NHS Shetland vows to improve on mental health

This week is Mental Health Awareness Week.

“I’M LUCKY I have a great support network behind me, otherwise I don’t think I would have been around to see my first appointment.”

That’s the thoughts of a Shetland woman suffering from depression who says she had been waiting for two years before receiving her first sit-down meeting with a mental health counsellor this summer.


The woman, who does not wish to be named, is just one of many people who have been frustrated at the lengthy waiting times associated with NHS Shetland’s mental health department.

At the moment, health boards have been set a target by the Scottish Government for 90 per cent of patients to have psychological therapy treatment within 18 weeks from referral.

The local board, however, is one of many in the country falling behind on that target.

Between January and March this year, just over 60 per cent of patients started treatment within 18 weeks with adjustments, which included unavailability and missed or rearranged appointments.


The figure for unadjusted waits – the overall time from the point of referral – is just around 25 per cent.

In response, NHS Shetland bolstered their mental health staffing levels this summer, with new consultant psychiatrist Martin Scholtz joining in June.

Specialist doctor in psychiatry Almarie Harmse started work in July, while consultant psychiatrist Dr Helen Dawson visits ten times a year, and consultant clinical psychologist Dr Celina Kelley holds three clinical sessions during each of her twelve visits per year. There is also an increased amount of community psychiatric nurses.


However, for many this feels too little too late. The woman previously mentioned claims she was left feeling abandoned by the system after initially experiencing a high level of care following a bout of post-natal depression a number of years ago.

“Right after having a child there was more support. Now, past the health visiting stage, I was out on my own,” she said.

“At the start of 2013, I went to the doctor and broke down. I was honest and explained I had suicidal thoughts. I was immediately put on anti-depressants and was added to the counselling list.

“Now, over two years since I went to the doctor relapsed with depression, I got a letter with my first counselling appointment.

“Some people don’t have two years. I’ve lost two friends who had mental health issues that went untreated. I hope the system gets sorted soon before more people give up the will.”

And she’s not alone. Another woman suffering from bouts of depression told Shetland News that after “plucking up the courage” to ask for help last year, only an initial face-to-face assessment has been forthcoming.

“When I did try to get help I had to go through lots of doctor appointments and CBT [cognitive behavioural therapy] forms to then be then told after months that I needed counselling. I was told the waiting list was long,” she said.


“That was kind of hard, but understandable. However, when it comes to months and months of waiting for help, when you have your worst days, it feels like hell. You wish you had physical pain because you’d get seen sooner.”

NHS Shetland chairman Ian Kinniburgh said the issue of mental health waiting times is something that has been on the board’s radar for some time.

He added that the historical problem of staffing specialised jobs in the field should now be alleviated with the recent recruitment drive.

“I hope that people waiting should now begin to see a good improvement in their situation,” he said.

“One of the things I would apologise for is the slow change that’s taken place.

“We’d anticipated recruiting a new consultant psychiatrist far earlier than we actually managed to.

“What we’ve really committed to doing is to make sure that any changes or any redesign to the service was done fully with the consultant psychiatrist, because we rely on his expertise.

“The team is starting to feel much stronger and is now in a better place to deliver these services.”

Kinniburgh also offered a personal apology to anyone currently frustrated by their waiting time.

“I do accept there has been a real issue around mental health and that we haven’t performed as well as we could do.

“What I can say is that we’re committed to turning this around, and I genuinely believe that we are beginning to deliver a service that means they won’t suffer from the same problems in the future.”

NHS Shetland chief executive Ralph Roberts believes the health board could hit the Scottish Government target by the end of 2015.

“We think [we could reach the target] later this year,” he said.

“We need to see the service settle down over the course of the autumn, but I’d be very disappointed if we weren’t reaching the target by next March.

“But there’s a lot more work we need to do. It’s taking one step at a time and understanding what impact that will have.”


Local charity Mind Your Head meanwhile said they hope to start running their own support service in early 2016 to help bridge some of the gaps in mental health provision.

At the moment their work centres around raising awareness of mental health issues and reducing stigma with the aim of encouraging those struggling to seek support informally from work colleagues, friends and family.

In 2014 the charity ran a wide-ranging survey of mental health provision in the isles and it suggested that speed of referral was one of the major problems faced by locals.

Chairperson Shona Manson said the charity offers access to early help and guidance when other avenues may not be available.

“People often end up on waiting lists for services that they need now and hence it is important that we consider how we can intervene earlier and people be able to access more generic support at the time that they need it,” she said.

“Mental health is completely different than physical health, because we’re all individuals and our experiences are very different, and there’s not one service that fits all.

“And that makes planning for services, and making sure we have the right services, pitched at the right level, challenging at times.”

Manson added that a business plan and service structure is currently being developed to address the need for “significant funding” as the charity looks to secure “longer term sustainable services”.

Shetland MSP Tavish Scott has also expressed his concern at mental health provision in the isles.

Earlier this week, results of a survey undertaken by the politician revealed that almost three quarters of Shetlanders believe the provision of mental health care in the isles is not adequate.