Wednesday, 31 December 2014

design of new £3m IPCU at Stratheden Hospital - what about the £1.4m? Are any experts by experience involved? Update

[Update to original blog post about new-build IPCU]

from Fife Herald 26 December 2014

Email response to my questions about £1.4m and patient/carer involvement in design plans, from Dr Brian Montgomery, Interim Chief Executive, NHS Fife, on 30 December 2014, my responding Email follows:

"Dear Mrs Muirhead

Thank you for your enquiry.

The total funding associated with the IPCU has not changed and remains at £4.4 million,  However there is more than one element to it and it is also being phased over more than one financial year.

I can confirm that service users including patients in IPCU and the low secure unit were involved in the early stages of the design.  The Board has now enlisted the assistance of Circle network to identify previous service users to work with us on the next stage.

Artist drawings were on display in the staff dining room for a period of time.  More detailed floor plans have been drawn up and will be considered when the Project Board meets in January.

Once the business case is approved there will be public engagement sessions.

Brian Montgomery"

My response in an Email, this morning, 31 December 2014:

Subject line: Re: what about the other £1.4million? I am still none the wiser. Staff centred services, no surprise there then. Hierarchical shenanigans and uncivil servants.

"Dear Dr Montgomery

Thanks for your response re the £1.4m enquiry and the question about meaningful involvement of experts by experience in the new build IPCU designs.

I am still none the wiser, regarding the £1.4million and what it is to be used for.  "more than one element" and "phased over more than one financial year" doesn't tell me, or any other non-NHS Fife health board folk, what is happening.  I would have appreciated some detail rather than what appears to be a fobbing-off reply.  As if you and the board are not going to tell a carer, activist and campaigner in Fife what is really going on. 

It's disappointing but not surprising.  I've sat through a number of health board meetings now and know the score.  Graphs and statistics that do their best to obscure the facts except when a point is being made.  Handpicked patient stories to praise services or government/parliament initiatives.

As for the "involvement" of patients and carers, I see none of the latter and the former doesn't appear to be either meaningful or rigorous in its execution.  As usual it's staff at the centre. getting the drawings on display for "a period of time".  Staff-centred services at Stratheden Hospital, what I have been used to, over the years since 1995/6 when my oldest son was an inpatient of Lomond Ward, was injured, had a critical incident with ECT, rushed to Ninewells, and I had to make complaints.  What's new?

"public engagement sessions" are not the same as consultations (mind you, to be honest, the government consultations haven't been the best use of my time, the civil/uncivil servants just write their own stuff anyway).  It sounds like asking for approval after the gate has shut, the horse has bolted.  Please do correct me if I'm wrong?  I speak as a community development worker of over 30 years. 

Where I was involved in setting up grassroots community projects (not mental health specific), involving stakeholders from the offset, empowering individuals and being empowered.  Working in partnership with statutory agencies, in South Lanarkshire, throughout the 1980's.  But things were different on coming to NE Fife in 1990.  It has to be said.  Like stepping back in time.  Since 1990 I've worked in paid posts (not mental health specific) in Fife and in Perth, the latter was more like the Lanarkshire experience.  More level playing fields and multi-disciplinary working. 

However since 2008 and setting up Peer Support Fife it soon became very clear to me that Fife mental health services were a top-down affair with little if any meaningful involvement of the real experts by experience.  The national situation wasn't and isn't that much better.  Hierarchical shenanigans, tokenistic involvement and cronyism abounding.  You can only climb the ladder of success if you tell them what they want to hear and keep quiet about your real opinions.  Otherwise exclusion.

I will put your response and mine into a blog post for others to see, 

Yours sincerely"


13 December 2014
I just came upon this information about the new IPCU planned for Stratheden Hospital, by chance when searching the internet:

"NHS Fife - Stratheden IPCU, Cupar

As part of the Graham Construction PSCP team under the HFS Framework Scotland 2 we are undertaking the design of a new £3m Intensive Psychiatric Care Unit for NHS Fife at Stratheden Hospital in Cupar. Construction works are scheduled to start on site in early Spring 2015."

So I have sent an Email to the NHS Fife Chief Executive Dr Brian Montgomery, saying:

"Can you please let me know where I can view the plans for this development?  I would like to be informed, particularly considering my activism in this area.  I am sure that others will also be interested.

I would like to know if any patients, carers, service users, people with experience of psychiatric settings from the customer perspective, have been involved in the design and planning process?  I haven't heard anything on the grapevine or from colleagues. 

I do hope that people like me are having a say from the beginning.  That our voices and experience are being recognised and respected.  I think it makes sense to invite us in rather than have us only spectating on the sidelines.  After all, we are the ones who may be having to engage with the service, support our family members who may find themselves detained in the IPCU.

I will put this link on my Stratheden Hospital blog in the expectation of hearing more from you .."

[the original amount promised by Scottish Government was reported as £4.4million so I have sent another Email asking "what about the other £1.4m?", what is it being used for?  Eg Lomond Ward which is in need of restructuring, internally, so that female patients are not sleeping in dormitory accommodation overlooked by male patients in single rooms down the same corridor.]

Saturday, 27 December 2014

'New psychiatric unit under way' Fife Herald, 26 December 2014

Just read this article in the Fife Herald, 26 December 2014: 'New psychiatric unit under way':

It says "The design and construction of the new IPCU has been strongly influenced by patients and staff across Fife".  My comment?  Well that's news to me as neither I nor my son were asked for our views on the new build unit.

There is no mention of money although I had read on the architect website that it was to cost £3 million and not the £4.4m as promised previously.  See my blog post about this.  I'm still waiting for a response from NHS Fife senior managers about this although my MSP Roderick Campbell has responded in an Email, saying he notes my request.

I read that Mary Porter, NHS Fife General Manager, says "Improving mental health facilities is a key priority" which I am glad to hear and I hope that this includes Lomond Ward, Stratheden, where the female dormitory beds are overlooked by single rooms which in the past had male patients in them.  Very risky if no nurses around to keep an eye on behaviours.

Ms Porter also talks about ensuring "our patients can receive high quality care in a modern, safe, secure and therapeutic environment".  My response to this comment?  The feedback from all patients and carers will tell us if psychiatric services in Fife are safe, secure and therapeutic.  

Just because NHS Fife senior managers say all is well does not mean that all is well, mental health service wise.  I've learned this to my cost and that of my family, over the years.  I am looking for evidence of good practice and Mental Health Act safeguards that are safe.  

I've been picking up the pieces for nearly 3 years.  On £61/week Carers Allowance with no other support from statutory agencies.  Instead there have been attempts made to lay the blame at my door for system failure and buildings unfit for purpose.  It's disgraceful when you think of the work I've done with Peer Support Fife and before that as a community worker in various settings, in Fife.

[I'll be sending this blog post to NHS Fife mental health managers for some holiday reading and to rattle cages]

Saturday, 20 December 2014

my experiences of OT in Stratheden, Fife, compared to Carseview, Dundee, and in the communities

"STRICTLY STAFF ONLY PLEASE" toilet Ceres Centre, Stratheden Hospital (taken Dec12)

I remember meeting with the head of OT for mental health (AHP Clinical Services Manager) in Stratheden Hospital, Ceres Centre (patients' cafe here), where she was based, late 2010 think it was.  I was unhappy about the lack of OT group activities in Lomond Ward when my son was a patient that summer.  I'd also asked for a meeting with the head of psychology (Head of Service, Clinical Psychology), for the same reason.  

I had witnessed there being no therapeutic activities in the wards for patients who were detained or restricted and thought this was detrimental to recovery and to the wellbeing of patients.  I'd noticed patients pacing in the wards, up and down, and going round in circles even.  Nothing to do.  Aimless and restless due to the medication/drugs. 

As a community education worker group work was central to what we did to empower and encourage learning in communities, of children, young people and adults.  From 1980 I'd been involved in grassroots initiatives, being part of groups, helping set them up and also leading from the front.  In 1998 I gained a postgraduate qualification to back up my work experience.

Therefore when I met with the OT head it was from a knowledge that groupwork was of real benefit.  However during the meeting of 2 hours and more I met with resistance from the offset.  There was no shifting her stance.  My words fell on deaf ears.  

In February 2012 my son became an inpatient of the Stratheden IPCU where the ward situation was dire.  An activity room locked for long periods, only getting pens to write with if two nurses were available to oversee.  Where were the OTs?  I saw one of them at the clinical meeting on occasion but never saw any working with patients. 

Then in late December 2012 another son of mine became an inpatient of the Carseview IPCU, then the open ward and eventually into the community, using day services.  I witnessed OT groupwork in a variety of situations, in the wards and in the community.  This is what I'd been looking for in Stratheden but didn't find.

In the Carseview IPCU there was an art group held regularly by an OT and I noticed this happening on one occasion when visiting, my son being part of the activity.  I saw the conversations and sharing of information, relationships formed and the art work was a bonus.  

There was a greenhouse out in the Carseview IPCU patio where a volunteer, a retired gentleman, planted out seedlings and patients occasionally helped while others smoked and observed from a distance.  Once a patient was allowed out of the ward they could join a horticultural group in the building, and my son did this although not a gardener in "real" life.  The main benefit to him and others, so I heard, was the human interaction.

The OTs were involved in helping patients to budget, to plan meals, to prepare for discharge, and sometimes went on buses down town with them so as to help build confidence and/or to find out information.  The engagement with patients and planning of activities was done in the ward.  

Unlike in Stratheden where appointments were made in the ward, to go to the Ceres Centre, and often the patients didn't turn up on the day because they didn't feel like it or weren't well enough.  I witnessed this happening and thought it wasn't a good use of time.  On occasion I tried to contact OTs at Stratheden but when I phoned the OT office was told that there was no diary for OTs so no-one appeared to know where any of them were.  Nice job if you can get it was my thought.  A service run for the staff.

My son has been using the Dundonald Centre services in Dundee since discharge from Carseview where there are a range of activities going on, by OTs and nurses who work together therapeutically with the people who use services.  Again there are volunteers involved in leading eg a weekly art group in the Centre.  The programme is flexible and adaptable.  Service users are able to join groups, to play pool, to get themselves a tea or coffee.  I've visited on occasion and the atmosphere is non-clinical even although nurse managed.

It hasn't been like this in Stratheden or in Weston Day Hospital, the latter of which lost the OT input a number of years back.  Not sure why.  It seemed that the OT strategy in NE Fife was to withdraw from involvement in clinical settings and to concentrate more on one-to-one work with patients, occasional groups in the community and management tasks.  This has been detrimental to patients and service users.

However it's been my experience that in Fife psychiatric services any negative or critical feedback from carers, patients or service users is met with defensive attacks and a refusal to engage further.  They do not listen to the voices of experience and have been allowed to do what they like in and with their service, and not be accountable.  Great job if you can get it.

This is what was going on in the Stratheden IPCU in February 2012, I contend.  They had been getting away with it for years.  Using a locked seclusion room with no toilet or drinking water.  Leaving patients locked in for hours at a time, unobserved.  Locking other rooms in the ward, not allowing patients in to their bedrooms through the day so they had to lie down wherever they could find a space eg the corridor in my son's case.

I believe that the OTs were taken out of the Stratheden wards because of the dire state of affairs going on there.  Abandon ship.  Rather than stay onboard and try to sort out the problem, repair the holes, get everything shipshape.  Leaving the patients to suffer for it.  And the carers.  Well it's just not good enough, in my opinion. 

The failures in the wards at Stratheden Hospital are the responsibility of all the staff working there.  It's a corporate affair and you can't just turn a blind eye to human rights abuses, saying it's nothing to do with me.  Yes it is if you're on the payroll.  If patients are not being allowed pens to write with in the Stratheden IPCU, no freedom of expression, then the OTs and others who attend clinical meetings in the IPCU are witnesses and involved.

I will be sending this blog post, as usual, to the senior mental health managers employed by NHS Fife and based at Stratheden Hospital and to the heads of OT and clinical psychology, for their information.  If I receive any responses I will publish them.  So far I have had no response.  I would prefer a dialogue or a debate but I have no power to make this happen.

Monday, 3 November 2014

PVG (protecting vulnerable groups) scheme - lawlessness in psychiatric settings and the dangers of whistleblowing

[the body of an Email I sent this morning to a collective of mental health human rights campaigners and allies, in response to an Email about the issues around the failures to investigate mental health professionals ill-treating patients or knowingly making false statements on relevant documents, under the PVG scheme]

"There is also the issue, in my experience, of mental health professionals doing things to vulnerable adults in psychiatric settings and not writing it in the "notes" or relevant documents.  For example using drugs and not recording it.  Using restraint and "forgetting" to write it down.  Locking patients in seclusion rooms with no toilet or drinking water for hours at a time, in the dark, light switch outside.

It seems to me that the reluctance to investigate and prosecute in the case of mental health professionals behaving unprofessionally means that many of them are getting away with human rights abuses.  This is a scandal. 

They are getting away with it because mental patients are often "returners" to psychiatric wards.  If they complained about the treatment then they would be in for worse treatment the next time around.  So they keep quiet to protect themselves from the consequences of whistleblowing.  This is where Independent Advocacy should come in, also the other "safeguards" in the Mental Health Act.  But unfortunately the safeguards aren't safe when the system is corrupt or not being held to account.

I raised a number of concerns about Lomond Ward, Stratheden Hospital, in 2010.  With NHS Fife, with the Mental Welfare Commission and with Scottish Government mental health division.  I spoke out about the risks to patients in the ward, especially female patients who were most vulnerable.  I had witnessed them in states of undress in the mixed gender ward and male patients seeing this.  I had witnessed male nurses behaving inappropriately with female patients.  Lack of dignity and respect.  I raised this with the charge nurse.  I spoke out about it at a Mental Welfare Commission event in 2011.

Then unfortunately at Christmas time 2011 my youngest son was in mental distress.  Christmas can be a difficult time for people with mental health difficulties.  My son had a CPN and we alerted his CPN after the holidays but nothing was done, no help or support given.  My son went to the police first week of January to say he had suicidal thoughts.  They sent him to St Andrews A&E who sent him to Lomond Ward.  The junior doctor ... who met with my son sent him home again. 

Three weeks later on 1 February 2012, my son still in distress, not sleeping, no help from anyone, went up to Stratheden Hospital in the middle of the night looking for help.  He sat on a bench waiting for the sun to come up.  He went up to the Lomond Ward window and waved to a member of staff inside who he knew.  She phoned the police, told them "ex-patient Daniel Muirhead from ....... is causing a disturbance".  I know this because Sgt ....., police officer at Cupar, told me later.  My son got taken by the police to a "safe place", a prison cell in Glenrothes where he was stripped, put in a blue suicide suit, tested for drink and drugs.  He had neither.  The police took him back to Lomond Ward, at about 4am.

I got a phone call from my son at about 6am wanting me to advocate for him in the ward 1 Feb12.  I went up to the ward, got let in by a nursing assistant, a man I had raised concerns about in 2010 because of his inappropriate behaviour with female patients.  This man then let my son out into the darkness with his suicidal thoughts.  He expected I would follow my son but I didn't.  I stayed in the ward and asked to speak to the charge nurse, made a complaint about the male nursing assistant.  The police were called for again to look for my son who could have taken his own life by this time. 

My son had gone back down to our house, fortunately had his keys.  The police went into my house, without my permission, got my son and brought him back, again to Lomond Ward.  They told me to "look after him" in the ward.  I tried to do so but when I left the ward for an hour or so at lunchtime, to complain about another male nurse who had behaved inappropriately with me, I got back into the ward to see my son face down restrained by 3 nurses.  By the end of that day he had a broken hand, was taken in bare feet and underpants by 2 male porters up to the IPCU where he was further brutalised.

That is what can happen, unfortunately, when you raise concerns or complaints about the treatment of vulnerable people in psychiatric settings.  You may be subject to psychiatric abuse, have your rights taken away from you and the mental health act safeguards will be of no use whatsoever against a coercive and lawless system."

Friday, 31 October 2014

Email from Geoff Huggins on 24 June 2014 that caused me pain, wounding me with its underlying blaming and shaming

I received an Email from Geoff Huggins on 24 June 2014 at 17.07 which caused me pain with its underlying blaming and shaming of the person I am and the work that I do.  It was a personal attack on my character, behaviour and intentions.  Copied in to others.

I contend that it was slanderous and defamatory.  However I am an unpaid carer, on £61/week Carers Allowance, live in a council house, separated from my husband, supporting my son 24/7 after his dehumanising treatment in Stratheden Hospital, Fife, in February 2012.  I can't afford to take my case against Geoff Huggins to a solicitor.  I'm not on benefits and wouldn't be entitled to legal aid.  

You might describe me as "poor" in comparison to Scottish Government civil servants.

This Email wounded me to the extent that I had to cancel my presentation on the Mental Health Act Safeguards at the INTAR Liverpool Conference the next day, 25 June, and then on 27 June my son had to call out the paramedics because I was feeling very unwell, linked to the high blood pressure condition I have, as a result of taking lithium.

I was targeted with this Email because I had complained about being excluded from the Scottish Patient Safety Programme exchange with the International Initiative for Mental Health Leadership.  And was then left out of celebrations at Edinburgh Castle with leading Scottish politicians.  It felt very unfair and unjust.

I responded to the Email later that night of 24 June, justifying my reputation and my life's work, here are the opening paragraphs:

"Geoff I have considered your accusations in this Email and I don't accept them as being an accurate representation of my character and behaviour.

In fact I consider your tone and words used to be both hierarchical and denigrating, unbefitting to someone in your position with Scottish Government.  It's not the first time you've spoken to me like this.  It reads as bullying and undermining, and in the social networking world they would call it trolling."

On 28 June 2014 I raised a complaint about Geoff Huggins' Email, with Paul Gray, Director General Health & Social Care and Chief Executive NHS Scotland.  

My complaint was investigated by Yvonne Strachan, Head of Equality, Human Rights and Third Sector at Scottish Government, and middle man throughout this process was Ben Plouviez, Head of Information Management at Scottish Government.

I received a letter from Paul Gray via Email dated 2 October 2014, saying that my complaint was not upheld and that Geoff Huggins' Email was "direct and robust". 

In the complaint investigation report written by Yvonne Strachan and dated 3 September 2014 one of the recommendations was that:

"Ms Muirhead demonstrates acceptable behaviour in the manner in which she engages and participates in such meetings and events."

Here is the copy of the Email sent to me from Geoff Huggins on 24 June 2014 and copied in to various Scottish senior mental health workers (bolding is mine):
24 June 2014       17:07 



Dear Chrys

I have been reading your recent correspondence with a number of my colleagues in this and other organisations.

In your correspondence with Scottish Government, NHS and voluntary sector staff you indicate a belief that it is part of our terms and conditions that we are obligated to accept to be spoken to in an abusive manner. It is not. If people disagree with you or question your behaviour you describe them as bullying and cite your personal experience of illness and your status as a carer as in some way justifying your behaviour. It is not a justification. If people do not accede to your demands for priority access you say they are not treating you with respect. People have consistently treated you with respect.

We and others have regularly involved you in meetings and events related to mental health in Scotland, making every effort to accommodate you as a full participant. Where you have attended or participated your contribution focuses on your experience and that of your family. That is an entirely reasonable contribution to make, but you make it in a way that excludes or devalues the experience of others and which prevents other voices from being heard. Your tone is consistently belligerent and denigrating of others, including others with lived experience of the mental health system, whether as a patient or carer. 

You trivialise other’s experience with the consequence that people tell us they do not want to speak up when you are present at events for fear of what you will say. That is neither desirable or acceptable. Where we involve others or work through representative organisations you describe them as collaborators and demean their actions. That is not acceptable and we will no longer tacitly tolerate it.

I have read the correspondence about the decision not to allocate you a place at the IIMHL match on patient safety. You had previously selected a different match which had a focus on lived experience and there was no suggestion that you would not have been welcome to attend that match. Ruth and others have set out the reasons for refusing your application to join the session previously and I will not add to their explanation other than to say that I agree with their reasons given previous experience as set out above. As you were not attending the session on patient safety or one of the other matches you were not invited to the reception at the Castle. Had you attended the match on human rights which was also hosted in Edinburgh you would, of course, have been invited to the Castle with the members of Plus Perth.

We will continue to listen to and where appropriate investigate concerns that you raise with us. However, we will no longer give you special treatment or consideration to the detriment of other service users or carers. I would ask you to consider your behaviour and the impact it has on the health and wellbeing of others.

I am copying this correspondence to regular recipients of your correspondence including the Cabinet Secretary for Health and Wellbeing Alex Neill MSP, the Chief Executive of the NHS and Director General for Health and Social Care Paul Gray, Colin McKay at the MWC, Billy Watson at SAMH, Nigel Henderson and Simon Bradstreet at the Scottish Recovery Network, Joyce Mouriki at VOX, John Wilson at NHS Fife, Denise Coia and Ruth Glassborow at HIS and Fran Silvestri at IIMHL. I anticipate that you will want to share this correspondence on your blog and request that if you do so that you reproduce it in full.

Geoff Huggins

Geoff Huggins | Acting Director of Health and Social Care Integration | The Scottish Government | 1E.12 | St Andrew's House | Regent Road | Edinburgh | EH1 3DG |Tel: 0131 244 3210 | Mob. 07515 559192

Wednesday, 29 October 2014

Mental Health (Scotland) Bill – my second submission & 6 page testimony that the Mental Health Act Safeguards were not safe in February 2012

Here is a link to my second submission and testimony, evidence given to the
Health and Sport Committee, Scottish Parliament, in respect of the Mental Health (Scotland) Bill:

 “Sometimes, when people are unwell, they may have to be detained in hospital or have treatment against their will. But they still have rights. We all have human rights, and mental health law contains special rights and safeguards to protect people.” Mental Welfare Commission for Scotland  

In my testimony I contend that it was my family’s experience in February 2012 that the safeguards contained in the Mental Health (Care and Treatment) (Scotland) Act 2003 were not safe.  That the Act was not implemented properly or monitored effectively.  Which resulted in my son being subject to unreasonable treatment in Stratheden Hospital, Fife.  I write about Named Person, Independent Advocacy, Mental Health Tribunal, Advance Statement and the Mental Welfare Commission for Scotland.  

I also speak about how the Mental Health Act Principle of Respect for Carers was not adhered to:

"Respect for carers: Those who provide care to service users on an informal basis should receive respect for their role and experience, receive appropriate information and advice, and have their views and needs taken into account"  

In fact when I raised concerns with statutory agencies in February 2012 they focused a main part of their Adult Protection Investigation into my character and behaviour, when my son was detained under the Act in a locked ward and being further locked in a seclusion room in the ward which had no toilet or water to drink.  I was accused of causing my son "psychological harm" when he was under the "care and treatment" of NHS Fife.  A psychiatrist and CPN were questioned about me, two men who didn't know me personally, only as a carer and mother.

I suspect that the label of "schizoaffective disorder" that still sits in my "notes" has had some influence in the discriminating treatment shown towards me in February and March, 2012.  I say this because we have copies of my son's notes from that time and it says "family history of schizoaffective disorder" in his notes, and I am described as a "difficult and demanding mother".  I believe this was because I challenged their practices and asked for evidence of their policies and procedures, through FOI requests.  And I advocated for my son at clinical meetings in the ward when he wanted me there.

more short stories from the critical viewpoint about OT and Stratheden Hospital

In February 2012 when my son was an inpatient of the Stratheden Hospital IPCU he wasn't allowed a pen to write with unless accompanied by two nurses in the "activity room".  It seemed the OTs had abandoned the patients and left it up to the nurses to gainfully occupy the patients as well as treat them with drugs.

staff only toilet Ceres Centre Stratheden 2012
I had met with the head of OT in 2010, who is based near the Staff only toilet in the Ceres Centre at Stratheden, a long meeting that went nowhere.  She said how she'd taken her staff out of the wards at Stratheden because she was not managing to retain staff.  That was her story at the time.  All about the staff.  My concerns were more to do with the patients.

Staff centred care.  A common feature at Stratheden in my experience over the years.  Because the staff have been left to get on with stuff in a Cinderella service.  Lack of resources, bottom of the pile.  The patients and carers having to suffer for it. 

It is just not good enough.  Basic human rights denied.  No freedom of expression.  No toilet or water to drink.  

I remember attending one clinical meeting in the IPCU Feb12 and saying to the OT who was there that he should get rubbery or squidgy pens that weren't "dangerous weapons" because that was the excuse given for not allowing patients to have writing utensils.  Similarly with the plastic cutlery and no plastic bottles of water (also allegedly dangerous weapons).  

I suggested blackboards on the walls and chalk, or white boards with plastic pens.  No-one listened or appeared to listen to what I had to say.  Just like the head of OT in 2010.  Brick wall comes to mind.  And the patients, and carers, having to suffer for it.

I had a meeting in early 2011 with the then General Manager of mental health who has now taken early retirement and I wish him well.  His line manager was also there, a woman.  I complained about the head of OT not listening to the words of a carer.  I recommended that he should send her on a 6 month sabbatical, get someone else in to do a better job of it, someone who was patient centred.  I was told that this wasn't financially viable.  Unfortunately.

(however I think she did go off under her own steam a wee while back, and came back)

I really didn't appreciate being patronised by the head of OT who is/was based at Stratheden Hospital.  It's not good enough to take her staff out of the wards and expect the nurses to do occupational therapy as well as everything else.  A recipe for disaster. 

Saturday, 25 October 2014

lawless individuals

Here's a wee story of "What If":

What if the locked seclusion room in the locked ward of a psychiatric hospital is being used by nursing staff to forcibly drug and abuse patients and nothing is written about the drugs, the force or the abuse in the records or the notes?

What if the nurse in charge of a locked ward of a psychiatric hospital keeps telling carers and family members of patients in the locked ward that the nursing staff are all about "relationships" when in fact they are more to do with coercion, bullying and intimidation?

What if the acute wards, open and locked, of a psychiatric hospital are places where vulnerable patients are at risk of, and being subject to, sexual exploitation?

What if an NHS health board is allowing and condoning the behaviour and practice of lawless individuals who are employed by them and subject to their policies and procedures.  

Who is responsible?

It absolutely and definitely isn't the patients, the carers and the family members (or the whistleblowers) who are in any way responsible for system failure and abusive practices.  That's for sure.

Sunday, 19 October 2014

'A Plea to Scottish Parliament: Fair and Just Treatment for All People in Psychiatric Settings' my latest post on Mad in America

'A Plea to Scottish Parliament: Fair and Just Treatment for All People in Psychiatric Settings' my latest post on Mad in America


"Today I Emailed a submission with strapline ‘A Plea: Fair and Just Treatment for All People in Psychiatric Settings’ to the Health and Sport Committee at Scottish Parliament as evidence in respect of the Mental Health (Scotland) Bill. The overarching objective of the Bill is stated in the policy memorandum as: “to help people with a mental disorder to access effective treatment quickly and easily.” 

I am looking for more than this.  As a mother and carer of two sons with mental disorder labels I want to see:

  • The Mental Health Act implemented properly and monitored effectively in every Scottish Health Board area, including Fife where I live
  • Mental Health Act safeguards that are safe: in my family’s experience we have found that advance statements were overruled, named persons (myself) were uninformed, Mental Health Tribunals were weighted in favour of “professionals”, Mental Health Officers behaved unprofessionally and the Mental Welfare Commission were wise after the event and had no power to influence health boards to improve buildings that they had declared “unfit for purpose”
  • Carers, and mothers, respected by all mental health professionals, including Scottish Government civil servants and Healthcare Improvement Scotland
  • Patients not subject to dehumanising treatment and a denial of their basic human rights when locked up and locked in Scottish psychiatric units."

"Many people have sent me words of encouragement in response to the upholding of my complaint by the Ombudsman and to my son for speaking out to the national newspaper, the Sunday Express, about his ordeal in the locked seclusion room within the locked psychiatric ward.  Here is a selection of these:

“Congratulations on the vindication of your account of the treatment of your son.  Your strength, courage and commitment are immense.”

“Well done! Your tenacity is an inspiration to us all.”

“This is an important victory and shows others that they can take on the system.”

“I hope that the attention generated by this article helps stimulate genuine and lasting improvements in mental health care standards.”

"It is a brave step that you have taken, and you have my support. I hope that others find the strength to voice their concerns and stories.”

“I am so proud of Daniel and his special Mum.”
Thanks to all my friends and colleagues who have stood with me and my son in our fight for justice and for our voices to be heard.  It is a small but important step on our justice quest.  And many thanks to Robert Whitaker for giving me the space to speak out on Mad In America.  

Bob invited me to be one of the first “foreign correspondents” in January 2012, after having invited Bob to speak in Fife, Scotland, in November 2011, on Anatomy of an Epidemic.  The opportunity to write here has opened doors and given me strength, to be in solidarity with others and to be listened to.  Thank you."

Friday, 17 October 2014

My Evidence Submitted to Health and Sport Committee Scottish Parliament re Mental Health (Scotland) Bill

[Today I Emailed this submission to the Health and Sport Committee at Scottish Parliament as evidence in respect of the Mental Health (Scotland) Bill] 

A Plea: Fair and Just Treatment for All People in Psychiatric Settings 

"The overarching objective of the Bill is stated in the policy memorandum as: to help people with a mental disorder to access effective treatment quickly and easily.

I am looking for more than this.  As a mother and carer of two sons with mental disorder labels I want to see:

  • The Mental Health Act implemented properly and monitored effectively in every Scottish Health Board area, including Fife where I live 
  • Mental Health Act safeguards that are safe: in my family’s experience we have found that advance statements were overruled, named persons (myself) were uninformed, Mental Health Tribunals were weighted in favour of “professionals”, Mental Health Officers behaved unprofessionally and the Mental Welfare Commission were wise after the event and had no power to influence health boards to improve buildings that they had declared “unfit for purpose” 
  • Carers, and mothers, respected by all mental health professionals, including Scottish Government civil servants and Healthcare Improvement Scotland 
  •  Patients not subject to dehumanising treatment and a denial of their basic human rights when locked up and locked in Scottish psychiatric units.

On 29 September 2014 I received a decision letter from SPSO informing me that my complaint against NHS Fife Health Board (submitted to the Ombudsman on 17 September 2013) had been upheld.  I had originally wanted the judgement to be about “human rights abuses and dehumanising treatment” but I was told by the SPSO adviser in September that the most I could hope for was “unreasonable treatment”.  Human rights abuses would have to go before a criminal court. 

Here are the reasons given by the Ombudsman Complaints Reviewer as to why my complaint was upheld:

“It was inappropriate to transfer your son to the IPCU in his underwear and without shoes (I had observed this happening when standing in the car park outside the acute psychiatric ward).  In addition, I do not consider that the observation of your son in the seclusion room was adequate or that there is evidence of a plan to ensure that your son had appropriate access to food, fluids and a toilet during his period of seclusion.  This is not acceptable.”

I am not satisfied with this decision as I had listed a range of complaints, including injuries untreated, intimidating behaviour and psychiatric abuse. Therefore I have made a Review Request, detailing a large number of inaccuracies in the written report within the letter, by NHS Fife Health Board, and the conclusions that were reached.  I have also asked for a copy of all the evidence sent by NHS Fife Health Board to the Ombudsman because I am not confident that all my complaints and FOI requests made at the time were handed over to SPSO.  The investigation I contend was not a “level playing field”.

I am concerned that there is a two-tier treatment regime in Scotland’s psychiatric system and that this is reinforced by Scottish Government’s Mental Health Strategy which differentiates between “common mental health problems” and “severe and enduring mental illness”.  And for those of us in the latter category it can lead to stigma and discrimination, to unreasonable treatment, to disabling mental and physical conditions and to a much shorter life span.  This is unfair and unjust.

I was/am one of those labelled with a mental disorder, Schizoaffective, in 2002 after being coercively treated in a psychiatric ward with an antipsychotic when experiencing a menopausal psychosis, which lead to further drugs being prescribed, an antidepressant venlafaxine, maximum doses, and a “mood stabiliser”.  Finally I was told that I had a “lifelong mental illness” and could not expect to recover or to come off the “mood stabiliser” lithium.  Fortunately I am a skeptic and didn’t believe it. 

I made a full recovery by 2004, under my own steam, although I had a serious leg break in March 2005 aged 53, resulting in 3 fractures to my fibula when only walking down a stair, after a library job interview.  Research now tells us that venlafaxine in maximum doses given to older people can result in bone loss.  That explains my leg break and 6 inch metal plate which is now welded to my fibula and causes me arthritic pain and cramp. 

I believe that my “lived experience” of recovery from coercive psychiatric drug treatment and stigmatising mental disorder labels has benefitted my family members, 8 of us in 3 generations, who have engaged with psychiatry and got the “severe and enduring mental illness” because of experiencing psychoses or altered mind states at times of life transitions.  And because the drugs didn’t cure anything.  I was able to advocate for my family in psychiatric circumstances and give mentoring support for those who decided to taper and come off psychiatric drugs/medication. 

I am now a writer, activist and campaigner in mental health matters because of personal circumstances and having to stand with family members, to support and protect them in psychiatric settings.  But I shouldn’t have to

The Mental Health Act for Scotland should be protecting the rights of people who have been given a mental disorder diagnosis.  Scottish Government civil servants should be supporting mothers and campaigners who are influencing positive change.  Scottish Government Ministers should be overseeing the civil servants and the mental health law so that mothers, carers and campaigners are being given their place and respected.

I hope that the Health and Sport Committee will consider my Plea.
Chrys Muirhead  17 October 2014

another critical Courier article written by a former facebook "friend" (as of 15 October 2014)

[Email sent to The Courier 16 October 2014]   

Anonymous Glenrothes woman: "If people read things like this they could end up killing themselves"

Irresponsible reporting, in my opinion.  I say this as a writer and blogger, a social networker and campaigner.  Fortunately someone has alerted me to the piece this morning by Email.  

Firstly, I don't doubt that the Glenrothes woman has found her care and treatment to be OK but others have not found it to be good.  In fact some people, I contend, have killed themselves because the treatment has been sub standard and sub human.  But I didn't say this in a news article.

Secondly, this type of prose is more suited to the tabloids than the local paper.  I would have liked to see something more sophisticated.

Thirdly, there are others who have had their human rights abused in Stratheden's IPCU and it goes back a long way.  The culture is a negative one, especially for anyone who whistleblows.

I am disappointed in seeing two articles which are critical of my complaint, both written by the same reporter who I did have as a facebook friend and who now isn't, as of yesterday.  I would recommend that you try and report incidents in a balanced manner.  It does not help the cause of patients in Stratheden Hospital to be setting one person against another. 

The fact that I had my complaint upheld by the Scottish Public Services Ombudsman was a big event in mental health circles.  It doesn't often happen as usually the "mentally ill" do not have a voice.  This is a victory for human rights in psychiatric settings. 

If you are going to be reporting on my family's story then I would appreciate, in future, that you let me know.  That is an appropriate way of behaving.

Wednesday, 15 October 2014

'Claims Stratheden Hospital patient was ‘dehumanised’ denied' a painful strapline from The Courier on 13 October 2014

I have just come upon this article in The Courier online from 13 October 2014 with the strapline:  'Claims Stratheden Hospital patient was ‘dehumanised’ denied'.

It felt like I was coming under attack again by NHS Fife health board staff for trying to protect my son and our reputation.  I am not happy with the article strapline and content.  It has caused me pain.

Here are the comments from Dr Brian Montgomery, new chief executive of NHS Fife:

"“At all times the primary concern of the psychiatric staff was the safety of both Mr Muirhead and other patients,” he said.

“NHS Fife considers that the reporting of this matter does not fully reflect the full set of difficult circumstances faced by its staff on this occasion, nor does it reflect the full terms and findings of the SPSO letter that was issued in response to the complaints made.

I have sent an Email to Dr Montgomery, in response to his comments, expressing disappointment at the strapline and what he had to say, refuting his statements that patient safety was the primary concern of the staff and stating again that to use a locked seclusion room with no toilet or water to drink, for hours on end, was and is dehumanising.  It is a matter of human rights abuse.

Tuesday, 14 October 2014

it would break your heart

I remember in 1995 when my oldest son became unwell after leaving home to go to university in Glasgow.  It was the summer after first year at uni and he began to have altered perceptions.  I knew this during a phone call from him when I was a leader at a Christian summer 'Discovery' camp at Glenshee, think it was.

I quickly went home to see what he was like and knew it was a psychosis, that he would require hospital treatment in the local psychiatric institution, Stratheden Hospital.  We lived on what used to be the hospital farm, then Elmwood College Farm as my husband was the dairyman.  My oldest son had practised driving around the grounds with me sitting beside him.

I was broken-hearted on seeing my son in a psychosis as I knew what lay before him.  And so it was but even worse than what I'd expected.  The state of care in Lomond Ward, Stratheden, was dire in 1995 and it's even worse now.  I had to keep an eye on my son back then because the nurses didn't.  There was an injury and a complaint made by me about bad practice.  Nothing changes.

It meant I had to toughen up and so I did.  There's nothing quite like disempowerment and bad practice for toughening up one's resolve.  It was either that or go under, and I definitely wasn't going to do that.  Too much was at stake.

Eventually my oldest son made a full recovery, with my support, getting off the psychiatric drugs and getting back to university in Dundee, nearer to home, where he lives now, as it happens, and where he was born, in Ninewells Hospital.  He achieved a 1st class honours degree in the summer of 1998, when I got my postgraduate diploma in community education, and has never looked back.

Then on Friday past I received an Email from a man who I've known for 5 years, first meeting him at the United We Stand conference I ran in October 2009.  He sent me his story in the Email and today told me more of what happened, following his inpatient stay as a teenager in Ward 4 (IPCU) of Stratheden Hospital in 1981.

It would break your heart.

Sunday, 12 October 2014

'Stand up to Mental Health Act' Letter by Hunter Watson, Sunday Express 12 October 2014

Email sent to NHS Fife Chief Executive Friday 10 October 2014

Here is a copy of an Email sent to NHS Fife Chief Executive on Friday 10 October 2014, with strapline:

"Fife Herald comment today by NHS Fife "a spokesman said a number of Ms Muirhead's claims were disputed""

[I am taking some "names" out of this Email, using "......" instead, but leaving in the names of those professionals and government ministers who have been copied in to this Email for information]


I am writing to you about the comment in today's Fife Herald, my local paper, regarding the piece on page 3 written by ..... 'NHS Apology is just the start':

"a spokesman said a number of Ms Muirhead's claims were disputed"  (bolding is mine)

I am wondering what claims you are referring to?  I hope that you can enlighten me.  It seems that yet again I may be on the receiving end of defensive behaviour from NHS Fife which can be perceived as bullying to a mother and carer.

Eg is it to do with the Adult Protection Investigation that I raised with Fife Council and NHS Fife whereby I was accused of psychological harm when my son was detained in the Stratheden IPCU, for at least 4 nights in the seclusion room for hours at a time, no toilet, no water to drink, light switch outside, broken hand, asthmatic?  I made an FOI request at the time, regarding observation sheets, and got no response.  This was by Email.

Or could it be the claim by me that I was not allowed to photograph my son's broken hand and bruising on Saturday 4 February 2012, and subsequently was intimidated by 5 nurses in the dining room of the IPCU at around 3pm?  I was sitting down at a table in the dining room while one nurse sat and 4 nurses stood.  They refused to let me see my son, told me he didn't want to see me.  So I went home and there was a message on my phone from my son wanting me to visit.  All of this I wrote in Email complaints at the time.  I can resend them if necessary.  Or post them to you.

Or could it be the fact that I raised a complaint about a male staff nurse behaving inappropriately towards me in the Lomond Ward on the morning of 1 February 2012.  The complaint was made, face-to-face with clinical manager ........, on 1 February 2012, at approximately 12.15pm.  My son alleges that this same nurse assaulted him on the chest later when I was out of the ward getting clothes for him from our house.  Which led to my son being face-down restrained on the floor of the Lomond Ward by 3 nurses at approx 2pm.  

I entered the ward just after 2pm on 1 February 2012 with Dr ....... (junior doctor on call dealing with the whole of Stratheden) who had come back into the ward, he said, to deal with a distressed female patient for whom the police had been called.  We both walked into Lomond Ward to find my son held face down on the floor.  He is asthmatic and has had 3 collapsed lungs.  I was put into a side room by a nurse (secluded) and was left there.  I had to phone the Mental Welfare Commission from this room to find out what was going on, spoke to ........  

And so on.  I was not informed of my son's hand injury on 1 February 2012, despite meeting at around 4pm with Dr ...... and ....... (clinical manager) in Lomond Ward, after I witnessed my son being taken in his bare feet and underpants by two porters up to the IPCU/Ward 4 in a minibus.  I stood out in the car park and saw my son's shame although he wasn't aware of it, having been drugged up with Midazolam.

I started writing Email complaints on Wednesday 1 February 2012, copied in to various other mental health personnel, not knowing at that point about his broken hand because no-one told me.  When I eventually realised the extent of my son's injuries and bruising, when I saw them with my own eyes at 6pm visiting time on Saturday 4 February 2012, I was horrified.  I got the ward doctor Dr ..... (from Borneo) to examine my son and told him I wanted an X-ray organised.  I then went to St Andrews Hospital on the Monday to witness my son's hand getting X-rayed and confirmed it was broken in a few places.  I saw the X-rays and so did my son.  It was horrifying.

But worse was to come.  I did not know the full extent of what had been going on in the ward until my son was discharged in April 2012.  My son had been abused, humiliated and quite frankly terrorised by NHS Fife psychiatric nursing staff.  And we have both had to deal with the flashbacks resulting from the abuse, the pain, the betrayal, the injustice and why?  Because my son experienced mental distress.  

I am copying in various people to this Email, including the Fife Herald reporter and my MSP Roderick Campbell.  The chief executive of the Mental Welfare Commission Colin McKay and Paul Gray, the Director General Health & Social Care and Chief Executive NHS Scotland.  Also Alex Neil MSP, Cabinet Secretary for Health, and Michael Matheson MSP, Minister for Public Health.

It is now more than 2 and a half years since the dehumanising treatment happened to my son by NHS Fife staff behind the closed doors of the Stratheden IPCU.  It has taken all that time for my voice to be heard and listened to.  The Ombudsman has upheld my complaint regarding unreasonable treatment.  And still NHS Fife seem to be intent on laying the blame at my door rather than accept responsibility for what is unacceptable health care towards a vulnerable human being.

I look forward to hearing your response.  

Yours sincerely,


Saturday, 11 October 2014

'NHS apology is ‘just the start’' Fife Herald article, Friday 10 October 2014

Online link to: 'NHS apology is ‘just the start’' Fife Herald article, Friday 10 October 2014

[I have still to receive the "official" apology by NHS Fife as instructed by the Scottish Public Services Ombudsman, in respect of my son's dehumanising treatment in the locked "seclusion room" which had no toilet, no drinking water, light switch outside]

Tuesday, 7 October 2014

Chrys Muirhead Interview Stratheden Hospital, Fife, STV News 6 October 2014

I'm speaking out about my son's dehumanising treatment in Stratheden Hospital, near Cupar, in respect of my complaint against NHS Fife health board being upheld by the Scottish Public Services Ombudsman.

working in an advisory capacity with NHS Fife in Stratheden Hospital - a question

[Here is an Email just sent to the NHS Fife Acting General Manager, Mental Health Service, copied in to the General Manager and the Chief Executive]


Following the front page national newspaper coverage of my complaint with the ombudsman being upheld I have had many people write to me and some have asked questions.

Here is an example of a question from a colleague who is a recovery educator and we work together on the Scottish Mental Health User Led Research Group:

"have you had an offer yet to work with Stratheden in an advisory capacity to ensure operating procedures change and this never happens again?"

It was a good question, it made sense, in terms of reasonable action by a health board so as to improve services.  Meaningful involvement of "experts by experience".  It's what I've been trying to do in Fife since first becoming involved in mental health work in 2008.  It's why I started up Peer Support Fife and organised many events in the local area with a range of speakers and topics.  As a community worker for over 30 years I've always believed in level playing fields, empowerment and lifelong learning.  

Therefore I want to pass on this question to you, as Acting General Manager, Mental Health Service, NHS Fife.  Are you going to invite me to work in an advisory capacity with the NHS Fife Mental Health Service in Stratheden Hospital to ensure operating procedures change and that this never happens again?

I look forward to hearing your response and will put the body of this Email into a blog post so that others can see it.

Regards, Chrys