Carseview Centre mental health unit restraint ‘shocking’

Carseview Centre mental health unit restraint ‘shocking’

Marks on David Fong's face
David Fong says this photo, taken in 2013, was a result of being restrained in Carseview

An NHS mental health unit in Dundee restrained patients by pinning them down for too long and in a dangerous position, according to a leaked report.

The internal inquiry into the Carseview Centre was commissioned in response to a BBC Scotland documentary last year.

It exposed bullying and potentially life-threatening restraint on patients.

Prof Peter Tyrer, who chaired the group that wrote the NICE guidelines on restraint in mental health, said the report was “shocking”.

“I’ve seen reports like this before but not quite as damning as this,” he said.

The report has not been made public but has been seen by the BBC.

It found that untrained staff were carrying out risky restraints on patients and that the number of restraints was high.

It said face-down, and particularly face down in a prone position, are the highest tariff interventions of physical restraint, and the most dangerous techniques to deploy.

Carseview Centre
Carseview Centre was the focus of a BBC documentary last year

The report looked at a sample of 40 cases and found more than half were patients being restrained face down on the floor for longer than 30 minutes.

The longest restraint was one hour and 45 minutes.

“That is completely against all guidelines,” Prof Tyrer said.

“You may have to do things for five minutes or up to 10 minutes but to go beyond 40 minutes there is something badly wrong in the organisation of a unit if that is allowed to continue.”

Professor Peter Tyrer
Prof Peter Tyrer chaired the group which wrote the guidelines on how to handle mental health patients

Carseview is a hospital to care for patients with mental illness from depression and anxiety to schizophrenia and psychosis.

In July last year, BBC Scotland broadcast allegations by patients of bullying by staff, illegal drug-taking and being pinned to the floor unnecessarily.

Experts called it abusive and said the unit should be closed down.

NHS Tayside responded by commissioning an internal report into Carseview to go alongside independent reports into mental health in Tayside.

The internal report says a whistleblower has come forward and accused Carseview of “very serious concerns over leadership, safety and malpractice”.

report
The internal report has not been seen by the public

It came up with 11 recommended actions including urgent action on staff training and critical action on illegal drugs on the ward.

It said the restraint policy should emphasise the safety of patients as well as staff and that the culture of the unit should be “based around the caring and compassionate leadership approach”.

NHS Tayside said the recommendations covering patient care and culture were “now being progressed”.

Prof Peter Stonebridge, acting medical director for NHS Tayside, said a “steering group has been established” to focus on restrictive care practices, including the reduction of face-down restraint.

Joy Duxbury said there seemed to be a toxic environment at the unit
Joy Duxbury said there seemed to be a toxic environment at the unit

Joy Duxbury, professor of mental health at Manchester Metropolitan University, told BBC Scotland: “I think this is a terribly toxic environment.

“The figures on physical restraint are exceptionally worrying.

“These are very vulnerable clients who are being restrained, in my view, unnecessarily and by far too many staff in too many situations.

“For me, given what we know about psychological and physical trauma of the use of restraint in such setting, this is of significant concern.”

Marnie Stirling said the unit was supposed to be about recovery not punishment
Marnie Stirling said the unit was supposed to be about recovery not punishment

Marnie Stirling, who had two stays in Carseview with anxiety and depression, spoke to the BBC documentary last year.

Reacting to the report, she said: “If you think about mental health, it’s supposed to be about recovery. This isn’t recovery, it’s further punishment for people.”

David Fong spent a month in the unit after experiencing psychosis in 2013.

‘Total disgrace’

He claimed staff used restraint violently and repeatedly during his time there.

His mother Lorraine said: “This is a total and utter disgrace that this has gone on for seven years and maybe longer.”

David told BBC Scotland that staff were quick to see frustration and anger arising from detainment as aggression.

“Staff are too keen to initiate restraint and offer little or no de-escalation when no actual aggression has been displayed by the patient,” he said.

Former patient David Fong said he had had his face rubbed along the floor during restraint
Former patient David Fong said he had his face rubbed along the floor during restraint

“I ask how many of these restraints were actually needed and if some are instigated by staff rather than patients?

“I personally was physically assaulted with the application of intense pain through twisting of arms, wrists and fingers or a member of staff’s knee being dug into my back, had my face rubbed into the floor causing loss of skin from my face, and had verbal abuse screamed at me during restraint.

“I also could not have been the only patient that these tactics were being used upon.”

A separate report looking at the patient experiences came up with separate 23 recommendations in December.

It is feeding into an independent inquiry, which was announced in the Scottish Parliament last year, and is still ongoing.

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Families of Tayside suicide victims, including Carseview patients, wait for inquiry findings

Families of Tayside suicide victims, including Carseview patients, wait for inquiry findings

The independent inquiry into mental health services in Tayside has retired to consider the key issues hampering the system’s ability to care for patients.

Launched following pressure from the families of suicide victims in Dundee, the inquiry’s evidence stage has concluded after receiving hundreds of submissions from the public.

Alongside other evidence, these will now be examined by the inquiry, chaired by former chief inspector of prisons David Strang.

Mr Strang said: “I am pleased with the response we have received to our public call for evidence. More than 200 people have submitted written documents and personal statements and there have been more than 60 oral evidence sessions held.

“Evidence has been submitted from a wide range of people including patients, families, carers, NHS employees and third-sector organisations.”

David Strang is chairing the inquiry

Agencies such as Police Scotland, student welfare teams and Dundee Drugs Misuse Commission have also contributed.

The evidence stage has taken several months, with discussions held with parties with an interest in improving mental health services.

The inquiry has visited psychiatric units including the Carseview Centre, the Rohallion Clinic and Stracathro in order to understand the systems currently in place.

The information it has gathered to date will be used to identify key issues in mental health services.

A statement from inquiry chiefs said: “The next stage of the inquiry’s work is to analyse all the data evidence, relevant government reports, statistical data, internal NHS review documents and data, in order to identify common themes which will then be the subject of further investigation and analysis.”

The inquiry was commissioned by NHS Tayside last year after campaign group Lost Souls of Dundee claimed it had identified at least 10 suicides which could have been prevented in the area.

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Second charity football match in aid of young Dundee dad Lee, who took his own life

Second charity football match in aid of young Dundee dad Lee, who took his own life

Lee Welsh

 

link to Evening Tele article here 

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Mental health readmission rate rising in Tayside

Mental health readmission rate rising in Tayside

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Grieving mum still seeking answers 11 years after son died at Dundee’s Carseview Centre

Grieving mum still seeking answers 11 years after son died at Dundee’s Carseview Centre

Wilma is still heartbroken over the loss of her son Gavin (left)

Link to Evening Tele article here 

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‘Damning’: suicide rates in Dundee higher than any other Scottish city

‘Damning’: suicide rates in Dundee higher than any other Scottish city

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.”

 

Link to Evening Telegraph article here

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