Covid Scotland: 'I'm in limbo, there's no-one to refer me to', says patient, amid concern over gaps in psychiatrist workforce

Concerns have been raised over some Scots being left without access to a psychiatrist due to staffing gaps.

One woman in Edinburgh has been unable to get a diagnosis or treatment for suspected ADHD, as she was told there is no psychiatrist available on the NHS in her area.

The Royal College of Psychiatrists in Scotland (RCPsych) said the workforce has been “depleted” in the short and long term, and urged the Scottish Government to take urgent action.

Susana Ramos Sanchez, 34, went to her GP in south Edinburgh in December after realising she had symptoms of ADHD.

Susana Ramos Sanchez has not been able to get a referral to a psychiatrist in Edinburgh.

He agreed to refer her to a psychiatrist, but later said this was not possible as the local psychiatrist had retired, and he could not refer her outside the area on the NHS.

Ms Ramos Sanchez said while she understands the NHS is busy, having no option had left her “in limbo”.

"Without a diagnosis, I cannot access cognitive behavioural therapy and I cannot access medication,” she said.

“If you look at a private assessment, we're talking about over £1,000 … I can’t afford that.”

The pandemic has exacerbated her symptoms, Ms Ramos Sanchez said, leaving her feeling “broken”.

“I need to keep going,” she said. “I have a mortgage and I have two pets, so I have to pay for things.

“I'm just asking for a bit of support, like trying to teach my ADHD brain how to understand itself, and how to cope with the things that my brain struggles with, maybe along with some medication or some cognitive behavioural therapy.”

NHS Lothian said health boards across the country were struggling to recruit psychiatrists, and interviews for a replacement in Ms Ramos Sanchez’s area will begin in a month, with some locum cover in the meantime.

“We have multi-disciplinary teams who can provide a range of support according to a person’s individual needs, and patients are prioritised accordingly,” said Tracey McKigen, services director of psychiatric hospital Royal Edinburgh.

Dr Jane Morris, RCPsych Scotland vice chair, said lengthening waiting lists were “very sad”.

"The workforce is not only exhausted, but it is literally depleted,” she said. “We've got a hugely increased waiting list.”

There is still “enormous satisfaction” working in psychiatry, she said.

"I really do hope we can train up more young doctors, because this is certainly the time when mental health is going to contribute the most to society's recovery,” she said.

Ian Murray, Labour MP for Edinburgh South, said he has been contacted by constituents seeking psychiatric services who felt “let down and abandoned”.

He labelled the gaps “deeply worrying” and called on the Scottish Government to address these as an “urgent priority”.

Mr Murray said: “We are facing a crisis in our health service that must be the top priority for the Scottish Government and not another referendum.”

Minister for mental well-being Kevin Stewart said: “We know the pandemic continues to have a substantial impact on people’s mental health and that the demand for psychiatric treatment continues to grow.”

The Government is committed to expanding the psychiatric workforce, he added, with a 25 per cent increase in whole-time equivalent psychiatric consultants since 2006, and an increase of ten places for core psychiatry students this year.

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