Patients’ concerns highlighted in NHS Tayside mental health inquiry report

Patients’ concerns highlighted in NHS Tayside mental health inquiry report

Illegal drugs on wards and concerns over patient restraint have been highlighted in a report into NHS Tayside’s mental health services.

The independent inquiry’s interim report has identified “key themes for further investigation” after hearing evidence from more than 1,300 people.

It said some patients were frightened of certain staff members.

NHS Tayside said improvements had been made in key areas highlighted in the interim report.

The inquiry is reviewing safety, care standards and access to mental health services.

An investigation was initially ordered into Dundee’s Carseview Centre but was expanded following a campaign by families of people who took their own lives.

More than 200 written submissions were received by the inquiry team following its call for evidence, and more than 70 oral evidence sessions were held.

It said the key themes were patient access to mental health services, patient sense of safety, quality of care, organisational learning, leadership and governance.

Referring to risk management, the report said: “Patients report telling staff they were suicidal but the risk was not taken seriously until they made a serious attempt to take their own life.”

‘Violated and traumatised’

In relation to patient safety, the report noted: “Some patients report being frightened of certain staff on the wards who have a poor attitude to the patients in their care.

“Others mentioned that another patient had assaulted them whilst they were on the ward.”

The report said the use of restraint within inpatient facilities was of “great concern” to patients, who had experienced it or witnessed it taking place.

It said: “Patients feel violated and traumatised, particularly if they have personally suffered violent abuse in the past.”

People talking

It added that staff seemed unable to control the availability and use of illegal drugs on the wards in the inpatient facilities.

“Both patients and families report seeing drugs delivered, sold and taken within the Carseview Centre site,” the report said.

“Staff confirm this is a serious issue which is not being adequately addressed.

“There is a lack of support from management for frontline staff attempting to address this issue and it is having a detrimental effect on patient care and treatment regimes”.

‘Unexpected and concerning’

In a section on the Crisis Service, the report said that the Crisis team “struggles to respond to sudden surges in demand on the service.”

It said: “There are occasions when the length of time to wait to be seen is long and families supporting someone in crisis are advised to phone the police or NHS24, if they are worried.

“This advice is unexpected and concerning to carers coping with a crisis in a domestic situation.”

The report said the centralisation of the out-of-hours Crisis team to Carseview Centre has had a “detrimental effect on those patients in Angus and Perth & Kinross who are experiencing mental health crisis”.

It said: “There is a perception that whilst the Crisis service has expanded in recent months, the situation has worsened in terms of patients being assessed then not being offered any crisis intervention, or referred back to the GP.”

Inquiry chairman David Strang said: “The themes which have been identified will shape the next stage of the inquiry.

“Our final report will include conclusions and recommendations which will lead to the improvement of mental health services in Tayside.”

‘Top priority’

NHS Tayside chief executive Grant Archibald said: “We are taking on board all comments in the interim report, alongside the feedback we received from the Health and Social Care Alliance (the Alliance) published in their report in December 2018.

“The key themes which have been identified in both the Alliance report and in today’s interim report are recognised by the board and the mental health leadership team – and we are taking action on these.

“I also recognise and want to thank the many staff who are already working really hard to improve services and look forward to their continued support.

“It is clear that we have further work to do but since I came to Tayside, I have made mental health a top priority and I am confident we can learn lessons, strengthen our engagement with patients, service users, families and the public and make the right kinds of changes, at the right time, to transform our mental health services.”

He added: “We would like to thank everyone who has shared their experiences so far and we look forward to the independent inquiry’s final report and recommendations which will be a major influence on the future shape of mental health services in Tayside.”

Report into Tayside mental health services to be published ‘imminently’

Report into Tayside mental health services to be published ‘imminently’

First Minister Nicola Sturgeon has said an interim report into mental health services in Tayside will be published “imminently”.

Responding to questions from Scottish Labour leader Richard Leonard about the inquiry, Ms Sturgeon said she would expect relatives who campaigned for the inquiry to be given advance copies of the interim report, which is expected to be published this month.

The inquiry was launched following a public campaign by families who blamed poor care at the Carseview Psychiatric Centre at Ninewells Hospital for a series of suicides.

The interim report will be published next week although it will be several months before the full inquiry report is completed.

Mr Leonard told the First Minister that some of the relatives whose campaigning led to the inquiry feel they have not been kept up-to-date with its progress and believe it is not “transparent”.

He said that when the inquiry was set up then health secretary Shona Robison said it should be seen as “a force for good” and asked if Ms Sturgeon believed this aspiration is being met.

Mr Sturgeon said it would be wrong for the Scottish Government to “pre-empt” the inquiry but said its findings would be scrutinised and any recommendations acted upon.

She added: “Of course we want to learn lessons and our sympathies are with the families who have experienced those losses.

“We established an independent inquiry in Tayside. That hasn’t yet reported. I hope it will report soon and it will be fully scrutinised by the government.”

Mr Leonard said Mandy McLaren, the mother of Dundee suicide victim Dale Thomson, has lost confidence in the inquiry.

He said: “She asked me to ask you directly if families will see an advance copy of the interim report before it is published.

“Will you listen to the voices of those families? Will you do what you can do to restore their confidence in this inquiry?”

Ms Sturgeon replied: “This inquiry is being led by David Strang. It is an independent inquiry.

“If the government was interfering in the conduct of that inquiry,  I am sure Richard Leonard would be raising that in the chamber.

“I understand David Strang has met with family members. It would be full my expectation that an advance copy of the report would go to those directly affected.

“I will pass that specific point to David Strang but I would stress it is an independent inquiry.”

Earlier, Conservative MSP Bill Bowman pressed health secretary Jeane Freeman over plans for a 24-hour crisis centre in Dundee.

Councillor Ken Lynn, the the vice-chairman of Dundee Heath and Social Care Partnership, has  pledged his “total commitment” to creating a centre in Dundee, but Ms Freeman the issue had not been raised with her or the minister for mental health, Claire Haughey.

Mr Bowman said later: “It was clear from the cabinet secretary’s answer that the SNP are disconnected from the challenges faced on the ground.

“There seems to be no plans for the new centre in Dundee, or for the government to help NHS Tayside create one.”

Parents hit out at thieves who stole from grave of tragic Dundee dad Lee

Parents hit out at thieves who stole from grave of tragic Dundee dad Lee

The parents of a young Dundee dad who took his own life have hit out at thieves who stole sentimental trinkets from their son’s grave.

Parents Phil and Lesley at a mural which was painted in tribute to their son Lee

Lee Welsh, 27, was found dead at his Peddie Street home in the city’s West End in August 2017 after suffering from depression.

His dad Phil and mum Lesley discovered the heartbreaking theft when they visited Lee’s grave at Birkhill Cemetery on Sunday.

Phil said: “Lesley had four little glass trinkets in the shape of diamonds hanging on the little fence that goes round the gravestone.

“They aren’t worth anything financially but they are significant to us as a family as the words ‘Shine on you crazy diamond’ from a Pink Floyd song are engraved on the gravestone.

“We know they aren’t worth any money but it has been really upsetting for us.

“When we realised they had been taken we were really hurt.”

Phil added: “Whoever took them probably doesn’t think too much about what they have done but I want them to realise that taking things from a grave can be desperately upsetting for those left behind and grieving.

“People should think more carefully about their actions and be aware of the hurt they can cause.”

Since Lee died, Phil and Lesley have been campaigning for a 24/7 crisis centre in Dundee to give immediate access to people having suicidal thoughts.

They have also organised various fundraising events for groups and centres that currently offer support.

The next event is a soup and pudding lunch to be held at Dundee West Church on May 25.

Money raised from the lunch will this year go to the Art Angel charity.

Lesley said: “Art Angel is a unique and inspired arts project run by and for people with experience of mental health difficulties in Dundee.

“It helps people work towards recovery and mental wellbeing.”

A similar event last year raised almost £1,000 for Dundee Association for Mental Health (DAMH).

The second Lee Welsh memorial football match is also planned for July 20.

It will be held at North End Park and this year the money raised will be donated to Art Angel on behalf of the Not in Vain for Lee charity.

As well as football, there will be other attractions including a bouncy castle, face and henna painting and a demonstration by Dundee Mods Scooter Club.

Last year’s match, organised by Lee’s childhood friend Steve Martin, raised more than £1,000 for DAMH.

What Can We Do About Britain’s Male Suicide Crisis?

What Can We Do About Britain’s Male Suicide Crisis?

Men in the UK aged 20 to 49 are more likely to die from suicide than any other cause of death. Sam Parker investigates the reasons why, and meets the people determined to put a stop to it

Imagine a virus we don’t fully understand is killing young men in record numbers. It kills three times as many British men as women, although nothing adequately explains why. The government confirms that while almost all other leading causes of death are being slowly eroded by medical and social progress, deaths caused by this virus are at their highest for decades. Yet the money we spend on researching and treating the problem stands at a fraction of what we spend on those other leading causes of death, as do charitable donations from the public.

The deaths this virus has caused have risen to the point that if you are a man between 20 and 49, you’re more likely to die from it than cancer, road accidents or heart disease. It is the biggest threat we face, the number one killer. The figures are chilling, and yet still it is something we hardly discuss, in public or private — which is a significant part of the problem itself.

Last February, the Office for National Statistics published a report covering the years from 2001 to 2013, showing that suicide among men has reached its highest levels since the early Eighties, rising sharply in 2007 and hitting a peak in 2013. (In the same period, suicide among women declined, then remained constant.) Always a leading cause of death among the young — for the simple reason that death by natural causes is statistically less likely — suicide rates in men aged between 45 and 59 have also now begun to rise, increasing to their highest levels since 1981.

Former Deputy Prime Minister Nick Clegg earlier this year described suicide as “a massive taboo”, the last in mental health. The reasons for this are relatively easy to explain, if not to justify. Before the 1961 Suicide Act, taking your own life was illegal in Britain. It still carries with it a connotation of dishonour and shame, as if those who do it are deserters from the battlefield of life. “The easy way out” they used to call it, and perhaps some still do.

It is still the case that the type of men we think die by suicide are the unwell, the disturbed, the unlucky; who stumble at life’s biggest hurdles and are too weak to get back up. Most of us like to think we’re made of sterner stuff. We don’t know that 75 per cent of people who take their own lives have never been diagnosed with a mental health problem, or that only five per cent of people who do suffer from depression go on to take their own lives.

We think of recent high-profile examples of suicide, like fashion designer Alexander McQueen, who killed himself in 2010, Wales football manager Gary Speed (2011), or film star Robin Williams (2014), as anomalies. Men who had it all: money, fame, the adoration of the public, the respect of their peers, a glorious past and assured futures. We celebrate their memories as professionals, but we don’t pause to consider what their deaths tell us about mental health, about the way that no amount of external glory can ameliorate an inner pain.

But the statistics are clear. The problem has become too big for us to ignore. The question to be asked now is not just why young men are killing themselves in record numbers, but what are we going to do about it?

The thing people always want to know is: why?

I am sitting in the almost empty cafe of a no-frills hotel in North London. It’s a functional sort of place, designed for people with brief business in the capital rather than those on holiday. A couple of students scan the day’s papers. A waitress cuts fruit for the smoothie machine. A man in a suit drifts in and out of the room, talking self-importantly on his phone.

A hand lands on my shoulder. It is Shirley Smith, a small, energetic woman in her late forties with short red hair. I introduce myself and she immediately places my mild accent before pulling me in for a hug. She is from my neck of the woods: Durham, in the North East, where suicide rates among men are the highest in England.

Shirley is a woman I feel I’ve known all my life. She’s like the women who brought me up: warm, tough, unpretentious, prone to conspiratorial laughter. In no time at all we’re making fun of the self-important man, cursing the waitress for her noisy fruit blending. And then she tells me about Daniel, her eldest son, who was 19 when he took his life, about how she came home that day in August 2005 with her two other boys — only 10 and five at the time — and how the elder, Matthew, found Daniel with her, how she still can’t say the word that describes how he did it, even now, ten years later.

Shirley is in London to visit Westminster due to her role in an all-party parliamentary group for suicide prevention. After Daniel died, she and her family did the only thing they could to try and make some good come of it — they set up a charity, which is now their life’s work. If U Care Share — Daniel’s brothers and cousin picked the name in the year he hanged himself — works with Durham police to provide practical and emotional support to families bereaved by suicide. It is the only organisation of its kind in England.

“The thing people always want to know is: why?” Shirley explains, her hand slowly turning the cutlery on the table. “But I am yet to meet a family who gets a ‘ta da!’ moment when you find that out, because the person who can tell them isn’t here any more.

“Daniel falls into the group of men who had no diagnosis of mental illness at all before they took their own lives,” she continues, “and from the outside looking in, he hid the way he was feeling extremely well. Before it happened I didn’t think our son was the type of person who takes his own life. Daniel had all the things you think a person needs: he had a job, he had supportive friends, he had his family, he had plans. But it wasn’t enough.”

I ask Shirley, as a mother of boys, why she thinks three-quarters of all suicides in the UK are male. She can’t say for sure — no one can — but she offers an explanation I will hear in some form from almost everyone I talk to, from scientists and academics to charity workers and families.

“Daniel learned at a very early age to tie his shoelaces, he learned he needed to be physically strong, physically well. But nobody ever spoke to him — I never spoke to him — about the impact of life.”

I ask her hopefully about the government, the people she is here to visit today. Last January, when he made his “taboo” comment, Nick Clegg called for a “new ambition for zero suicides across the NHS”. Surely, that is a sign those in power are beginning to take the issue seriously?

Shirley shakes her head. “‘Zero suicide’ is a fabulous… not ‘pipe dream’, exactly… I would love for us to truly achieve it. But zero suicide is for people who have contact with mental health services. That’s what [Clegg] was talking about — people already diagnosed and in the system. What about the majority of suicide cases, who have no diagnosis at all? They’re the people we need to reach. We focus on the tiny percentage in care, because the bigger picture is baffling to people. It’s too scary to contemplate.”

As we say goodbye, Shirley hands me an If U Care Share pack, which I open later. Among the leaflets, pens and stress balls is a charity wristband, sealed in a plastic case with a card. On it is a photo of a handsome young man with short red hair, a smile playing across his lips, his head cocked slightly as though listening to a joke. Reading the dates under his name, I notice Daniel and I were born just a few months apart.Men are caught between two very different visions of masculinity – and feel they’re fulfilling neither

This “gender paradox” is most commonly explained by method. While women are more likely to opt for means such as a drug overdose, which are less immediately lethal, men are more likely to use more violent methods with greater success rates, such as hanging or shooting themselves. Men are also believed to be more naturally impulsive than women, meaning they are more likely to act rashly on suicidal feelings.

More puzzling and difficult to explain is the steep rise in suicide between 2007 and 2013 for British men, while the figure for that period has declined for women. In 1981, men were 1.9 times more likely to die by suicide than women. Today, we are three times as likely. It’s an increase charities and academics have been trying to explain since the Office of National Statistics report was published, without arriving at a clear consensus. But theories are emerging. Looking at the wider world in that period, the first and most obvious is the 2008 recession and the subsequent rise in unemployment and poverty. In 2013, research published by the British Medical Journal found English regions with the most job losses since 2008 also saw the largest increase in suicide, while a 2015 Samaritans report found “men from the lowest social class, living in the most deprived areas, are up to ten times more likely to end their lives by suicide.” Also this year, academics at Bristol, Manchester and Oxford universities estimated 1,000 extra deaths from suicide and an additional 30–40,000 attempts may have occurred following the economic slump.

Anecdotal evidence from suicide helpline staff also suggests a huge rise in callers citing unemployment, job insecurity and benefit cuts as the cause of suicidal thoughts in that period. Women, of course, are victims of economic pressures, too. But research suggests that even today, men attach greater importance to job status and income. A 2014 report by the male suicide prevention charity Calm (Campaign Against Living Miserably), found that 80 per cent of men aged 35–44 consider their job to be “very important” or “important” to their self-esteem, while 42 per cent still believe they should be the main breadwinners in their household (only 13 per cent of women felt the same).

Not only that, but men consider money as central to their appeal to the opposite sex: 40 per cent believed potential sexual or romantic partners are looking for “security/stability”, “financial dependability” and/or “hard-working, successful” men. In reality, a survey of women in the same report found “financial stability” ranked far lower (six per cent) than “kindness”, “sense of humour” and “trustworthiness”.

Which leads to the bigger issue of how men see themselves and their role in the world, and what impact that has on their mental health. One of the most alarming changes since 2007 is that suicide rates among men in the middle age bracket (45–59) have increased by around 40 per cent, meaning they have caught up with their younger counterparts, historically the highest-risk group.

A 2012 Samaritans report called “Men, Suicide and Society” suggests this “buffer generation” is “struggling to cope with major social changes”. Having grown up believing in the ideal of the silent, strong provider who was probably a war hero to boot — “austere men like their fathers, who believed you don’t talk about your problems, you just get on with it,” as O’Connor puts it — they now find themselves in a society where such qualities are no longer required or seen as exemplary.

Decades of social progress mean women are more financially independent and less reliant on men, while at the same time, the concept of the “modern man” — open, progressive, in touch with his feelings — has emerged as the new ideal. Caught between two very different visions of masculinity, often struggling financially at a time when they feel they should be at their professional peak, middle-aged men today are also more susceptible to a life event that makes them three times as likely to attempt suicide if it happens: divorce.

The average age of divorce for men in the UK is now 45. The divorce rate began to rocket from the early Eighties onwards and although figures began to slowly decline in 2006, around 120,000 British marriages still fail every year. The Samaritans report states that men in middle age are “dependent primarily on female partners for emotional support”, and from the age of 30 onwards tend to have less individual friendships than women. Once they lose their partners, they are less inclined to make new friends or seek help, and become twice as likely to plan to take their own lives.

An academic study published by the Medical University of Vienna in June 2015 looked at male suicide survivors aged 18–67, and family and friends of suicide survivors. It concluded: “Almost all men reported that their masculine beliefs led to them isolating themselves when they were feeling down, to avoid imposing on others… and instead, relied on coping strategies that required less immediate effort and provided short-term alleviation of problems, for example, drug or alcohol use, gambling and working excessively.”

Perhaps most worryingly, “some men reported that adherence to masculine norms meant that feelings associated with being vulnerable provoke greater anxiety than the thought of being dead.”

Often it’s the loudest voice in the room, the life and soul of the party, that is really struggling

It is a cool, bright sunday morning in July, and along Trafalgar Square, spectators are cheering on exhausted runners as they reach the final stretch of the annual British 10K London Run. Around the corner, the Old Shades pub on Whitehall is filling up with a steady stream of people. Red-faced and limping, smiling and triumphant, they queue patiently for well-earned pints, swapping stories of finishing times and confessing to various aches and pains.

There are 130 of them in total, all decked in the orange bibs of the charity Calm. They have run for sons, brothers, fathers, friends. Many have photos of those they’ve lost stuck to their backs — men with bashful smiles, captured in moments of joy that proved more precious than they should have.

David tried antidepressants but they didn’t work. Then, with some reluctance, he agreed to see a counsellor. “When I first sat down, I told the guy, I have no idea why I’m feeling the way I’m feeling, and no idea what I am supposed to say. But slowly, it works. By talking you join the dots and piece together how you are feeling.”

After David leaves, I tell another runner, a woman in her forties, how talking to him surprised me. She nods in agreement. “You hear the word ‘suicide’ and you immediately imagine a depressed, lonely person. I remind myself, it’s often the loudest voice in the room, the outgoing guy, the life and soul of the party, the one who is worrying about whether everyone else is OK, that is really struggling himself.”

After an hour or so, Jane Powell, Calm’s CEO and founder, gathers everyone together at one end of the pub. It’s a tight squeeze so she climbs onto a table to address them. She shouts out that today they’ve raised £50,000 — a record. A cheer goes up. It’s an excuse for another drink.

No other organisation is doing more than Calm to address male suicide in the UK. It stages music and comedy events, distributes a quarterly magazine called Calmzine and runs awareness campaigns that adopt a brisk, no-nonsense tone that has become the charity’s hallmark. You may have noticed its “Save the Male” posters, or those comparing the number of British soldiers killed in Afghanistan to men who have taken their own lives (40:50 in 2012), or heard public supporters like rapper Professor Green talking about it on Newsnight (below).

But the main way Calm tackles suicide is by giving men a safe place to talk. Its helpline is manned by eight staff members who work seven nights a week fielding over 5,000 calls and web-chats a month, more than they can handle. Team manager Zoe says the callers range from teenagers confused about their sexuality to lonely elderly men who want to hear a friendly voice before bed.

Aged 10, Matt came home to find his brother Daniel, his best friend, had killed himself.

Bootham crescent, home of York City Football Club, is an old-school League Two ground in the centre of the city, where you can still stand on the terraces, and adverts for local taxi firms and cleaning companies line the perimeter of the pitch. Upstairs at one end of a narrow function room, a group of players from the under-21 squad are gathering on assorted desks and chairs. They debate their performances and opponents in the last game. One lets out a loud fart and they all laugh. Another walks in dressed in a fresh white tracksuit, and they laugh again. “Didn’t know you were coming as Roger Federer!” someone shouts out.

At the other end of the function room, a young guy in a black tracksuit and glasses is setting up a TV screen. Matt Smith, from If U Care Share, assisted his father in running this workshop for three years, before his dad threw him in the deep end one day and told him he was on his own. Since then, he has delivered hundreds of talks at football grounds and schools all over the country.

Matt is a natural public speaker. He loves football and the lads sense it. It also helps that, despite being only 21 himself, he somehow appears a lot older. So they more or less respect him, a young guy telling them to talk about their feelings, telling them it’s actually OK not to feel OK, as far as their attention spans and their mobile phones will allow.

Then Matt sits down and plays the video. It shows Matt telling the story of how he came home one day, aged 10, to find his brother Daniel, his best friend, had killed himself. The chewing, the texting, the fidgeting all stops. The only sound in the room is a lawnmower buzzing faintly on the pitch outside.

“I used to end this presentation by telling you that suicide is the second biggest killer of young men,” Matt stands back up to tell them. “But I cannit. Not any more. Because now it’s the number one killer of young men.”

Targeting young males involved in sports has emerged as a major tactic in the fight for suicide prevention, with other charities such as Console performing similar workshops at rugby clubs. It is based firstly on the premise that so-called macho men who play sport are less likely to open up in the first place but, more positively, it is to try and harness the support network of a team: the men may not feel suicidal themselves, but they can be taught to spot the signs in those they share a dressing room with.

“It’s about trying to bring about a culture change, so that young lads learn to talk about being down or stressed in the same way they would having a bad ankle,” says Matt, who believes he should be able to run workshops with boys as young as four.

Charities like Calm and If U Care Share are trying to offer solutions to the male suicide crisis, but as with any area of public health, they can’t do it alone. Until the government takes the issue seriously, they will be fighting a losing battle. “The helpline is a bandage and what we do is try and stem the flow,” Jane Powell explains. “But the idea that Calm exists for the next 100 years? That’s terrible. If we’re going to get serious about it we have to change society, otherwise what are we doing?”

Professor O’Connor agrees the government needs to do more. “Speaking as a researcher, suicide is a chronically underfunded area,” he says. “Governments have a responsibility not only to make it a public priority on a policy level, but to provide resources and services that actually work.”

Overall, while £671m is spent nationwide annually on sexual health initiatives, £160m on encouraging people to stop smoking, and £108m on anti-obesity programmes, only £40m is spent on mental health, within which suicide prevention is just one problem. There is evidence, in other UK regions, of increased funding making real inroads into the issue of suicide. In the past ten years, Scotland has gone from being historically one of the worst affected areas of the UK to the sole region actually bucking the trend. A large part of the reason is that in 2002, the Scottish Government launched “Choose Life”, a ten-year national action plan aimed at reducing suicide, which has achieved a 19 per cent fall in incidents.

O’Connor, who helped develop the strategy, explains: “There has been a huge focus [in Scotland] on providing people on the front line of services — police, GPs, psychologists — with applied suicide skills training, so they could identify those at risk.

“At the same time, there was a big anti-stigma campaign, an effort to get the simple message out there that suicide prevention is everyone’s business and that talking about it is a good thing. There is this perception among people that goes: ‘if I ask somebody if they are suicidal, that will plant the idea in their head.’ There is no evidence for that at all. It does quite the opposite.”

We are trying to be comic book heroes, rather than real people.

Although there is no simple solution to reducing the number of men in Britain who take their own lives, everyone I speak to agrees there needs to be a concerted effort by the government to learn from Scotland’s success and support both gender-specific mental health research and services such as those provided by Calm and the Samaritans. At the start of 2016, pressure is mounting: 200 high-profile figures, including former spin doctor Alastair Campbell and director Danny Boyle, have signed an open letter from Calm calling for equality between physical and mental health treatment ahead of the government’s spending review.

But at the same time, the crisis suggests there needs to be a deeper societal shift that we all participate in. We need to re-evaluate our attitude not just towards mental health, but masculinity itself.

I talk to Joseph, one of the runners I met near Trafalgar Square. He’s a handsome, articulate 29-year-old with a winning grin.

“I made a suicide attempt when I was 18, and then found myself in a psychiatric ward,” he says. “It’s still very vivid. I remember two of my best mates visiting, and one of them sitting there in tears. It was one of the most desolate places I’ve ever been. I don’t remember feeling any lower than that.”

With the help of his family, Joseph managed to fight his way back. But in order to do so, he says, his perception of what it means to be a man had to change.

“We are trying to be comic book heroes, rather than real people. Still trying to hide behind the football terraces, or the computer game screen. Behind pints, or lifting weights, or talking about how many women we’ve fucked,” he says. “We’re not simple creatures, men, but we pretend to be. Because all this time we’ve been told being a man should be simple. Our dads believed it, and their dads did, and their dads did.

“Sometimes,” he continues, “to make fun of women, men say, ‘All they do is talk about their feelings.’ But we could learn from that. The truth is, our brotherhood is not as safe a place as their sisterhood. I think we need to really look at each other and ask: what are we doing? Are we being ourselves, or what we’re expected to be?”

It doesn’t sound enough, does it? That the cure for the British male suicide crisis is talking more about our feelings, and ridding ourselves of the unrealistic and outdated expectations we place on ourselves as men. But the truth is that, alongside greater action from our government, these might be the best weapons we have to make sure we lose less men like Daniel.

A few years after Joseph tried to kill himself again, aged 22, his girlfriend gave birth to a baby girl. “When I first knew she was coming, I was terrified,” he remembers. “But when she was born, I looked at her and I realised that even if every day was going to be tough as hell, I had to do something about it. I had to make sure I was alive.”

For more information:

This article was first published in 2015.

Child forced to wait 425 days for mental health treatment in Tayside

Child forced to wait 425 days for mental health treatment in Tayside

Children have been forced to wait more than year for treatment after being referred to mental health services in Tayside.

One mental health campaigner described the figure as “frightening”.

Figures released by NHS Tayside in response to a Freedom of Information request revealed the longest wait for treatment to begin at the health board’s Child and Adolescent Mental Health service was 425 days – around 14 months.

A small number of children were also required to wait more than a year for their treatment to begin.

However, the health board said no child – defined as someone under the age of 16 or 18 if in full-time education –  on the current waiting list for treatment has been on it for longer than 305 days.

Mental health campaigner Gillian Murray said there is “no excuse” for such lengthy delays between referral and treatment starting.

She said: “That’s frightening that a child has had to wait over a year for treatment, there’s no excuse for any wait that long.

“Isn’t there meant to be a set time limit when you’re legally meant to be seen?

“It definitely shows how poorly patients are being treated by NHS Tayside but I think those figures would likely be the same throughout Scotland, to be honest.”

Ms Murray’s uncle David Ramsay killed himself after being turned away from the Carsewive Centre at Ninewells Hospital and has campaigned for an independent review into mental health services in Tayside.

An NHS Tayside spokeswoman said patients are prioritised according to need.

She said: “There has been a lot of work undertaken by staff in our Child and Adolescent Mental Health Services (CAMHS) to improve access to services for young people in Tayside over the past 12 months.

“We have been working closely with Healthcare Improvement Scotland Mental Health Access Improvement Support (HIS) Team to deliver an improvement plan which will reduce waiting times. This includes a full CAMHS service workforce review and recruitment drive to key posts, to ensure that the team are fully equipped to manage the service demand and enhance the experience for children and their families.

“We are determined to continue making improvements to ensure all our children and young people receive the best quality care without delays and we hope to reach the national standard in the near future.

“When a child or young person is referred into CAMHS their referral will be scrutinised by our Clinical Specialist Referral Management Team and prioritised by clinical need into urgent, soon or routine. It is important that a child or young person who requires an intervention is seen by the right person at the right time.”

Jason Manford: Comedian shares mental health battle

Jason Manford: Comedian shares mental health battle

Comedian Jason Manford has opened up about his struggles with mental health.

In a video on Facebook, he said he wanted to let people know why he had been less active on social media.

“I wouldn’t go as far as to say a breakdown, but I had a struggle mentally and I found it very difficult to deal with,” Manford told his fans.

Describing his battle with anxiety and depression, he said social media can make things worse and encouraged people to talk about their problems.

The Mancunian comic said people – “especially blokes” – do not talk about mental health enough, even though male suicide is such a big issue.

‘Not failing’

“It’s taken me this long to be brave enough to say it… I’ve been struggling, you know, finding things hard and I think sometimes social media can not help with that,” he said.

Manford said it was not just trolls but also “bad news and nastiness… even down to comparing your life”.

The father of five said he suffers from anxiety and depression and at his lowest, he “felt like I’d let my kids down and I couldn’t do my job any more”.

Manford said he wanted to pass on the advice he was given that “still gets me through to this day”, which was “just because you’re struggling, doesn’t mean you’re failing”.

“The next time you’re struggling, maybe say it to someone you love,” he added.

Probe into Carseview abuse allegations could affect mental health services review

Probe into Carseview abuse allegations could affect mental health services review

A probe into serious abuse allegations at Carseview could impact a controversial shake-up of mental health services.

The first phase of a planned review, which will see general adult psychiatry acute admissions centralised in Dundee, is due to begin in June.

However, health chiefs say they are prepared to make changes if necessary,when the findings of an independent investigation into claims patients were pinned to the floor and mocked by staff at the Carseview mental health unit in Ninewells.

The Perth and Kinross Integration Joint Board heard preparatory work on the mental health review is already under way, with the first phase due to begin in June.

The plan was agreed in January 2018, following months of consultation and protest. Learning disability inpatient services will be provided at Murray Royal Hospital Perth, after services were transferred out of the outdated Mulberry unit at Stracathro in Angus.

The board was given an update by the four-person panel leading the review.

Conservative councillor Colin Stewart asked: “We’ve heard that we need to work quickly to address risks, but we are also told there are delays to the redesign programme.

“I understand there is going to be an interim report on the independent inquiry published later this month.

“Have you had any indication that there may be points raised for action in this report, that might have implications for the redesign programme?”

Arlene Wood, associate director for mental health, confirmed she had not had any feedback or update on the review. “The clear steer that we have had from the chief executive is that we continue, for now, on the quality improvement and redesign programme because we know there are inherent risks in the system and this work needs to happen,” she said.

“It would be remiss of us to wait for the report. If there are things raised that require us to change our course of action, then we would address that at the time.”

The board heard the heads of health partnerships in Dundee, Perth and Angus were working on a Tayside Mental Health Alliance, to tackle a range of challenges facing the sector.

Professor Keith Matthews, associate medical director for mental health services said: “It would be a mistake to underestimate how challenging the environment is for mental health services.

“We have issues with recruitment and there are emerging difficulties with retention of staff.”

He said the Scottish Government was attempting to address a national shortage of psychiatrists with an international recruitment campaign.

“Although many efforts are being taken to resolve these matters, the likelihood of anything being resolved soon are pretty low.”

He added there was a need to move away from a workforce reliant on high-cost agency work.

Controversial Dundee mental health unit MUST be shut down

Controversial Dundee mental health unit MUST be shut down

The only possible course of action is that Carseview Centre is shut down, says Record View

The best thing that could happen to the Carseview Centre would be if it was razed to the ground.

The details of a leaked report into the conditions at the Dundee mental health unit are nothing short of horrifying.

Patients were restrained using dangerous and “life-threatening” techniques.

Vulnerable people who needed care and attention were instead subjected to bullying and unsafe practices by untrained staff.

The internal inquiry even found evidence staff pinned down patients for as long as an hour and 45 minutes.

And the suspicion remains that this would all still be going on if it wasn’t for the brave actions of whistle-blowers.

The scandal is another serious headache for Health Secretary Jeane Freeman who has an overflowing in-tray.

It’s vital the SNP minister ensures the complete report is published as soon as possible and that its recommendations are delivered in full.

The case raises extremely grave questions about mental health provision in Scotland. Steps must be taken to ensure these types of failures are not being repeated elsewhere.

The families of suicide victims are demanding the facility is shut down so new mental health services that are fit for purpose can be introduced instead.

That is now the only possible course of action.

Social media crisis

Responding to the myriad of ways social media is changing the world is one of the biggest challenges facing politicians.

An important Scottish Government report today raises fears of a looming mental health crisis among teenagers.

It reveals the number of 15-year-old girls in Scotland reporting emotional and behaviorial difficulties has soared over the past decade.

And it’s no coincidence this decade coincides with the rise of social media.The new pressures of Facebook, Twitter and Instagram are immense.

Young people’s every action is scrutinised online. This can be destructive to people’s body image and sense of worth.

The evidence suggests young girls are particularly susceptible to the problem.

The Scottish Government has responded by unveiling a £90,000 package to boost wellbeing in schools, including teaching healthy use of social media and screen time.

This is a welcome first step in a very important battle.

Carseview Centre mental health unit restraint ‘shocking’

Carseview Centre mental health unit restraint ‘shocking’

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

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

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

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

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

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

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

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

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

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

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

The longest restraint was one hour and 45 minutes.

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

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

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

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

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

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

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

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

The internal report has not been seen by the public

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

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

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

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

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

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

“The figures on physical restraint are exceptionally worrying.

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

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

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

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

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

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

‘Total disgrace’

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

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

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

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

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

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

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

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

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

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