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Utah, Idaho, South Dakota, Kansas, Oklahoma, Vermont and New Hampshire all saw suicide rate increases between 43 and almost 58 percent.

Increasingly, suicide is being viewed not only as a mental health problem but a public health one.

In addition to the skyrocketing number of suicides in middle-aged adults, deaths by suicide are also on the rise in teens, with suicide now the second leading cause of death for all U.S. teens and young adults from ages 10 to 35.

The most common method used across all groups was firearms. So far this year, 27 people have taken their lives.

"At what point is it a crisis?" asked Nadine Kaslow, a past president of the American Psychological Association. About 45,000 people died from suicide in 2016 alone. "But homicides still get more attention". The rate fell in just one state, Nevada, where it has historically been higher than average. "Increases in suicide tend to correlate with economic downturns", she said, and this generation has been hit particularly hard by economic hardship in recent years.

Experts say confronting the issues needs to be a priority.

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Indiana, Ohio and Kentucky each saw double digit increases in suicides between 1999 and 2016. It also can happen when a close friend or family member commits suicide.

In 2016, 72 suicides were reported in Berks County. The rising suicide rate for women, then, is "increasing but at a much, much lower level" than for men.

"A lot of suicide is a one-time effort, so having guns available, for example, makes one more likely to complete suicide, but that in and of itself is not an explanation for why suicide is going up", Galea said. "That is very, very troublesome".

They also made a clarification: "More than half of people who died by suicide did not have a known mental health condition", dismissing the idea that it is only a problem for those with mental health problems.

In Pennsylvania, the suicide rate has jumped more than 34 percent.

Telling media to share "stories of hope and healing" reads like Dr. Phil integrative medicine advice, not sound mental health policy.

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"Just to sit with someone when they're in a crisis and they know you get it".

Cultural attitudes may play a part.

"We want to be there for your pain", Levin said. Many factors can contribute to suicide risk, including relationship problems, financial troubles, health issues, and substance abuse.

Suicide prevention strategiesThe report calls on state and local communities, health care providers, and individuals to take steps to prevent suicide. "What are we doing as a nation to help people to manage these things?"

Dr. Patton Van Nickell, the chairman of the Department of Psychiatry for the Allegheny Health Network, says, "It's not an aberration, it's a 15-year trend". "If they did, we would all respond, but that isn't how it works".

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