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- 13 - accessHealthNews.net August 2023 Volume 9 | Issue No. 73 READ MORE W hen 17-year-old high school junior Thomas Smith initially sought support for his depression, his parents blamed his lack of dedication to God and said the pain he felt was a consequence of failing to live a godly lifestyle. Smith lived in a rural area near the Lake of the Ozarks where his father had established a church and became a Baptist preacher. The middle-class family had a longstanding stellar reputation in the town and lived in a fourth-generation farmhouse on the top of a holler with no neighbors. However, nearby there were methamphetamine manufacturers they purposely avoided. After someone under the influence of meth broke into the house when Smith was 12, the fear of violence fueled the Southern machismo gender dynamics within the family. According to Smith's high school girlfriend Krista Hanson, a 14-year-old freshman at the time, these dynamics created expectations for a role Smith didn't necessarily want to fill. Though he hunted occasionally with his family, the only real gun safety education he received was during 8th grade. Following the break-in, his father equipped himself, his wife, and Smith each with their own pistol, recommending it be kept under their pillows in case of another intruder. This is the same gun Smith would use to take his own life on March 11, 2018, not long after his father died of cancer. Despite multiple suicidal warning signs, his obituary reads, "He departed this life in St. Louis" with no further explanation other than that from family stating, "He couldn't live without his father." "His lack of familial support and the shame he received talking about mental health had everything to do with his passing," Hanson said. Though Smith sometimes struggled to make social connections, Hanson's openness to discussing mental health allowed him to share with her his prior history of self-harm. With her support, he reached out to his godparents, but the need to retain the family's pristine and godly reputation prevented them from taking much action. Suicide Among Missouri Youth Suicide is one of the top 10 leading causes of death in Missouri according to the Centers for Disease Control and Prevention (CDC). A study found a 21.8% increase in Missouri suicide rates among young adults 19-24 years old are associated with the repeal of the permit-to-purchase law. In 2017, CDC reported suicide as the second leading cause of death for children and young adults aged 10 to 24 years old, with Missouri ranking sixth in the nation in firearm deaths. While access to firearms doesn't necessarily cause a suicide, experts historically observe that simply having a lethal weapon available can turn a bad situation into a fatal one. According to America's Health Rankings, the most significant risk factors for suicidal behaviors include mental health disorders, substance use disorders, and environmental factors. Environmental factors can include stressful life events and access to lethal means including firearms and drugs. Previous suicide attempts and family history of suicide are also factors that can increase risk of suicide among adolescents and young adults. Poverty also contributes to suicide, especially in rural areas where food and transportation deserts prevent access to necessities. People living in poverty and those experiencing homelessness struggle with mental health challenges due to prolonged stress and lack of physical care which in turn can lead to struggles coping and eventually suicide. The combination of mental health challenges (and potentially substance use as they often coexist) along with shameful stigmas and access to lethal means can turn a preventable situation into a tragedy. Victor Schwartz, chief medical officer at suicide nonprofit The Jed Foundation, said in an interview that social media can also play a role among adolescents. According to Schwartz, using social media "in a way that detracts from face-to-face interactions" can be especially harmful to mental health. After lockdowns and virtual schooling for more than a year, it is reasonable to expect that the distanced interactions among Missouri youth will make an emotional impact. According to America's Health Rankings, the most significant risk factors for suicidal behaviors include mental health disorders, substance use disorders, and environmental factors. Environmental factors can include stressful life events and access to lethal means including firearms and drugs.

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