The number of people in the Lakes district who have taken their own life has more than doubled over the past year.
Locals involved in the mental health area say it is sad and disappointing to see.
The annual provisional suicide statistics released yesterday show in the year to the end of June 2016, 21 people in the Lakes area died by suicide.
It is up from 10 in the 2014/2015 year and is the highest number since the 2010/2011 year when 23 people died by suicide.
Lakes had the second highest increase year on year, behind Canterbury.
Te Runanga Ngati o Pikiao Trust co-ordinates suicide prevention programmes and Kia Piki te Ora project leader Michael Naera said it was sad to see the statistics rise.
Mr Naera said there needed to be more collaboration between all service providers and councils in the region.
He said agencies had a huge amount of resources which could help bring the rate down.
Rotorua coroner Wallace Bain said he was "terribly disappointed".
He said he and comedian Mike King saturated the area two years ago in community halls and schools with their 'Coroner and a King' talks.
"In that time the suicide rates for the Lakes area reduced by 50 per cent. Now they have reverted to what they were."
Coroner Bain and Mike King said in a joint statement yesterday: "We would suggest a lack of follow up would be at the heart of this.
"It's been close to two to three years since we have been back presenting and the figures speak for themselves sadly. We intend to saturate the area again."
Lakes District Health Board Mental Health and Addictions portfolio manager Marita Ranclaud said the board was very concerned about the figures.
Ms Ranclaud said the board had a suicide prevention and postvention plan that linked in with the Ministry of Health's national Suicide Prevention Strategy.
Through training, the plan had a focus on building community capacity to identify when people were psychologically distressed and refer them to agencies able to support, she said.
They would be making their own analysis of the last 12 months of data to ascertain what system factors might have contributed to outcomes, she said.
She said the nine-year picture for the area averaged out at 17 completed suicides a year.
"This is not a comfortable statistic for the DHB, however it can help put into perspective the variation in year by year data and the need to think about suicide prevention within a bigger and longer term context."
Rotorua woman and Tree of Life - My Journey With Grief author Heeni Morehu, who lost her 16-year-old son Hepa to suicide in 2011, said the rise was "sad and very disappointing".
There was increased stress on individuals and whanau, she said.
"We need to return to the basic principles of manaaki and aroha, many of our service providers are tied up in organisational bureaucracy where basic principles are minimised or missing completely."
Rotorua Salvation Army corps officer Ralph Overbye said the biggest issue was hopelessness.
"People are overwhelmed by the feelings of no future, unemployment, debt, mental health, family dysfunction etc.
"On top of that is loneliness and social isolation, especially for the elderly where there can be hidden unidentified suicide."
Clinical and quality manager for Lifewise Mental Health and Addictions Services Tepora Apirana said more education was needed so families would be able to recognise signs and symptoms of distress and could respond immediately.
"There could be numerous factors that have contributed to the rise in our area and each person/whanau have their own unique story.
"A loss of identity, unresolved grief and trauma are the primary factors that contribute to self-harm behaviours."
Nationally 579 people died by suicide in the 2015/16 year.
It is the highest number of suicide deaths since the provisional statistics were first recorded for the 2007/08 year.
Where to get help
- In an emergency: Call 111.
- Lifeline: 0800 543 354 (available 24/7).
- Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7).
- Youthline: 0800 376 633, or text 234 (available 24/7) or email@example.com or live chat (between 7pm and 11pm).
- Kidsline: 0800 543 754 (available 24/7).
- Whatsup: 0800 942 8787 (1pm to 11pm).
- Depression helpline: 0800 111 757 (available 24/7).
- Rainbow Youth: (09) 376 4155 (weekdays 11am to 5pm).
- NetSafe: 0508 NETSAFE (0508 638 723), www.theorb.org.nz