Nationally 654 people died by suicide, compared to 685 the year before – a decrease of 31 deaths.
Lifetime Black Power member and community advocate Denis O'Reilly, who last year called for political help in combatting Hawke's Bay's rising suicide rate, said meth use was likely a "significant factor" in the region's struggle.
In a national wastewater testing programme for the third quarter of 2019, described as a "giant urine test", police said Hawke's Bay was second-highest in methamphetamine use per capita, exceeded only by the Northland region.
"There's never one single cause, but meth has become pervasive - it is endemic across all of society, not just one age group or ethnicity," O'Reilly said.
"Users get the highest of highs, and the lowest of lows."
He said society as a whole needed to move away from "vilifying users" and "wagging their fingers".
"We need to help them [users] liberate themselves, help themselves, take control of their lives."
Ordained Napier-based pastor Rangi Pou, a former meth addict and dealer, also knows the grim realities of suicide - he has lost his 30-year-old sister, along with a friend and also a nephew to it.
At the height of his dealing days, Pou also attempted suicide.
"When someone within the Māori community commits suicide, it is talked about at the tangi, it is not a taboo subject, but no action is taken," Pou said.
"What I see is whānau looking towards the Government and iwi to find solutions, but the whānau are not doing anything themselves.
"It's the 'she'll be right' attitude."
Pou said he was seeing a worrying amount of "emotionally vulnerable" Māori men in Hawke's Bay aged in their 20s to 30s wanting to commit suicide.
"These men are struggling, vulnerable, there's a sense of hopelessness, and bleakness for the future."
Director of the Suicide Prevention Office, Carla na Nagara, said there were a number of contributing factors to suicide.
"On an individual level strong families, whānau and communities play a major role in helping prevent it," she said.
She said regardless of suicide rates, there needed to be "an acknowledgment of the burden, but also encouragement for communities and individuals to support each other".
WHERE TO GET HELP:
If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111.
OR IF YOU NEED TO TALK TO SOMEONE ELSE:
• 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP) (available 24/7)
• https://www.lifeline.org.nz/services/suicide-crisis-helpline
• YOUTHLINE: 0800 376 633
• NEED TO TALK? Free call or text 1737 (available 24/7)
• KIDSLINE: 0800 543 754 (available 24/7)
• WHATSUP: 0800 942 8787 (1pm to 11pm)
• DEPRESSION HELPLINE: 0800 111 757 or TEXT 4202