KANSAS CITY, Mo. - There is hope beyond the headlines, according to a child and adolescent psychiatrist at Children's Mercy Hospital and Clinics, even as research shows children and teens are taking their lives by suicide in greater numbers.

Dr. Shayla Sullivant said stigma and easy access to guns are problems that can be remedied in individual homes. She pointed to famous figures who experienced depression and suicidal ideology, ranging from Abraham Lincoln to actress Halle Berry and author J.K. Rowling.

"Think of all these people and the contributions they have made to our society," she said. "There is reason for us to hope and there is reason for us to also think about how not having access to a firearm when these people were in the depths of despair is partly why they contributed what they did."

Sullivant said she often counsels parents of her clients to either remove guns from their homes or keep them locked in a safe. She said it's a misconception that youths always plan suicide well in advance of taking their lives. Often, she noted, teens who attempted suicide tell her they made their decision just 10 minutes prior to the act. If children don't have a highly lethal means to take their lives during this impulsive period, Sullivant said, their lives often can be saved.

It's simply not true, Sullivant said, that victims of suicide will always find a way to complete the act if the most lethal option isn't available. She pointed to the nation of Sri Lanka, which had the highest rate of suicide in the world when deadly pesticides were readily available. Once restrictions were put on the most lethal pesticides and safe storage was prioritized, the suicide rate plummeted. She also recalled that in the United States in the 1970s, many people didn't wear seat belts "and how no one wanted to do it - and how now we don't even blink, we just get in the car and do it."

Automobile fatalities were skyrocketing in the '70s, but the number of deaths per capita in auto crashes has dropped by more than 35 percent since that time. Sullivant said suicide rates among youths also can be dramatically curtailed by reducing stigma, keeping firearms stored or by family members making the decision to remove guns from the homes of struggling youths.


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The ruling on abortion by the U.S. Supreme Court has returned the issue to the states, fulfilling long-held goals of Republican lawmakers in Texas to ban and criminalize abortion.

With the 49-year-old Row v. Wade case overturned, a trigger law takes effect next month, banning abortions from the moment of fertilization - there is no exception for rape or incest.

Texas lawmakers were ahead of the high court, passing legislation last fall to prohibit abortions after six weeks. Aimee Arrambide, executive director of the Texas chapter of the abortion rights group Avow, said she expects half the states to follow Texas' lead.

"We've been ringing the alarm that what is happening in Texas, doesn't stay in Texas," said Arrambide. "And that the public health crisis Texans have been facing for nearly 10 months will be the reality in half the country. Our opponents are not going to stop until abortion is completely inaccessible in the country."

In his concurring opinion with the 6-3 vote, Supreme Court Justice Clarence Thomas said high court rulings that established a right to contraception, as well as gay rights should also be reconsidered.

Following the ruling, Texas GOP Gov. Greg Abbott said abolishing Roe v. Wade, "reinstated the right of states to protect innocent, unborn children."

New Mexico is now the closest state for many Texans seeking an abortion, but getting there may not be possible for low-income people who don't have the time, money or child care to travel out of state. Progress Texas Advocacy Director Diana Gomez said education is the next step.

"There are a lot of folks who don't know about the existence of abortion funds," said Gomez, "of infrastructures that are already in place to help people get abortions, and so we want to let people know about clinics in surrounding states."

In addition to Texas, 25 other states are expected to make abortion illegal, affecting the lives of 36 million people. University of Texas at Austin Associate Professor Kari White said entire regions of the country may soon be in the business of extreme criminalization.

"In a state like Texas," said White, "it's also going to criminalize a whole range of behaviors and practices for people who are trying to help someone get an abortion."

Prior to the court's ruling, a poll by Reuters showed about 71% of Americans - including majorities of Democrats and Republicans - believed pregnancy termination should be a patient-doctor decision.

Medical negligence cases in Washington and elsewhere have taken on a new shape during the pandemic, as hospital resources have been strained and the potential usefulness of certain treatments has ebbed and flowed.

Drugs like ivermectin, for instance, were touted online as a potential COVID-19 treatment but ultimately lacked scientific evidence to back up those claims.

Elizabeth Calora is a Tacoma lawyer who specializes in medical negligence cases. She said there are some legal requirements for determining if a health professional acted carelessly which have been affected by COVID.

"We need to figure out what a reasonably prudent provider should have been doing in that context," said Calora, "and it usually means talking to experts in the field and then determining if what the provider did in the moment or over the course of several visits violated that standard of care."

Calora said after that, the person has to prove that the breach is what caused the damages.

The Washington state Legislature modified evaluations of negligence cases in 2021 so that resources and staffing must be taken into account. For instance, hospitals have often lacked beds at the height of different COVID waves, a factor outside of doctors' or facilities' control.

Calora said the standard of care evolves over time. What was once an acceptable medical practice in the 1970s, for example, might not be anymore.

"But usually it happens in a much slower timeframe than what we experienced at the start of the pandemic," said Calora. "With COVID, you had physicians all over the world basically - it makes me think of throwing spaghetti on the wall to see what sticks. Everyone was trying everything they could."

Calora said the unforeseen nature of the pandemic has made it hard to bring medical negligence cases forward. However, she added that shouldn't discourage people from speaking with an attorney if they feel they or a loved one has been wronged.

"Even though things were bad," said Calora, "it doesn't give people license to practice beneath the standard of care."

Since the beginning of the pandemic, several states have passed "safe staffing" laws aimed at balancing patient-nurse ratios in hospitals. In Pennsylvania, health care advocates are calling on lawmakers to vote on legislation still stalled in committee.

Senate Bill 240, also known as the Patient Safety Act, would establish limits to the number of patients one nurse is responsible for during a shift.

Maureen May, president of the Pennsylvania Association of Staff Nurses and Allied Professionals, said it is about ensuring positive outcomes for patients.

"I want to be in a hospital bed in which I know that there are enough nurses to care for me and my family members," May asserted. "I want to be a nurse that works in a hospital and walks away from the bedside at the end of the day and know that I did everything I could to make sure my patients received the best care possible."

Many health care system administrators oppose safe-staffing legislation, saying it is costly to their bottom line. Senate Bill 240 and its companion House Bill 106, which has more than 100 co-sponsors, have been referred to each chamber's health committees and await a vote.

Sen. Maria Collett, D-Montgomery County, said the pandemic exposed the cracks in the health care system and the need for legislation such as the Patient Safety Act. She stressed it has been disappointing to see the legislation stalled by a few lawmakers, given the bipartisan support for the bill.

"If you're someone that's not going to stand with nurses, that's not going to stand with patients, then put your name on the record," Collett urged. "Vote no on this bill because the people in our communities deserve to know where we stand when it comes to protecting patient outcomes and protecting the hardworking nursing staff."

A 2017 study found patients were much more likely to survive when nurses followed a hospital-mandated patient-nurse ratio. Lower patient-to-nurse staffing ratios also have been associated with significantly lower rates of cardiac arrest, hospital-acquired pneumonia, respiratory failure and patient falls.