"I thought that after swallowing all those pills, it would be simple -- just a matter of time! I felt excited and exhilarated. For the first time in ages I felt happy and that I was at last in control of my own destiny." These are the words of a young man from the Scottish Borders following his failed suicide attempt. Young Scots men are twice as likely to commit suicide as they are to die in a road accident -- and the numbers are climbing. Between the years 1971-73 and 1996-98, the suicide rate for Scots men rose by 76 per cent. In the same period the overall adult female suicide rate actually fell by over 15 per cent.

The statistics make grim reading. In the seventies, for both sexes, the tendency was for suicide rates to increase with age. As we face our new century, the peak rate of male suicide is now found in the 25 to 34 age group -- where it has leapt in the intervening decades by an astonishing 245 percent. Things are not looking bright for 35 to 54 year olds either.

What are we to do about it? The Sorrows of Young Men, a conference held at Edinburgh University recently, brought together practitioners, policy-makers, academics and religious leaders to look for some answers.

Overwhelmingly, it is unskilled men in the 25 to 34 age group who are taking their own lives. Men who can't find a job or whose work is insecure. Edinburgh University's Professor Stephen Platt says: "The risk of suicide among the unemployed compared to the employed is between twofold and threefold."

Richard Holloway, the Bishop of Edinburgh, pointed out in his address to the conference that the death of heavy industry is devastating the poorest in Scotland. "Much of this is the consequence of global economic changes coupled with the closure of the pits and defence industries," he said. The bishop argued that at least in the days when most people were poor there was a camaraderie and social cohesion in belonging to the working class that gave them strength and pride.

"But in a society where most people are prosperous, and the poor are a minority whose culture has disintegrated, the pain and anger they feel is heightened," he added.

In that culture, men once had each other: the miners' welfare, working men's clubs, trade unions, political activity. Their erosion led to exclusion and isolation. But people are beginning to challenge the despair. Mike Spring of the Wester Hailes Heath Agency says that until recently most discussion around men's difficulties has focused on their criminal or anti-social behaviour. Now more attention is being paid to men's health.

For the past two years, Spring has been running a group for men in Edinburgh's Wester Hailes Health Project. The men who turn up are aged anywhere between20 and 60. He says: "We have come to realise that men fare very badly. Men die younger than women. Men commit suicide more often than women. Men make comparatively little use of medical services. Men have the highest rates of alcohol and other drug addictions."

Spring says that men find it hard to express their feelings, but suggests that men's groups can provide a safe and confidential environment in which to open up.

Gay men face the same challenges as their straight peers -- with stigma and rampant homophobia thrown into the bargain. Gay Men's Health, an organisation set up to work in the area of HIV prevention, runs a group in Livingston called Go West, which explores the problems facing gay men who live in non-urban areas, such as homophobia, lack of confidence and isolation. Bob Irvine (not his real name), a Go West member, might be describing a common feeling about the potential for men's groups in general, when he says: "Go West has done for West Lothian gay men what bingo halls did for OAPs: safety, support and, most of all, fun."

Further south there is the Borders Youth Project, run by the mental health charity Penumbra since 1993. Its aim is to support young men and women in the area, and thus keep them out of the psychiatric system. Many of the young people attending the project had a history of suicide attempts and deliberate self-harm. So they decided to make a video for schools, youth groups and, most importantly, professionals. Eve-Marie Haydock, who co-ordinated the video project, explained that the participants felt that the only people who can speak to youngsters alp out attempted suicide and self-harm are other young people who have been through it themselves. The video will be released in the spring of 2000.

But what's happening at the policy level to address the crisis facing young Scots men? Platt told the conference that in the recently published white paper on public health in Scotland, suicide is not specifically identified as a target for action. The Scottish executive's health and community care minister, Susan Deacon, explained the omission in a parliamentary answer to the SNPMSP Kenneth Gibson in August, saying: "The white paper ... emphasises that improving life circumstances - poverty, unemployment, bad housing, etc - will have a beneficial effect on people's mental health and sense of well-being; healthier lifestyles, too, contribute to better mental health. The thrust of the white paper should lead to improvements in mental health and, therefore, to reductions in the suicide rate."

Fine. But where's the much-hyped "joined-up thinking" here? What Scotland surely needs is policy developed across all the executive's departments - from agriculture to housing, employment to education. Each has a mental health element. In the meantime, throughout Scotland, knots of men are working together, trying to refute Henry David Thoreau's assertion that "the mass of men lead lives of quiet desperation". The Scottish executive could do worse than to listen to them.

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