On average, there's a suicide every 15 minutes in the United States.

Those 34,000 deaths cut across gender lines and all age groups and economic classes. American women attempt suicide at a rate three times that of men, but four times as many men die by suicide as women. And middle-aged men represent the highest risk group, with more than 16 deaths per 100,000 population.

Many reasons exist for those patterns, but the main cause for suicide continues to be mental illness and disorder. At least 90 percent of the people who kill themselves are affected by a mental health problem, experts say.

"They can't get rid of the pain. They see death as a release," said Dr. Paula Clayton, medical director of the American Foundation for Suicide Prevention, which tracks statistics on suicide deaths in the country.

That said, job loss and economic stress have both been shown to be a contributing, possibly even a precipitating factor in suicide.

"But you've got to remember that if you are already depressed or anxious, handling those factors is almost impossible," Clayton said.

No household or profession is immune. Physicians have among the highest rates of suicide, Clayton said.

"We underestimate the potential lethality of anxiety and worry," she said. "That's one of the biggest obstacles to overcome in preventing suicide."

Resources to aid those dealing with depression and suicidal thoughts are available locally. They include government mental health programs and nonprofit and privately-run efforts. Most offer crisis hotlines for emergency intervention as well as ongoing treatment.

Help also is available for who've attempted suicide or those left in its wake. For the latter group, grief counseling has a chief goal: to remove the guilt and stigma surrounding suicide and educate friends and family about mental illness.

Those left behind often misunderstand the reasons for their loved one's suicide, said Margo Requarth, child and teen bereavement program coordinator for Sutter VNA and Hospice in Santa Rosa. "They think this is a willful act rather than one of desperation."

Contact Staff Writer Brett Wilkison at 521-5295 or brett.wilkison@ pressdemocrat.com.