Amanda McIntosh has worked at the Southeast Utah Health Department since 2018, where she has worked to raise awareness of mental health care and the high suicide risk in the area. She also administers QPR training — the mental health equivalent to CPR, meaning “question, persuade and refer.” She’s passionate about the importance of the work, and for good reason. Amanda McIntosh lost her husband to suicide in 2014.

“When that happens, you’re grasping at all straws to find ways of healing and moving through your grief,” she told the Moab Sun News. One of those straws was the Hope Squad of Grand, Emery and Carbon counties, where she learned that the tri-county area leads the state in suicides. The statistics scared her — especially learning that when someone loses a parent or loved one to suicide, they are more likely to end their own life.

“When my husband died, my daughter was 16 months old. Learning that statistic scared the ever living crap out of me,” McIntosh said. “I didn’t want to sweep it under the rug or keep it taboo. I wanted to provide my daughter with all the resources necessary so that if her mental health ever did take a downturn, we would be prepared as a family to get her the help she desperately needed.”

In partnership with the Moab Regional Hospital, McIntosh will offer an in-person suicide prevention and QPR certification workshop on July 1, after a Facebook Live presentation about substance use, self-harm and suicide on June 29.

“I have two teenage girls, and what I’ve learned while putting this event together is alarming,” said Christy Calvin, director of marketing and community relations at Moab Regional Hospital, who will moderate the Facebook Live on Tuesday. Those who tune in will be able to submit questions to a panel of experts, featuring child psychiatrist Dr. Kristin Becker, family medicine physician Dr. Whitney Mack and Helen M. Knight Elementary school therapist Kelly Vagts. Calvin, these experts and other hospital personnel felt compelled to host an event on substance abuse, self-harm and suicide given significant suicide attempts by children of the Moab community in recent years.

A focal point of the two events next week is the national trend of substance abuse, self-harm and suicide affecting younger children each year. Vagts said that she “absolutely” sees signs that students at HMK are suffering mentally, turning to substances or engaging in unhealthy coping mechanisms.

“It’s about recognizing the changes in behavior that stay consistent, which parents and teachers can look for,” Vagts said. Such changes can include loss of interest in formerly favorite activities, inconsistent sleep, isolation from friends, bruising, hair loss, changes in eating patterns, irritability, defensiveness, emotionality, suffering grades or lack of care for hygiene.

“Sometimes as parents, when we see that our children are experiencing things we can’t help them with, it’s a really helpless and debilitating experience. There’s also often a bit of embarrassment, thinking ‘I should be able to do this,’” said Vagts. “You can be a really good parent and still have children that need help that you’re not able to give. There’s no shame or embarrassment in that — don’t be afraid to reach out.”

Though mental health in children and teenagers is worsening nationwide, and even globally, McIntosh and Vagts have observed the ways that living in Moab specifically have impacted residents’ mental health. First and foremost, according to McIntosh, is Moab’s rurality.

“We are so far away from any major metropolis, so while we have great resources, there’s not a plethora of them,” she said. To get an inpatient stay during a mental health crisis, patients have to travel to Provo, Utah or Grand Junction, Colo. “Access to resources is a major hurdle for Moab residents,” McIntosh continued.

Grand County also has the fourth-highest rate of intergenerational poverty in the state of Utah.

“Just because you live in poverty doesn’t mean that you have trauma, abuse or substance use,” said Vagts. “Being poor is stressful. What happens to the brains and nervous systems of those living in poverty can set the stage for future mental illnesses.”

Vagts also cited Grand County’s high level of residents suffering from intergenerational trauma. She reported that 80 to 90% of the school district therapists’ caseloads are children whose parents likely score highly on the ACE score, a gauge of different types of neglect, abuse and other signs of a difficult childhood.

“With epigenetics, that’s transferred through your DNA and genes,” Vagts continued. “You have these biomarkers and phenotypes, and it doesn’t mean that they’re going to come to fruition, but they’re in there.” Vagts also disclosed that she frequently sees cases of complex post traumatic stress disorder in Grand County’s schoolchildren.

“If you’re being raised in a community that’s predominantly reliant on tourism, there’s a portion of the year where you don’t have enough money, and then another portion of the year when your parents are working two to three jobs to make as much money as possible,” Vagts said. “That creates a really stressful environment for a child’s developing brain.”

McIntosh added that lack of sleep and even high elevation can affect the brain’s ability to process stress, and Moab’s “community of shift work” doesn't help. Many Utah residents are also avid outdoorsmen and hunters, so residents have easier access to lethal means.

A 2019 report concluded that Utah had the fifth-highest age-adjusted suicide rate in the country from 2017 to 2019, and that suicide was the leading cause of death for Utahns ages 10 to 24.

“Those are babies,” said McIntosh. “They have no idea yet the beauty that this world has to offer. Because they can’t see outside of their narrow focus beyond their crisis, they do something drastic and everlasting that has a ripple effect throughout their families and communities.”

Realizing that substance abuse, self-harm and suicide are real concerns specific to the Moab community is an important first step in prevention, said McIntosh, along with attending events such as the June 29 panel and July 1 workshop.

“You’re never looking for these resources until you’re in the depths of it,” she continued. “Having these skills on hand could prevent someone from ending their life. You might not need this information today, but weeks or years from now, you might find yourself needing to fall back on this training.” McIntosh emphasized the event’s relevance to teachers and parents, who interact with children daily.

Those who attend McIntosh’s suicide prevention workshop on July 1 will earn their QPR certification, which is good for three years. Her presentation will include information about suicide and mental health on global, national and local lebels. “I hope it opens people’s eyes to how this is an ongoing issue that is prevalent in our community, especially for our youth,” she said. McIntosh’s in-person workshop will be capped at 20 participants.

“Suicide is 100% preventable and can happen to anybody. We all need to do our part to make sure that nobody in our circles ever feels so hopeless as to think that ending their own life is the only way out,” said McIntosh.

“The more we ignore it, the more frequent it’s going to be, and the more losses our communities will suffer.”