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If you or someone you know is having thoughts of ending your life, there are resources out there to help.

"Talking is what makes the difference, that personal connection that you have, one to one, where it's being talked about".

"It implies sin or crime" - we "commit" sins and crimes - "and pathologizes those affected".

With almost 45,000 suicides across the country in 2016, the report described suicide as a "growing public health problem" and said a variety of factors may contribute to the increase.

Andrew Spade, Spade's husband, said she had seemed fine when he'd talked to her just before her suicide.

A similar guideline actually has become the rule of thumb for major news organizations, including CNN, which often set the tone of public conversationaround suicide. The state's suicide rate ranks 27th in the nation, according to the report, which analyzed data from 1999 to 2016. Precision medicine has transformed cancer research.

With other community advocates, Smith works to promote suicide-safer communities and schools.

Because suicide is a topic Stage is intimately aware of, she offers advice to those who are concerned about someone they love and are struggling with what to say.

Prohibitions are apparently loosening in some quarters, she said. "You have to be comfortable saying that word, and some people avoid it at all costs because they're scared". It takes the power away. "We need more access, better measures and better quality of care". "Do you have a time frame?" But the Centers for Disease Control says that suicide isn't just now becoming a problem, rather that it is an ongoing and growing epidemic. "Not talking about suicide might".

She added that you should directly ask someone if they are considering suicide, don't beat around the bush.

Don't rattle off the list of people for whom a person must live, Stage said.

Years later, it feels fresh for her. They were the latest markers of an intractable public health crisis that has been unfolding in slow motion for a generation.

The study, which spanned 1999 to 2016, found that more than half of people who killed themselves did not have a known diagnosed mental health condition at the time of death. "You do need to be nurtured after a suicide attempt, but you don't need to be treated like an egg".

The CDC, the top U.S. public health agency, said individual states need to do more to boost suicide prevention "and address the range of factors contributing to suicide".

Even in the year 2018, there is still a stigma placed on suicide.

It's human nature to want to identify the reason why people take their lives.

Pro - who has previously spoken of his struggles with anxiety and depression - said: "Social media is both good and bad".

Regina Gillis lost her 24-year-old son to suicide on May 2, 2016. Vermont, New Hampshire and ME, all in New England, had among the highest rates of increase in suicides. "Shelby was up and down, so you never could get on the same page as him". Instead, she remembers going out to eat and hearing people whispering about their loss.

One local woman understands the effect of suicide on a very personal level. "I always say follow your gut".