Tragically, in New South Wales, almost twice as many people are lost in this manner than on our roads.

Worryingly, regional areas are seeing a larger increase in the death rate than Greater Sydney.

According to the North Coast Primary Health Network, the rate of suicide is higher on the Mid North Coast than the rest of NSW.

In Kempsey, the rate of self-harm hospitalisations is almost double the NSW average.  

About You Psychology's Allan Anderson, has been involved at the forefront as a counsellor in several suicide cases. He considers self-harm, in many cases, to be a plea for help.

"It's a plea for attention, it's a plea for help and I think it's important to provide that help without encouraging people to take action to get attention," Dr Anderson said.

"It's a very fine line there, between providing adequate attention without seeming to encourage that behaviour to gain attention."

The experienced psychologist surmises there is insufficient services to provide people with the necessary care.

"I think that we need to have a greater presence of mental health professionals to give adequate follow-up attention," he said.

"It must be a multi-disciplined approach.

"The mental health, education and political systems must work together to create workable strategies and shape community attitudes."

He postulates that mental health units need to take more seriously people who present with self-harm or who have attempted suicide.

"I believe that people may present at mental health units and I'm not saying they aren't helped, but very few seem to be admitted to the units and perhaps they are sent home with follow-up.

"I sometimes wonder whether the follow-up that occurs after presentation at a mental health unit is sufficient help."

He links depression, but also anxiety to suicide.

"Anxiety is worrying about things, a large proportion of which, will never happen.

"This is a major problem treated by mental health professionals, perhaps more than depression.

"I think it's a mistake to believe that everyone who attempts suicide or self-harm is depressed."

He asserts that illicit drugs and alcohol are often contributing factors.

"It leads to desperation.

"It leads to dissatisfaction with life without drugs.

"They begin to think they need those drugs to make them feel good about themselves and about their life.

"If they can't access the supply that they need, when they are in a frenzy of mental activity, that desperation can definitely lead to suicide.

"The drugs can contain additives that can send them quite literally crazy and so in that time, that's a very high-risk group."

He identifies young people as another vulnerable group.

"Young people who may be unemployed or without sufficient family support, this is a group who is at risk as well.”

Men are also a high-risk group.

According to the Hunter Institute's Mindframe, suicide is three times more prevalent in males.

Other alarming statistics from Mindframe show the death rate for Aboriginal and Torres Strait Islander people was considerably higher than the non-indigenous population in NSW in 2015, with suicide the fourth leading cause of death for Aboriginal and Torres Strait Islander people in the state, compared to the 18th leading cause of death for non-indigenous.

"Perhaps, indigenous people are more susceptible to drugs including alcohol and they may see their lives as being more desperate than the broader community. 

"They may feel that they have less opportunities, less education, less chance of getting a job.

"All of the racist problems that occur in the community must also have an effect on the number of people who attempt self-harm.

"I think the community should be encouraging indigenous members of our community to engage more with their own culture, including language and other social activities to give them more respect and self-confidence, and anything resulting in people gaining respect for themselves and gaining confidence is obviously part of the fight against self-harm and suicide.”

Dr Anderson emphasises the part education plays in reducing the stigma associated with self-harm, suicide and other mental health concerns.

"For good reason, the publicity surrounding instances of suicide is dampened down because they don't want to give undue publicity to a problem that might result in copycat actions.

"Publicity can attract the wrong kind of attention from young people who may think it is a way of gaining some sort of recognition of their existence.

"But there needs to be a lot more publicity and education about problems such as mental health and drug use, and the associations both of those have with the extent of self-harm and suicide.

"The community attitude and response is where I think we can do a lot, it comes back to education to help mold community attitudes."

He stresses it has to be hospitals and mental health units that offer the front-line service to people who are at risk.

"Psychologists can certainly work together with other mental health professionals, including psychiatrists and mental health nurses, to provide follow-up service to people who may have presented to hospitals with issues of self-harm.

"We cannot offer acute services, that's why more readily available mental health services is vital.

"Anyone at grave risk must be treated urgently and seriously by relevant professionals at hospitals and mental health facilities." 

If you need support contact Lifeline on 13 11 14.