It shows the growing severity of the issue

The report says suicide is rarely caused by a single factor.

Of those with no diagnosed mental health conditions, men are more likely to commit suicide and do so with firearms. Finding economic circumstances was a major contributing factor, especially during the Great Recession (2008). "It points to the need for a comprehensive approach to prevention".

She and her colleagues collected data on suicides from every state.

"Most people that either attempt or complete suicide, they aren't so much wanting to die as they want to be out of the pain they are in", Summers said.

Rates of suicide increased by more than 30 percent in half of states in the USA - only decreasing in Nevada. Minnesota, North Dakota, South Dakota, Montana, Wyoming, Idaho, Utah, Kansas, and Oklahoma each reported increases from 38-58%.

The most common method was using a firearm, followed by suffocation, the agency said. Only half of the people had a known mental health condition.

The problems most frequently associated with suicide, according to the study, are strained relationships; life stressors, often involving work or finances; substance use problems; physical health conditions; and recent or impending crises.

"Any change in behavior patterns, withdrawing, sadness, irritability, anger, and losing their temper more quickly - those would all be indicators that possibly that person's mental health is deteriorating", says Dr. Christine Moutier of the American Foundation for Suicide Prevention.

"None of this is surprising information, which is not to trivialize its importance".

The CDC is hoping future research delves into the specific causes of suicide trends, as NVDRS was capable of providing significant insight into decedent characteristics in more than half of the states.

The CDC report was released at a time of heightened attention to the issue with the suicide this week of fashion designer Kate Spade.

Prevention has been elusive, in part because doctors have not had programs that reliably reduce suicide rates. However, teens who aren't likely to reach out could be internalizing what they see. The most important takeaway, mental health professionals say, is that suicide is an issue not only for the mentally ill but for anyone struggling with serious lifestyle problems.

"New Hampshire definitely has access to guns", Tilley said.

The new report also found that, among US states and the District of Columbia, suicide rates varied fourfold in 2014-2016, from about 7 per 100,000 residents per year in Washington, D.C., to 29 per 100,000 residents per year in Montana. A 2008 study in the New England Journal of Medicine compared states with the lowest household gun ownership rates (15 percent) to those with the highest (47 percent).

Among decedents aged 18 years or older, 20.1% of those without known mental health conditions and 15.3% of those with had served in the USA military. "The conversation about firearms and suicide doesn't have to be a debate about the Second Amendment. They make sure that they are getting the help that they need".

Vermont also has a high rate of binge drinking, and evidence suggests that people who drink too much are at higher risk of suicide.

Many experts have said that the United States is in the midst of a 'loneliness epidemic, ' with one recent report finding that almost half of Americans sometimes or always feel alone.