On an overcast, melancholy Friday morning, 2,500 lone boots and sneakers are spread out across an oval in a regional town.
Each represents one of the male suicides that occur across Australia each year.
Inside them sit photos of young, fit men in the prime of their lives, who died by suicide.
Nearby, a handful of heartbroken families gather to view the pop-up memorial at the showgrounds in Sale, in Gippsland, about 210 kilometres east of Melbourne.
The memorial is the work of the Zero Suicide Community Awareness Program, a volunteer initiative that campaigns for the mental health and welfare of men and boys.
Its founder, Paul Withall, who curated the first visual presentation of 2,500 shoes on the lawn of Parliament House on National Men's Day in 2022, said Gippsland had one of the highest male suicide rates in Victoria.
"We have people come down who can honour their loved ones, place a pair of shoes down and tie a ribbon to them with a photo or a note to honour their loved ones lost to suicide,"
he said.
The memorial comes as Victoria has appointed its first minister for men and boys.
In 2024, 3,307 people died by suicide in Australia, including 2,529 men and 778 women, according to Australian Bureau of Statistics figures.
Recognising situational distress
Mr Withall said situational distress, the term for life complications that are not linked to a diagnosed mental health problem, was a key risk factor for male suicide.
"When men and boys are in positions in their lives that are situational, it's usually linked back to family, children, money or work,"
he said.
"Relationship breakdowns are at the top of the scale. A contributing factor to around 43.1 per cent of all male suicide comes back to relationship breakdown," he said.
He said support services did not exist for men affected by situational issues.
His approach echoes findings of a 2017 report by researchers from Western Sydney University and the Australian Institute of Male Health and Studies.
The report called for a new approach to suicide prevention, which acknowledges the link between situational distress and suicide.
It found the current approach to suicide prevention focused on mental illness while drawing attention away from the suicide risk caused by "highly challenging, albeit common, life events and consequent experiences".
Calls for a rethink on mental health
Victoria recently appointed Frankston MP Paul Edbrooke as the state's first minister for men and boys.
Following his appointment, Mr Edbrooke said the portfolio would be focused on "how we make young boys into healthier men" and has already identified family violence and suicide rates as key areas of concern.
Anthony Smith is an investigator working with the Critical and Ethical Mental Health team at the University of Adelaide, and the author and co-author of books on distress and mental health.
When it comes to suicide prevention, he said the conventional view has placed too much onus on individuals in identifying and treating personal depression rather than the root causal factors or cultural circumstances that fuel human distress.
"Situational distress encompasses a significantly challenging or troubling experience of thoughts, emotions, bodily sensations, and or behaviours associated with difficult life events, such as bereavement, health problems, relationship breakdown, financial problems, or occupational difficulties,"
he said.
"There is increasing concern about excessive medicalisation of common human behaviours and emotions. Too often, distress is interpreted as symptomatic of mental illness."
He said it was important to understand the difference between the broad spectrum of difficult human experiences and emotions encountered across the life span and mental illness by using distinctive language and terminology.
"Diagnoses of mental disorders, and prescriptions of antidepressants and other psychotropic drugs, have increased dramatically in recent decades, facilitated by ever-increasing funding for mental health and suicide prevention,"
Mr Smith said.
"Despite this, suicide deaths are continuing to increase, suggesting that medicalisation of distress may not be the answer."
Encouraging communication
Leongatha social worker Donna Kerr began youth mental support group Daniel's Wings of Pride, after her son Daniel took his life in September 2023, soon after his 21st birthday.
"There were no drugs or alcohol involved in this situation; his pain was that great,"
Ms Kerr said.
Bullied during his teenage years for his sexuality and ridiculed online, she said her son suffered from long-term trauma.
Ms Kerr said LGBTQIA+ and Aboriginal men were particularly susceptible to suicidal ideation.
Tragically, within weeks of Daniel taking his life, his 17-year-old cousin William Vosper also died by suicide in 2023.
His brother Lawrie Vosper described Daniel as a "bit of a jokester" who used his sense of humour as a shield, as "a mask for the bullying and everything he was dealing with".
Ms Kerr welcomed the appointment of Mr Edbrooke as Victoria's minister for men and boys.
"Finally, now we have a minister in Victoria. We just need all the states to follow and also have a federal minister as well, looking over every state,"
she said.
She hopes men's mental health will be an urgent priority for the minister and help shift the cultural stigma around men and boys reaching out for help due to a fear of being dismissed or stigmatised.
Ms Kerr said online sites such as the Brotherhood, Dad's Line and Kids Help Line provided good services, as did in-person men's sheds and walk-and-talk support groups.
But she said more formalised, customised "safe place" support groups and drop-in centres were needed to listen to men and boys, help them navigate the different stresses and injustices of life and alleviate pressure on the health system.
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