Deaths from suicide, substance use and other forms of self injury have surpassed deaths due to diabetes in the United States, according to a new study.

Researchers from the Centers for Disease Control and Prevention found 29.1 people per 100,000 died from self injury, compared with 24.8 per 100,000 from diabetes in 2016. Deaths from self injury are now the seventh-leading cause of death, ABC News reports.

“It is time to end the siloed approach to prevention,” study co-author Hilary S. Connery, M.D., Ph.D., Clinical Director of the Division of Alcohol and Drug Abuse at McLean Hospital, said in a news release. “We’re so entrenched in separating suicide from drug overdose or alcohol poisoning deaths that people can’t wrap their heads around the idea that they are related.”