A former health board chief has sparked fury by suggesting a landmark inquiry into mental health services should not have gone ahead because it held up work to improve care.
Crawford Reid, former chairman of the Perth and Kinross integrated joint board (IJB), believes the independent inquiry “completely screwed” plans to redesign local mental health facilities.
The inquiry, led by former prisons governor David Strang, strongly criticised what it described as a loss of “trust and respect” in local psychiatric services.
But Dr Reid believes the launch of the inquiry – at the behest of the bereaved families of suicide victims – has set progress back in Tayside by two years.
The redesign was signed off in January 2018 by Perth and Kinross IJB, which is in charge of inpatient mental health services, but was put on hold following the inquiry’s interim report in May last year.
Ahead of an NHS meeting to discuss a proposed action plan on mental health tomorrow (Thursday), Dr Reid said: “Several aspects of the inquiry report give me great concern. (Ex-chair and ex-chief executive) John Brown and Malcolm Wright came in at a time when Tayside was in a dysfunctional shape – it was a knee-jerk reaction.
“I’m not minimising how ruinous suicide is but what’s happened is the mental health transformation programme has been basically put on hold.
“If the transformation programme had started to move in, things would have improved with a full complement of consultants.
“They completely screwed it.”
Relatives of those who took their own lives after engaging with local mental health services have criticised Dr Reid’s comments as poorly considered.
“There have been ample opportunities for genuine change with regards to mental health services in Tayside over the years given the sheer volume of investigations and horror stories.
“Nothing was changing hence why I, and others campaigned for this inquiry.
“Perhaps if these fantastic changes that are being proposed had actually been implemented years ago, lives would have been saved and there would have been no need for an inquiry.”
She added: “I feel yet again that we, the bereaved families who campaigned tirelessly for change, are being used as a scapegoat for the never-ending list of failures.”
Mandy McLaren, who lost her son Dale Thomson to suicide in 2015, said: “The redesign was in the interim report, and it did say it should be halted.
“The matter with him is he doesn’t want to take any responsibility for the part they all played in allowing these failures and allowing these deaths.”
Following a near-two-year investigation, the Independent Inquiry issued 51 recommendations on February 5.
Witnesses who gave accounts to the inquiry described how the transformation programme appeared to be little more than an asset management plan to save money.
However, Dr Reid believes that, with time, the programme could have gradually reintroduced localised care at facilities such as the Mulberry Unit in Angus, which was mothballed in 2017 despite being only despite being opened in 2011.
He also believes independent case reviews should have been held for each person who dies after engaging with mental health services.
“If you look at each and every recommendation there’s not one that moves the process of improving mental health services in Tayside one inch forward,” he added.
“Not one of those 51 recommendations, without the transformation programme going on, will improve anything.
“The transformation programme had no time to bed in and move forward – if it had been allowed to develop the situation would have been fantastic compared to what it was two years ago.
“It’s not perfect but it’s far better than what we’ve been left with at this time. The sooner it gets put back on the boiler the better.
“Without a shadow of a doubt, this inquiry should not have gone ahead.”
NHS Tayside and the independent inquiry have been contacted for comment.
“We really need to work with staff to fix mental health”
Renewed calls have been made by NHS staff representatives for health bosses to work with them to improve mental health services in Tayside following the publication of the Strang report.
Jenny Alexander, employee director at NHS Tayside and a Unison rep, said the 51 recommendations were unlikely to be met unless staff were on board with the health board’s plans
She warned that actions could not be rushed through in the way the mental health transformation programme was perceived to be by some observers in 2018.
She told a meeting of Dundee’s health and social care partnership board (HSCP) yesterday: “The partnership aspect of this is very, very important.
“If we are running off and doing things like in 2018 we’re not going to do anything differently.
“We really need to start working in partnership with staff-side – if we don’t have staff on side we will never get through those 51 recommendations.
“We need to make sure we have improvements done for these people that we’re caring for.”
The independent inquiry found that staff reported feeling disrespected and undervalued by senior colleagues.
One mental health staffer described the atmosphere in mental health services as “a culture of fear”.
Arlene Mitchell, Dundee HSCP locality manager, says actions have already been taken in response to the inquiry.
These include the creation of new senior mental health posts, a new process for investigating adverse events and a plan to improve better support for those leaving mental health inpatient services.
Ms Mitchell said: “From a Dundee perspective, we’re in a good position…to ensure a strong staff partnership approach.
“We feel there’s a need to strengthen some of the staff partnership activity.”
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 firstname.lastname@example.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.
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.”
Mandy, however, said at the time the apology was “too little, too late” and should have been made to her personally.
Phil received an apology from the NHS after what was described as a “callous” response to Lee taking his own life.
Phil said he and Lesley were “disgusted” with the Dundee Health and Social Care Partnership’s statement in the wake of Lee’s death.
They later received a personal apology from then-chief executive of NHS Tayside, Lesley McLay.
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.”
“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.”