Northland's suicide figures are at their highest level ever - following a national trend the chief coroner has called "stubbornly high".
There were 36 deaths by suicide confirmed in Northland in the 12 months from July 2016 to June 2017 according to provisional figures made available yesterday by Chief Coroner Judge Deborah Marshall.
Those 36 suicides represented the loss of 15 more people than the year 2015/16 when there were 21, and seven more than the horrific 2012/13 year when Northland's 29 deaths included one of New Zealand's biggest youth suicide clusters - 19 young people taking their lives.
Those who lived through the 2012 suicide cluster suffered more trauma last year when six people aged 25 and under died of suspected suicide within three months in Kaitaia.
In a number of analyses of ''why?'', the deaths were associated with social issues such as poverty, broken families, welfare-dependency, abuse and loss of hope.
The 2016/17 figures have not yet been broken down into ethnicity, gender, age, location within each region, or poverty and family factors. Those figures would be available in a week or more, the coroner's office said.
New Zealand has the second-worst suicide rate among people aged 25 and under in the OECD, and the teen suicide rate- officially those aged 15 to 19 - is the worst.
Nationwide, a record high of 606 people died by suicide in the 2016/17 year; the third year in a row that the number has increased. The suicide rate per 100,000 people for the year was 12.64.
Judge Marshall described the rate as "stubbornly high" and said New Zealand had much to do to turn it around.
"In the last year, we've seen a lot of discussion about suicide and the incredible emotional toll it takes on those who are left behind," she said.
"While acknowledging that people are taking their own lives is important, it is only part of the conversation about suicide in the community.
"What is equally important is our discussion around how we can prevent suicides and how everyone - family, friends and colleagues - is able to recognise someone at risk and ensure they get the professional help they need."
Ezekiel Raui is a young Northlander who has designed a support programme based on keys referred to by the coroner - hope, communication and support.
The 19-year old is the creator of a suicide prevention programme called Tu Kotahi, to be trialled in four New Zealand schools next year.
In 2012, the then-15-year-old student at Taipa Area School wrote about the reasons why his friends were taking their lives.
His programme,Tu Kotahi, started with the premises youth were not being listened to and had given up hope.
When asked why, despite public campaigns and conversations, the suicide toll had climbed this year, Ian McKenzie, Northland DHB Mental Health and Addiction Services, said: ''Suicide is a complex issue that requires everyone's attention and we cannot speculate on a year to year variance.
''Northland DHB continues to prioritise our work with partners across the community with specific focus on youth, Maori and our rural population.''
Mr McKenzie said the service had identified a need for more focus on middle aged men's mental health and was promoting Sad Blokes Workshops in Northland, seminars for men with depression.
The Mental Health Foundation (MHF) described the suicide figures as "devastating and shocking".
"There is no denying that social factors such as poverty, inequality, racism and homophobia contribute to our suicide rate," MHF chief executive Shaun Robinson said.
He said the country needed to enact policies that addressed suicide as part of a mental health strategy.
That would require resourcing schools adequately, ending bullying, teaching young people the skills they need to cope when life gets difficult, strong crisis services and universal access to early mental health care.
New Zealand also needed to address the drivers of poor mental health and suicide, Mr Robinson said.
In July 2016, the Coroners Act was amended to allow schools - and the media - to say a death may be a "suspected suicide'' before a coroner rules on it.
The coroner's provisional figures differ from Ministry of Health data which include active cases before the coroner, and which are recorded by calendar year.
In 2012, $62 million was spent on mental health services, with an extra $8m targeted towards Maori and Pasifika patients in 2013. An additional $224m was earmarked in Budget 2017.
Where to get help
If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111.
Or if you need to talk to someone else:
- LIFELINE: 0800 543 354 (available 24/7)
- SUICIDE CRISIS HELPLINE: 0508 828 865 (0508 TAUTOKO) (available 24/7)
- YOUTHLINE: 0800 376 633
- KIDSLINE: 0800 543 754 (available 24/7)
- WHATSUP: 0800 942 8787 (1pm to 11pm)
- DEPRESSION HELPLINE: 0800 111 757 (available 24/7)
- SAMARITANS: 0800 726 666
- OUTLINE: 0800 688 5463 (confidential service for the LGBTQI+
community, their friends and families)