A RETIRED teacher is calling for a change to the way doctors deal with sharing information about patients with mental health issues after her son died following a long battle with depression.

Had Barbara Bauld, 72, been aware of the medication her son Douglas was prescribed – and the side effects she claimed exacerbated his problems – she would have been better equipped to help support him, she said, and perhaps have saved his life.

Doctors were unable to tell Mrs Bauld, a former teacher in Cumbernauld and at Bearsden Academy in East Dunbartonshire, details about her son's medical problems and subsequent medication as he had asked them not to.

Guidelines from the General Medical Council (GMC) forbid doctors from sharing patient details without explicit consent.

Mrs Bauld argues her son was not in a fit state to make that decision.

Whenever she tried to get help for Douglas and talk to medical staff, they cited data protection as a reason for not engaging with her, she said.

She believes his illness was not treated appropriately and he was left to fend for himself, leaving him a danger to himself and to others.

"Douglas had no idea what reality was, he suffered from hallucinations and believed he was being attacked, yet he was put on heavy-duty anti-psychotic drugs and sent home alone without supervision or any family members warned to keep an eye on him," she said.

"Relatives or carers should be treated as equal partners in providing help and support with the NHS."

Douglas's problems began in 2010 when he was made redundant from his job at Kelvin Kitchen, Bedroom and Bathroom Systems in Cumbernauld and split up with his girlfriend. His father was then diagnosed with cancer and later died, sending Douglas on a downward spiral.

"I was aware of his depression but he wouldn't speak to me about it," Mrs Bauld said. "He was a typical Scottish man, 'everything is fine'. You didn't talk about things like that. He was aware of the stigma around mental health and didn't want people to know."

Douglas returned to live with his mother and was prescribed antidepressants.

"One time, he woke me up in the middle of the night waving an air rifle about," Mrs Bauld said. "He believed we were being attacked. One of the side effects of the drugs was hallucinations but I didn't know that at the time.

"I was completely in the dark [about his medication] but officially I was his carer as far as the Department for Work and Pensions (DWP) were concerned. But the DWP didn't share this information with the GP so I wasn't allowed any information. The doctors sent me away and told me not to interfere when I tried to talk to them."

Mrs Bauld initially believed the symptoms her son displayed were as a result of his depression or his self-medicating with valium and alcohol. She later found out they could be linked to the drugs he had been prescribed by the doctors at Abronhill health centre in Cumbernauld.

"That sits heavily with me now. If I had done something about it then he might still be here."

Despite numerous attempts to talk to Douglas' doctor, Mrs Bauld kept hitting a brick wall. Meanwhile, Douglas's condition was worsening.

"He thought he was under attack when he wasn't," Mrs Bauld said. "He shuffled and he stumbled, he was quite capable of setting the kitchen on fire. The drugs also caused him a lot of muscle pain. He put on a lot of weight. You could see the physical deterioration. He was shaking so much that he couldn't write. He was self-medicating with alcohol and illegal drugs. As time went on, it was anything and everything. It sounds awful to say it but he was proud of the fact that he wasn't injecting heroin."

Douglas had moved out into a flat on his own where, on one occasion, Mrs Bauld found him staggering around and lighting cigarettes, one after another, and dropping them on the floor.

"He didn't know what he was doing," she said. "It was a miracle the flat didn't burn down. They were sending him home on heavy duty medication and not telling anyone. That was totally irresponsible; it was an issue of public safety, not just his."

In 2014, Douglas went to an addiction service run by NHS Lanarkshire where he was assessed by psychiatrists.

Mrs Bauld said he wanted to get better and he kept taking the prescribed drugs.

"I think they zombified him," she said. "He escaped the emotional pain of depression.

"The crux of my complaint was he was being prescribed drugs that were making things worse. They were creating the problem.

"He went from being a funny, irreverent, good-looking man, with a quick silver intelligence, to obese, incoherent and in pain."

Douglas was found dead aged 42 in his home in Cumbernauld on February 25 last year.

The cause of death was undetermined but a post mortem found traces of heroin, cocaine, morphine, etizolam (an anti-anxiety medicine) and cardiac enlargement.

Mrs Bauld found the medication he had been taking in the house and investigated the side effects.

He had been prescribed quetiapine, which has suicidal thoughts listed as a common side effect, pregabaline, which has memory impairment and tremors as a common side effect, chlordiazepoxide, which also has a suicide risk warning in patients who abuse drugs or alcohol or suffer from depression.

"It seemed obvious to me they should not have been prescribed to someone in his situation," she said.

"I think he had given up, he had no reason to go on living. He was so physically incapable by the time he took heroin it finished him off. It wouldn't have done so if it wasn't for the 'treatment' he got from the NHS."

Ultimately, Mrs Bauld believes family members can play a crucial role in helping support patients in society, working with the NHS to provide an integrated support system.

She is not calling for full disclosure of someone's medical history or treatment, but a "commonsense" approach where doctors or medical staff could alert family members if drugs with potentially harmful side effects are prescribed to enable them to "keep a closer eye" on their relative.

Abronhill health centre in Cumbernauld did not respond to a request for comment but, in documents sent to Mrs Bauld, Dr Steven Twaddle said they were bound by GMC rules on confidentiality of medical information.

He said: "The drugs were prescribed by ourselves in association with the NHS Lanarkshire addictions service. Our approach is always to minimise any risk to patients by only prescribing drugs that are necessary for the relief of symptoms and trying to avoid potentially harmful effects.

"Douglas contacted the practice on many occasions looking for drugs and we always tried to keep his medication as safe as possible. We could not share details of Douglas' health without his explicit consent. Douglas had been seen by the psychiatry team at Monklands hospital who concluded he did not have a mental illness and was capable of making his own decisions."

NHS Lanarkshire told Mrs Bauld that it was standard practice for them to discuss patients' wishes with regard to sharing information.

"This is done not only to determine if they are happy for us to share information but to give professionals an opportunity where appropriate to highlight the benefits of support from family members/carers."

But they said that "ultimately, it is a patient's right to ask for information not to be shared and we must respect that, both while a patient is alive or deceased".

Janice Hewitt, chief accountable officer for the health board, said they were duty bound to accept Mr Bauld's wishes that he did not want clinical information shared with respect to his care and treatment.

She admitted that there may been "barriers" to Mrs Bauld sharing her concerns about her son with the health professionals.

She said: "We appreciate that staff awareness and training may be required in terms of how staff respond when they receive concerns from a relative/carer about a patient or service user and how this is escalated to the appropriate clinician.

"As a direct result of Mrs Bauld's concerns we are working to review our patient/carers information leaflets with regard to information sharing and also the wording that appears on letters around this."

Frances Simpson, chief executive of Mind Scotland, told The Herald on Sunday that it was a "very common and complex issue."

She said: "The law protects people with mental illness by ensuring that they maintain control where at all possible – although there are circumstances where medical professionals can make decisions without their permission but there are safeguards in place to make sure that their rights are still protected.

"However, when people are very unwell, family members particularly can feel very excluded as, although they have a right under the legislation to have their views taken into account, and to be given information that helps them in their caring role, but in fact their right to be involved does not over-rule an individual's rights protected by the law."

She acknowledged it could lead to a "very frustrating" situation for family members.

She said that Mind believed family members could give valuable insights into the situation and professionals should "do what they can to to inform and reassure families without breaching confidentiality".

She added: "This is not simple and requires good professional judgment and also skills in communicating general information that can reassure and inform; without giving away detail.

"The Mental Welfare Commission has already produced guidelines for professionals on how to deal with this, and these guidelines have been widely circulated; but we still find that families are simply given a blanket 'we can't tell you anything' when in fact there is information that might be given in ways that allow the person who is unwell to be protected."

The Scottish Association for Mental Health (SAMH) declined to comment on the case but referred to an answer they submitted to the Scottish Government last year in response to a request for a change to the law on consent.

Annette McKenzie, from Glasgow, launched a petition and told MSPs parental consent should be needed to prescribe strong mental health medication to under-18s after her daughter Britney died after taking an overdose of beta-blockers that she had been prescribed without her parents' knowledge.

SAMH said: "We share the view of the GMC that without assurances about confidentiality, children and young people may be reluctant to get medical attention or to give doctors the information they need to provide good care.

"However, the GMC’s guidance makes clear that confidentiality can be breached if it is in the public interest: this would include the interest of protecting the patient."

The mental health charity said it was unable to support the request for a change to the law on consent because it feared it could put people off seeking help.

The GMC told The Herald on Sunday that its guidance stated that if a patient refused to consent to information being disclosed and the doctor felt it was necessary for their protection, they should warn them of the risks of refusing to consent. Ultimately, however, the doctor "should usually abide" by the patient's refusal.

If the person is judged not to have the capacity to make a decision, however, "doctors may disclose personal information if it is of overall benefit to a patient".

The spokeswoman said: "If a patient who lacks the capacity to make the decision asks a doctor not to disclose personal information about their condition or treatment, which the doctor considers important to disclose, the doctor should try to persuade them to allow an appropriate person to be informed and involved in their care.

"If the patient refuses, and the doctor is convinced that it is of overall benefit to the patient, the doctor may go ahead and disclose relevant information to an appropriate person or authority.

"The guidance also emphasises that doctors must be considerate to those close to the patient and be sensitive and responsive in giving them information and support, while respecting the patient’s right to confidentiality.

"Confidentiality is not in itself a reason to refuse to listen to those close to the patient and doing so can be helpful to the patient’s care, for example by providing additional insights into a patient’s condition."

Statement from NHS Lanarkshire:

DR Steve Conroy, lead GP for addiction services in Lanarkshire, said: “Like all health boards, NHS Lanarkshire and its staff are governed by national legislation and professional codes of conduct in relation to patient confidentiality.

“It would be a serious breach of professional conduct by the national bodies which regulate medical and nursing staff, for any member of staff to break confidentiality against the will of a patient receiving a service.

“For some services, there is also evidence to show that in some instances, a guarantee of confidentiality is the only basis in which some people will come forward for treatment.

“Ethical guidance by the General Medical Council (GMC) states that, as a principle, adults who have capacity are entitled to make decisions in their own interests, even if others consider those decisions to be irrational or unwise.

“It goes on to state that staff should explore the patient’s reasons for this and warn the patient of the risks of refusing to consent.

“However, if the patient is deemed to have the capacity to make their own decisions, staff should abide by the patient’s refusal to consent to disclosure.

“In such a situation, staff would also give a patient the information and support they need to make decisions in their own interests.”

Have you been affected by the issues raised?

Samaritans 116 123

Breathing Space 0800 83 85 87

CALM is the Campaign Against Living Miserably (for men aged 15 to 35) 0800 58 58 58

Mind 0300 123 3393

SANE 0300 304 7000