A damning review of mental health services in Tayside has found suicidal patients were regularly delayed access to proper treatment.
Inspectors blamed a lack of leadership for people not getting the right intervention “at the time of greatest need”.
The Healthcare Improvement Scotland (HIS) study, published on Thursday, highlighted inequalities across Dundee, Angus and Perth and Kinross, with patients in some areas waiting up to 12 weeks for a routine assessment, compared to two weeks in others.
NHS Tayside has been told resolving management issues is a top priority, with leadership highlighted as a “significant concern”.
The review follows the release earlier this year of an independent review by Dr David Strang, which called for a radical redesign of the area’s mental health services to repair a breakdown in trust.
Mental health charity Plus Perth said it feared this latest review could interfere with ongoing efforts to meet Dr Strang’s recommendations.
“NHS Tayside need to be given time to address the totality of the independent inquiry, rather than focus on detail which may ultimately change when the service redesign is finalised,” said the charity’s development manager Susan Scott.
HIS officials carried out its review over three separate weeks between January and March.
The report stated that a national shortage of psychiatric consultants had led to “too many ever-changing locum consultants” which, coupled with a large number of staff vacancies, “tips the balance with regards to the provision of care into a significant risk for the service.”
Officials found staff spent “considerable” amounts of time and energy supporting new locum psychiatrists. “We were told by staff how this makes daily working life even more difficult while trying to deliver a service where demand far exceeds capacity,” the report notes.
“The need to constantly adapt to and monitor the work of a new doctor creates its own risks due to the distraction it causes.”
It said the “lack of leadership and management of the situation is an area of significant concern which NHS Tayside and the partnerships need to address as a priority.”
The review said community mental health teams were regularly accepting referrals of patients with “vague suicidal thoughts” when they may have been better being sent to third sector organisations or primary care services.
It states: “Current working practices may be detrimental to the person receiving care due to the delay in receiving the most appropriate intervention at the time of greatest need.”
Just over half of GPs questioned by the review team said they knew about the referral criteria for mental health teams.
The report also highlighted a “disconnect” between senior leadership and frontline staff, which had led to low morale and staff feeling they weren’t listened to.
Ann Gow, HIS deputy chief executive and director of nursing, said: “The main focus of this review was to find out if people referred to community mental health services in Tayside have access to care where and when they need it, and if they are able to move through the system easily to receive appropriate care in the right place at the right time.
“We found that this is not always the case for everyone.”
Apart from concerns about leadership and management, she said the team observed ” a very committed workforce from all specialties across the service and identified areas of good practice which had a positive impact on patient care and services.”
A statement from NHS Tayside and Angus, Dundee and Perth and Kinross Health and social care partnerships said: “We will now ensure that the actions and recommendations set out in the report are progressed through the improvement work already under way across mental health services Tayside.
“Today’s report also highlights a number of examples of good practice with the HIS review team observing a very committed workforce from all specialties across mental health services.
“We made a promise to the people of Tayside that we will listen, learn and change in response to the independent inquiry and the further actions which we will take from today’s report reinforce that pledge.”
