Two thirds of people dying by suicide in Scotland are in contact with the NHS in the year before their death.
A quarter had attended A&E within the three months before taking their life.
The figures are leading to calls for people seeking help for mental health problems to be better monitored by health experts.
Between 2009 and 2015, there were 341 probable suicides in Fife.
James Jopling, Executive Director for Scotland at Samaritans said: "Whilst a sizeable minority of those who take their own lives in Scotland are not in contact with healthcare services prior to death, this important report highlights that a large proportion have been.
"We fully support all efforts to make us all more aware of suicide risks amongst friends and family, but we must also ensure that those professionals that come into contact with people at risk of suicide have the right training and resources to identify, engage and effectively support them.
"We don’t want to miss any chance to change someone’s life.
"The report also tells us that of those who do attend A&E in the three months before they take their own life, nearly 40% die within just a week of their last visit.
"We welcome recent Scottish Government initiatives such as the Distress Brief Intervention programme designed to better meet the needs of people who are struggling, but this report suggests there is clearly much more we can do."