Psychiatry in Scotland will remain under strain without investment, study shows

A study has shown that without investment psychiatry in Scotland will “remain under severe strain” as posts across the country are not being filled.

Figures from a Royal College of Psychiatrists (RCPsych) workforce census show that, at the end of March 2025, there were 642 consultant psychiatrist posts across Scotland and more than a quarter were either vacant or only covered by locum staff.

Dr Jane Morris, chair of the college in Scotland, said: “We’ve been warning for years that Scotland is struggling to retain experienced psychiatrists. This latest data shows that the problem is not improving – and in some areas it is getting worse.

“Behind these figures are overstretched teams, longer waits for patients and a growing pressure on clinicians.

“Despite repeated warnings in successive workforce censuses, we are continuing to lose experienced consultant psychiatrists from Scotland’s services.”

The findings, from a survey completed by 11 out of 14 health boards alongside specialist organisations, including the State Hospital and the Mental Welfare Commission, highlight that many psychiatry jobs are not permanent.

It said there are similar pressures in other senior psychiatry roles with about one in nine speciality and associate specialist posts either vacant or not permanently filled.

The RCPsych report also highlights that in the north of Scotland, almost half of consultant posts (45%) are empty or filled by locum staff.

The college has said it is concerned by the particular strain on general adult psychiatry as the Scottish NHS Census 2025 showed that 45% of all adult patients recorded were seen by a consultant with a “general psychiatry” specialty.

The college also raised concerns about unequal access to specialist mental health care depending on where people live.

Dr Morris continued: “The regional variation is particularly alarming as this has real implications for patient care and for the clinicians working under sustained pressure.

“We cannot afford to let this trend continue. Without focused investment and workforce planning, services – particularly general adult psychiatry – will remain under severe strain.”

Mental Wellbeing Minister Tom Arthur said: “We expect spending on Mental Health to exceed £1.5 billion this year. We recognise the workforce pressures in psychiatry and are taking forward action to address this as set out in our Mental Health and Wellbeing Workforce Action Plan.

“We remain committed to working closely with the psychiatry profession across NHS Scotland to address workforce challenges and improve outcomes for people across Scotland. We have provided NHS Education for Scotland with over £31m to continue multi-disciplinary education, training and workforce expansion.

“We have invested over £160m since 2020 in community-based mental health supports for children, young people and adults.

“We are making progress on waiting times – CAMHS has met its 18-week treatment standard for 5 consecutive quarters with 90% of children and young people starting treatment within 18 weeks.

“We know there is more to do and are working with partners to refresh our Mental Health and Wellbeing Delivery Plan.”