In the CDC’s 2022 finalized data, **Montana** had the highest age-adjusted suicide rate—about **29 deaths per 100,000 people**. Rankings can shift yearly, with Alaska and Wyoming often near the top.
Researchers point to a combination of factors rather than one cause: **high firearm availability, rural isolation, limited access to mental-health care, economic stress, and disproportionately high risk among some American Indian/Alaska Native communities**. High elevation has also been studied as a possible contributor in Mountain West states, but that connection remains uncertain.