Two Parkland school shooting survivors have died by suicide over the last week — a tragic reminder of the lingering pain and trauma brought by gun violence.

Sydney Aiello, a 19-year-old recent graduate of Marjory Stoneman Douglas High School in Parkland, Florida, took her life last weekend. On Sunday, police confirmed that a second survivor, a current student, is also now dead in an apparent suicide.

The pair of tragedies comes just over one year after a gunman opened fire in the Florida high school, killing 14 students and three teachers. The shooting marked a turning point in the debate over gun violence and horrific attacks on school campuses.

Before her death, Aiello had been close friends with one of the shooting victims, Meadow Pollack. While Aiello graduated from Stoneman Douglas last year, her parents say she continued to live with “survivor’s guilt” long after leaving the school. Aiello’s mother told CBS Miami that her daughter had been recently diagnosed with post-traumatic stress disorder.

”The death of Sydney Aiello is tragic, shocking and heartbreaking, and surely at least in significant part the result of the ripple effect of the MSD shooting,” Pollack’s family said in a statement.

The trauma of a shooting can be long lasting

The Parkland shooting is now best known for the outspoken survivors who became the public faces of a newly revived gun-control movement. Several students, like Emma González and David Hogg, emerged from the tragedy to give an eloquent and impassioned plea for the US to address its gun violence problem. These students helped inspire thousands of young people to become outspoken and politically engaged by lobbying for tighter gun safety legislation, leading nationwide marches, and holding political leaders accountable for being beholden to the National Rifle Association.

While their actions are inspiring, the shooting is also a trauma that follows many survivors every day. It’s not unprecedented for tragedies such as Parkland to have a ripple effect of trauma for survivors. Students who lived through the Columbine shooting in 1999 notably struggled in the aftermath of the massacre. Some also died by suicide soon after.

Parkland students’ deaths also broadly fit into a new, troubling trend. Suicides in the US are at their highest rates in decades. As Brian Resnick explained for Vox last month, teen suicides, in particular, are increasingly common.

Here are some sobering statistics. Between 2009 and 2017, the number of high schoolers who contemplated suicide reportedly increased by 25 percent. Deaths by suicide among teens increased by 33 percent in that time period as well. Suicide is now the second leading cause of death among teens after accidents (traffic, poisoning, drownings, etc). But don’t be mistaken: Teen suicide is still rare. Just 10 out of 100,000 teens ages 15 through 19 die this way. But even a single death is one too many.

As Resnick highlights, researchers remain stumped on how to identify the most effective approaches toward intervention. It’s difficult to isolate the individual factors that make a person more at risk of suicide, and there’s little evidence defining what works and what doesn’t, but there are some promising, available approaches toward suicide prevention. For example, educating the adults who surround at-risk youth on how to support and talk to suicidal teens may offer a crucial lifeline.

Another approach to suicide prevention is addressing the underlying problem that embroiled the Parkland survivors in the first place: gun violence. Research shows that states with higher rates of gun ownership also have higher rates of suicides by guns. States with tighter gun regulations saw just the opposite, which matters because according to the Centers for Disease Control and Prevention, 48 percent of suicide deaths involved firearms.

These data points may help unlock a potential solution, one that Parkland survivors have been pointing to all along: Fewer guns lead to fewer deaths.

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