"We have a lot of research," he said. "We have access to a lot of mental health experts. But if we all sat in a room to facilitate a discussion and looked at a regional strategy — what do we need to do?"

Stark evidence of poor mental health leaps from numbers provided to The Record by health, police and government agencies.

•People are killing themselves more often. The local rate of suicide has soared 27 per cent since 2008, surging past the Ontario rate in 2011 and staying above it according to numbers from the chief coroner. Suicide is often linked to mental health.

•People hurt themselves a lot. Since 2010 the rate of local residents harming themselves badly enough to be hospitalized has been 55 per cent higher than the Ontario rate, the regional public health department reports. There were 532 local residents hospitalized for self-harm in 2014 — 351 females and 181 males.

•Police are responding more often to suicide attempts and to mentally ill people. Regional officers were dispatched to more than eight such calls per average day in 2013, up from fewer than seven calls in 2011, a Record analysis found. Officers typically spend two hours at the location of each call, sometimes in potentially violent situations.

•Since 2010 residents have reported more life stress, according to a federal health survey, while fewer residents perceive their mental health as very good or excellent.

If this region matched Ontario averages, it would have seen 33 fewer suicide deaths and 610 fewer people hospitalized for self-harm between 2012 and 2014.

"I'm frightened of the numbers," said Maria Sousa, 52. She suffered her mental illness alone and attempted suicide before medication and counselling helped bring her clinical depression under control.

"Nobody knew," she said. "I just couldn't cope any more."

Today Sousa is a local teacher with a positive message for others with poor mental health. "I went through it, too," she said. "It can be better. There's always hope at the end. You do not have to live with this. Do not let it define you as a person. It's only part of your story. It is not who you are."

She found that there are professionals and others willing to provide support, and she found that their help works. "No one has to be alone going through this," she said. "The supports that are out there are out there for a reason, and don't be afraid to ask for help."

To stress her helpful message, Sousa recently tattooed her wrist with a semicolon, meant to highlight mental health awareness and suicide prevention. Her fiancé, Jim Rovers, tattooed his wrist in support.

Local agencies agree there's no single or clear explanation for fraying mental health. They can't explain why distress is so high.

"We are looking at this and paying attention," said Tana Nash, executive director of the Waterloo Region Suicide Prevention Council. She said concerned agencies are meeting Monday to discuss strategies. Her agency supports Larkin's call for a community mental health forum.

Factors typically linked to poor mental health include unstable housing, money woes and addictions. Larkin says synthetic drugs, such as crystal methamphetamine and ecstasy, play a role. And he cites university and college students who use food banks while struggling to pay for housing, books and tuition.

A weakened economy may be a factor. Yet local suicides didn't begin to surge until two years after the local economy began its mixed recovery from the downturn that began in 2008. Other communities have shed manufacturing jobs without the same fallouts. And there are affluent residents who struggle with mental health.

"We all know people in our lives that despite all the great things that are happening … have some illness that makes them depressed," Larkin said.

The Record mapped 8,036 reported suicide attempts or calls to police about mentally ill people between 2011 and 2013. The analysis shows that incidents are concentrated in poorer, urban areas.

•By household, people reportedly attempt suicide almost three times more often in the poorest patrol zones (average household income below $66,700) than in the richest patrol zones (average household income above $101,300).

•By household, the poorest patrol zones generate almost five times more calls to police about people who appear mentally ill, compared to the richest patrol zones.

This analysis does not include suicide deaths. It is not evidence that being poor or living in a city causes someone to attempt suicide or develop a mental illness. It points to a correlation — poorer neighbourhoods have a lot more people who attempt suicide or have a mental illness that draws police.

Larkin and Lauckner say public agencies are co-operating more than ever to improve mental health care. Police and social support agencies jointly identify individuals deemed at risk and develop a plan to respond. Psychiatric care has been improved at Cambridge Memorial Hospital.

The Waterloo Wellington health agency says it has committed an extra $5 million per year since 2014 to help patients with mental health and addiction challenges.

The cash has helped pay for 24/7 distress services. It has paid to have psychiatric nurses join police for mental health calls. It has paid for a program that aims to keep people who have attempted suicide from pondering it again. It has enhanced supports and treatment for addicts. It has paid to enhance counselling for eating disorders and self-harm. It has provided more supports for people in social housing.

But are these efforts working? Today, health-care providers see a disconnection between efforts to improve mental health and evidence of greater distress.

"Something else is happening in the community that I think it's safe to say all social and health service leaders are concerned about," Lauckner said. "We aren't going to sit around and wait, fingers crossed in the hopes that this works."

If current efforts aren't working, agencies need the courage to try something different, he said.

"We'll never achieve zero (suicides) but we want to make sure these investments we're making and the partnerships are actually making a difference," Lauckner said.

Larkin sees a silver lining in signs of greater distress.

"People are starting to feel comfortable coming forward to say 'I'm not feeling well. And it's not that I have a sore abdomen or a sore chest or a sore arm. My mind is not well,' " he said.

jouthit@therecord.com