Suicide rates have been rising significantly in almost every state; in both men and women; and across all age and ethnic groups, according to an alarming new CDC report released the same week that both fashion designer Kate Spade and celebrity chef Anthony Bourdain reportedly took their own lives.

CDC researchers examined state-level suicide rate trends between 1999 and 2016 in the “Vital Signs” report released Thursday afternoon, and also analyzed 2015 data covering 27 states from the CDC’s National Violent Death Reporting System to study the circumstances of suicide among people with and without known mental health conditions.

They found that suicide rates increased in every state except Nevada over the past two decades; and half of the country (25 states) saw suicide rates rise more than 30%. About 45,000 people died from suicide in 2016 alone. Suicide is the 10th leading cause of death in the U.S., and is one of just three leading causes that are on the rise. The others include Alzheimer’s disease and drug overdoses.

The CDC notes that suicide is rarely caused by a single factor or life event; and in fact, more than half of those who died by suicide actually did not have a known diagnosed mental health condition at the time of death (54%), according to the report. Rather, factors such as relationship problems or loss; substance abuse; physical health problems; as well as job, money, legal or housing stress often contributed to risk for suicide.

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And the most common method of taking one’s own life was using a firearm, which accounted for 48.5% of suicide cases. The CDC suggested that limiting access to lethal means – such as medications and firearms – among people at risk of suicide could help prevent suicide.

“Suicide is a leading cause of death for Americans – and it’s a tragedy for families and communities across the country,” said CDC principal deputy director Anne Schuchat in a statement. “From individuals and communities to employers and healthcare professionals, everyone can play a role in efforts to help save lives and reverse this troubling rise in suicide.”

The report called for every society sector — government, public health, healthcare, employers, education, media and community organizations — to cooperate in addressing the factors related to suicide. The CDC lists its own recommendations for policies, programs and prevention practices here, including strengthening economic supports to ease financial strains; creating protective environments where people live and work; and promoting connectedness in communities.

“We have a long way to go to strengthen our community and health systems to make sure when someone is at risk we get them to care,” Jerry Reed, an executive committee member of the National Action Alliance for Suicide Prevention, told The Wall Street Journal. He added that the alliance is working with more than 250 hospitals to make sure that those treated after a suicide attempt are also connected to long-term mental health care.

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The national conversation about suicide prevention has been reaching a crescendo, particularly after Spade, 55, was found dead in her Park Avenue home on Tuesday; her family has revealed she suffered from anxiety and depression before taking her own life. And on Friday, “Kitchen Confidential” author Bourdain, 61, was found dead in his French hotel room, which CNN confirmed was also a suicide.

And the controversial Netflix series “13 Reasons Why,” which follows a high school girl who takes her own life after being bullied and sexually assaulted, has sparked discussion about the alarming rates of teen suicide, in particular, which has also seen a frightening increase. The CDC has also warned that the suicide rate for girls ages 15 to 19 doubled from 2007 to 2015 — when it reached its highest point in 40 years; the suicide rate for boys the same age increased by 30% during the same time period. And after some studies suggested that the Netflix series may have inadvertently encouraged the self-harming behavior it was supposed to be addressing, the show and the streaming service created the 13ReasonsWhy.info resource page to encourage troubled youth to get help by highlighting the free and confidential 24/7 Crisis Text Line (text REASON to 741741).

If you are in crisis and considering hurting yourself, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255), or use that same number and press “1” to reach the Veterans Crisis Line. You can also reach out to the Crisis Text Line by texting ‘Home’ to 741741.

If you are concerned that someone you know may be suicidal, the Mayo Clinic suggests being sensitive, but asking direct questions such as:

  • How are you coping with what’s been happening in your life?
  • Are you thinking about dying?
  • Are you thinking about hurting yourself?
  • Have you ever thought about suicide before, or tried to harm yourself before?
  • Have you thought about how or when you’d do it?
  • Do you have access to weapons or things that can be used as weapons to harm yourself?

If this person talks or behaves in a way that makes you believe that he or she may try to attempt suicide, then get help from a trained professional as quickly as possible. The person may need to be hospitalized until the suicidal crisis has passed. And encourage him or her to call a suicide hotline number.