 Management of psychiatric patients in remote areas is a concern |
An investigation into the management of psychiatric patients in remote areas has identified a "very high level of concern" among health workers. The investigation by an NHS Scotland-funded body found that staff may have been exposed to "highly stressful" situations and "unacceptable risks".
The report also revealed cases of patients being placed in police cells, a practice it deemed "inappropriate".
It recommended that a Rural Mental Health Network should be set up.
Highly stressful
The network would share good practice and encourage collaboration between NHS boards for the safe management of psychiatric patients in remote areas.
The report, by the Remote And Rural Areas Resource Initiative (Rarari), was presented by its author, Arran GP Dr Malcolm Kerr.
He said: "The project has identified a very high level of concern and in some instances frustration among health and social services workers at the problems they face during mental health crises.
"Incidents occur infrequently but are highly stressful for all involved and may entail unacceptable risks.
"It is strikingly apparent that much of the current service hangs on good will."
The report documented the various issues facing staff and patients in remote and rural areas.
The most pressing issues were transport and escort, the uses of "places of safety", clinical governance issues and the availability of appropriately trained staff.
The case studies highlighted in the report indicated the wide variety of accommodation pressed into use as a "place of safety".
These included the use of police cells, which although at times were unavoidable, were deemed inappropriate in the report's recommendations.
Rarari Chairman Stewart Whiteford said: "If you are physically unwell, even in remote areas, there are very clear pathways for rapid access to appropriate health services, but this is not always the case for the mentally unwell.
"Various solutions are being developed in isolation without collective support and co-ordination and I commend the suggestion of the establishment of a Mental Health Network."
The report has made 10 recommendations, including robust psychiatric emergency plans, protocols and standards, better transport and escort arrangements, as well as the establishment of the Mental Health Network.
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If you are physically unwell, even in remote areas, there are very clear pathways for rapid access to appropriate health services, but this is not always the case for the mentally unwell. 
