Bosses at the health board aim to get rid of 1,300 posts to plug the hole in its finances, official papers revealed.
They say they can do that over several years through “natural staff turnover”, but it is feared cuts to backroom staffing will have an impact on patients.
The decision to shrink the workforce comes as the board benefits from having at least £62 million of debt written off by the Scottish Government.
The plans are revealed in an assurance report to the board from September.
It said there was an “acceptance that staff levels need to reduce by 10%”.
Gillian Murray, who has been campaigning for better mental health services after failings in the care of her late uncle, said the decision shows that “balancing the books obviously means more to them than saving lives”.
“People in Dundee are dying because NHS Tayside is a shambles and to cut the workforce is another slap in the face for all of us,” she added.
Murdo Fraser, the Conservative MSP in Perthshire, said: “Local people will be wondering what impact these massive reductions in staff will have on their already pressured services.”
Annie Ingram, NHS Tayside director of workforce, said no one will lose their job but said spending on the workforce is higher than health boards of a similar size.
She added: “We are carrying out a review of staff numbers, grades and skills, which is being carried out in partnership with our staff and our trades unions, to ensure we have a safe, affordable and sustainable workforce.”
He has called for “all those politicians who claim to care about justice or young people” to “consider their shameful silence on this issue”.
Responding to the latest case, a Scottish government spokesman said: “Our thoughts are with the family and friends of this young man.
“Investigations have begun ahead of the Fatal Accident Inquiry and it would therefore be inappropriate to comment on the specifics of this individual case.
“We recognise, however, that many young people entering the criminal justice system have complex needs and we work with agencies to ensure appropriate support is available when needed.”
A Crown Office spokesman said: “The investigation into the death of William Brown (or Lindsay) is ongoing and is under the direction of Scottish Fatalities Investigation Unit (SFIU).
“There will be a mandatory Fatal Accident Inquiry in due course once investigations are complete.
“The family will be kept updated in relation to any significant developments.”
An SPS spokesman said: “Every death in custody is subject to a DIPLAR (Death in Prison Learning and Audit Review), which we will conduct along with partner agencies, and that process would feed into the FAI.”
Dave Barrie, service manager with Addaction, said the new strategy is being put in place following changes in the way people with an addiction to powerful opiates such as heroin are helped.
Previously, all those with heroin addictions would be referred to the NHS for treatment via Addaction.
But now users can go directly to the Tayside Substance Misuse Service, based in Constitution House.
Mr Barrie said the charity is now focusing more on people with problems with other drugs and those whose addiction to opiates isn’t at the stage of a long-term addiction.
He said: “Previously, everyone in Dundee who had an alcohol or drug problem would come through Addaction. That’s changed, and now people can go directly for NHS treatment.
“We are now looking at having a more preventative approach to substance misuse.
“We will be looking at helping people who are starting to have problems with drugs, or are recognising some concerns about their drug or alcohol intake.
“We are really looking to support people much earlier on in their alcohol or drug use.
“With the Dundee Drugs Commission being set up, the spotlight is on services in Dundee, so we really want to help people whose drug problems are less entrenched than the ones we previously helped, some of whom have been drug addicts for decades.
“It may be people with problems with other drugs such as cocaine or amphetamines. Often we find issues with these drugs can lead to problem with other drugs such as diazepam or heroin, as folk start to use these drugs to bring them down following a binge.
“We are starting to go into some hostels, chemists and GP surgeries in Dundee for drop-in sessions. If we can get into those venues, then we think we can access people sooner. What we’ve found is we can help people and point them in the direction of the support they need for other things.
“We previously had a presence in the Carseview Centre and it was received well. We realise people with mental health problems, housing problems and other health problems often have substance misuse problems and can be accessed at these places.”
Dave said another key focus would be supporting the family members of those who have drug or alcohol problems, as well as people who have lost a loved one to overdose.
He said: “We recognise that there is a huge isolation and stigma attached to drug addiction and being the parent or family member of someone who is an addict.
“If you have people around you to support you then it makes it so much easier to deal with.
“When you think of the year we have had for drugs deaths – every one of those people leaves behind extended families who are all left grieving.”
As fundraising for the Sleep in the Park charity event breaks £1 million, Jack McKeown talks to its founder Josh Littlejohn about what the money will do to tackle homelessness.
On Saturday December 8, thousands of people will sleep rough in Scotland’s four biggest cities to raise money to tackle homelessness.
Of course the awful reality is thousands of people sleep outdoors in Scotland every night of the year because they have no other choice.
Sleep in the Park takes place in Dundee, Aberdeen, Edinburgh and Glasgow and will see people get a taste of homelessness while raising money to tackle one of the saddest blights on 21st Century Scotland.
The event is run by the charity Social Bite, which was founded in 2012 by Josh Littlejohn and Alice Thompson.
Fundraising has just smashed through the £1 million barrier and Josh said he was delighted with the built up to the event.
“We’re just past 1,000 people signed up in Dundee and the same again in Aberdeen,” he said. “And we’ve got 2,500 in Glasgow. We’ve also broken £1 million in fund raising already, which is excellent.
“The target for the event is £4 million but the majority of donations come in the last two weeks before the event so I’m very happy that we’ve made a great start.”
The money will be used to secure 830 flats in five Scottish cities that will give rough sleepers their own home.
“In Dundee we’ll have 100 flats. That’s 100 people who will have their own home for the first time,” Josh added. “Over Scotland we want to get 830 people off the streets and into a place they can call their own.”
The properties have been leased from local authorities, housing associations, and a small number of private landlords.
“We’re targeting those at the most extreme end of the spectrum, who have been homeless for a long time and are often dealing with very difficult challenges in their lives.
“Our premise is people are best equipped to deal with those challenges from a place they can call home. If you’re sleeping rough or living in hostels it’s almost impossible to deal with any challenges from such an insecure base.”
As well as providing accommodation for the first 18 months, money raised by Sleep in the Park will give people personalised support to help improve their lives.
“Our strategy involves what’s called a ‘by name’ list,” Josh continued. “Local charities and councils know the names and backstories of those most badly affected by homelessness. They’ll know ‘John Smith’ from Dundee has been homelessness for three years and has mental health issues.
“We want to track John Smith down, give him his own home and personalised support. Some people will need help dealing with mental health or addiction issues. Others may just need help with paying bills, grocery shopping or setting up a direct debit.”
Ultimately, Social Bite wants to come as close as possible to eliminating homelessness in Scotland. “If you take Dundee as example, with the right focus, resources and political will, there’s no reason why homelessness there shouldn’t become a thing of the past.”
Members of the public can join Sleep in the Park by committing to raise a minimum of £100. Businesses can sponsor the event by signing up a team of five with a minimum fundraising commitment for £3,000.
To find out more about taking part visit www.sleepinthepark.co.uk.
The number of university students in Scotland seeking support for mental health issues has increased by two-thirds over five years, analysis shows.
The BBC asked universities across Scotland for the numbers of students seeking some form of support.
It found more than 11,700 students asked for help in 2016-17 compared with about 7,000 in 2012-13.
The 68% increased among students in Scotland was higher than the 53% total for the UK over the same period.
University counsellors and wellbeing staff told BBC Scotland that they deal with cases ranging from anxiety, depression, gender-based violence and body dysmorphia.
The figures – obtained by the BBC’s Shared Data Unit through freedom of information requests – showed that only 12 of Scotland’s 19 universities recorded how many students sought help for their health help over the five-year period.
The data shows:
The number of students seeking help for their mental health at the University of Edinburgh doubled over five years
The University of Glasgow experienced a 75% rise in students seeking help for their mental health between 2012-13 and 2016-17
The University of Stirling had a 74% rise in students seeking help for their mental health between 2012-13 and 2016-17
Glasgow School of Art experienced a 72% increase in students seeking help for their mental health over the same period
‘Not being able to return the favour had a toll on me’
Connor Smith was in his third year studying computer games development at the University of the West of Scotland when his close friend, who was also a student, took his own life.
“I was really shook up and didn’t know what to do with myself,” he said.
“I had struggled with my mental health before but the person who took his life was able to help me out of that, so not being able to return the favour had a toll on me.”
The university’s counselling team quickly offered to help Connor.
“I couldn’t speak to my family because I felt like I was burdening them,” he said.
“I couldn’t speak to my close friends either because they were going through the same thing.”
Connor said that he was struggling not only with the death of his friend but also his future prospects.
He said: “One evening I sat down and thought ‘what am I doing?’.
“I forced myself to work at university but I wasn’t in a good mind space. I really wasn’t enjoying what I was doing.”
Connor said he did not know what would have come of his life had it not been for the university’s support.
He said: “I wouldn’t have done so well.
“I might’ve quit university and if I did that, I don’t know what I would be doing.
“I had nothing lined up as a fall-back.”
Connor returned to counselling for a second time during his final year of studying. He was struggling with stress, overeating and had money worries.
He said: “[The support] wasn’t immediately available like before but, when I did get it, being able to speak to someone was so helpful.
“University was the best stretch of my life but easily the lowest I have been as well.”
‘I don’t like the term snowflake’
Ronnie Millar, director of counselling at the University of Edinburgh, said there is a “pernicious perfectionism” among students, which can affect their mental health.
He said: “When I was at university, there were no fees and we had student grants.
“Nowadays, more students have to work in part-time jobs and study, which puts a lot of pressure on them to succeed.”
Mr Millar said it was not helpful to label young people seeking help with terms such as snowflake, which imply they are less resilient than previous generations and too emotionally vulnerable.
He said: “I don’t like the term snowflake. I think it is a pejorative.
“In terms of resilience, some students struggle more than previous generations – but that’s not pointing the finger of blame.”
Mr Millar said that while there’s been a doubling in the male students coming forward for help for their mental health, the “proportion” has stayed the same over the five-year period.
“We say to students that [counselling] is not activity just for women, it’s for everyone.”
Social media bubble
Dr Phil Quinn, head of counselling and psychological services at the University of Glasgow, said that while there was greater awareness of the help available, a “saturated” NHS had resulted in fewer community services for students to access mental health support.
He said: “We have had a record year in terms of referrals to the service, of students starting their university careers with already diagnosed mental health conditions.”
The University of Glasgow employed 20 staff in 2016-17 – ranging from cognitive behavioural therapists and a consultant psychiatrist to a counselling manager – to assist with the 2,330 students that came forward that year.
Quinn believes that staff numbers are sufficient to meet demand, and that the increase in students coming forward for help is partly down to a “24-hour social media bubble” where they are exposed to “criticism, bullying, and abuse”.
Jackie Main, who is the director of student life at Glasgow Caledonian University, said it was not just the volume of students seeking support that was increasing but the complexity of the issues they presented with.
“We see a lot more crisis students than before,” she said.
“That could mean a student is actively self-harming, threatening suicide or requires being sectioned or hospitalised.
“Crisis students experience severe emotional distress, including panic attacks.”
At Glasgow Caledonian University, the number of students seeking support in 2016-17 hit 661, up 69% since 2012-13.
Ms Main added: “Anxiety and depression are the two big issues we’ve see increases in.
“We are not a crisis support service. We don’t have the resource and it is not our job. But we don’t let students fall through the net.”
Eight of Scotland’s universities provided the BBC with their total budgets for mental health services – which in some cases included services that don’t just support student mental health, such as a disability service – in the five years to 2016-7.
It revealed an increase of 31% from £2.4m to £3.1m.
The University of Strathclyde (which did not provide complete figures for the number of students seeking help between 2012-13 and 2016-17) was the only institution to report a decrease in its overall budget over the five year period, down by 18%.
A spokeswoman for the university put the drop down to “re-structuring” and emphasised that significant investment – about £400,000 – had been made since 2017, including the creation of three full-time and 12 part-time posts on the mental health and wellbeing teams.
She said: “We have also introduced an online mental health support programme, which works hand-in-hand with our dedicated advisers and therapists, to ensure support is available for all.”
‘Finding out you’ve failed all your classes is horrible’
Hannah Moles was in her third year of studying maths at the University of Strathclyde when she approached student services for help.
Not only had she failed her first set of exams but she was also caring for her grandmother who had dementia.
She said: “My brother and I were going over three times a week to make my gran dinner, get the shopping and keep her company.
“She was really lonely.”
Hannah said that when she wasn’t caring for her gran, working in a part-time job which paid for her flat, or sleeping, she’d be in the library trying to study.
“I was really tired and had things on my mind constantly,” she said.
“So I went along to support services to see if I could calm myself down. I wanted to improve my mental state before my next set of exams.”
Hannah said that eight weeks after approaching student services, she received her first counselling appointment.
However, by this point Hannah had failed her second round of exams – meaning she wouldn’t be allowed to return for the fourth year of her degree.
“Finding out you’ve failed all your classes is horrible especially when you have put in the work but it is still not enough,” she said.
Hannah said that she was grateful to her university for providing mental health support but more counsellors would help meet the increasing demand.
“I am lucky that I got the support I needed,” she said.
“But there are lots of students who seem to need help with their mental health. I just hope that universities can keep up with the increasing demand.”
’80 new counsellors’
The Scottish government’s most recent Programme for Government promised to provide more than 80 additional counsellors in further and higher education institutions over the next four years, with an investment of about £20m.
However, there is no indication yet how the funding will be split or which universities will receive more counsellors.
Health Secretary Jeane Freeman said every student “should have access to emotional and mental well-being support”.
“We will work closely with the university and college sectors, NUS Scotland and other partners, on the implementation of the additional counsellors, and to ensure an integrated and wrap-around approach to student wellbeing in higher and further education.”
Details of organisations offering information and support with mental health issues are available at bbc.co.uk/actionline, or you can call for free, at any time to hear recorded information on 0800 888 809.
The NHS in Scotland is not financially sustainable and its performance has continued to decline, the public spending watchdog has warned.
Audit Scotland said health boards were “struggling to break even” and none had met all of the key national targets – with NHS Lothian not meeting any.
It highlighted increasing demand on NHS services, and rising waiting lists.
Health Secretary Jeane Freeman said the government was already taking forward Audit Scotland’s recommendations.
But the watchdog’s report prompted widespread criticism of the Scottish government, with the Conservatives claiming it should “make shameful reading for the SNP”.
The report said pressure is building in several areas – including the recruitment and retention of staff, rising drug costs, Brexit and a significant maintenance backlog.
It said “decisive action” was needed to protect the “vital and valued service”.‘
What does the report say?
The report warned that the NHS in Scotland is “not in a financially sustainable position”, with NHS boards “struggling to break even, relying increasingly on Scottish government loans and one-off savings”.
And it said the “declining performance against national standards indicates the stress NHS boards are under”.
The only target met nationally in 2017/18 was for drugs and patients to be seen within three weeks.
Only three of Scotland’s regional health boards met the target for patients beginning cancer treatment within 62 days of being referred
The proportion of youngsters seen by CAMHS within 18 weeks fell from 83.6% in 2016/17 to 71.2% in 2017/18.
The Scottish government invested £13.1bn in NHS services last year, but Audit Scotland said when inflation was taken into account there was a 0.2% real terms drop in cash.
Health boards made “unprecedented” savings of £449.1m, but many relied heavily on one-off savings for this, while three boards – NHS Ayrshire and Arran, NHS Highland and NHS Tayside – needed £50.7 million of loan funding from the government to break even.
This was “significantly more” than in previous years, with Audit Scotland saying four boards have predicted they will need a combined total of £70.9m in this current financial year.
The report said the “NHS is managing to maintain the overall quality of care, but it is coming under increasing pressure”, adding Brexit would create “additional challenges” for the health service.
However the scale of these challenges was “difficult to assess” because of “significant uncertainty” over the terms of the UK’s withdrawal deal from the European Union, and because data on workforce nationality is not routinely collected.
Auditor General Caroline Gardner said: “The performance of the NHS continues to decline, while demands on the service from Scotland’s ageing population are growing.
“The solutions lie in changing how healthcare is accessed and delivered, but progress is too slow.”
What has the Scottish government said in response?
Health Secretary Jeane Freeman said the government was already taking forward Audit Scotland’s recommendations.
She said NHS funding had reached “record levels of more than £13bn this year, supporting substantial increases in frontline NHS staffing, as well as increases in patient satisfaction, reductions in mortality rates, falls in healthcare associated infections, and Scotland’s A&E performance has been the best across the UK for more than three years.”
She added: “While our NHS faces challenges, common with health systems across the world, we are implementing a new waiting times improvement plan to direct £850m of investment over the next three years to deliver substantial and sustainable improvements to performance, and significantly improve the experience of patients waiting to be seen or treated.
“Ultimately we want to ensure people can continue to look forward to a healthier future with access to a health and social care system that continues to deliver the world-class compassionate care Scotland is known for.”
What other reaction has there been?
Conservative health spokesman Miles Briggs claimed the NHS was “facing an unprecedented challenge” with boards across the country “staring into a black hole of more than £130m.
He said: “For a government which has been in charge for more than 11 years, this should make shameful reading for the SNP.”
Labour’s Monica Lennon added: “After more than a decade of SNP complacency our NHS is in crisis.”
Dr Lewis Morrison, chairman of the British Medical Association (BMA) in Scotland, said the “stark warning” from Audit Scotland “could not be any blunter”.
But he added this would “come as no surprise to frontline doctors who have faced the consequences of inadequate funding year after year”.
And RCN Scotland director Theresa Fyffe said the report “underlines what those in the nursing profession have been warning about for a number of years – an unsustainable pressure on staff to deliver more care.
“This leads to staff burnout and, in some cases, a choice between staying in the profession and their own health.”
A WEST of Scotland MSP has called for improved access to mental health services, particularly among young people
To mark World Mental Health Day last week, Labour’s Mary Fee lodged a motion at the Scottish Parliament calling for greater support for people who need help with their mental health.
Ms Fee’s motion says every individual who experiences poor mental health should have access to well-funded and adequately resourced support services within their local communities.
It is estimated that one in four people in Scotland suffer from poor mental health.
This year’s annual theme for World Mental Health Day, that took place on October 10, is young people.
Research conducted by Stonewall Scotland in 2017 found that 58 per cent of lesbian, gay or bisexual pupils and 96 percent of transgender pupils have deliberately harmed themselves.
Ms Fee said: “It is important that politicians, public servants and public bodies help to raise the profile of mental health.
“I believe that in order to break the stigma around mental health we must widen the conversation and deepen our knowledge and understanding of the range of mental health issues that people may experience throughout their lives.
“I am unequivocal in my belief that mental health should be treated with the same priority as physical health.
“It is a scandal that nearly one-third of young people are waiting longer than 18 weeks for vital mental health treatment. It is simply unacceptable.”
In marking the 70th anniversary of the NHS, Scottish Labour outlined a 10-point plan in which they pledged to provide access to a mental health counsellor for every school pupil in Scotland and improve the access to crisis mental health services.
The Scottish Government has since promised to invest in extra mental health services in schools, though Ms Fee warned that any dilution of the pledge will cause greater difficulties for children and young people accessing much needed treatment and support.
Clydebank MSP Gil Paterson added:“Most families will have known of someone with a mental health problem who has kept it hidden.
“The Scottish Government have done a lot of work on raising awareness of mental health and tackling the stigma associated with it.
“This work has resulted in a lot more people coming forward for treatment and the Government recognises that this puts added demands on the service, which is why the SNP Government has allocated an extra £250 million for mental health services, which includes £60m for schools to support 350 counsellors and 250 extra school nurses so that every secondary school will have a counselling service.
“I have asked a series of questions at the parliament about exactly what has been done to support mental health services in the past and the Post will be first to know when I get the answers.”
Drug use to tackle mental health conditions in Tayside and Fife has rocketed by nearly two-thirds, it has been revealed.
NHS Tayside has increased its use of anti-depressants by more than 73% since 2007/8, while treatments for psychosis and related disorders have risen by 42%.
Pharmacies under the health board handed out nearly twice as much dementia medication, an extra 95%, and there was also an increase in the number of doses used to treat ADHD of nearly 175%.
NHS Fife recorded a slower rise in every treatment type except anti-depressants, where there was an increase of more than 90%. However, it experienced an overall rise of nearly 65%.
Only hypnotics doses decreased, with a drop of nearly 11% for Tayside and just over 2% for Fife. NHS Tayside, which paid out nearly £9.5 million for mental health drugs last year, an increase of more than 37% on 2016/17, insisted drug therapy can be important to recovery.
A spokeswoman said: “Increased levels of identification and diagnosis of mental health conditions, including dementia, means that more patients are accessing important treatments that can improve quality of life.”