The Courier & Advertiser (Perth and Perthshire Edition)
‘They killed my son’
• Grieving mum Mandy McLaren will never forgive NHS Tayside for son’s death • Damning report into mental health services in Tayside demands total overhaul
A bereaved mum has blasted NHS Tayside as a damning report into mental health services in the region laid bare the scale of its failings.
The independent inquiry into mental health services in Tayside has made more than 50 recommendations to the health board.
Its author Dr David Strang said: “A breakdown in trust and a loss of respect has... led to poor service, treatment, patient care and outcomes.”
Dr Strang’s report was released on the fifth anniversary of Dale Thomson’s funeral.
His mother Mandy McLaren, right, said she would blame NHS Tayside for the death of her son, who had been a patient on the troubled Carseview ward, until the day she died.
“They killed my son. If they had done their jobs, he would still be alive,” she said.
A radical redesign of mental health services across Tayside is needed to repair a “breakdown of trust”.
A damning independent report into mental healthcare provided by NHS Tayside and its Integration Joint Boards (IJBs) has revealed a catalogue of problems with trust and support.
Its author Dr David Strang said: “A breakdown in trust and a loss of respect has undoubtedly led to poor service, treatment, patient care and outcomes.”
Fifty recommendations were laid out following a 16-month investigation.
The report calls for a “fundamental redesign” based on a new culture of trust and respect and said the “most striking lack of governance” was the absence of a mental health strategy.
It also highlighted the need for improvements to referral systems, communication, and support for junior staff and an assurance that bullying “is not tolerated anywhere in mental health services in Tayside.”
Dr Strang, a former prison inspector and chief constable of Lothian and Borders Police, launched the inquiry in September 2018 following campaigning by bereaved families.
The report said: “The challenges facing mental health services in Tayside have not just arisen in recent years – they are of a long-standing nature.
“There is an urgent need for the development of a long-term strategic review of the requirements for mental health services across Tayside.
“The most striking failure of governance of mental health services in Tayside is the lack of a mental health strategy.
“There needs to be a strategy to deliver a whole system, radical, transformational redesign of mental health services.”
Dr Strang said the problems could not be fixed before a full review is carried out by the health authority.
“Without a proper assessment, any changes can only be piecemeal and may not fit in with the longer-term plans,” he said.
Evidence gathered during the probe showed a lack of trust and respect between patients, staff and management with the health board accused of being defensive and calling patients “problematic”.
The report said: “It is clear there has been a breakdown of trust in many aspects of the provision of mental health services in Tayside. While there are undoubtedly examples of good relationships which have led to positive outcomes for patients and staff, there have been too many instances of relationships across Tayside which have suffered as a result of a lack of trust.
“The independent inquiry team has received widespread evidence of a lack of respect in a range of relationships.
“Patients, families and carers have been described by some staff as troublesome, antagonistic, problematic and not to be trusted.
“A radical, new approach to restoring and building trust is urgently needed.”
The report said Tayside had adopted a “defensive” position on too many occasions and that this had left the impression of wanting to protect its reputation at all costs.
“Frontline staff feel that the organisation is more interested in identifying who is to blame and attributing fault than genuinely learning in a supportive environment.
“There has been a breakdown in trust in Tayside, between organisations, partners, staff, patients, families, carers and communities.
“There is a real danger of a perception that NHS Tayside is more interested in protecting its reputation than looking after the interests of its patients.”
Staff shortages were deemed a “major risk” to mental health services. The report warned junior doctors were vulnerable, while patients suffered inconsistency due to a reliance on locum staff.
Employees said their concerns were not listened to, and there was evidence from one doctor who said employees were “discouraged” from reporting staff shortages.
The report warned NHS Tayside had yet to make improvements that had been recommended previously and said there were no measures in place to force them to do so.
It said a review into mental health services had not been carried out, despite an interim report by the inquiry board published last year warning it was “urgently required”.
“There appear to be no consequences for the board if they publicly accept such recommendations but do not proceed to implement them,” the report said.
“When the independent inquiry interim report was published in May 2019, it emphasised the urgency of completing such a review.
“Seven months on, this work remains incomplete.”