The toll keeps grimly rising. North Dakota loses a person to suicide every 57 hours, on average. In Minnesota, suicide claims an average of a person every 11 hours.

Both states have suicide rates far exceeding the national average, and the rates for this tragic form of preventable death continue to climb. The increase in suicides is especially alarming in North Dakota, which saw a spike of almost 58% from 1999 to 2016, the highest in the nation.

Nobody thinks this is acceptable. The causes of suicide are varied and complex, varying from person to person. There is no easy fix. Reaching Zero Suicide — the goal of an initiative among many health providers, including major health systems in the region — requires a broad and sustained effort.

Both North Dakota and Minnesota have detailed suicide prevention plans. Both plans aim their efforts broadly, including outreach to high-risk groups, such as middle-aged men, American Indians, the LGBTQ community and military veterans. Both focus widely on increased education and awareness.

But efforts to end suicide collide with a towering obstacle: the stigma of mental illness generally and suicidal thoughts in particular. Too often, those whose despair is so deep that they want to end their lives withdraw and keep their suffering a secret.

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That stigma, that deadly silence, must be overcome.

Today The Forum is embarking on a five-part series, “Breaking the Silence.” The series features the stories of suicide survivors, family members who have lost loved ones to suicide and those who have considered or even attempted suicide but lived.

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Reporters also focused on representatives of the high-risk groups, members of the communities that struggle the most with suicide. They interviewed health providers, health officials, advocates and activists.

They asked why people are driven to suicide and what can and should be done to prevent it. The goal was to dive deeply. But mostly the goal was to heighten awareness and to spark discussion.

Let’s talk about suicide. Why it keeps rising and what we must do to end it.

Let’s talk about why this area is especially prone to suicide and how that can change.

Let’s talk about the mental health crisis that is especially acute in North Dakota — and how our elected leaders have failed to adequately address what has been acknowledged for years as a crisis of staggering proportions.

Let’s talk about what we can do, as families, as faith communities, as communities at large, to get at the root of why so many among us are in such grave despair.

Let’s talk to each other. Let’s learn the warning signs of suicide and if we see someone at risk, say something.

And if you are even thinking of taking your own life, pick up the phone or go online to talk to someone with the National Suicide Prevention Lifeline, 1-800-273-8255, available 24 hours a day, every day.

Let’s talk. But then let’s act.