CLEVELAND– Cancer, heart disease and diabetes are all in the ten leading causes of death in the United States; they are all also decreasing, according to the Centers for Disease Control and Prevention.

But suicide is the 10th leading cause of death in the U.S. and CDC data shows it is on the rise.

“The CDC says that we are in a current epidemic of suicide because we have experienced about a 40% increase over the last 20 years,” says Dr. Jane Timmons- Mitchell, a senior research associate at Case Western Reserve University.

Timmons-Mitchell is the lead investigator on the Substance Abuse and Mental Health Services Administration (SAMHSA) grant to the Ohio Suicide Prevention Foundation funded AT $3.68 million over five years.

The grant is expected to serve 30,000 Ohioans and focuses on the needs of young people. Timmons-Mitchell has been a child clinical psychologist for 34 years and co-authored a book on suicide prevention.

“In Ohio, we’re kind of right at the center of [it] because our increases are big even though we have had prevention programs, and have more prevention programs in place all the time, the increases keep overtaking the gains that we make,” said Timmons-Mitchell.

In Ohio, there was a 36% increase in suicide from 1999-2016, according to the CDC. Nationally, suicide is increasing across all age groups for both men and women.

“It affects everybody who knew that person; families sometimes never recover, understandably,” she said.

In 2016, suicide became the second most common way young people between 10 and 34 years old died, according to the CDC. Timmons-Mitchell says there are hard numbers connecting the opioid epidemic and easy access to guns to suicide.

“If somebody attempts suicide with a gun they are 85% likely to die by suicide. If somebody attempts suicide using any other means they are about 80% to 90% likely to be found and referred and intervened with and eventually not to die by suicide,” she said.

Timmons-Mitchell says there is not enough research yet on the connection between suicide and social media, but it is likely part of the equation leading to the increase.

“The rise of the open access to social media kind of corresponds with this rise of the public health problem becoming an epidemic and unfortunately to date we don’t really have any good tools to combat cyberbullying,” she said.

CDC researchers say more than half of people who died by suicide in 2015 were not diagnosed with a mental health problem. So suicide often takes family and friends by surprise.

“A lot of times it is impulsivity, lack of judgment and opportunity if you happen to be in a situation,” Timmons-Mitchell explained.

But she says if you are concerned about someone don’t be afraid to respectfully ask them what is going on. She says someone who is at risk for suicide may need increased supervision, they should be separated from any lethal means, look for resources and services and know the suicide prevention lifeline number.

Timmons-Mitchell says it may seem simple, but the golden rule is a way that everyone can prevent suicide.

“Reinforcing something uplifting for somebody else every day and if they did that it’s not going to fix this problem, this is a huge problem, we have a long way to go, but small steps around the edges might be able to help,” she said.

 If you or someone you know might be at risk of suicide, here are ways to help:

Call 1-800-273-8255 to reach the National Suicide Prevention Lifeline. It provides free and confidential support 24 hours a day, seven days a week for people in suicidal crisis or distress.

You can learn more about its services here, including its guide on what to do if you see suicidal language on social media. You can also call 1-800-273-8255 to talk to someone about how you can help a person in crisis. Call 1-866-488-7386 for the TrevorLifeline, a suicide prevention counseling service for the LGBTQ community.

Text HOME to 741741 to have a confidential text conversation with a trained crisis counselor from Crisis Text Line. Counselors are available 24/7. You can learn more about how their texting service works here.

For crisis support in Spanish, call 1-888-628-9454. For support outside of the US, a worldwide directory of resources and international hotlines is provided by the International Association for Suicide Prevention. You can also turn to Befrienders Worldwide.