Despite the steadiness of the suicide rate in the state, Allen says there is a lot of work to do.
"We have been on a rise here in the county", ADAMHS director of external affairs Beth Zietlow-DeJesus said, in terms of completed suicides as well as depressive symptoms and suicidal thoughts and attempts, especially in young people.
Suicide ranked as the ninth-leading cause of death in Canada in 2009, the a year ago for which numbers are available, and is the 10th-leading cause of death overall in the U.S.
A few days ago fashion designer Kate Spade also committed suicide, with her husband declaring he did not know she was at risk.
In Baltimore, about 53 people die from suicide annually, and 82 percent of those deaths occur among men, according to 2014 data from the Baltimore City Health Department. "Suicide is one of the top 10 causes of death in the U.S. right now, and it's one of three causes that is actually increasing recently, so we do consider it a public health problem - and something that is all around us", Schuchat said.
That means any public health effort to reduce suicides can't exclusively focus on those who have reached out for help.
"If the first person you talk to laughs at you or says, 'Oh just get out of it, you just got out of the wrong side of the bed this morning, ' find another person because that's not the only person", said Keltz.
Across the country, suicide rates - the number of suicide deaths per 100,000 people - rose by more than 25 percent from 1999 to 2016.
The CDC report cites several different approaches, such as working to stabilize housing and teaching coping and problem-solving skills early in life. "But I think the truth is, you really make it less likely, because they know there's somebody who cares about them, and you can help them get help".
The Cuyahoga County Board of Health does not have any suicide prevention programming, according to communication officer Kevin Brennan.
Brown said warning signs can include something as simple as talkative people becoming more quiet or the opposite- those who are normally quiet becoming more verbal; or letting their hygiene go as well as verbal cues. "And there's good research to support that". Teens in North Dakota are three times more likely to die by suicide, Public News Service reported a year ago. It also can happen when a close friend or family member commits suicide. "There are some for youth, but they're very, very tiny", says Gebbia.
Dr. Deborah Stone, the CDC's lead researcher, told the BBC that while there is no single factor that leads to suicide, relationship issues and financial troubles tend to be top contributory factors. "The idea that suicide is not preventable is completely fallacious".