A new Tayside mental health strategy designed to “reinstate confidence” among service-users and staff has been unveiled.
But the draft document, which is still subject to consultation, has failed to convince mental health campaigners in Dundee.
The Tayside Population Mental Health and Wellbeing Strategy was drawn up with help from around 300 stakeholders, including professionals, service-users and families.
It highlights a raft of initiatives NHS Tayside hopes will “improve how we work as a health and social care system” and “ensure people in crisis and distress get to the right place first time”.
Among the proposals is the establishment of a Distress Brief Intervention (DBI) service, an ‘innovative’ pilot scheme first launched in Scotland in 2016.
The service consists of two parts, with part one involving a trained front-line health worker, police officer, paramedic or primary care staff member helping to ease any individual in distress.
They then ask the person if they would like further support and, if they agree, they are
referred to the DBI service with a promise of contact within the next 24 hours to start providing further support.
The programme was expanded in April into a nationwide response for people struggling during the coronavirus pandemic.
In September, Nicola Sturgeon extended the pilot scheme to 2024, where it is then expected to be embedded in all health boards across Scotland.
The report plans to strengthen “engagement and participation”, “restore public trust, respect and confidence in our mental health services by improving mental health services” and to deliver a “comprehensive programme of work”.
The report highlights a raft of initiatives, which NHS Tayside hopes to “improve how we work as a health and social care system by working closer with other NHS Scotland services such as NHS24, Scottish Ambulance Service, and Police Scotland joining up with NHS Emergency departments to ensure people in crisis and distress get to the right place first time.”
“There appears to be very little in here in regard to people at the pinnacle of crisis,” he said.
“Once again the cops will pick up the pieces and take the person to `the right place first time.`”
The report states that work to improve the organisational culture of mental health services in Tayside is underway.
This includes the need to attract and retain trainee psychiatrists, to ensure that staff feel valued and listened to, and to give urgent priority to the development of community-based mental health services.
The strategy is due to be finalised next year, following a feedback exercise.
Kate Bell, interim director of Mental Health and Learning Disability Services in Tayside, said: “We are fully committed to making this strategy reflect the needs of all and, in particular, reflect the voices of people living with mental health conditions, their carers and families.
“We will continue to work with all stakeholders, including all staff who provide support, care and treatment across our mental health services.
“Mental health affects us all and we want to make as many people as possible in Tayside aware of how we are changing how we care for those in need of our services and supports.
“We are seeking everyone’s views on this first draft of the strategy so please get involved, share the strategy and survey, and give us your feedback to help us connect with as many people as possible.
“Our commitment is clear: we will Listen, Learn and Change with service users, carers and staff and families in mind.”
Holyrood’s cross-party group on mental health found people are turning to the private sector due to a ‘lack of support’.
Holyrood’s cross-party group on mental health found people are turning to the private sector because of a “lack of treatment and support”.
This applies to those who are mostly “able to go about their daily lives with a mental health diagnosis”, the report said.
It found funding has helped recruit mental health workers, while both new and expanded services have been running during the coronavirus pandemic.
Although MSPs found “emerging evidence of some positive outcomes” for Scots accessing mental health services, they expressed concern children and young people continue to be left without support and the scale of investment in new services may not meet demand.
People with mental health problems also feel there is a lack of support for them to stay well, according to the report, with most commitments on accessing adult services in the Scottish Government’s Mental Health Strategy focusing on crisis support or initial contact with mental health services.
Commenting on the report, which was compiled with input from 78 MSPs on the cross-party group, co-convener Oliver Mundell said: “When it comes to access to treatment, we are right to recognise the progress that has been made but we cannot do so without acknowledging that for many this still proves far more difficult than it should be.
“Demand is often too great, resources too few or patchy and, definitely from what we hear from the group, it is inconsistent across the country.”
A Scottish Government spokesman said: “We are pleased the cross-party group has acknowledged the progress that has been made on mental health in recent months. This has been a very difficult period for many, particularly those experiencing mental ill health.
“Since the beginning of the pandemic, we have provided £6m of dedicated funding to provide additional telephone and online support services.
“This includes £2.1m to expand the NHS 24 Mental Health Hub to be available to the public 24 hours a day, for seven days a week, £1.2m to provide extra capacity for Computerised Cognitive Behavioural Therapy (CCBT) and over £1m to roll out the Distress Brief Intervention (DBI) programme on a national basis.
“Protecting good mental health in Scotland will be central to our long-term response to the pandemic and – as set out in our recent Mental Health Transition and Recovery plan – the Scottish Government is committed to doing more.
“A key part of this is our work to enhance access to and the quality of services.
“We have committed to building on innovations and new service designs that have emerged, such as the establishment of mental health assessment centres and the expansion of digital services where they can best meet patient needs.
“We will also work with NHS boards to ensure they are able to respond to any increase in demand over the coming months.
Matthew Simpson, 23, is currently in his final year studying law at Dundee University, and at the beginning of the year went to his GP surgery looking to be referred onto a psychiatrist as he believed he was suffering with undiagnosed ADHD (attention deficit hyperactivity disorder).
However he claims he was ridiculed and accused of looking to get an unfair advantage at university both at his appointment and in a letter to his doctor written by a locum psychiatrist.
In the letter it said: “There is no evidence from your referral of ADHD, and the fact he insists on a referral, presumably against your better judgement, might say something about his personality, but it does not suggest ADHD.
“If he has managed to get to the third year of a law degree, then presumably he does not have significant cognitive impairment, and is not, of course the duty of the local mental health services to help him get a 2:1 degree in law.
“The best advice is that he works hard.
“I do not want to offer him an appointment and a diagnosis simply as a safety net, just because he might not do as well as he expect in his exams.
“Presumably he has no medical training and is not an expert in psychiatry.”
Matthew has now spoken out about his experiences and said mental health services up and down the country need to be drastically changed if people are to be properly supported.
He said: “I went to the GP very much knowing what I was asking for and the GP didn’t necessarily deal well with someone coming in and knowing what they wanted to get out of the appointment.
“I was rejected and belittled by the doctor and people must know that is not an acceptable way to talk to someone.
“I have never met the doctor who wrote the letter and they made assumptions about my personality in an insidious fashion.
“ADHD is a neurodevelopmental condition but a lot of health professionals still look at it like it’s a disorder, which is outdated and dangerous.
“The doctor essentially told me to bury my head and get on with it, but if I had a lump discovered the doctors would not be telling me to do that, it would be taken very seriously.”
Matthew went onto seek private treatment where he was ultimately diagnosed with ADHD and is now receiving treatment to help him.
However he wants to see the whole mental health system overhauled as he believes the lack of support and long waiting list are not actually helping those who need it.
Matthew added: “The conversation about mental health is making sure people can talk about their depression or their anxiety but it is all worthless if we don’t have a system that can support people.
“There are issues in Tayside and I understand mental health support is oversubscribed and the NHS has issues recruiting psychiatrists across the country, but they have to deal with that.
“People are being faced with an 18 month long waiting list and it is abusive because that is not a solution and demonstrates the service is not fit for purpose.
“I am still being refused treatment as the GP would not honour my private diagnosis so I am still paying for private prescriptions.
“But I can’t allow that to go on, I should be allowed the treatment I need.”
Dr Mike Winter, associate medical director for mental health and learning disabilities, said: “We have recently recruited and retained a number of regular locum consultants to cover vacant posts within the mental health and learning disability service.
“As part of NHS Tayside’s ongoing mental health and learning disability service redesign, we are working closely with staff within our inpatient and community services in Tayside to develop new workforce models.”
Meanwhile, Dundee Health and Social Care Partnership encouraged Matthew to raise an official complaint, which he has done already.
Mental health experts in Dundee are urging city residents to stay connected this coming winter.
With Saturday marking World Mental Health Day, Wellbeing Works said the prospect of households not being able to mix indoors would have greater impact in the colder months.
As a result, people across Dundee are being urged to get outdoors – and take advantage of every opportunity to walk and talk with friends.
A recent YouGov survey revealed that more than eight in ten adults across Scotland have already experienced stress because of the pandemic.
And, although Scotland is not embarking on a new lockdown similar to that enforced during the first wave of the pandemic, cases of Covid-19 are again rising, leading to fears that more restrictions could be heading our way.
Social distancing and a ban on households mixing indoors, coupled with uncertainty over job security had already had a marked negative effect in Dundee, said Wendy Callander executive director of Wellbeing Works.
She said: “One concern which we’ve been focusing on is people’s worries about losing jobs and their income, and the impact that has on people when it comes to paying their bills.
“Another concern is for people who were already having issues with their mental well-being, and it seems like the biggest thing for them is just that they miss people.
“For a lot of them, being with family and friends keeps them well, it gives them a reason to get up in the morning and taking that away is always going to cause problems.”
Wendy also claimed that the holiday season, which is already a tough time for people who suffer from issues such as depression or anxiety, will be even tougher this year.
She said: “Anyone who celebrates Christmas is is already thinking to themselves that this is not good.
“I think that by the time we get to Christmas we will have had nine months of not being close with the people we care about, and for many it will be the icing on a pretty horrible cake.”
She added: “It is really hard for a lot of people to get their heads around it, and the other thing which doesn’t help is the confusion over messages, people are really struggling to understand what is going on.
“The best advice we can give people is just to stay in contact. Although you can’t visit people at home you can still meet up for coffee or go for a walk with a friend.
“We’ve been encouraging walking sessions, where you can get together and talk about what’s on your mind while you walk with someone.
“I think we all need to appreciate and understand that it’s okay to feel anxious, worried and scared, especially at this time of year.”
According to the YouGov survey, nearly four in ten people who had experienced stress because of the pandemic said that maintaining a healthy lifestyle, such as sleeping well and eating healthily, had helped them cope.
Four in ten people (41 per cent) said that doing a hobby was helpful.
Professor Tine Van Bortel, from the University of Cambridge and De Montfort University Leicester, said: “There’s a growing body of strong research evidence about the determinants of our health and wellbeing.
“That is replicated by our findings. Access to nature and safe green spaces, positive social contacts, healthy lifestyles and meaningful activities are all crucial, for us to function well.”
Phil Welsh, a local mental health campaigner who lost his son to suicide in 2017, warned that a socially-distanced winter will be difficult for many people.
He said: “It’s going to be a hard time.
“It’s coming up to those darker nights, and with that and the cold many people are going to be stuck inside.
“It’s really difficult to predict what will happen, but it’s definitely a concern.
“I think that, coming up to the festive season, a lot of people are going to blatantly ignore this advice because they’re going to want to see their families and friends for the holidays.
“It’s a pretty damning thought that a lot of people are going to be stuck, sitting on their own at home for Christmas.”
Libby Emmerson, founder of the charity, launched the organisation in 2018 after she attempted to take her own life and was saved by a footballer.
Through its patrons and ambassadors across Scotland – including local player and Ex-Aberdeen star Jamie Winter – the charity has been working on “changing room chats” to share stories and get people talking.
She added: “Every club we work with we’ve encountered three or four players who are facing problems.
“The service is completely confidential, even if it is just a chat with someone out with their family we are able to assess if they maybe need more support in the form of counselling.
“I thought it was very powerful the post Vicki Cairney had put out there. Around 60% of the folk we are working with just now are in the Dundee area.
“Some of those people are in Cognitive Behavioural Therapy (CBT) with us or just drop in-sessions.
“We will continue to work hard to help day and night to provide that support for those who need it.”
For those who would like more advice they can reach Libby Emmerson on 07528 243 100. If you’re struggling, you can you can also contact the Samaritans on 116 123.
A Dundee youth mental health charity has launched a new peer coaching and listening service.
Feeling Strong has set up its new service to meet the developing needs of young people in the city, providing a safe space for young people to talk about their mental challenges, as well as any other issues they may be facing.
Peer Coach Errin Mathieson said “We’re so excited to launch this new service, and ensuring we’re equipped to help any young person as best we can.
“We hope to promote the exploration and embracing of challenges, with our carefully tailored service assisting in successful recovery and positive destinations for all who come to our doorstep.”
Developed by young people, for young people, the service is for anyone aged 12 to 26 that lives, works, or studies in Dundee.
They are open Wednesdays from 1.30pm to 5.30pm.
Anyone interested in speaking to a member of the charity’s peer coaching staff can click here for a referral form.
Tonight at 8pm I will have Big Welshy (Phil), Lesley & Kirsty on the Show!These guys tragically lost a beautiful son & an amazing brother Lee 3 years ago to suicide!This inspiring family are coming on to tell their personal story & share some special stories about Lee as well as the struggles he went through in his life.This along with what they are up to now & campaigning to get a Crisis Centre set up right here in Dundee.This has actually been planned for a few weeks & I didn’t even realise it was landing right in & around this time!I’ve know these guys & Lee from I was just a wee laddie growing up on the Tap O’ the Hull & it’s an honour to have them on & really try to share their message & help save lives ❤️🙏🏼❤️http://www.notinvainforlee.co.uk/
In-roads are being made after a controversial report outlined mental health provision in the city, say officials.
Latest data – published by the Scottish Social Services Council – revealed six exclusive mental health officers (MHOs) were employed across the region
As a result, Dundee City Council used nine other MHOs to provide cover in 2019.
Cover MHOs are determined as social workers who step in when no exclusive or non-exclusive MHOs are available.
“The amount of MHO work, if any, they do each week tends to be very small. They are very unlikely to have the job title Mental Health Officer,” the report added.
Fife, in comparison, had 14 exclusive MHOs and 29 non-exclusive MHOs.
Phil Welsh, whose son Lee took his own life in 2017, said the report was very disappointing.
“Considering that Dundee is the suicide capital of Europe this report is damning and shocking,” he said.
Phil, who is campaigning for a new mental health crisis centre, added: “Six dedicated MHO’s to cover a city with the highest suicide rate in mainland Scotland, is desperately inadequate.”
He added: “Dundee, the fourth largest city in Scotland is way down in the stats.
“Once again we have empirical evidence that Dundee is not being supported sufficiently when it comes to the recruitment, training and retention of mental health professionals.”
Dundee Labour councillor Richard McCready said the report showed there was a clear need to improve mental health services in Dundee.
He said: “Instead of an integrated approach we have a confused and patchy service.”
John Alexander said the report was eight months out of date – and when a current vacancy was filled, a full quota of 16 MHOs would be in place.
Three people were currently in training and would be added to the team “hopefully within a matter of months,” he added.
A Dundee Health and Social Care Partnership spokesman said: “Since the data was collected there has been a positive impact in this area of work due to an increase in capacity within the Mental Health Officer team, this has put us in a better position to meet demand.
“Our Mental Health Officers can and do provide out of hours services through contact from out of hours.”
The SSSC report also revealed a total of 249 weekly hours were spent on MHO work in Dundee compared to 334 in Aberdeen, 276 in Angus and 278 in Perth and Kinross.
And Dundee fared worse than 13 other local authority areas in Scotland for the number of mental health care hours it offers residents, with 16.7 hours per 10,000 of the population.
The Scottish average is 20.5 hours. In comparison Edinburgh has 19.6, Angus 23.7, and Glasgow city 17.2.
Phil Welsh, who has been campaigning for a 24/7 crisis centre since the suicide of his son Lee, said: “The review, specifically in regard to immediate crisis support, still leaves the region far short of what is needed – namely a non-referral 24 hour crisis centre.
“What is offered in the report exemplifies that no real change will be forthcoming.
“While the review goes on to acknowledge that the partnerships and NHS Tayside recognise that they are struggling to provide the appropriate levels and quality of crisis response – but what is really alarming is the vagueness and empty gesture that `steps are being taken to address this’.
“The public have a right to understand `what steps` will actually be taken. This review does nothing to assure the people of Tayside that mental health provision will change,
“Will we as a region suffer more preventable suicides until these ‘steps’ are put in place?”
HIS also criticised the reliance on temporary staff, which the organisation claimed was unsustainable in the long-term.
And the organisation has recommended the health board and partnerships address these issues urgently.
However, the report did acknowledge that Tayside was not the only board facing these challenges, and that it was a nationwide problem.
And it also praised the commitment and dedication of staff, in the face of a number of challenges outwith their control.
NHS Tayside has issued a joint response with Angus, Dundee and Perth and Kinross health and social care partnerships.
It maintains they will continue to work to keep their promise of listening and acting on what requires to be done to improve mental health care in the region.
A spokesman said: “We will now ensure that the actions and recommendations set out in the report are progressed through the improvement work already under way across mental health services Tayside.”
The statement added: “This HIS review coincided and overlapped with the final report of the Independent Inquiry into Mental Health Services in Tayside which was published by Dr David Strang in February 2020.
“The findings released are reflected in the 51 recommendations of the independent inquiry’s report, and they will be taken forward in our Listen Learn Change draft Action Plan, which was submitted to Scottish Government in June 2020.
“Our final action plan will be completed later this month and include any further recommendations from this review, alongside the detailed work which is being progressed to improve mental health services across Tayside.
“We made a promise to the people of Tayside that we will ‘Listen, Learn and Change’ in response to the independent inquiry and the further actions which we will take from today’s report reinforce that pledge.
“As we move forward we will continue to refine our plans and ensure that these voices feature strongly and influence the new Tayside-wide Mental Health and Wellbeing Strategy which will be published in early 2021.”
Mental health campaigner Gillian Murray, whose uncle, David Ramsay killed himself after being refused treatment at Carseview Centre, said the report highlighted the “same old rubbish.”
She said: “Given Health Improvement Scotland undertook multiple reports and investigations that proved worthless – hence the need for a truly independent inquiry – I have little faith in the substance or impartiality of their reports.
“Thankfully David Strang will be returning early next year to see which, if any, of his recommendations have been implemented. That will be a report worth reading.”
Richard Peter–Tenant, who formed Dundee men’s mental health charity Walk and Blether said he supported any effort to improve mental health services in Tayside.
Richard said: “It’s at least encouraging that a further review has been carried out into what is available in Tayside.
“I am a strong supporter of a 24-hour mental health crisis centre for Dundee.
“One was needed before but I think it is going to be even more necessary as we begin to come out of this situation.”
Richard added: “If this report is listened to, along with the recommendations made in the Strang Report then maybe we can go some way to resolving Dundee’s mental health crisis.”
The Independent Inquiry Into Mental Health Services in Tayside
In May 2018, concerns were raised in the Scottish Parliament about the provision of mental health services in Tayside.
An inquiry to examine the accessibility, safety, quality and standards of care provided by all mental health services in the region was commissioned as a result.
The final report, Trust and Respect, was published on February 5 and was chaired by David Strang CBE.
It contained 51 recommendations to improve mental health care in Tayside and highlights numerous failings, including a breakdown of trust, a failure to deliver services, a lack of psychiatrists, a lack of leadership and a lack of accountability.
Addressing his findings at the time Dr Strang said the board had “lurched from crisis to crisis”.
Dr Strang said he’d been disappointed NHS Tayside appeared to not have listened and did not learn from previous incidents.
He said: “On too many occasions, Tayside has adopted a defensive position, giving the impression of wanting to protect its reputation at all costs.”
Dr Strang said, while he couldn’t make any promises NHS Tayside would act on his recommendations, he was confident there would be strict monitoring of what the board was doing and he vowed to revisit the situation.