As they are in almost every state in America, suicide rates are up in North Carolina. But if there's good news, it's that North Carolina's rate of increase is among the smallest in the country — and half the national average.
According to figures published Thursday by the Centers for Disease Control, suicides in North Carolina increased 12.7 percent from 1999 to 2016. That's half the national increase of 25.4 percent for the same period.
Suicide rates rose in 49 states. Only Nevada saw a decrease, down 1 percent. Every other state saw increases ranging from North Dakota's 57.6 percent to 6 percent for Delaware.
Delaware (5.9), Maryland (8.5 percent) and Florida (10.6 percent) were the only states with increases smaller than North Carolina's 12.7 percent.
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Suicide in the news
The numbers also coincide with a local controversy over state budget funding for North Carolina's Suicide Prevention Lifeline call center. Initially, state legislators failed to include funding for the hotline, which fields an average of 255 calls per day and needs $348,558 annually to operate.
But State Rep. Nelson Dollar, a Republican from Cary, promised the hotline "will absolutely be funded."
"We've identified a source of funds for the suicide hotline," Dollar told the News & Observer on Friday afternoon.
Suicide in North Carolina
Nationwide, 2016 saw nearly 45,000 suicides committed by Americans 10 years of age or older. Men accounted for three-quarters of all suicides, with the highest numbers among non-Hispanic whites between 45 and 65 years old.
Suicide is the No. 10 cause of death in the United States and one of three in the top-10 with a rising rate. The other two are Alzheimer's and drug overdoses.
On average, North Carolina sees one suicide about every six hours. In 2015 (the most recent year for which figures have been released), there were 1,379 suicides in North Carolina, according to the Suicide Prevention Resource Center.
Mirroring national figures, the most common method was the use of firearms at 56 percent. Hanging came next (21 percent) followed by poisoning (17 percent) and "other" (6 percent).
Among military veterans in North Carolina, 73 percent of suicides are by firearms. Veterans have a suicide rate more than double that of non-veterans — 32.9 per 100,000 compared to 15.2, according to North Carolina Injury and Violence Prevention.
That rate is even higher for younger veterans between the ages of 18 and 34. From 2011 to 2015, that age bracket's suicide rate of 72.1 per 100,000 was nearly six times the rate for non-veterans the same age.
Circumstantial factors include depression, mental and physical health issues and death of friends and family. For both sexes in North Carolina, about one-third left a suicide note and almost one-quarter disclosed suicidal intentions to someone else.
In terms of prevention, that last point is key. Barbara Lowe, a licensed psychologist in Durham who works with a lot of suicide cases, said the best thing you can do is directly ask someone if they are considering suicide.
"There's this idea that we should be afraid to put the idea in anybody's head," said Lowe, who has also lived through the suicide of a close family member. "But you should ask, and if there's any leeway, if it's not an emphatic 'I am safe,' ask the next question: Do you have a plan, a method, access? If they answer yes to any of that, you need to get them to help."
Help is available from the National Suicide Prevention Lifeline: 800-273-8255.