Almost half of Dundonians who have died by suicide sought help from crisis services in the year leading up to their death, according to official figures.
The Scottish Suicide Information Database (SSID) report shows that 45.5% of the city’s 198 suicide victims between 2011 and 2018 contacted one or more unscheduled care services in the 12 months prior to taking their own lives.
NHS Scotland’s latest update to the SSID comes after it emerged tragic TV star Caroline Flack had been visited by an ambulance crew at her London home less than 24 hours before her death on Saturday.
Two-thirds of those who sought unscheduled help in Dundee did so by calling for an ambulance – and half attempted to get support from the NHS 24 telephone service.
Just over a quarter of those who sought help from Tayside’s out of hours service, which currently operates from Dundee’s Kings Cross Health and Community Centre.
Researchers who compiled the SSID noted that people who went on to take their own lives were six times more likely to have had at least one contact with the ambulance service in the year leading to their death.
The out of hours service can make referrals to NHS Tayside’s Crisis Resolution Home Treatment Team (CRHTT) for cases of mental health crisis in Dundee.
However, staff working for the CRHTT have reported feeling undersupported as NHS Tayside focuses on inpatient services such as those offered at the Carseview Centre.
NHS Tayside is reviewing the SSID report, along with the final report published by the Independent Inquiry into Mental Health Services in Tayside two weeks ago.
Mike Winter, associate medical director for mental health, said reducing suicide attempts was “a priority”.
He added: “NHS Tayside and partner organisations have been reviewing our crisis care and home treatment centres and working to develop a Psychiatric Emergency Plan.
“It should however be recognised that a key aspect of suicide prevention is the opportunity for people in despair to talk about their problems, whether this is to a work colleague, a friend or family member, or to a volunteer from Samaritans.
“The Independent Inquiry report will guide our further work on suicide prevention and other improvements we wish to progress.”
Scottish Labour health spokesperson Monica Lennon said opportunities for health and care services to refer people for mental health treatment “cannot be allowed to be missed”.
She added: “Reducing mental health stigma needs our collective efforts, proper funding for health and social services, and joined up working so that there is no wrong door.”
Responding to the report, mental health minister Claire Haughey said £3 million of funding was supporting the Scottish Government’s existing Suicide Prevention Action Plan.
Ms Haughey noted: “This report represents a significant contribution to the growing evidence base around suicide in Scotland which will inform current and future policy and activity.”
Support is available by calling Samaritans free 24 hours a day on 116 123. If you prefer to write down how you’re feeling, you can email jo@samaritans.org.
The parents of two young men who committed suicide after perceived failures of care by medical staff in Tayside have said they hope the deaths of their sons will not be in vain.
Dale Thomson took his own life in 2015 after spending time in Dundee’s heavily-criticised Carseview Centre, used to house and treat patients with mental health problems.
Dale’s heartbroken mum Mandy McLaren, a vocal critic of the health board and a campaigner for better mental health provision in Dundee, claims NHS Tayside “killed her son” and said she will “never forgive” the board and staff for the treatment Dale received.
She sat down for an interview with Tele, joined by Phil Welsh and Lesley Nicoll, who are also from Dundee.
Their son Lee Welsh took his own life in August 2017 after what the couple say were failings by his GP.
Lee, a talented musician, had endured mental health problems on-and-off for over nine years, being prescribed various alternative medications, but never actually receiving a particular diagnosis.
Phil and Lesley feel if he had received different treatment when he contacted his doctor in the days prior to his death, he would still be alive today.
Phil was given a Valium prescription to give to Lee on Friday August 4 and told to double his dose as his anxiety worsened, when his parents felt he needed to be admitted to Carseview.
They said his doctor told him he would not be able to get a referral to Carseview as it was the early evening on a Friday.
Lee went back to his GP on Monday August 7, having self-harmed over the weekend. However, he was again not referred to Carseview.
Lee’s parents Phil Welsh and Lesley Nicoll.
He took his own life the following day, aged 27.
NHS Tayside said that as an independent contractor, the actions of Lee’s GP were not the responsibility of the health board.
Mandy McLaren said it was the lack of care by NHS Tayside’s staff at Carseview in 2015 which led to Dale’s death.
The 28-year-old died in January 2015 after leaving the unit, which is part of Ninewells Hospital.
He had referred himself to Carseview via his GP and had been staying there between January 8 and January 10 that year. He discharged himself against medical advice.
Dale Thomson.
Dale’s sister later phoned police to inform them he had threatened to burn down people’s homes once out of the unit, and he was detained by police and returned to Carseview.
However, once assessed by doctors, he was returned to police custody and allowed to live with his grandmother.
Despite a follow-up GP visit and the prescription of an anti-depressant, Dale took his own life.
In 2016, while saying she could not comment on specific cases, the then-health minister at Holyrood, Shona Robison, apologised for any care which fell below the expected standard.
Ms Robison, who was replaced in the role by Jeane Freeman in June 2018, said: “If a service or part of the health service doesn’t meet the standards it should meet, then of course I would apologise to their family — whether that’s in mental health services or any other service.
“Obviously I can’t comment on individual cases to any great extent, because I’m not party to the full clinical information.
“Most of the time, our services are of a very good quality – sometimes services do fall short of where they should be.”
The three grieving parents spoke openly and frankly about the circumstances surrounding Lee and Dale’s deaths, and the heartbreak they have lived with since losing their sons.
Both Lee and Dale’s cases have tragic similarities.
The pair were both men in their 20s, had a history of mental health problems, had been supported by their families and had sought help from the NHS.
Both families claim the care they received fell far short of what their sons needed.
And, perhaps most tragically of all, both men left behind young daughters.
Mandy has been involved with a Stakeholders’ Group, set up in 2018, made up mainly of families or service users whose lives have been affected by mental illness or suicide.
They continue to campaign for better mental health services and meet next on February 20, one week before the upcoming NHS Tayside board meeting.
Mandy said she also receives messages and phone calls, sometimes from strangers in Carseview, asking for advice as they struggle with their mental health.
The website aims to share stories relating to mental health issues which can be shared with politicians, charities, and other people, in the hope that “funding and a fresh approach to the subject of mental health will finally be discussed and implemented”.
The family say that if they can prevent one family from enduring the same heartache they are currently suffering, Lee’s death will not have been in vain.
They are also campaigning for a crisis centre for people who can access acute mental health services without referral.
In the Trust and Respect report, it states that the Scottish Association for Mental Health (SAMH) has been working with various agencies and bodies in Tayside “to support the drive to increase access to preventative and short-term interventions”.
The leader of Dundee City Council has responded to an independent inquiry into mental health services in Tayside.
John Alexander has today posted a statement on Facebook, stating that the capacity of the services “needs to increase” and that there are “too many people spread too thinly”.
An inquiry to examine the accessibility, safety, quality and standards of care provided by all mental health services in the region was commissioned after concerns were raised in the Scottish Parliament.
Mr Alexander wrote: “Last week in a 136-page document, Dr David Strang set out the results and recommendations stemming from the independent inquiry into mental health services in Tayside.
“I spent the weekend pouring over the entirety of the document, considering it’s contents and thinking about what kind of service could be provided if those 51 recommendations are adopted.
“It’s vital that each word on those page is taken in. It was hard hitting, honest and to be frank, painted a deeply worrying picture of where things were.
“Mental health and it’s impact on too many people is an issue very close to my heart, even closer more recently but it’s also something that isn’t talked about enough – between family members and friends. I spent my Sunday morning with friends and one of the things we were talking about was the battles with mental health.
“I defy anyone to find someone that doesn’t have a family member, friend or someone that they work with who hasn’t suffered from issues related to mental health.
“We need to continue to remove any stigma associated with it and support those who need support. There is of course, a wide spectrum and the impacts can often be unseen, sometimes until it’s too late.
“There continues to be a significant number of people in crisis, at the end of their tether and struggling to manage daily life. What this report says very strongly and clearly is that people have been let down by services in Tayside. What it also says is that going forward, the services must change.
“The bottom line for me is that the capacity of those services needs to increase. There are too many people spread too thinly and too many silos that don’t allow for sustained collaboration.
“The Chief Executive of NHS Tayside has, to his credit, apologised for those failings and has said that his “…personal commitment to the people of Tayside is that I will work with them to address all the recommendations made by Dr Strang in his report.”
Grant Archibald.
“I’ve already discussed the matter with officers and look forward to meeting with NHS colleagues to see what actions have already been taken forward and hear how they intent to address the 51 recommendations.
“This report has been long anticipated and whilst I think there was a general expectation that there were issues, the fact that it has done such a thorough analysis and 1,500 interviews during that process should provide the evidence base required to make some big and necessary changes.”
The chief executive of NHS Tayside has publicly apologised to patients, family and staff for the failings of mental health services laid bare in a damning report.
Grant Archibald has also pledged that he personally will oversee and drive change and improvement in the mental health care offered by the health board.
Mr Archibald spoke to the Tele six days after the findings of the Independent Inquiry into Mental Health Services in Tayside was published.
David Strang’s Trust and Respect report identified 51 recommendations to be implemented to improve mental health services in Tayside.
It also highlighted numerous failings, including a breakdown of trust and respect, a failure to deliver services, a lack of psychiatrists, a lack of leadership and a lack of accountability.
Mr Archibald said: “We apologise, I apologise to all patients and families who have felt let down by services.
“Our aim is to care for each individual patient. I apologise if that has not happened.”
“Dr Strang’s report was hugely important for Tayside and for the people of Tayside.
“We recognised 18 month ago the level of concern there was over mental health services in Tayside. We responded by commissioning the independent review.
“We now realise that it is important that we now learn from this report which goes into significant detail following interviews with 1,500 people during the process.
“It is important that we listen to these voices and to the experiences detailed by patients and others.
“First of all we apologise, we have listened and now we need to learn and change.
“We must rebuild confidence in the NHS and we recognise that that is not going to be easy.
“My personal commitment to the people of Tayside is that I will work with them to address all the recommendations made by Dr Strang in his report.”
Among the recommendations the board are now going to look at are the provision of a 24/7 crisis care centre.
A review will also take place into its current facilities, including Carseview, to establish whether they are fit for purpose.
Meanwhile, allegations of bullying from staff will also be investigated, and the board is also going to attempt to identify new ways of attracting more staff, including more psychiatrists.
Mr Archibald said that the process of change had already begin, with a statement of intent now signed by him, the chief executives of the local authorities in the board area, and police
He added: “This will take time but we will be listening and we are are committed to learning from past mistakes
“I personally will be playing a key role and will continually report back progress that is made.
“We are aware the the spotlight is now on us I will be ensuring that all the recommendations made by Dr Strang to improve mental health services are acted upon.”
“I recognise there are challenges with all of these issues but there is a real enthusiasm to meet these challenges and improve mental health services provided by NHS Tayside.”
Mr Archibald said Dr Strang will return in a year’s time, by which point he hoped to “provide him with the evidence that change is actively taking place”.
Dr David Strang’s long awaited report on the health authority’s performance was finally released yesterday, on the fifth anniversary of Dale’s funeral in February 2015.
Speaking after reading the highly critical 133-page document, Ms McLaren said she could not forgive NHS Tayside for its part in her son’s death.
“I am watching my granddaughter grow up without her dad because of them,” she said.
“I want her to know that we fought for him and he fought for help, but he wasn’t getting it.
“They killed my son. If they had done their jobs, he would still be alive.
“He was looking forward to the future. He went to them for help and they let him down. I blame them and will say that until the day I die.”
Ms McLaren said she was appalled that NHS Tayside had been allowed to run mental health services in an inadequate way for so long.
“Report after report has been done without anything being done,” she said.
“There’s a lot of blame and nobody is standing up and saying the buck stops here.
“I am not saying it’s staff at fault, but it comes down the line.
“In all professions you get some who are good at their job and some who are bad, but in this kind of job it is costing lives and it can’t continue.”
She said she wanted a sign that NHS Tayside would follow through on Dr Strang’s recommendations, after failing to take action in the past.
“They keep saying they will learn from mistakes, but they haven’t implemented what they been told before,” she said.
“Nothing has been done since the interim report was published last year. That’s not reassuring.”
Another campaigner, Phil Welsh said he was heartened by some of the recommendations in Dr Strang’s report and hopeful that other families would be spared the heartache which he had suffered.
Phil’s son Lee took his own life in 2017. He would have turned 30 next week.
Mr Welsh welcomed a suggestion that crisis provision should be available 24 hours a day – a measure which the Not In Vain For Lee campaign has called for.
Mr Welsh said: “The recommendations are really in line with what our campaign wants.
“It’s also good to read there should be more help for university students and young people.
“But it’s really important going forward that we get the support from local and national government.
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.”
Phil Welsh has been left heartbroken by his son’s suicide.
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.
The Tay Road Bridge.
“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.”
Lee Welsh died at the age of 27.
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.
