NEW YORK (CBS) In the wake of fashion icon Kate Spade's suicide, a new study shows suicide rates have increased 30-percent in the U.S. in the last 20 years.
The Centers for Disease Control and Prevention is calling suicide a national public health problem.
New research shows suicides are on the rise in almost every state across the country. In 2016, nearly 45,000 people took their lives. More than half did not have a known mental health diagnosis.
"We found that many common life stressors were present in the period preceding the suicide. Relationship problems, financial and job issues, physical health concerns," said the CDC's Dr. Anne Shuchat.
The increases have been greatest in people 45-64. And while suicide is more common in men than woman, there has been a rise in female suicides.
Signs and symptoms to look for include isolation, agitation, anger, alcohol or drug use and changes in sleep patterns.
Dr. Christine Moutier is the chief medical officer at the American Foundation for Suicide Prevention.
Reporter Nikki Battiste: If you're worried about a loved one, how do you begin that conversation?
Dr. Christine Moutier: Be quite direct and say, 'I'm concerned about you, here's what I've noticed' And if they're expressing feelings of hopelessness, I would encourage anyone to ask the question: 'When it gets that way for you, do you ever think of ending your life?' And just like that, that will open up a space where they can talk about what's really going on.
She says anyone can call the National Suicide Prevention hotline at 800-273-talk or text talk to 74174 if they're concerned about themselves or others.
Experts say they saw higher suicide rates in rural areas in western states hit hard in the economic downturn.