The New York City medical examiner’s office said Thursday that the death of Kate Spade, the designer who was found in her apartment this week, was a suicide.
Ms. Spade, 55, had suffered from severe depression, her husband, Andy Spade, said Wednesday.
The designer, with her husband and business partner, built an accessories empire off an idea about a handbag that resonated deeply with many women for almost three decades.
Long after Ms. Spade and her husband left their company to devote themselves to other projects, they launched a new venture in 2016, an accessories label called Frances Valentine.
[If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK) or go to SpeakingOfSuicide.com/resources for a list of additional resources.]
Image copyright Getty Images Image caption Family members say the fashion designer had severe depression in recent years
A New York medical examiner has ruled that Kate Spade's death was caused by suicide, two days after the fashion designer died in her Manhattan flat.
Spade's body was discovered on Tuesday by a cleaner in her Park Avenue home.
Federal health officials said on Thursday that US suicides had risen by 30% since 1999, and presents a "growing public health problem".
Her family said that Spade would have liked if her death could help shed light on mental health issues.
"One thing we feel is that any talk that they do that helps somebody else - Katy would have liked that," her 89-year-old father, Frank Brosnahan, told the Kansas City Star.
"She was always giving and charitable. If that helped anybody avoid anything - fine, she'd be delighted."
Image copyright Getty Images Image caption Spade's handbags brought her worldwide fame and success
Mr Brosnahan added that the iconic designer had "been taking some pills, which I advised her not to take", and said that he was aware that his most famous of six children had been having mental health issues.
"Well, I don't know what happened," her father said while recalling a phone conversation they had the night before she died.
"The last I talked with her... she was happy planning a trip to California to look at colleges. She doted on her daughter."
Media playback is unsupported on your device Media caption Prince William and Lady Gaga discuss mental health
Spade's 13-year-old daughter, Frances Beatrix, was not at home when the death occurred, police say.
Meanwhile, officials from the Centers for Disease Control and Prevention (CDC) said on Thursday that suicide is the 10th leading cause of premature death in the US.
CDC principal deputy director Anne Schuchat said in a briefing: "From individuals and communities to employers and healthcare professionals, everyone can play a role in efforts to help save lives and reverse this troubling rise in suicide."
How Kate Spade shaped the catwalk - and high street
Police have previously said that she left a note pointing to "a tragic suicide", but her husband, Andy Spade, said on Wednesday that he had "yet to see any note".
Her husband and business partner said that Spade had been taking medication to deal with depression and anxiety, but that her death was a "complete shock".
He said she "sounded happy" the night before her death, and added that his priority is caring for their daughter as she deals with her "unimaginable grief".
Where to get help
From Canada or US: If you're in an emergency, please call 911
You can contact the US National Suicide Prevention Lifeline on 1-800-273-8255 or the Crisis Test Line by texting HOME to 741741
Young people in need of help can call Kids Help Phone on 1-800-668-6868
If you are in the UK, you can call the Samaritans on 116123
For support and more information on emotional distress, click here.
Image copyright Shutterstock Image caption Family members say the fashion designer had severe depression in recent years
The news that fashion designer Kate Spade took her own life earlier this week is highlighting to many the universality of mental illness and the sad reality that it can affect anyone in any walk of life.
Social media quickly filled with tributes to the 55-year-old as news broke of her death on Tuesday. Many of the headlines focused on public shock, because the successful designer, on the surface, appeared to "have it all".
"It's often been said that mental illness and suicide doesn't [sic] discriminate," says Dr John Draper - director of the US National Suicide Prevention Lifeline service. "It's not really about a person's circumstances,"
"In some ways a highly successful person can even feel trapped because everything seems perfect - they think nobody will understand or believe that they have a problem."
In recent years there have been efforts made throughout society to try and break these taboos about emotional struggles and mental health.
A number of well-known celebrities, from actor Dwayne Johnson to singer Demi Lovato, have opened up about their personal struggles with conditions such as depression and anxiety.
'You can't compute the positive'
Canadian comedian Jessica Holmes knows too well the problems of going through depression in the public eye.
"I'm a person who had it all going on in my career," she tells the BBC. "I had opened for Ellen DeGeneres, Oprah Winfrey and Jerry Seinfeld; I was on a popular Canadian comedy show.
"And despite having all of that, and two healthy kids and a supportive husband - I still sank into a depression that lasted about two years."
Image copyright Supplied Image caption The 44-year-old describes herself as a "zombie" at the depths of her depression in 2013
"My psychologist explained to me that a depressed mind is like a sieve: only negative thoughts make it through. You can't compute the positive things that are happening in your life - even if, like me, you have so much to be grateful for."
Kate Spade's sister has suggested in media interviews that her sister had struggled with depression for some time but had expressed worry that seeking treatment could harm the "happy-go-lucky" image of her fashion band.
Jessica says she "absolutely understands" how people under public pressure can feel like they have to keep up a "vibrant healthy preppy" image.
"I just hope we see cases like Kate Spade's with empathy and understanding," she says.
"There are people out there who think there's no other option for them - but I feel like it's our duty to remind people there is."
Celebrity 'contagion'
International research has long-recognised the risk of a "contagion" effect after high-profile suicides.
Image copyright Getty Images Image caption One report suggests US suicides rose 10% after comedian Robin Williams died
Many in the media now follow guidelines about responsible reporting of suicide - which includes being mindful of phrasing and not discussing the suicide method.
But Dr Draper believes celebrities can also contribute to a "positive contagion" and are pivotal in normalising dialogue around mental health.
"There's research that has shown that when people share their stories of hope and recovery, that it was associated with a reduction in the rate," he told the BBC.
The phenomenon has also been recognised in physical public health issues - HIV awareness and testing reportedly went up after actor Charlie Sheen spoke publicly about his diagnosis.
The number of the US suicide prevention helpline Dr Draper directs was given a huge platform last year when US rapper Logic named a song after it.
1-800-273-8255 deals with severe depression and suicidal thoughts - with the chorus evolving from lyrics of "I don't want to be alive" to a transformative message of recovery.
Image copyright Getty Images Image caption The helpline said it received a surge in calls after the song was released and performed at the 2017 MTV Video Music Awards
"In the US, for every one person that dies by suicide, there's another 280 who think seriously about don't," Dr Draper says. "The other 280 don't make the headlines."
Jessica agrees that public discussion, especially by high-profile figures, is integral to breaking taboos. She now speaks openly about her experience - even writing and performing humorous motivational comedy about depression.
"Recovering for me was sort of like pulling the cord on a motorboat," she says.
"It doesn't work and won't start and then for no apparent reason - maybe it's the 30th time, suddenly it does and the boat goes."
Chris Smith, a clinical professor at the USC Annenberg School for Communication & Journalism, says he has seen a change in the media treatment of mental health in the last decade or so - despite our appetite for celebrity revelation being as high as ever.
Media playback is unsupported on your device Media caption Prince William and Lady Gaga discuss mental health
He believes the internet has been transformative in allowing celebrities to get ahead and control their own narratives - not leave it to tabloids.
"Typically celebrities have had someone to speak on their behalf or broker information," he says. "If wielded well, social media can be productive, positive and powerful."
Does fashion have a problem?
Research has long looked into links between creative professions and high reported incidences of mental illness.
In the fashion world, British designer Alexander McQueen and L'Wren Scott have taken their lives in recent years.
Image copyright Shutterstock Image caption Kate Spade opened her first store in 1996, three years after founding her namesake brand
Other high-profile industry names have also openly struggled with substance abuse.
Professor Carolyn Mair, from Psychology for Fashion, believes the clothing industry is particularly difficult to work in.
"There's increasing pressure on designers to create more and more, and be out-and-about themselves," she told the BBC.
"It's a very tough industry. Every collection is expected to be better than the rest and even more perfect."
She believes more needs to be done for models, designers and others working in fashion - starting in education.
Where to get help
From Canada or US: If you're in an emergency, please call 911
You can contact the US National Suicide Prevention Lifeline on 1-800-273-8255 or the Crisis Test Line by texting HOME to 741741
Young people in need of help can call Kids Help Phone on 1-800-668-6868
If you are in the UK, you can call the Samaritans on 116123
For support and more information on emotional distress, click here.
NEW YORK -- New York City's chief medical examiner has ruled fashion designer Kate Spade's death a suicide by hanging. The determination was released Thursday, two days after the 55-year-old Spade was found dead in her Park Avenue apartment.
A housekeeper discovered her body in her bedroom. Police say she left a note that pointed to "a tragic suicide."
Spade's husband and business partner says she suffered from depression and anxiety for many years.
Andy Spade said in a statement Wednesday that his wife was seeing a doctor regularly and was taking medication to treat her disease.
He said she "sounded happy" the night before and her death was a complete shock.
Andy Spade said his main concern is protecting their 13-year-old daughter's privacy as she deals with "unimaginable grief."
Kate Spade's father said that she was planning a trip to California, The Kansas City Star reports.
"I don't know what happened," 80-year-old Frank Brosnahan told the publication Wednesday. "The last I talked with her, the night before last, she was happy planning a trip to California to look at colleges. She doted on her daughter."
Brosnahan said he knew Spade was having troubles and that she had been taking pills that he advised her not to take. He also said his daughter would be glad if ongoing, global talk about her death were to have a positive impact.
"One thing we feel is that any talk that they do that helps somebody else, Katy would have liked that," he said. "She was always giving and charitable. If that helped anybody avoid anything -- fine, she'd be delighted."