Health officials, suicide prevention advocates and educators have been working to curb suicides, but officials don't know why Utah's child suicide rate is more than double the national rate and climbing.
State health officials haven't been able to find any clear causes of the state's growing rate, but the health department is working to launch an in-depth study, said Andrea Hood, a suicide prevention coordinator at the Utah Department of Health.
Hood said there are some risk factors found more frequently in Utah and other Rocky Mountain states that may explain why suicide rates are higher in those states than the national average.
Residents in Utah move more frequently, which could leave them with fewer social connections and support. There are also theories that lower oxygen levels at higher altitudes can contribute to higher suicide rates and a western, rugged mentality of self-reliance may keep some from seeking help for depression. Utah and other Rocky Mountain states also have higher rates of gun ownership.
Firearm owners aren't more likely to die by suicide, but people who commit suicide are more likely to use guns if they own them than any other method, Hood said.
That extends to children, as nearly half of the youth who have died from suicide in recent years used a firearm. To try to prevent that, advocates are encouraging gun owners to ensure their weapons are secure and last year, Utah began distributing 40,000 free cable gun locks.
Much of the work to combat youth suicides is done in public schools. The state has worked to get prevention programs in every school, offering help to parents, teachers, administrators and students about watching for signs of depression, risk factors for suicide and intervention.
State law requires all teachers to undergo two hours of training about youth suicide prevention, and Utah lawmakers in 2013 required the state office of education to hire a full-time suicide prevention coordinator.
The goal is to train "the gatekeepers, the people that are on the front lines with the kids," said Cathy Davis, the suicide prevention specialist with Utah's state education office.
"You want to create this great safety net for kids because it's really taking all of us to help prevent suicide," Davis said. "It's just making everybody alert to the signs of suicide, what to look out for, what signs of depression are in youth."
Davis and other advocates are also pointing to a new smartphone app Utah lawmakers voted to create last year called SafeUT, where people can have confidential and anonymous chats with crisis counselors at the University of Utah Neuropsychiatric Institute.
Officials say the app helps technologically savvy young people connect with help outside of a traditional phone hotline. In addition to using the app to text, call or submit tips about depression and suicide, the app allows students to speak to someone about bullying, threats of violence, drug problems and more.
"Students need skills to know how to navigate the terrain of adolescence. It's a tough area, I think for a lot of kids," Davis said. "That gives them a safe way to text and access help."