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The state of Wyoming finished 2023 at the top of the list for its suicide rate, which is the subject of this next story. The popularity of guns has made it hard for mental health professionals trying to prevent suicides. NPR's Kirk Siegler reports on how they're responding.
KIRK SIEGLER, BYLINE: Shortly after Christina Williams's fiance died last spring, her daughters came to her, crying. They said they missed their dad. It got to be too much.
CHRISTINA WILLIAMS: I couldn't handle my grief and my girls' grief at the same time.
SIEGLER: She made a plan, as grief counselors call it, to take her life that day, but by chance, a couple hours later, stopped at a light on Dell Range Boulevard in Cheyenne. She saw LIV Health, a newly opened mental health urgent care clinic.
WILLIAMS: Honestly, I seen the sign, and I Googled it, and it just happened to be at a really bad time in my life.
SIEGLER: Williams drove in without an appointment and was seen immediately by a crisis clinician and a psychiatric nurse practitioner. She then agreed to check herself into the hospital. Sarai Guerrero-Vasquez was working that day. It's standard protocol to ask where the guns are at home.
SARAI GUERRERO-VASQUEZ: I mean, if they're disclosing any type of suicidal thoughts - active or passive, whatever it might be - my first question is, like, what firearms do you own at home? How are they secured?
SIEGLER: Fortunately, Christina Williams had already given her gun to her best friend when she experienced feelings of suicide. But Guerrero-Vasquez says some patients actually resist getting more treatment because they're afraid their guns will be confiscated.
GUERRERO-VASQUEZ: And I always assure them. I'm like, I'm just a social worker. I'm not going to go into your house and take anything. I just want to make sure that you stay safe. And, you know, if that means having your parents or a family member, neighbor secure them for a little bit until you go through this bump - like, life will resume.
SIEGLER: This is the reality of suicide prevention work in a state with one of the highest gun ownership rates in the nation. Emily Loos, who came up with the idea to open this urgent care, is CEO of LIV Health.
EMILY LOOS: We've had to get very creative because, of course, the police can't go and remove someone's firearm.
SIEGLER: She's referring to red flag laws that have been effective in other states, including next door in Colorado, where a judge can temporarily remove guns from people in crisis. Now, this would probably never pass in Wyoming, so here you talk about safe gun storage, never gun control. In the lobby next to the requisite doctor's office magazines, Loos is restocking a basket full of gun safety locks.
LOOS: I mean, we probably fill this basket every couple of weeks.
SIEGLER: People take them.
LOOS: If we're worried about impulsivity, you can put the key somewhere - you know, put it up high where you have to really work to get it too. Sometimes we'll talk to people about that. If they're hesitant about giving up their firearm, we'll talk to them about making it harder to access it within the home.
SIEGLER: Unlike, say, intentional drug overdoses, suicide by firearm is almost always lethal. Here in Laramie County, which includes the capital, Cheyenne, guns are used in 85% of suicides.
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SIEGLER: At Cheyenne's hospital, Brittany Wardle runs the suicide prevention program, where she works with local employers, schools and veterans, pushing mental health awareness and safe storage.
BRITTANY WARDLE: I think some days it feels very overwhelming because you think if we didn't have firearms to worry about, what would suicide look like here in Wyoming?
SIEGLER: But she says we'll probably never know that. There are few topics more polarizing in the Cowboy State than guns.
WARDLE: Firearms accessibility and availability in Wyoming isn't likely going to change for us, so we need to figure out how to move around it, how to move with it.
SIEGLER: And the new mental health urgent care in Cheyenne is one way. These have been popping up across the country since 2020. Patient numbers at LIV Health are up 171% since it opened a year ago. Clinician Sarai Guerrero-Vasquez says people in crisis can't wait for a doctor's visit.
GUERRERO-VASQUEZ: Yeah, to get on somebody's calendar, it's anywhere from, like, three to six months for therapy. Yeah, and then for psychiatry, it's, like, six-month wait usually.
SIEGLER: And care can be hard to get to. Roads close all the time for wind or blizzards. And then there's the culture. Christina Williams, the patient we heard at the beginning of this story, describes growing up in Wyoming this way.
WILLIAMS: It's kind of just cowgirl up. You just hide everything down low, and you don't talk about it.
SIEGLER: She says she's hanging on the best she can. She's been doing regular counseling for months.
WILLIAMS: I feel like I'm going in the right way, and I feel like they are helping me in the right way.
SIEGLER: Staff are helping her see she's not alone. And her best friend - she's still storing her gun.
Kirk Siegler, NPR News, Cheyenne, Wyo.
(SOUNDBITE OF ISATO NAKAGAWA'S "TREE CIRCLE")
INSKEEP: If you or someone you know may be considering suicide or is in crisis, you can call or text three numbers, 988, to reach the Suicide & Crisis Lifeline.
(SOUNDBITE OF ISATO NAKAGAWA'S "TREE CIRCLE") Transcript provided by NPR, Copyright NPR.
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