VACANCIES for consultant psychiatrists in Scotland are now the highest on record, with nearly two thirds of unfilled posts lying empty for more than six months.

Vacancy rates were highest among specialists in old age psychiatry, with almost one in five (17.4 per cent) of posts empty at a time when incidence of dementia is soaring.

Brian Sloan, Age Scotland’s chief executive, said: “The rising number of staff vacancies to support people with dementia is sadly not surprising.

"The social and health care sector in Scotland is under enormous pressure with problems recruiting and retaining staff.

"However, it means that older people living with dementia are not properly supported through their diagnosis or needs.

"With the right support people with dementia can live well and independently.

"More must be done to encourage people to see old age psychiatry care as a fulfilling career and this includes better pay packages.”

Read more: End 'inequality' of terminally ill dementia patients paying for their care, urges report

One in 10 positions for child and adolescent psychiatrists are also vacant amid criticism over lengthy waiting times for young people experiencing mental health crises.

The latest figures from ISD Scotland show that more than a quarter of children and teenagers are waiting longer than the 18 week target for treatment in the Child and Adolescent Mental Health Service (CAMHS), and that nine out of Scotland's 14 health boards had failed to ensure than 90% of CAMHS patients were seen on time.

NHS Grampian, Borders and Tayside were showing the greatest strain with fewer than half of CAMHS patients getting a first appointment within 18 weeks. In Grampian, the median wait was 25 weeks.

The data also shows that 198 out of 453 young people admitted to hospital for mental health care in 2017/18 were treated in adult inpatient psychiatric wards due to bed shortages in CAMHS units.

Read more: Warning young people becoming 'extremely ill' before they meet criteria for CAMHS treatment

The Scottish Children's Services Coalition said the Scottish Government is making "great efforts" to improve mental health provision, including pledging an extra £250 million in funds over the next five years, but said the latest figures were "clearly disappointing".

A spokesman for the SCSC said: “There must be a radical transformation of our mental health services, with a focus on preventing such problems arising in the first place and intervening early, especially when we know that half of all mental health problems begin before the age of 14.”

In the past five years alone, the total number of consultant psychiatry vacancies in Scotland has spiralled more than threefold, from 21.5 to 72.5, based on the whole-time equivalent measure used to adjust for part-time working.

As a headcount, the shortfall in psychiatrists has increased from 23 to 75, of which 49 - as of December 2018 - had been empty for six months or more.

It is the highest number of vacancies since records began in 2003, and puts the overall vacancy rate for consultant psychiatrists in Scotland at 12.1%.

Read more: From overcrowded asylums to a shortage of beds, has psychiatry in NHS Scotland come full circle? 

The actual number of staff in post has also dwindled from a peak of 554.7 in September 2016, to 526.5, indicating that the increased vacancy rate has been driven in part by consultants leaving the NHS and not just an increase in the number of posts being created.

Dr Linda Findlay, vice-chair of the Royal College of Psychiatrists in Scotland, said: “Workforce is one of the biggest challenges facing the mental health sector and this 31% increase in vacant posts is deeply concerning.

“The Royal College of Psychiatrists’ ‘Choose Psychiatry’ campaign is intended to encourage medical students to choose a speciality which is increasingly in demand.

"The campaign has already produced results across Great Britain, with a 25% increase in the amount of doctors choosing psychiatry in 2018 compared with 2017.

“The College will be running its next workforce census in 2019 which will provide detailed analysis of the psychiatric workforce in Scotland, England, Northern Ireland and Wales.”

It comes as BMA Scotland hit out at an “ongoing and worrying” overall level of consultant vacancies across NHS Scotland.

The ISD Scotland figures show that there was a total consultant shortfall of 412, including 252 posts not filled after six months.

However, the trade union has previously voiced concerns that the true picture is likely to be much worse, as the official statistics do not take into account posts that have not yet been advertised or which are removed after recruitment efforts fail.

Dr Simon Barker, chair of BMA Scotland's consultant committee, said: “Vacancies – and long term vacancies in particular – continue to be an ongoing and worrying problem in the NHS.

"Too many posts are lying empty for far too long, and this is impacting on the care we as doctors are able to provide.

“There are just not enough doctors working in the NHS, which means those in post have to work doubly hard to cover the work of colleagues who simply don’t exist.

“What makes this problem worse is that the figures are still not telling the full story and indeed are hiding the real scale of vacancies among the consultant workforce.

"Vacant posts are still being left out of these figures for various reasons. This just isn’t acceptable."

A Scottish Government spokesman said: “We recognise the pressures Health Boards face in relation to staffing recruitment and retention, and we are working to address some of the underlying challenges in the specialities concerned.

“Although there remain unfilled consultant psychiatrist vacancies in a number of health boards, over the past five years we have increased the number of posts and in 2018 we saw a significant improvement in recruitment to psychiatric specialities.

“There has also been an increase of 15% (11.8 WTE) in the number of CAMHS psychiatrists since this additional funding came into place in March 2016.

“We are investing £54 million in a comprehensive package of support to improve access to mental health services for adults and children, providing funding for additional staff and  workforce development.”