NO HELP – JUST AS PEOPLE ARE AT THEIR LOWEST

FOR more than a decade, the chosen way of dealing with what health boards call ‘unscheduled self-referrals’ – people who go to psychiatric units for help with mental problems or are taken there by concerned relatives – is to tell them to go to their GP, talk to NHS 24 or take a trip to A&E.

I found this out after we adopted our two daughters who were diagnosed with severe mental conditions in their early teens.

My younger daughter, a classically trained musician, often came off her medication because her illness, and the very powerful medication she had to take to control it, destroyed her life and her career.

So she would stop taking the tablets in the sad hope that ‘this time’ she would no longer be ill. But she quickly became delusional and wandered the streets while we had no idea if she was dead or alive.

A couple of years ago, my son set out to find her. Aware that she was acutely ill, he took her to the nearest psychiatric unit – himself, because the police refused to help – and was turned away by a receptionist.

He was dismissed with the instruction: ‘Take her to A&E.’ So for hours he sat with her in a casualty department on a Saturday evening, a time when such over-worked places are even busier than normal.

Convinced of a plot to kill her, she lashed out as her brother desperately tried to restrain her, and she ‘escaped’ several times with him in desperate pursuit.

There had been no help, no assessment even, from any mental health professional in the dedicated psychiatric unit – just the ‘GP, NHS 24 A&E’ mantra.

These days, GPs complain about their heavy and increasing workloads and the difficulty of attracting applicants because of it. As any patient can testify, getting an early, far less an instant, appointment with a GP can be impossible.

A&E departments are also under pressure and are mainly staffed by doctors and nurses with less experience and qualifications than those in psychiatric units.

Despite this, people with mental health problems have first to be seen there before a psychiatrist is sent for, as happened with my daughter.

A psychiatrist was eventually sent from the unit that had turned her away long hours before, and she was then admitted. And it is not just the patients and their equally distressed families who are at risk here.

Not all mentally ill people are or can be violent, but some are – and how can the general public tell the difference? Someone waiting in a GP surgery with a sore throat, or in A&E to have a sprained ankle dealt with, has no way of knowing who is sitting beside them or what they may do.

The current system is designed specifically to stop people looking for help from psychiatric units – and it works. When they are sent away, no one knows who they are, what happens to them or where they go.

ONE excuse put forward by psychiatric units is that, unlike A&E departments, they do not have security staff, but with this system running for years already, there has been no great demand for security at psychiatric facilities. It seems turning away disturbed and sick people is the preferred end in itself.

I have been lobbying politicians to get change. When told about the ‘unscheduled self-referral’ system, most do not believe it until they look into it, and find that only life-and-death cases will be seen, a decision made by a receptionist.

Yet Health Secretary Shona Robison and the Scottish Government have done nothing, and show no signs of ever doing anything, about this situation. I think the truth is that they are simply not interested.

Lisa Cohen, national programme manager of mental health charity See Me, says: ‘For people to have the best chance of recovery, they need help and support quickly. To end stigma and discrimination it is vital that people are able to speak about their mental health and ask for help.

‘They will not do this if they get turned away when they take that first step. When someone presents in an emergency, they need to be given support. People should only need to ask once to get help.’

First Minister Nicola Sturgeon has repeatedly said mental health provision is a priority for her party and promises better treatment by 2020. Maureen Watt, the SNP’s minister for mental health, said in a statement: ‘We understand how difficult and distressing it can be for people experiencing mental ill health, and the impact this can have on their families.

‘Anyone experiencing mental illness can seek help through their GP, who can refer patients to specialist mental health services, if appropriate, and through roundthe-clock services such as NHS 24, Breathing Space and the Scottish Ambulance Service.

‘We are working to invest more in community mental health services and improve access for patients – including a drive to reduce waiting times for access to psychological therapies and to child and adolescent mental health services.’

Like David Ramsay, my daughter has now killed herself, and as one of the many families coping with the impact of that reality I can tell the minister her statement proves she has no understanding of her remit.

In this climate, getting justice for David Ramsay will be an uphill battle.