A young student who had a minor operation on his testicles committed suicide after becoming paranoid that the surgery had left him impotent.
James Wentworth-Stanley was 21 when he developed a rapid depression following the surgery in 2006.
The operation was successful but he began to feel like there was something wrong, a feeling he couldn't shake off that left him feeling suicidal.
Speaking in March 2019, his mum Clare Milford Haven told the ECHO: "Almost immediately he was calling me saying 'I don't feel right'.
"He said he was feeling a bit down and I told him anaesthetic could do that sometimes and it might take a while to exit his system and to give it a bit of time. "
James visited home the following weekend and it was apparent to his mum that he still didn't feel like himself.
His family tried to reassure him that the feelings he had would pass, that things would improve and that he could always make an appointment to see his doctor and talk through the concerns he was having.
Clare said: "He went back to Newcastle [where he was a student] and called me and said 'mum you always make me feel better' I thought he was getting over this difficulty, whatever it was."
Later the same week it became clear that James was still struggling, he missed an exam and came home where he continued to tell his mum he "didn't feel right".
An appointment was made to go and visit the surgeon the following Monday and make sure James could talk through his concerns.
During that weekend James asked his mum if he 'looked different' and said he felt like he'd 'lost strength'.
Clare said: "For James, being a man was very important, masculinity meant a lot to him. I think he felt he'd been stripped of his masculinity by this operation. What I didn't know at this stage was he worried the op had made him impotent."
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In December 2006, just 10 days after his operation James took his own life. He took a shotgun from his father's safe, walked out of the house and shot himself.
It emerged after James died - despite asking for help and telling staff at a local walk in centre that he felt like killing himself - James was considered a low priority and referred to A&E.
Clare said: "I didn't know at that stage that he'd been to a walk in centre in Newcastle on the Wednesday, and told them what he felt. They wrote that he felt anxious about the operation, it said he felt suicidal. He told them that, he never told me.
"They gave him a form to take with him to A&E and they put it as a priority four, a low priority which still staggers me, a young man, he was the highest risk category for suicide in 2006."
Claire said James went to A&E with his form but "walked in and pretty much walked out. In the state he was in that was the wrong environment."
She added: "What kills me is he asked for help, he didn't want to die. He didn't do what he did without looking for help first.
"Had there been somewhere for James, he needed to talk to someone, he didn't need A&E, he needed someone to reassure him, needed that person to feel they had permission to call me. He would have said yes - we were incredibly close.
"There were so many things that went wrong, the nurses [at walk in centre] should have have been trained to know he was high risk.
"If a young man comes in and feels suicidal alarm bells should have rung but he was made a low priority. When I reflected - if only there had been a place for him to go to.
"Not A&E - that's hectic and chaotic, brilliant for physical trauma, but for this it was the wrong place.
"If there had been a James' Place, he would be here. "
Since his death James' family have worked to help suicide prevention and in 2018 opened a suicide crisis centre for men in Liverpool called James' Place.
Liverpool was chosen for the centre because it is a large university town and Clare met with several people who suggested it would be supportive of her vision.
Jane Boland, centre manager at James’ Place said: “We chose Liverpool as the home for the first James’ Place, as the city is an area of high mental health need and Mersey Care NHS Foundation Trust is one of the best and most innovative mental health providers in the country."
The centre, on Catharine Street, aims to offer immediate help for men in crisis and reassure them so that they don't feel they need to take their own life.
This week, James' mum Clare said: “Last year, I spoke to the Echo about how the loss of my son James to suicide led us to set up James’ Place as a new service offering specialist support to men facing suicidal crises.
"That was just a few months after we opened our centre in Liverpool. Since then, we have seen more than 400 men, helping them to talk about how they are feeling, how they got to where they are, and how they can find a way through it.
"Working with many partners across Merseyside and beyond we have developed a specialist approach and many lives have been saved as a result of this work.
"The support we have received from the community in Merseyside has been fantastic.
"We have built relationships with key NHS contacts so that we can take referrals from A&E and through GPs practices, and we have received amazing support from local companies and individuals who have raised funds and spread the word about our work."
She added: "2020 has been a difficult year for everyone, and we have had to adapt our work so that we can continue to provide the life-saving support which is so desperately needed by men facing suicidal crisis.
"Hardship, isolation, debt and family breakdown are all issues linked to suicide, and sadly it is likely that the need for our work will increase in the coming years, but with the support of our friends and partners we will carry on with this work so that no man has to face a suicidal crisis alone."
