And, in the case of suicide, accurate figures are notoriously problematic. Data released this week by the Australian Institute of Health and Welfare may present one of the more accurate pictures, showing 68 deaths in the Ballarat region from 2013 to 2017.

READ MORE: Ballarat's male suicide rate is 30 per cent above the state average, according to new AIHW report

Even so, mental health campaigner Nick Shady still believes they "grossly underestimate" the true picture of what is happening around Ballarat.

But leave the exact numbers to one side and one message still comes through all too clearly.

Ballarat has a problem with people taking their own lives; and that the high toll is disproportionately men, with males accounting almost 90 per cent of the total.

Released at the same time the mental health Royal Commission was being held in Maryborough, the figures are another stark reminder of the urgency of the issue.

Perhaps unsurprisingly a common thread in discussions The Courier has had with campaigners and mental health advocates surrounds male traits that might help explain such grim toll.

There may be many diverse reasons underlying the suicide statistics: child sexual abuse is one that is often mentioned in Ballarat, while domestic violence, addiction issues including gambling and drugs, and work stress are potential root causes.

However, what links many of them, Mr Shady believes, is a culture of men not feeling able to talk.

He says he believes that mental health is an issue that affects genders equally, but that men show a greater tendency to take risks and internalise their problems.

"How many times do you hear 'I don't want to be a burden on people'?"

"It has a cultural aspect - we don't know how to access help when we are in crisis."

READ MORE: AFL player breaks help make grassroots mental health change

He said that many deaths may have come from people who had never been in touch with mental health services before.

"There are plenty that have just all of a sudden have suicided.

"The issue is that for men especially, it's a spur of the moment thing. They've thought about and they get to a breaking point."

Leading Senior Constable Des Hudson, chairman of the Ballarat and District Suicide Prevention Network, agreed, saying men often had trouble expressing vulnerability or feelings to others.

READ MORE: 'On the other side there is the hope'

"Maybe we need to take the advice from females who can reach out and have the conversations, there's nothing wrong with blokes having the same approach.

"The over-representation of males to females, and the age - 15 to 45 age bracket - there are a lot of life pressures."

"Not everyone who completes suicide has a mental illness, but maybe their buckets are full, so it's okay to reach out, it's okay to not be okay and reach out to others."

Ballarat's Alex Bayley, who identifies as non-binary, also believes that communication could be an issue, saying: "When I see those stats, I think about how many of those men are struggling with traditional expectations around masculinity, and what it means to be a man, and feeling that if they're not a real man then it's not worth living".

"Men talking to each other or not talking to each other, expressing emotions or seeking professional help - if you're told real men don't need that, people won't seek it out.

"It's the underlying systems and social patterns that are causing all this harm for men, for the queer community, for everyone."

Ballarat's Phil Nagle is a survivor of child sexual abuse, and has talked openly about classmates he lost to suicide.

The announcement of the Royal Commission into Mental Health in Victoria is a "positive step forward," but he said the situation wasn't changing fast enough.

"It'll be interesting to see what recommendations come from (the Royal Commission)," he said.

"Like a lot of other things, it'll show there's a catastrophic failure to do anything about it."

A Victorian government spokesperson, meanwhile, said that one in five Victorians experience mental illness and that the Royal Commission was "a once-in-a-lifetime opportunity to fix our broken system and ultimately save lives."

"The Royal Commission is the first of its kind in Australia and will map out a plan of action that drives major changes to mental health services to support Victorians with mental illness, including those at risk of suicide."

READ MORE: Mental Health Royal Commission: Georgia planned her suicide while waiting for a doctor in Ballarat

For Des Hudson, stigma remains a problem.

"We're not [all] trained clinicians or mental health workers, but we want the community to recognise the signs, have a conversation, to keep someone safe."

"We need to get better at de-stigmatising the issue of suicide, we need to get better at promoting conversations, and recognise we're all human, with good days and bad days."

Mr Shady would like to see a more coherent national and state level strategy rather than relying on so many different groups. However, one issue, he believes, is that many politicians have a problem really understanding the issue.

He would also like to see more accurate and timely reporting. "If there's a three-year lag, how do we change something? There's no point looking at 2017. We need to get the reporting better."

Affected by these issues?

You are not alone.

There are a wide variety of numbers you or friends and family can call for crisis support and professional help.

This includes:

Lifeline: 13 11 14 or lifeline.org.au

Beyond Blue: 1300 224 636 or beyondblue.org.au

headspace Ballarat for youth: 5304 4777 or eheadspace.org.au

Ballarat Centre Against Sexual Assault: 5320 3933

Kids Help Line: 1800 551 800

Suicide Callback Service: 1300 659 467

MensLine: 1300 789 978 or mensline.org.au

Ballarat and District Suicide Prevention Network: suicidepreventionBallarat.com.au

QLife: 1800 184 527 (support for LGBTI community.)

Emergency Services: 000 (triple zero)

SANE Helpline: 1800 187 263 (talk to a mental health professional weekdays, 10am-10pm)

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