Is it really so bad in St Helens? Why is this happening? Why is it us?
These are the questions public health bosses have sat and asked themselves in the face of figures naming the area as the nation's 'suicide capital'.
St Helens has the highest suicide rate in the country, according to the most recent data available from the Office for National Statistics.
Understanding why your town has such a shockingly high suicide rate isn't easy.
Staff at St Helens Council have spent the last few years trying to understand why so many people are driven to take their own lives - and what they can do to try and change things.
They've examined the demographic of people dying by suicide in the area to try and see the people behind the statistics.
Do you have a story you want us to cover? Email emilia.bona@reachplc.com
This has all led to a robust and far-reaching suicide prevention plan aimed at driving down St Helens' suicide rate.
We spoke to the experts faced with tackling the crisis and the people who have lost someone to suicide about why so many people are taking their own lives in the town.
A death every fortnight - the scale of the problem in the suicide capital of Britain
St Helens has the highest suicide rate in the country according to data published by the Office for National Statistics.
There were 29 suicides registered in the borough in 2017, which is the most available period that data is available for.
That works out at a suicide every two weeks in St Helens, if you were looking at it across an entire year.
There were also 29 deaths in 2016 and 25 in 2015, giving St Helens a suicide rate of 17.9 suicides per 100,000 population between 2015-17,.
That was the highest in England and Wales and more than 80 per cent higher than the national average of 9.6 suicides per 100,000 people.
The ONS records the number of suicides each year, but rates for individual local authorities are given as a three-year average in order to smooth out relatively low absolute numbers and give a more accurate picture.
Faced with these concerning statistics, St Helens Council have spent the last few years working to reduce death by suicide.
Despite their best efforts, the rates are now the highest in the country - and the council were forced to review their suicide prevention plan to understand what they can do going forward.
So why are so many people taking their own lives in St Helens and what can possibly be done to try and stop it?
"People in St Helens are really traditional, strong, working class people"
If the suicide rate in St Helens had a simple cause, then it would have a simple answer.
Unfortunately for public health bosses in the borough, it's far from simple - and the figures show that there is no 'typical' person who is at risk.
In her role as Assistant Director for Public Health at St Helens Council, Michelle Loughlin has been tasked with understanding who the people behind the suicide rates are.
The hope is that by better understanding who these people are, the council will be able to understand how they came to find themselves at such a desperate crisis point.
Michelle is clear that while there is no single cause, public health experts do know that suicide affects some groups of people more than others.
The statistics show more men than women, more people of middle age and more people in a position of disadvantage.
Of course, this isn't true for all cases.
The Sefton Coroner, who is routinely passed files on deaths in the borough, confirmed they see deaths from all ages, and people from all walks of life.
From these statistics, Michelle is tasked with picking out themes that could hold the answers.
She said: "It's tricky one. Every single person is different, every situation is different but we do statistical analysis of people's situations and you do see certain patterns and risk factors.
"We've got common themes - that people have been experiencing the breakdown of a relationship, mental health problems are a risk factor but not affecting everyone, people with physical health problems or people feeling isolated, people who have lost their jobs, a group of people who may be high risk from abusing drugs or alcohol."
All of these factors make sense - but none of them are specific to St Helens.
People lose their jobs, break up with their partners or suffer painful physical conditions across the country.
Michelle said: "There's not one answer and it's not a question we haven't asked ourselves. [People in St Helens] are a really traditional, strong, working-class people and a very proud people - when things go wrong in their lives, traditional male roles may be something to do with it that they feel they should be the provider and if they lose their jobs they're not able to fulfil that role.
"Maybe it's the explanation of the role but that's a generalisation again. We've asked ourselves these questions.
"We have had a decline in local industry but now that's building up again. The public are asking the same question - why is this happening, why is it us, is it really so bad in St Helens?"
With no obvious answer to why St Helens has such a high suicide rate, trying to find a solution isn't straightforward.
But faced with holding the highest suicide rate in the country, the council has put all its energy into a robust prevention plan to try and tackle the problem.
"Men don't talk" - what it's like to lose a loved one to suicide
On Wednesday, April 10, St Helens Council held their annual suicide memorial event for people to remember the loved ones lost to suicide.
Families, partners and friends filled the local rugby ground for an emotional night of tributes and calls to prevent further deaths.
People stood up to talk about their loved ones - and the same phrases kept coming up over and over again.
"They were the life and soul, they lit up a room, they had everyone laughing."
For so many families there were no warning signs - they never saw it coming.
The tributes read out at the memorial service reinforced the reality that there is no obvious outline of an 'at risk' person. Every case is unique.
One of the people who stood up to tell their story was Lisa Vint, 49, who had none of the red flags or warning signs that suggested her husband Peter would take his own life on April 26, 2017.
The couple met at a caravan park in Rhyl when Lisa was just 15. They were together for 33 years and married for 23. They grew up together, raised a family and fostered children.
Lisa said her husband wasn’t known to mental health services - but one day she came home from work to find he had hanged himself. She didn’t know he was struggling.
Speaking to the ECHO, Lisa said: “He went to the gym, he was very sociable, was the life and soul - always laughing, always making people laugh.
“He made one comment the week before along the lines of saying he may have been depressed. It was in the past tense he said it was just not wanting to do stuff.”
Peter didn’t talk about how he was feeling - and Lisa thinks a tendency to bottle things up and put on a brave face is a major factor in the region’s suicide crisis.
She said: “I know from people who have tried to access mental health services that it can be hard to try and get the right help. Men don’t talk - it’s a big problem.
“What I struggled with, and people that know Peter knew, is that as a foster carer he always said 'I can’t help you if you don’t talk about it' - and then he didn’t talk about it himself.”
Tackling St Helens' suicide crisis
In trying to dramatically reduce the borough's suicide rate, the council have come up with a plan which they hope will tackle the issue at every stage.
Things are already looking more positive, with Michelle claiming that local services have started to see a turnaround that's left them hopeful of a decline in suicides.
But trying to solve a problem like the suicide crisis requires the involvement of everyone, not just St Helens Council.
Michelle said: "Because it's complex then the solutions have to involve a partnership approach. Everyone doing their bit."
The suicide prevention plan breaks down into four target areas - prevention, safer care, support for those bereaved by suicide and understanding the themes.
Prevention work focuses on helping everyone spot when someone might be at risk and how to direct them towards the right support, while safer care means making sure care services are equipped to spot people in crisis and offer them the help they need.
In the community, organisations like Survivors of Bereavement by Suicide and AMPARO offer support for people who have lost a loved one, while public health staff like Michelle are charged with understanding the people behind the statistics and who to target.
The local authority hope that this plan will help prevent further lives being lost to suicide.
A wide range of services are available in St Helens for anyone wanting to talk about their mental health and wellbeing.
If you want to find out more, click or tap here.
