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Reporting should also not avoid focusing on community expressions of grief and instead highlight suicide warning signs and prevention resources.

It brought the suicides of two celebrities: fashion designer Kate Spade and TV food and travel journalist Anthony Bourdain. Spade's husband said she suffered from depression and anxiety for years, while Bourdain had spoken openly about his past drug addiction.

"Whether [officials] think it's mental health or not is based on a box on the forms that a medical examiner checks", she says.

The national suicide prevention hotline number is 1-800-273-8255.

If you're anxious someone you know may be at risk of suicide, you should talk to them about it, says the Canadian Association of Suicide Prevention.

The CDC study found that 54% of Americans who died by suicide had no known mental health illness.

The report showed an overall 25.4 percent increase nationally during the period, with only one state - Nevada - seeing a decrease in its rate.

Bourdain and Spade died at 61 and 55, respectively - an age cohort with strikingly high suicide rates in the US, according to the CDC. The gun shops have been receptive, she said. Rates ranged from 6.9 per 100,000 in the District of Columbia to 29.2 in Montana. The CDC report found that the majority of people who died by suicide didn't have known mental health diagnoses at the time of death. "Instead, these folks were suffering from other issues, such as relationship problems, substance misuse, physical health problems, job or financial problems, and recent crises or things that were coming up in their lives that they were anticipating", says Stone. In a country that has as many privately owned guns as it does people, this presents a unique public health problem.

Men were not only more likely to die by suicide with no known mental health condition, but they were also more likely to die by using a firearm.

The report is bad news, the CDC acknowledges, but people are not helpless to prevent suicide.

LeBron James punched white board, played NBA Finals with injured hand
They were powerless to stop the onslaught of Warriors players rotating into the game, hitting jump shots and driving for layups. James finished with 23 points and spent the final minutes on the bench, contemplating what went wrong and maybe his next move.

Say things like "I noticed you've been looking down, or I've noticed you've said things that seem like you're really not as motivated towards life", he said.

In Hawaii, rates went up about 18-percent from 1999 to 2016. The rates declined slightly among black men and people older than 75 during that time.

The high suicide rate is also a concern in New Hampshire, said Patricia Tilley, deputy director of New Hampshire's division of public health services.

"This is a very important population right now in terms of national statistics", Schuchat said, noting the high rates of drug overdose in this group as well as "deaths of despair" described in social science literature.

Overall, the rate rose to 15.4 per 100,000 in 2014-2016 from 12.3 per 100,000 in 1999-2001. Research has shown that "suicide contagion" - a potential increase in suicidal behavior after people are exposed to suicide, either directly or through media coverage - is a real and troubling phenomenon.

Middle-age adults had the highest increase. Crisis hotlines can save lives; so can psychiatric treatment. It's not situational. It's a deep and certain knowledge that your world is awful and will always be frightful, that other people are happy but you never will be, that something is wrong with you such that you don't even deserve happiness and you probably aren't capable of it anyway.

In 2016, there were 38,658 firearms deaths in the United States ― 59 percent of these deaths were suicides.

Researchers have only recently begun to understand the elements of suicidal thinking that actually predict an attempt. "You can have everything we associate with happiness and success - a loving family, an interesting career, good friends - and still be vulnerable if you suffer from depression or other risk factors".

Opioid use is also surging across the US.