Despair – the loss of hope – can be deadly.

Chronic alcohol abuse and opioid addiction are two of the best-known killers of people who can’t imagine a better future, but there is a related public health crisis that needs to receive more attention.

It’s suicide, and it’s quietly killing more than 200 Mainers a year.

According to the U.S. Centers for Disease Control, suicide is the 10th leading cause of death, claiming an average of 122.9 lives a day. In 2016, 226 Maine people died of suicide – a rate of 17.9 per 100,000 of population. That’s well above the national average of 13.9 and far beyond the New England average of 11.8.

More troubling is that despite year-to-year fluctuations, the trend is upward. Tragic stories of teen and young adult suicides emerge from high schools and colleges in nearly every community, forcing parents and school officials to question whether they did everything they could to stop them before it’s too late.

But the less heralded and more common victims are middle-aged and older people, mostly men, who are also not getting access to the psychological interventions that could save their lives. This is made more difficult by a lack of community mental health resources, and the stigma around depression and other disorders of the mind. People are too ashamed to ask for what little help might be available.

A lot of misinformation contributes to the silence around the issue. Prevention measures, such as fencing on bridges or restraining orders that take guns away from people who have demonstrated that they are a danger to themselves, are considered futile, because of the mistaken notion that someone who is determined to kill themselves will always find a way.

“But it’s not true,” psychologist William Schmitz Jr. told Scientific American magazine. “We know if we get people through a suicidal crisis, most of them will never end up dying by suicide.”

Therapies that focus on helping patients understand their emotions and having a plan to get help when they are sliding into crisis are effective.

Suicide is a preventable cause of death, but only if more of us learn to recognize the signs and get people the help they need in time.

But too often, the only treatment available is medication prescribed by a primary care physician who does not have the time or training to deliver therapy. There are resources available to people in crisis, such as the Maine Crisis Hotline, (888) 568-1112, or the National Suicide Prevention Lifeline, (800) 273-8255.

But they can’t help people who don’t reach out and ask for help. And many won’t do that if we continue to avoid talking about suicide.

Despair doesn’t have to be a death sentence. In this public health crisis, it’s everyone’s job to insist that there is a reason to keep hoping.