The headlines were bleak last year with the release of the latest official statistics on suicide in Australia.
They told us that, in 2017, 3128 Australians died from intentional self-harm – up 9 per cent from the previous year and equal with 2015 as the highest recorded preliminary rate in the past 10 years.
In Victoria, the news was a little less grim – in fact the suicide rate recorded a small decrease, but all of us working in mental health, and those who have been affected by depression, anxiety and suicide, know this gives us no cause for complacency.
For me this was reinforced last year when my own family gathered to mourn the death of a young dad who took his own life, leaving behind a young family. With no known mental health issues and no history of suicide attempts, his death came out of the blue. It sent a shock wave through his extended family, work colleagues and the community.
A total of 621 people died by suicide in Victoria in 2017, more than double the number who died on the state's roads. At least 20,000 Victorians attempt to take their lives each year.
Yet unlike the road toll, which last year was the lowest in at least three decades in Victoria, the suicide rate stays stubbornly high.
Worryingly, what suicide rates have in common with the road toll, is their disproportionate impact in rural and regional areas.
As the Centre for Rural and Remote Mental Health tells us, the rate of suicide among those who live outside Australia's capital cities is higher than that for residents who live within them.
A 2017 briefing paper produced by the centre acknowledges the many strong advantages in living in rural and regional Australia. They include higher levels of civic participation, social cohesion, social capital, volunteering and informal support networks from neighbours, friends and the community.
But it also warns that people living in rural areas experience unique conditions that can increase the risk of ongoing mental health problems and suicide. One of the most obvious causes or contributors is the impact of extreme weather and environmental management on those who rely on nature to make a living.
Over the past weeks we've seen the shocking pictures of the mass die-off of fish in the Darling River at Menindee in New South Wales, that has prompted international headlines and an outcry over what and who is to blame.
It's a very graphic reminder of how many people living in rural and regional areas rely heavily on the vagaries of the season, and of policy-making. A range of other factors are also behind the high rates of suicide and mental health issues in rural and regional Australia.
For men in particular, it can also be about shame, the struggle to talk about what is hurting, often because of unrealistic ideas about masculinity – to be always strong and independent, to not reveal vulnerability.
And a stigma remains – particularly in rural and regional areas where it's harder to seek help without others knowing.
Yet we also know that rural and regional communities often have poor access to health and social services, and that puts them further at risk.
A total of 621 people died by suicide in Victoria in 2017, more than double the number who died on the state's roads.
Victoria’s mental health system is about to go through the biggest shake up in 30 years with the Royal Commission to commence in March. The long term outcome should see more investment in suicide prevention and other services in rural and regional communities.
But government services are not the full solution. Families, friends and work colleagues have an absolutely critical role to play in preventing self-harm and suicide.
If you have a niggling feeling that someone you know or care about it isn’t quite themselves, trust that gut instinct and act on it.
By starting a conversation, you could help them open up. If you are not sure where to start, services like Lifeline, beyondblue and RUOK are there to help family, friends and colleagues who are not sure what to do.
You could help save a life.