Of those deaths, 22 were male and seven were female.

The grim data was released by the Australian Institute of Health and Welfare recently and it shows the top 20 causes of death by local government area from 2014-18.

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In Cowra, suicide was the 10th most common cause of death and it accounted for 1.9 per cent (16 people) of all deaths.

This is below the NSW rate of 2.4 per cent (where it ranked as 9th), and equivalent to the national rate of 1.9 per cent (where it ranked 11th).

In Parkes it ranked as the 16th most common way to die and accounted for 1.7 per cent of all deaths (13 people).

In the Hilltops LGA it ranked 8th with 23 deaths by suicide (2.4 per cent of all deaths), while in Forbes suicide did not rank in the top 20.

The data might be shocking, but every death was someone's brother, sister, mother or father, Lifeline Central West chief executive officer Stephanie Robinson said.

"We know that for every completed suicide, there's at least 20 attempts," she said.

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"It's the biggest killer of men and women aged 15 to 44 years old."

Ms Robinson said family and friends are often left shocked when someone they know dies by suicide.

"Overwhelmingly people say 'if I had of known and if I had of seen the signs I would have helped that person'," she said.

"They say, if they 'could have changed the outcome' they would have."

Ms Robinson urged those left behind not to feel guilt and said that no-one is to blame for suicide.

"At the end of the day you can't control people's actions," she said.

"People get very good at allowing people to see what they want them to see.

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"You don't know what you don't know."

She urged people to be alert to any behavioural changes in their friends and family, and in particular to anyone who withdraws from the life they once lived.

"The thought of having to reach out to someone else is a big ask when you're in a big, dark depression," she said.

"So many people have that attitude where it won't happen to us.

"Every life matters, lets make it count."

For help in a crisis call Lifeline 24 hours a day on 13 11 14.