One in four consultant psychiatrist roles are currently vacant across the NHS in Scotland amid warnings that the service is "desperately struggling".
Freedom of information responses from health boards reveal that 162 out of the 586 consultant psychiatry posts have no permanent appointee in place - equivalent to a 28% shortfall in senior clinicians.
Vacancy rates are much worse in some parts of the country, however, with Fife and Borders both reporting that 46% of their consultant psychiatry posts were unfilled on a permanent basis.
In NHS Grampian, the figure was 43% and in NHS Highland it was 37%.
Forth Valley has not yet responded and NHS Tayside said it did not hold the information "in a centralised location".
The figures come after MSPs were told that hospital mental health services were "in a death spiral" due to over-reliance on temporary locum psychiatrists to plug gaps.
The responses show that a total of 117 out of the 162 vacant posts are currently filled by locums, meaning they account for a fifth of all consultant psychiatry staff in Scotland.
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Both Shetland and Western Isles reported having no permanent consultant psychiatrists in place, although between them they had three locums.
Official workforce statistics do not count locum-filled posts as vacancies, leading to criticism that the true scale of staffing shortages is being concealed.
In November, Dr Pavan Srireddy - vice chair of the Royal College of Psychiatrists in Scotland - told Holyrood's Public Audit Committee that a "critical loss" of permanent consultants was jeopardising the health service's capacity to provide training and supervision to younger medics and to carry out critical incident reviews to learn from mistakes - functions that a locum consultant does not perform.
Permanent consultant psychiatrist numbers had become "so low that it has become virtually impossible to provide a safe service, let alone a good quality service, in large parts of the country", said Dr Srireddy.
The FOI requests were submitted by the Scottish LibDems.
The party's leader and health spokesman, Alex Cole-Hamilton, said: “There is a dangerous staffing crisis within NHS mental health services, with vacancies at particularly high level in rural and remote parts of the country.
“A significant number of the most senior mental health roles are either lying empty or being filled on a temporary basis, carrying grave repercussions for both staff and patients.
"These vacancies will only add to the devastating waiting times that thousands of children and adults are already having to endure, while putting existing staff under further pressure and strain.
“The SNP Government has compounded this emergency by stripping £50 million from the mental health budget last winter, a reckless decision that was swiftly followed by Humza Yousaf breaking his personal commitment to clear waiting lists by the spring.”
It comes after Dr Joanna Bredski, a consultant psychiatrist and chair of BMA Scotland’s consultant committee, told the Herald that hospital mental health services were becoming overwhelmed by referrals for patients with "normal negative emotions".
Reacting to the latest figures, Dr Bredski said: “We have always said some specialities – like psychiatry – are particularly badly impacted and the vacancy levels these FOIs show represent a service that is desperately struggling.
"This is at the same time as demand for these services has increased – leaving people waiting far too long for treatment and doctors struggling desperately to provide the best care possible.
"Add in treatment targets that at best are unrealistic and at worst making it hard to see the people who need help the most, and we are looking at mental health services in Scotland stretched well beyond what we can reasonably expect them to deliver."
Mental wellbeing minister Maree Todd said mental health staffing in the NHS is at a "record high".
She added: "More than £1.3 billion will support mental health services, with £290.2 million direct investment - more than double that in 2020/21 - enabling record numbers of staff to provide more varied support and services to a larger number of people than ever before.
"We've exceeded our commitment to fund over 800 additional mental health workers in A&E departments, GP practices, police custody suites, and prisons. We are taking steps to continue to grow the mental health workforce.
"We're committed to improving mental health service provision in primary care settings and focus more on prevention and early intervention in the community, providing high-quality mental healthcare in general practice."
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