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 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.”
SCOTLAND’S most senior civil servant has been commended for speaking about her personal experience of mental health problems.
Permanent Secretary Leslie Evans said she had worked through “several tough and very stressful episodes” in the past, and had seen a health professional at one point.
She shared the information with Scottish Government staff in a personal blog in July, and yesterday made it available publicly on the government’s website.
She said she wanted to help stamp out the stigma surrounding mental ill-health.
Ms Evans had been a low-key figure since being appointed Permanent Secretary in 2015.
But she was thrown into the public spotlight last month when it emerged she had investigated sexual misconduct allegations against Alex Salmond, and the former First Minister launched a legal action against her handling of the case.
Ms Evans did not identify her particular mental health experiences, but they are understood to predate her time in the civil service.
Nicola Sturgeon this week announced an extra £250m for mental health services, particularly those required by young people.
In her “Catch up with Perm Sec” blog on 2 July, Ms Evans included a section on mental health which stressed the importance of good mental health and wellbeing at work.
She wrote: “Last week I took part in an open and frank session at Victoria Quay [the government office in Edinburgh] which reflected on our mental health experiences as individuals, how this informs the culture of our organisation, and where we need to improve mental health and wellbeing support.
“Like many people I have worked my way through several tough and very stressful episodes. What helped me was the support of my line manager, on one occasion seeing a health professional, and the continuing support of my friends and family.
“We all have a role to play in stamping out stigma surrounding mental health and improving our workplace culture.”
Calum Irving, director of See Me, the Scottish campaign to end mental health stigma and discrimination, said: “I was fortunate to hear Leslie speak very passionately about mental health at work and to share her own experience. It is a very challenging thing to do but can have a profound effect, especially coming from people in leadership positions.
“Workplace discrimination because of mental ill health is sadly still commonplace and it prevents people from being treated equally. So concerted action from senior leaders is very much needed, to ensure that we can all live fulfilled lives.”
In recent years, a series of politicians and public figures, including MPs and Prince Harry, have spoken about their experience of mental health.
But Scottish LibDem health spokesman Alex Cole-Hamilton said it was rare for officials to do likewise.
He said: “This is very brave of Leslie and hopefully will give courage to others to come forward and talk about things they might have been going through.
“We often think of the civil service as quite severe and dry place to work. It’s really significant that the most senior civil servant in the land has paved the way for this traditionally quite conservative profession to open up about mental health and I commend her for it.”
Ms Evans is being taken to court by Mr Salmond over her handling of two complaints made against him in January which relate to his time as first minister in 2013.
He is challenging the investigatory process through a judicial review at the Court of Session, drawing on a £100,000 war chest funded by a controversial online appeal.
Ms Evans also referred to Mr Salmond’s case in her blog of 27 August.
She said: “You will appreciate that for legal reasons I am unable to say anything further at this point, but I can assure you that the Scottish Government will defend its position vigorously. I shall update you as and when I can.
“In line with work already underway to tackle inappropriate behaviour, and in consultation with our trade unions, we are carefully considering any issues about culture and working practices.”
We were having coffee when my friend took the call to say her brother was in the waking nightmare of psychosis.
He has been battling mental ill-health for many years and the family saw this coming in symptoms building over weeks.
They had seen it many times before – the paranoia, the withdrawal, the aggression, the fearful phone calls.
When a loved one has a chronic mental illness, the family exist in a bunker made of matchsticks, waiting for the blast.
This is not the flu, so popping round with soup is not the answer.
A loved one adrift in an alternative reality is tortured by voices, delusions and false beliefs.
As the crisis mounted, my kitchen became the war room and my friend knew the drill.
Calls were made to the out-of-hours psychiatric crisis team, a path well-trodden over the years, the same case history being painstakingly told each time, a five-minute micro-biography of chronic relapsing illness, rattling through the litany of distressing symptoms, the past suicide attempts, to the current state of unravelling.
For weeks, fears had been raised to a care team. Medication wasn’t being taken, such is the nature of the illness, and things were slipping fast. The notion of coming to harm wasn’t just a fear, it was a reality.
This persuasion was laborious. Imploring a team of strangers towards the goal of seeing your sibling on an acute psychiatric ward is certainly no prize.
Emergency teams visited but left, unconvinced he was in need of immediate hospitalising, despite the numerous red flags from a family well-educated in the symptoms over a lifetime of care.
The following day, another visit, which ended after three minutes when my friend’s brother asked the nurses to leave.
Four hours later there was a phone call. He’d been found at a well-known suicide spot, after police were tipped off by a concerned member of the public.
If the potential killer in his brain had been an aneurysm, he would have been treated straight away.
But the response to his medical emergency was an ambulance with no wheels.
This is Mental Health Awareness Week, an attempt to open up discussion around a subject too long whispered about in the shadows.
So let me shout it from the rooftops – Scotland’s mental health services are not fit for purpose.
The spotlight fell on mental health services in Tayside after the case of David Ramsay was raised at First Minister’s Questions.
The 50-year-old took his own life in 2016 after twice being turned away from the Carseview unit in Dundee and told to take a breather, take his dog for a walk.
There are calls for a public inquiry but why limit it to Tayside when such services across the whole of Scotland are equally broken?
Research has shown that two-thirds of us experience a mental health problem in our lifetime, a third have considered suicide and too many follow through on it.
It is laudable that in Mental Health Awareness week, we are being urged to talk about stress, depression and disorders of the mind but sometimes words are not enough.
In an editorial this week, Nicola Sturgeon urged people worried about mental health problems to contact their GP or NHS 24 , akin to recommending a water pistol to tackle a blaze.
Care is defined as the provision of what is necessary for the health, welfare, maintenance and protection of someone.
By such definition, our care in the community is a derisory misnomer, commodifying our most vulnerable with pitiful ever-decreasing budgets.
I don’t know the answers – that’s what my taxes pay the experts for. But I do know we should no longer tolerate the insanity of doing what amounts to nothing at all.
More than 5,000 young people in Scotland have been denied mental health treatment during the wait for a national probe into rejected applications.
Nicola Sturgeon was challenged repeatedly at First Minister’s Questions on her government’s progress in tackling mental health issues.
Scottish Labour leader Richard Leonard said the SNP administration has let down vulnerable children by taking more than a year to complete an investigation into why so many youngsters are not getting the treatment they seek.
In Tayside and Fife alone, 816 young people have been knocked back by Children and Adolescent Mental Health Services since last March, when the government promised to launch the review.
Labour’s analysis of the Scottish Government figures showed the national figure was 5,410.
“Nicola Sturgeon once claimed she had a sacred responsibility to make sure every young person gets the same chance to succeed,” Mr Leonard said.
“She has abdicated that responsibility to some of the most vulnerable children in Scotland.”
Ms Sturgeon said the results would be published on June 12, adding there are legitimate reasons why children are not offered CAMHS treatment.
“We announced an audit, we had to plan how that audit was going to happen so that we get it right,” she said.
“The work is now underway and I’ve given the progress report on that.
“It’s important that we get that work right in order that the action that flows from it are the right actions.”
She added that the 2017/18 budget for mental health exceeded £1 billion for the first time, while the CAMHS workforce has increased by 65%.
Meanwhile, Jenny Marra, the Labour MSP, asked what progress had been made towards setting up an emergency mental health unit in Dundee that provides 24-hour support.