A report, by Health Improvement Scotland (HIS), found “significant concerns” with adult mental health community services, which are managed by NHS Tayside and health and social care partnerships.
It is the latest blow for the local service’s reputation following a string of damaging inquiries and reports in recent years.
HIS raise questions over the area’s “crisis resolution” service, and claims there are inconsistencies in access to treatment depending on where people live.
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 February of this year The Independent Inquiry Into Mental Health Services in Tayside published its Trust and Respect report and called for an urgent overhaul of the practices.
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.
After being rescued from the freezing waters of the River Tay, Zana Grant felt only one thing – disappointment.
The 25-year-old had attempted to take her own life in January 2018 but, having survived the harrowing experience, felt she had “failed”.
In a candid account of a life spent battling her own mental health issues, Zana has bravely discussed what brought her to the edge on numerous occasions over the past few years.
Discussing her experience being rescued from the Tay over two years ago, Zana said: “I did not want to survive, I had no idea that I would survive. This was no cry for help, I wanted to die.
“I just wanted the pain I was suffering from to end. I had made my peace and wasn’t even particularly distressed when I took the decision.
“I remember it all clearly – I was so disappointed I was still alive.”
Zana has been rescued from the river twice since her first experience.
She told the Tele she will reach a point of crisis again and cannot guarantee she will not make attempts on her own life again.
Despite her own demons, Zana is training to be a mental health nurse and is also a qualified crisis volunteer.
She has made the difficult decision to speak out about her own battle as she calls for a self-referral crisis centre to be introduced in the city to help hundreds of others like her.
In bravely telling her story, Zana hopes the authorities take notice of what people are going through on a daily basis.
A crisis centre, Zana believes, would help people like her who feel they have nowhere to turn when they reach rock bottom.
A campaign led by Phil Welsh, whose son Lee took his own life in 2017, has called for a 24/7 crisis centre in Dundee.
It would operate similar to those elsewhere in Scotland, providing access to counsellors and support in a home-like environment allowing people time and space to seek appropriate help.
Zana said: “If by speaking out I can make people sit up and listen to my story and understand the dreadful mental health crisis that is taking place in Dundee then it will have been worth it.
“Dundee needs this centre. It would give people somewhere to go when they are at their very lowest and in their darkest hour.
“I don’t know if it would have prevented me doing what I did but it would have given me an option. At the crisis moments I would have had somewhere to turn instead of having to wait six or seven hours to speak to someone, which is the way the system works currently.”
Zana admits she has probably been suffering from mental issues for her whole life.
It was only when she reached secondary school that it became clear what was going on inside her own head.
She has been on medication, had a number of doctors appointments but has yet to receive a definitive diagnosis.
Zana also spent five months in the Carseview Centre and, although praising the staff and help she received there, admits it alone cannot deal with the demand and needs of those suffering mental health.
“There is something very far lacking in the mental health help that is available in Dundee,” Zana said.
“I know I need help. I have a constant need to die and it is very likely I will try again.
“On one occasion when I tried to take my own life, I told hospital doctors I’d attempt to do it again if I was released.”
Zana did make another attempt shortly after her release, only to be rescued by emergency services.
She knows that her battle is far from over – but hopes others can gain courage from reading about what she has gone through.
Zana said: “I have thought long and hard about going public with this. But I am ready to do it .
“Something needs to be done and if by speaking out it helps someone else and helps to get things changed then it will have been worth it.”
Charities back calls for crisis centre
Leading Dundee charities have backed calls for a 24-hour crisis centre in the city – and said more must be done to support those in need.
Feeling Strong and 18 and Under, who both support young people suffering from mental health issues, have insisted there would be huge benefits to having a drop-in centre in the city which would give people a first port of call if they are struggling.
Laurie Matthew, who founded 18 and Under, said: “I totally agree – a 24/7 crisis centre is needed in Dundee.
“I would like to see it extended to also cater for young people.
“Many mental health issues begin during teenage years and it is so difficult for young people to get support and help when they need it.
“I have known young people to have to wait up to a year to get proper support. It is outrageous.
“If they could have access to a 24/7 centre when they needed it we might go a long way to preventing mental health issues and problems developing and becoming even worse.”
Brook Marshall, project director of Feeling Strong, said: “We already support the idea of a 24/7 centre in the city.
“There are equivalent centres in other parts of Scotland and these have had a huge impact on mental health and well being.
“It is time that Dundee City Council, the Scottish Government and the NHS realised how big a mental health problem we have in Dundee and how important a centre like this in the city could be.”
Scottish Government has their say
A spokeswoman for the Scottish Government said: “Mental health and wellbeing is a top priority for the Scottish Government and we want to ensure mental health crisis services are available for all those in distress whenever they need them.
“We have funded NHS 24 to increase the support it provides by telephone. We have also extended the Distress Brief Intervention programme to support people contacting NHS 24 in distress from anywhere in Scotland, subject to assessment of individual callers’ needs.
“NHS Tayside and its partners are working on the redesign of mental health services and supports in response to the recommendations of the Strang report. This will include improving the local response to people in mental health crisis.”
Get help: Hotlines for suicide support charities
If you’re feeling low or suicidal, there are a number of helplines you can call and gain
support from trained professionals. They are:
Samaritans – for everyone. Call: 116 123 Email: jo@samaritans.org
Campaign Against Living Miserably (CALM) – for men. Call: 0800 58 58 58 – 5pm to midnight every day. Visit the webchat page.
Papyrus – for people under 35. Call: 0800 068 41 41 – Monday to Friday 9am to 10pm, weekends and bank holidays 2pm to 10pm. Text: 07860 039967. Email: pat@papyrus-uk.org.
Childline – for children and young people under 19. Call: 0800 1111 – the number will not show up on your phone bill.
Dundee City Council’s leader has backed calls for a 24-hour crisis centre for people struggling with mental health problems – after admitting support services in the city “have not been good enough”.
Campaigners have previously urged public bodies in Dundee to fund and open a 24/7 mental health crisis centre in the city following previous cases of self-harm and suicide.
The issue came to the fore again after a person was helped from the Tay Road Bridge on Thursday. The bridge has now been seen as a “crisis area” according to councillor Lynne Short – with numerous people rescued by emergency services on the bridge and surrounding area.
Speaking to the Tele in a video interview, councillor Short, who represents Maryfield, said: “The bridge staff work really, really hard to support people, and I can only thank them enough for all that support that they do give.
“It’s just really unfortunate that people in the city do see that area as being somewhere to find help.
“I recognise it, as an individual, and I’ve always found the support I’ve needed. That’s why I’ve always been very open about my struggles with my mental health, and the fact that we can talk about it nowadays.
Maryfield councillor Lynne Short spoke about the matter during a video interview.
The council leader echoed Ms Short’s views, and cited the Strang Report’s findings into mental health.
Mr Strang’s Trust and Respect report identified 51 recommendations to be implemented to improve mental health services in Tayside.
Strathmartine councillor Mr Alexander said: “The Strang Review, which was pretty hard-hitting, gave some very serious, well-thought out recommendations.
“One of the key recommendations was around this kind of idea of a support centre that was accessible to members of the public at any point in time.”
However, the council leader questioned whether the bridge would be the best place for a centre, because people may feel uncomfortable seeking help at such a visible location.
John Alexander joined the Tele for a video interview with colleague Lynne Short.
“You have to be conscious and listen to people who have real-life experience, rather than a politician saying, ‘I think it needs to be here’,” he added.
A leading mental health charity has said stranded students in Dundee are feeling the biggest strain during lockdown.
Feeling Strong, which offers support to young people who are suffer mental health issues, have said there has been an increase in worries among many in the city.
But, according to Marla Heier, lead volunteer at Feeling Strong, students attending universities in Dundee have been left feeling isolated, with coronavirus restrictions meaning some haven’t seen loved ones in month.
Ms Heier said: “Young people are definitely having increased mental health worries as a result of lockdown.
“Some of the worst affected are students who chose to stay in the city when lockdown began.
“Many believed it would maybe only last for around a month.
“Now we are several months in and for many it has been impossible to leave the city or to go home.
“Some of these students can’t leave Dundee to go to home because their families are shielding or have vulnerable members.
“Other students from foreign countries are also unable to go home and for them the situation is worse because they are so far from their loved ones.”
In January, Feeling Strong opened a community hub in Stobswell aiming to deliver a number of services for the young people of the city.
The hub is also designed to be a one stop shop for those who are indeed of support.
However, throughout lockdown, the base has been closed to its users.
Although unable to physically meet with those struggling, volunteers at Feeling Strong been able to offer counselling online.
Ms Heier said: “We are regularly in touch with some people who have turned to us for help and we have also provided advice and support to people who have come to us even once.
“We can offer peer support but they can also signpost and make referrals to other groups in the city who can also offer to help.”
“Hopefully we are providing a lifeline for young people who may be facing this current crisis alone and feel they have no one else to talk to.”
A female was rescued from the Tay by emergency services late last night.
The woman, who has not been identified, was hauled out of the water close to City Quay just before 11.30pm.
She was transferred to a waiting ambulance. The woman was reported to be very cold but otherwise uninjured.
Emergency services including Police Scotland, Scottish Ambulance Service, Broughty Ferry Lifeboat crew and two coastguard teams from Dundee and Arbroath raced to the scene shortly after the alarm was raised at 10.55pm.
A spokesman for HM Coastguard said they received a call from police saying that a female was in the water just off City Quay.
The spokesman said: “Emergency services, including both Broughty Ferry lifeboats, raced to the scene to the woman’s aid.
“The woman was traced by the RNLI crew and she was pulled on to the inshore lifeboat.
“She was then transferred to a waiting ambulance. She was conscious and breathing but was very cold.”
The Tay rescue is the second in three days for the volunteer Broughty Ferry lifeboat crew.
On Sunday they rescued a woman who was seen to enter the water opposite City Quay and began swimming out into the river.
The woman, who had been overwhelmed by the current, was saved by the crew of Broughty Ferry lifeboat who managed to haul her out of the water just as she was going under.
A spokeswoman for Police Scotland said: “Around 11.10pm on Tuesday, 16 June, police were called to a report of a woman in the River Tay near to City Quay in Dundee.
“The woman was rescued from the water and taken by ambulance to Ninewells Hospital to be checked over then later released.”
Inspectors have commended staff at a Dundee mental health unit following a visit earlier this year.
The Mental Welfare Commission Scotland said patients in the 10-bed intensive psychiatric care unit at Carseview Centre spoke positively about the care and support they received and said staff had a supportive manner.
It also said nursing students were well supported and patients’ care plans were detailed, person-centred and clearly structured with good information about specific needs and interventions.
The Carseview Centre, Dundee.
Johnathan Maclennan, lead nurse for mental health and learning disabilities at NHS Tayside, said: “This report recognises and demonstrates the commitment of the intensive psychiatric care unit team to high quality, person-centred, rights-based, least restrictive care.
“The team should be incredibly proud of the work undertaken – and ongoing – to improve the overall care experience, which also includes working towards accreditation as part of the Royal College of Psychiatry quality network for psychiatric intensive care units.”
One recommendation the inspectors made was to provide more storage space for patients’ belonging, and NHS Tayside has said it has already addressed this by adding new bedroom furniture where needed.
Since the commission’s last visit to the unit, staff have worked to reduce one-to-one observations and have also bought more outdoor furniture to provide therapeutic outdoor spaces for the patients.
Spencer Mason has spoken about his path to publishing the book.
“It started developing when I was about 12,” he said.
“It sent everything rocketing for pretty much the entire past 10 years. It’s having to live like a normal human being when you don’t experience anything that a normal human being experiences.
“It’s people not realising how much of a struggle every day is and how much is dictated in the moment about my ability to do things.”
He said: “There was a day where I noticed that I was perceiving more things in a sensory way than I usually would, but I was young at the time.
“Over the coming months and years, it became more obvious that these were sensory hallucinations. It took a while for me to realise that the voices were perhaps in my head and they weren’t a radio trapped in the wall that I couldn’t get to.
“It’s really strange to know you’re delusional about certain things but you still can’t shake that belief. There are those phobias and fears that are so incoherent and when I say them out loud and try to explain it to people it can feel like ‘oh my goodness I am actually a crazy person’.
“I can’t shake that feeling but also it’s so logical. Some things are just absolute facts and no matter how much you try to resist them those beliefs just don’t go away.
“As an early teenager, people couldn’t understand my justifications of certain things and I couldn’t understand how they couldn’t see my justifications of things.
“That was the first time I really noticed a difference between my experience and what other people were living.
“I didn’t realise that it was abnormal for a really long time. There was a really long period where I didn’t understand how people were functioning with the same problems that I had.”
Spencer’s book, which combines poetry and prose, has been a work in progress for 18 months, beginning after he made an attempt to take his own life.
“About two years ago I made a suicide attempt and jumped out of a window. I broke my spine and that was kind of the first time I’d ever considered how my mental health could affect other people,” he said.
“That’s a big part of the book – we always think about looking after ourselves with mental health but how do you care about the people who care for you? Because some people got really hurt in the process.
“Around six months after that, when I moved to Manchester, I was speaking to a friend who had been affected really badly by my mental health. I decided that, for the first time, I really wanted to make positive moves to try and change myself so I started writing the book.”
An encounter with Dundee-based author Tina McGuff, who wrote a memoir about her recovery from anorexia, was key in Spencer’s decision to share his story.
“She made me believe how honest we need to be with our mental health. It’s great talking about ending stigmatisation but the only way to do that is to actually educate and speak, which is really what I wanted to do,” he added.
“Over those 18 months I focused on writing, developing poems and trying to rack my brain for everything that other people might not know about schizoaffective disorders, even if it may be obvious to me.
“I tried to Google for some self-help books to see if there was anything about coping mechanisms. There were quite a lot of stories and information but there wasn’t really anything about how you live it and how you can function alongside it, rather than recover from it.
“You have to learn to make it a part of your life and accept that, which is what the main premise of the book became; how to make this as accessible to people who would have absolutely no understanding of the situation.
“When you meet someone in the street you have no idea about their background or their daily life or how difficult it might be for them to keep up with the same routine as you.”
The book, which was published on Sunday, is currently ranked number one in new releases for poetry books on Amazon.
He said: “The initial reaction was really beautiful. The amount of messages I’ve received and support from people that I would never have expected has been amazing.”
Spencer is now looking to the future and is hopeful for what a post-lockdown world looks like.
“I’m currently not taking any medication, I prefer to try and just live my best life as I can with the tools that I have,” he said.
“I’m definitely in a better place now than I was two years ago in terms of my mental health but it doesn’t mean that those problems are gone, it just means I have better coping mechanisms.
“I can definitely make it through the next months but I think it’s going to be a mixed bag.
“I would like to stress, particularly in quarantine, the importance of looking after yourself and making sure that the people you love are OK.
“It’s a really difficult time. Humans need to look after each other, we can’t be selfish right now.”
Campaigner Phil Welsh believes Dundee could be on the cusp of a mental health pandemic at the end of the coronavirus crisis – as hundreds across the city struggle to cope during the nationwide lockdown.
Mr Welsh, whose son Lee took his own life in 2017, has fears over the future and thinks the current situation the country finds itself in is likely to set people back in a battle against anxiety and depression.
The Tele has spoken to one man, who wished to remain anonymous and is currently battling depression, about his struggles and he admitted that he had contemplated taking his own life throughout the lockdown, with isolation and loneliness playing a major part in his life.
Mr Welsh believes it is one of many examples of people struggling across the area – and believes a number of factors could be seeing even those living “normal lives” struggling with mental health conditions.
He said: “When the end of this Covid-19 crisis becomes apparent, my fear is the country will be faced with another pandemic, a mental health one.
“Isolation, social distancing, people being furloughed from their place of work will be playing a part because, it’s perhaps the case that work is the only social interaction many people have.
“My fear is those who in `normal` times have had no issues with mental health, may, through this unprecedented experience, begin to develop depression or anxiety.
“Added to this pressure, third sector organisations which are normally available to offer support to people with mental health issues are not available in the usual sense.”
Mr Welsh added: “These are challenging times with no rule book available.
“When we come out of this, we are going to be faced with a broken economy, a stretched to the max NHS and a mental health crisis such like the country has never experienced before.”
Indea Ogilvie, who has recently taken over the the Let’s Talk Tayside support group, said that she was noticing many more people are asking for help help.
The Facebook page, which helps those suffering from mental health issues, supports many across the region and Ms Ogilvie believes there will be an even bigger demand for those sorts of groups in the coming months.
She said: “There is definitely an increase in messages from people facing mental health concerns.
“However there is also an an increase in people helping others out.
“I have been in touch with people personally and many others are also offering words of support and comforting each other at this difficult time.”
A Dundee filmmaker has released a short online video aimed at helping men in the city open up about their mental health battles.
“Mind Yersel” is a short, three minute film by 21-year-old, Bonnie MacRae, and explores the devastating topic of male suicide in the city – which has the highest rate in Scotland.
“I watched first hand how suicide can affect a family, I’ve dealt with depression myself and then I came across an article saying Dundee was Scotland’s suicide capital and it wasn’t something that I was willing to just accept,” Bonnie said.
“When I first had the idea to turn the piece into a short film, I knew I wanted it to be totally about Dundee.”
The film features a small cast who all hail from the City of Discovery, something which Bonnie felt was pivotal to the project.
She added: “Every person featured in the film is born and bred Dundee, and that was really important to me.
“Real boys in Dundee need to see themselves represented in the media, they need to know that they’re not alone in feeling a certain way. I have a younger brother and wanted him to watch it and see a little bit of himself in the film.”
The young filmmaker, who is from Broughty Ferry, was also full of praise for the film’s leading man, who narrated the short video and also appeared on camera throughout.
“Stephen McMillan features and I think he’s totally done both Dundee and the topic justice,” Bonnie said.
“He was on board with the film as soon as he read the script having personally experienced similar issues. He genuinely inspires me and I’m so lucky to have had him involved, Dundee should be proud of him.
“I think it’s had such a big impact already because of how close to home it hits. People watch and see someone opening up who speaks the same way they do, who walks the same streets as them – that was imperative.
Bonnie hopes that through watching the video, people of all ages and backgrounds in the city will be encouraged to seek help if they are struggling and hopefully save lives.
She added: “This film isn’t me preaching on how to cure depression, but I hope that in making the film I’ve started a long overdue conversation that needed to be had in Dundee.”
A man whose entire adult life has been plagued by mental health difficulties believes a 24-hour crisis centre for those suffering in Tayside would be a “great idea”.
Marc McLeish backed the Not in Vain for Lee campaign aimed at setting up a round-the-clock self-referral service, warning vulnerable people desperately need more support resources across the region.
The 33-year-old, from Perth, said: “If something like that existed in Tayside, it would be great.
“I have probably had about 40 emergency assessments in total but in almost 90% of these, I have been sent away with no treatment.
“If there was somewhere that was 24 hours, then it could be the case that I would not have self-harmed as much as I have.
“It would be great to have one in Perth as well but Dundee would be a good start.”
Marc, who was diagnosed with borderline personality disorder aged 23, has spent his entire adulthood battling his demons and the years since his school days have been marred by repeated incidents of self-harming and multiple hospital stints.
He said: “When I was in my teens and early 20s I attempted suicide quite a few times by taking an overdose.
“I have been a prolific self-harmer since I was in my teens and I have probably done it up to 100 times in 17 years.
“I always felt like I was a bad person because I was gay and I believed I needed to be punished, so that’s what I have done.”
Marc’s struggles with his mental health have had a profound impact on his day-to-day life and he admits he has difficulty coping. He added: “I really don’t have a very good quality of life.
“For me right now, it’s not a day at a time but rather two hours at a time and that’s what’s getting me through.”
Marc spoke about his mixed experiences with health services throughout his struggles, having been admitted to hospitals in both his hometown and Dundee.
“The first inpatient treatment I had was probably about 10 years ago in the Murray Royal Hospital and I had no issues with the treatment there,” he said.
“My GP practice has been fantastic, but there is definitely a lack of resources in Tayside.”
Marc’s most recent stint in hospital was just last month, when he spent five days in the Carseview Centre in Dundee after being admitted following an appointment with his GP.
He also raised concerns that his time at the Dundee unit was spent unsupervised – so much so he claims he was able to harm himself twice during his stay.
He said: “In Carseview, I felt people were left to their own devices.
“I asked my named nurse for a razor, saying I wanted to shave and I was told that as long as I wasn’t going to harm myself, I could have it.
“I then severely harmed my right arm with the razor and the wounds were gaping wide.
“I discussed with my family whether I should leave and we came to the joint decision that I should.”
A spokeswoman for NHS Tayside said: “Due to patient confidentiality, we are unable to comment on matters relating to individual patients.
“However, we can confirm we are in direct contact with the patient’s family.”
Zana admits she has probably been suffering from mental issues for her whole life.
