MERRILL - A decade ago, some of the highest rates of suicide in the state came from Lincoln County.
Those numbers have improved slightly since then. But death by suicide is still a major concern in the area.
A billboard in the center of Merrill serves as a reminder. It directs people to call the Hopeline, a free crisis prevention line.
"The mental health coalition has been doing a lot of work in suicide prevention efforts for several years," said Debbie Moellendorf, a co-facilitator for the new Healthy Minds for Lincoln County group.
Moellendorf's coalition is responsible for the billboard, and for trying to change attitudes about mental illness.
"Many times, people struggle with going for help and asking for help. We wouldn't hesitate if we had a broken leg or a broken arm to go seek medical help," Moellendorf said. "I think we are doing a disservice when we treat mental and physical health needs differently."
Sometimes, when the calls for help do come, they come to the dispatch center at the Lincoln County Sheriff's Office. Just this year, the office has had 71 reports of a possible suicide threat.
Dispatchers are trained to talk to a suicidal person or their friend or family while police are on the way.
"If somebody contacts you and they are saying they're having thoughts of self-harm, take those thoughts seriously," said Lt. Tim Fischer. "Contact local law enforcement. Get us involved, and we will get the help to you as soon as we can."
But thoughts of suicide aren't just limited to the general public.
Mary VanHaute's brother, a Milwaukee firefighter, died by suicide.
VanHaute now trains emergency responders to look for suicide signs from their colleagues. On Monday, she was teaching at the Merrill Fire Department.
"Suicide in rural America is greater than it is in urban settings, so good on Merrill for bringing this in," VanHaute said. "We're just starting to break the barrier to actually say the word 'suicide,' to say, 'this is what's happening if we don't deal with the mental health issues that come with the job.'"
VanHaute uses zero as a suicide goal, because it's a preventable form of death. The first step, she says, is breaking the stigma of talking about suicide.
"If they leave today and they talk to one person about what they learned today, we have broken the silence," VanHaute said. "That's my goal."
The Healthy Minds for Lincoln County is targeting teens for suicide prevention. Last year, nearly one in five teens in Lincoln County said they seriously considered attempting suicide, above the averages for both Wisconsin and the United States.