Suicide rates in Dundee are higher than any other city council area in Scotland, according to a new report.
The Scottish Suicide Information Database also shows that men accounted for three-quarters of suicides across Tayside in the last seven years.
According to the report, there were 164 deaths caused by suicide in Dundee with an average of 16.7 per 100,000 population between 2011 and 2017.
Angus along with Perth and Kinross Councils recorded 98 and 126 suicides respectively.
For Tayside as a whole, 388 suicides were recorded with an average per 100,000 population of 14.1.
Men were more likely to take their own lives, with the rates across Scotland highest among those aged 35-54 and in deprived areas.
Nearly three-quarters of those who died had contact with healthcare services in the year before their death.
An inquiry is currently under way into NHS Tayside’s mental health services after a number of concerns surrounding the Carseview Centre.
Phil Welsh, whose 28-year-old son Lee took his own life last year, said the latest statistics were “damning”.
He said: “It’s clear that there’s a situation here that isn’t working.
“I think the fact there is an inquiry shows there’s something amiss.
“Mental health is a discussion point now but it’s all well talking, we need support for people afterwards and that is why we badly need a crisis centre.”
A spokeswoman from NHS Health Scotland said: “National suicide prevention programmes need to incorporate a comprehensive public health approach which seeks to reduce stigma, improve mental wellbeing in the whole population and address the underlying causes of poor mental health.”
The Scottish government has ordered a review of mental health services for young people in custody.
It follows recent deaths at Polmont Young Offenders Institution.
Sixteen-year-old William Lindsay died while on remand there in October and 21-year-old Katie Allan took her life in June while detained for a drink-driving offence.
Justice Secretary Humza Yousaf said the review would involve a mental health expert and HM Inspectorate of Prisons.
The review is expected to report back early next year.
It will look at mental health provision for young people entering custody, including background information ahead of their admission, reception arrangements, and ongoing support and supervision while in custody.
Mr Yousaf announced the review in a letter to the Scottish Parliament’s justice and health committees.
Health Secretary Jeane Freeman has also confirmed that NHS Forth Valley has already engaged with the Scottish Prison Service to assess and increase provision for people living at Polmont.
In his letter, Mr Yousaf said that although fatal accident inquiries would be undertaken into the deaths of William Lindsay (also known as William Brown) and Katie Allan “I have reflected on some of the more immediate questions raised particularly around the provision of mental health support and services for young people in custody”.
He said the review would look at relevant operational policies, practice and training and where practical, would also look at comparisons between the support and arrangements in place in secure care accommodation and HMP&YOI Polmont.
He added: “As with current formal inspection and independent monitoring arrangements for prisons, the review will include direct engagement with young people in custody about their experiences.
“The review will not consider the specific circumstances of recent cases which are the subject of current or future mandatory fatal accident inquiries.
“We are also aware of issues being raised about the information that is available about a young person’s history before decisions are taken that can lead to them being sent to custody or secure care. Separate consideration is being given to how best to look at these issues.”
Ms Allan, a 21-year-old geography student at Glasgow University, was convicted in March of a drink-driving offence which saw her injure a pedestrian and she was sentenced to 16 months in jail.
Stuart and Linda Allan said their daughter was bullied in Polmont YOI near Falkirk and lost more than 80% of her hair due to the state of her mental health. She died there in July.
They had called for a review of the Scottish prison system.
Mr Lindsay, who was also known as William Brown, was one of four deaths in the space of two days at Scottish jails last month.
An entry on the Scottish Prison Service (SPS) website states he was remanded at Glasgow Sheriff Court on Thursday 4 October.
He died on Sunday 7 October.
Lawyer Aamer Anwar, representing the families of Ms Allan and Mr Brown, said they cautiously welcomed the announcement of a review.
“The deaths of Katie and William were never inevitable, the system and the Scottish Prison Service (SPS) failed them,” he said.
“The families of Katie Allan and William Lindsay expect and demand a lot more to happen in the days and weeks ahead.
“Today is a good start, but the families hold Polmont responsible for suicides which took place, ultimately they failed in their duty of care.
“If this review is independent then the families wait to see the proof of that as they must be fearless in the questions they ask.”
Bosses at the health board aim to get rid of 1,300 posts to plug the hole in its finances, official papers revealed.
They say they can do that over several years through “natural staff turnover”, but it is feared cuts to backroom staffing will have an impact on patients.
The decision to shrink the workforce comes as the board benefits from having at least £62 million of debt written off by the Scottish Government.
The plans are revealed in an assurance report to the board from September.
It said there was an “acceptance that staff levels need to reduce by 10%”.
Gillian Murray, who has been campaigning for better mental health services after failings in the care of her late uncle, said the decision shows that “balancing the books obviously means more to them than saving lives”.
“People in Dundee are dying because NHS Tayside is a shambles and to cut the workforce is another slap in the face for all of us,” she added.
Murdo Fraser, the Conservative MSP in Perthshire, said: “Local people will be wondering what impact these massive reductions in staff will have on their already pressured services.”
Annie Ingram, NHS Tayside director of workforce, said no one will lose their job but said spending on the workforce is higher than health boards of a similar size.
She added: “We are carrying out a review of staff numbers, grades and skills, which is being carried out in partnership with our staff and our trades unions, to ensure we have a safe, affordable and sustainable workforce.”
He has called for “all those politicians who claim to care about justice or young people” to “consider their shameful silence on this issue”.
Responding to the latest case, a Scottish government spokesman said: “Our thoughts are with the family and friends of this young man.
“Investigations have begun ahead of the Fatal Accident Inquiry and it would therefore be inappropriate to comment on the specifics of this individual case.
“We recognise, however, that many young people entering the criminal justice system have complex needs and we work with agencies to ensure appropriate support is available when needed.”
A Crown Office spokesman said: “The investigation into the death of William Brown (or Lindsay) is ongoing and is under the direction of Scottish Fatalities Investigation Unit (SFIU).
“There will be a mandatory Fatal Accident Inquiry in due course once investigations are complete.
“The family will be kept updated in relation to any significant developments.”
An SPS spokesman said: “Every death in custody is subject to a DIPLAR (Death in Prison Learning and Audit Review), which we will conduct along with partner agencies, and that process would feed into the FAI.”
The number of university students in Scotland seeking support for mental health issues has increased by two-thirds over five years, analysis shows.
The BBC asked universities across Scotland for the numbers of students seeking some form of support.
It found more than 11,700 students asked for help in 2016-17 compared with about 7,000 in 2012-13.
The 68% increased among students in Scotland was higher than the 53% total for the UK over the same period.
University counsellors and wellbeing staff told BBC Scotland that they deal with cases ranging from anxiety, depression, gender-based violence and body dysmorphia.
The figures – obtained by the BBC’s Shared Data Unit through freedom of information requests – showed that only 12 of Scotland’s 19 universities recorded how many students sought help for their health help over the five-year period.
The data shows:
The number of students seeking help for their mental health at the University of Edinburgh doubled over five years
The University of Glasgow experienced a 75% rise in students seeking help for their mental health between 2012-13 and 2016-17
The University of Stirling had a 74% rise in students seeking help for their mental health between 2012-13 and 2016-17
Glasgow School of Art experienced a 72% increase in students seeking help for their mental health over the same period
‘Not being able to return the favour had a toll on me’
Connor Smith was in his third year studying computer games development at the University of the West of Scotland when his close friend, who was also a student, took his own life.
“I was really shook up and didn’t know what to do with myself,” he said.
“I had struggled with my mental health before but the person who took his life was able to help me out of that, so not being able to return the favour had a toll on me.”
The university’s counselling team quickly offered to help Connor.
“I couldn’t speak to my family because I felt like I was burdening them,” he said.
“I couldn’t speak to my close friends either because they were going through the same thing.”
Connor said that he was struggling not only with the death of his friend but also his future prospects.
He said: “One evening I sat down and thought ‘what am I doing?’.
“I forced myself to work at university but I wasn’t in a good mind space. I really wasn’t enjoying what I was doing.”
Connor said he did not know what would have come of his life had it not been for the university’s support.
He said: “I wouldn’t have done so well.
“I might’ve quit university and if I did that, I don’t know what I would be doing.
“I had nothing lined up as a fall-back.”
Connor returned to counselling for a second time during his final year of studying. He was struggling with stress, overeating and had money worries.
He said: “[The support] wasn’t immediately available like before but, when I did get it, being able to speak to someone was so helpful.
“University was the best stretch of my life but easily the lowest I have been as well.”
‘I don’t like the term snowflake’
Ronnie Millar, director of counselling at the University of Edinburgh, said there is a “pernicious perfectionism” among students, which can affect their mental health.
He said: “When I was at university, there were no fees and we had student grants.
“Nowadays, more students have to work in part-time jobs and study, which puts a lot of pressure on them to succeed.”
Mr Millar said it was not helpful to label young people seeking help with terms such as snowflake, which imply they are less resilient than previous generations and too emotionally vulnerable.
He said: “I don’t like the term snowflake. I think it is a pejorative.
“In terms of resilience, some students struggle more than previous generations – but that’s not pointing the finger of blame.”
Mr Millar said that while there’s been a doubling in the male students coming forward for help for their mental health, the “proportion” has stayed the same over the five-year period.
“We say to students that [counselling] is not activity just for women, it’s for everyone.”
Social media bubble
Dr Phil Quinn, head of counselling and psychological services at the University of Glasgow, said that while there was greater awareness of the help available, a “saturated” NHS had resulted in fewer community services for students to access mental health support.
He said: “We have had a record year in terms of referrals to the service, of students starting their university careers with already diagnosed mental health conditions.”
The University of Glasgow employed 20 staff in 2016-17 – ranging from cognitive behavioural therapists and a consultant psychiatrist to a counselling manager – to assist with the 2,330 students that came forward that year.
Quinn believes that staff numbers are sufficient to meet demand, and that the increase in students coming forward for help is partly down to a “24-hour social media bubble” where they are exposed to “criticism, bullying, and abuse”.
Jackie Main, who is the director of student life at Glasgow Caledonian University, said it was not just the volume of students seeking support that was increasing but the complexity of the issues they presented with.
“We see a lot more crisis students than before,” she said.
“That could mean a student is actively self-harming, threatening suicide or requires being sectioned or hospitalised.
“Crisis students experience severe emotional distress, including panic attacks.”
At Glasgow Caledonian University, the number of students seeking support in 2016-17 hit 661, up 69% since 2012-13.
Ms Main added: “Anxiety and depression are the two big issues we’ve see increases in.
“We are not a crisis support service. We don’t have the resource and it is not our job. But we don’t let students fall through the net.”
Eight of Scotland’s universities provided the BBC with their total budgets for mental health services – which in some cases included services that don’t just support student mental health, such as a disability service – in the five years to 2016-7.
It revealed an increase of 31% from £2.4m to £3.1m.
The University of Strathclyde (which did not provide complete figures for the number of students seeking help between 2012-13 and 2016-17) was the only institution to report a decrease in its overall budget over the five year period, down by 18%.
A spokeswoman for the university put the drop down to “re-structuring” and emphasised that significant investment – about £400,000 – had been made since 2017, including the creation of three full-time and 12 part-time posts on the mental health and wellbeing teams.
She said: “We have also introduced an online mental health support programme, which works hand-in-hand with our dedicated advisers and therapists, to ensure support is available for all.”
‘Finding out you’ve failed all your classes is horrible’
Hannah Moles was in her third year of studying maths at the University of Strathclyde when she approached student services for help.
Not only had she failed her first set of exams but she was also caring for her grandmother who had dementia.
She said: “My brother and I were going over three times a week to make my gran dinner, get the shopping and keep her company.
“She was really lonely.”
Hannah said that when she wasn’t caring for her gran, working in a part-time job which paid for her flat, or sleeping, she’d be in the library trying to study.
“I was really tired and had things on my mind constantly,” she said.
“So I went along to support services to see if I could calm myself down. I wanted to improve my mental state before my next set of exams.”
Hannah said that eight weeks after approaching student services, she received her first counselling appointment.
However, by this point Hannah had failed her second round of exams – meaning she wouldn’t be allowed to return for the fourth year of her degree.
“Finding out you’ve failed all your classes is horrible especially when you have put in the work but it is still not enough,” she said.
Hannah said that she was grateful to her university for providing mental health support but more counsellors would help meet the increasing demand.
“I am lucky that I got the support I needed,” she said.
“But there are lots of students who seem to need help with their mental health. I just hope that universities can keep up with the increasing demand.”
’80 new counsellors’
The Scottish government’s most recent Programme for Government promised to provide more than 80 additional counsellors in further and higher education institutions over the next four years, with an investment of about £20m.
However, there is no indication yet how the funding will be split or which universities will receive more counsellors.
Health Secretary Jeane Freeman said every student “should have access to emotional and mental well-being support”.
“We will work closely with the university and college sectors, NUS Scotland and other partners, on the implementation of the additional counsellors, and to ensure an integrated and wrap-around approach to student wellbeing in higher and further education.”
Details of organisations offering information and support with mental health issues are available at bbc.co.uk/actionline, or you can call for free, at any time to hear recorded information on 0800 888 809.
The NHS in Scotland is not financially sustainable and its performance has continued to decline, the public spending watchdog has warned.
Audit Scotland said health boards were “struggling to break even” and none had met all of the key national targets – with NHS Lothian not meeting any.
It highlighted increasing demand on NHS services, and rising waiting lists.
Health Secretary Jeane Freeman said the government was already taking forward Audit Scotland’s recommendations.
But the watchdog’s report prompted widespread criticism of the Scottish government, with the Conservatives claiming it should “make shameful reading for the SNP”.
The report said pressure is building in several areas – including the recruitment and retention of staff, rising drug costs, Brexit and a significant maintenance backlog.
It said “decisive action” was needed to protect the “vital and valued service”.‘
What does the report say?
The report warned that the NHS in Scotland is “not in a financially sustainable position”, with NHS boards “struggling to break even, relying increasingly on Scottish government loans and one-off savings”.
And it said the “declining performance against national standards indicates the stress NHS boards are under”.
The only target met nationally in 2017/18 was for drugs and patients to be seen within three weeks.
Only three of Scotland’s regional health boards met the target for patients beginning cancer treatment within 62 days of being referred
The proportion of youngsters seen by CAMHS within 18 weeks fell from 83.6% in 2016/17 to 71.2% in 2017/18.
The Scottish government invested £13.1bn in NHS services last year, but Audit Scotland said when inflation was taken into account there was a 0.2% real terms drop in cash.
Health boards made “unprecedented” savings of £449.1m, but many relied heavily on one-off savings for this, while three boards – NHS Ayrshire and Arran, NHS Highland and NHS Tayside – needed £50.7 million of loan funding from the government to break even.
This was “significantly more” than in previous years, with Audit Scotland saying four boards have predicted they will need a combined total of £70.9m in this current financial year.
The report said the “NHS is managing to maintain the overall quality of care, but it is coming under increasing pressure”, adding Brexit would create “additional challenges” for the health service.
However the scale of these challenges was “difficult to assess” because of “significant uncertainty” over the terms of the UK’s withdrawal deal from the European Union, and because data on workforce nationality is not routinely collected.
Auditor General Caroline Gardner said: “The performance of the NHS continues to decline, while demands on the service from Scotland’s ageing population are growing.
“The solutions lie in changing how healthcare is accessed and delivered, but progress is too slow.”
What has the Scottish government said in response?
Health Secretary Jeane Freeman said the government was already taking forward Audit Scotland’s recommendations.
She said NHS funding had reached “record levels of more than £13bn this year, supporting substantial increases in frontline NHS staffing, as well as increases in patient satisfaction, reductions in mortality rates, falls in healthcare associated infections, and Scotland’s A&E performance has been the best across the UK for more than three years.”
She added: “While our NHS faces challenges, common with health systems across the world, we are implementing a new waiting times improvement plan to direct £850m of investment over the next three years to deliver substantial and sustainable improvements to performance, and significantly improve the experience of patients waiting to be seen or treated.
“Ultimately we want to ensure people can continue to look forward to a healthier future with access to a health and social care system that continues to deliver the world-class compassionate care Scotland is known for.”
What other reaction has there been?
Conservative health spokesman Miles Briggs claimed the NHS was “facing an unprecedented challenge” with boards across the country “staring into a black hole of more than £130m.
He said: “For a government which has been in charge for more than 11 years, this should make shameful reading for the SNP.”
Labour’s Monica Lennon added: “After more than a decade of SNP complacency our NHS is in crisis.”
Dr Lewis Morrison, chairman of the British Medical Association (BMA) in Scotland, said the “stark warning” from Audit Scotland “could not be any blunter”.
But he added this would “come as no surprise to frontline doctors who have faced the consequences of inadequate funding year after year”.
And RCN Scotland director Theresa Fyffe said the report “underlines what those in the nursing profession have been warning about for a number of years – an unsustainable pressure on staff to deliver more care.
“This leads to staff burnout and, in some cases, a choice between staying in the profession and their own health.”