During ten days last month in York County, nine residents killed themselves.

The deaths continued this month with three more suicides, including a woman who jumped off the Norman Wood bridge.

While the death of a 25-year-old woman after plunging from the bridge on June 6 generated news headlines because of its public location, dozens of other tragic suicides have occurred this year behind closed doors and without public notice.

York County Coroner Pam Gay said the burst of suicides, sometimes with multiples on a single day, caused her to consider issuing a news release like she did last year after a spate of youth suicides to call attention to the public health situation.

But Gay said she could not determine any pattern or commonalities among the nine deaths last month.

The mounting deaths in such short succession add to a rising number of suicides in recent years across the country and in York County.

The county averaged 58 suicides per year between 2007 and 2012, but that average jumped to 73 per year in the most recent four years.

The year of 2014 represented the peak with 88 suicides, more than five times the county's annual homicide rate. And those are just the suicides that were identified. Experts say suicide statistics arguably could be under-reported because suicides through overdoses and accidents can be overlooked if the evidence isn't clear.

"We're on the same pattern to have another horrible year," said Cindy Richard, who started a suicide prevention organization in York County about 10 years ago. "I don't know what it is. We just don't know enough about the brain to understand it."

The county hasn't gone a month without a suicide since December 1998, Richard said

This year's suicides roughly mirror last year's as far as age breakdown with 17 victims under the age of 50 and 11 victims who are 50 and older. Overall, the victims ranged in age from 22 years old to 90 years old.

Suicide statistics are lower in Dauphin County, but higher per capita. Still, the statistics in Dauphin County aren't on an upward trajectory. Instead, the figures have been up and down in recent years with an average of 47 per year over the past five years.

Domestic problems, including breakups and child custody disputes, are the number one reason cited in York County for triggering suicides through stress that overwhelms coping skills. But there are usually multiple causes for suicide, experts say, and many of the victims have underlying mental illness.

Stressors eventually pass and mental illnesses are treatable, which is why most suicides are considered preventable, Richard said.

The fact that suicides don't often get publicity can lull people into thinking it doesn't happen very often. But in York County, it is typically among the top four causes of death investigated by the coroner dwarfing statistics for auto accidents (47 deaths last year) and homicides (17 last year.)

People who kill themselves often feel like a burden, or that they can't contribute to society and they gradually inch closer over time to the idea of taking their life, Richard said.

That's why it's important to try to reach suicidal people before "they get too far down that tunnel," Richard said.

People shouldn't be afraid to ask a loved one if that person is considering suicide, "because that puts everything on the table," Richard said. "We need to start talking about it. We need to tell people what we're thinking."

Avoiding the topic can make a suicidal person feel even more isolated and misunderstood. Broaching the topic can put relatives in a better position to help.

Richard's organization provides free resources and screenings. They also offer support groups and an annual conference on suicide prevention set for September.

A change in behavior or the presence of entirely new behaviors is a red flag, especially if the new or changed behavior is related to a painful event, loss, or change, according to the American Foundation for Suicide Prevention.

Most people who take their lives exhibit one or more warning signs, either through what they say or what they do, according to the foundation's website, which includes specific warning signs.

Richard can be reached at 717-227-0048.

The National Suicide Prevention hotline is 1-800-273-8255.