on Thursday, she had accused the Scottish government of ignoring the family’s concerns – which was strongly denied by the first minister.
And she said her uncle had “needed that little bit of help” but had been “turned away”, with the hospital “passing the buck to the family”.
‘Evade accountability’
Ms Murray added: “It could happen to anyone – it could be me or you who needs that little bit of help, and he was turned away.
“I was having to Google how to look after a suicidal individual, how to look after somebody with psychosis. That shouldn’t have been left to us.”
She also said resigning would be the “honourable thing” for Ms Robison to do.
Mr Leonard also welcomed the inquiry, but added: “The reality is that it should not have taken years of campaigning by bereaved families – and a tragedy being raised at first minister’s questions – to deliver this limited review.
“Scrutiny should be an essential part of how our public services are run – but instead bosses at NHS Tayside and Shona Robison have attempted to evade accountability at all costs.”
Gillian Murray has been campaigning for a public inquiry into mental health services in NHS Tayside
Who was David Ramsay?
Mr Ramsay made three separate attempts at suicide in the space of a week in the autumn of 2016.
His family convinced him to seek urgent help from his GP, who referred him to Carseview because he “required admission”.
Mr Ramsay had two emergency assessments, but was turned away from the centre on both occasions.
His niece told BBC Scotland there had been a catalogue of failures over the handling of her uncle’s case in the days before he killed himself.
She said Mr Ramsay’s death had been preventable as he had told staff “in no uncertain terms” and on separate occasions that he did not want to live and needed help.
What has the health secretary said?
In a statement, Ms Robison welcomed the review, saying that: “People who need mental health services, and their families, should have full confidence that they will receive the highest standards of care when they or their loved ones are in a very vulnerable condition”.
She had earlier tweeted that Ms Murray and her family “have every right to raise their concerns and shouldn’t be criticised for doing so”.
Ms Robison added: “The voices of patients and their families are hugely important in our health service”.
