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The number of Americans dying from suicide is the highest it's been in 30 years, according to a report released today by the National Center for Health Statistics.

The report says the suicide rate nationally went up by 24% between 1999 and 2014, going from 10.5 per 100,000 in 1999 to 13 per 100,000 in 2014. More than 42,000 Americans died from suicide in 2014.

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And among women, the increase was even sharper: for girls aged 10 to 14 years old, the rate tripled between 1999 and 2014, to 150 deaths. Women aged 45 to 64 saw a 63% increase over that time. And the rate among Native American women rose by 89%.

The reasons for the increase in suicides among middle aged women needs more research, experts say, but it could be linked to economic downturns

“We don’t really know enough about what’s driving this rise,” Mark Kaplan, professor of social welfare at the University of California Los Angeles, told the Guardian. “Past research in this field has focused on young people and very old people. But we know far less about what’s causing suicides among the middle age range: 25 to 64-year-olds. We’re only now starting to invest in trying to understand this phenomenon.”

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Dealing with suicide for Native American communities has been an ongoing struggle, which for some communities is reaching crisis point. Last week, after a Canadian First Nation community declared a state of emergency over their suicide crisis, native groups in the U.S. shared their support–that's a crisis they're all too familiar with.

Part of the problem, for every group that's seen an increase nationwide, could be that suicide prevention and mental health care needs to be more easily accessible.

“We have more and more effective treatments, but we have to figure out how to bake them into health care systems so they are used more automatically,” Dr. Jane Pearson, chairwoman of the National Institute of Mental Health’s Suicide Research Consortium, told the New York Times. “We’ve got bits and pieces, but we haven’t really put them all together yet.”

You can reach the National Suicide Prevention Hotline here or at 1-800-273-8255.