Six months after being ordained as an Episcopal priest, Smith began serving a parish near Ferguson, Mo. There, a funeral was being planned for a 13-year-old female victim of a drive-by shooting. Although Smith didn’t know the young woman, he knew her grandmother, a client at the church’s food pantry. Out of respect for the grandmother, he attended the funeral.

“I remember coming home from the funeral and having my late wife ask me what my impressions were. Without hesitation, I said, ‘If it’s Tuesday, we bury our kids. If it’s Monday, we do the wash, if it’s Friday, we go grocery shopping, but if it’s Tuesday we’re at some church or funeral home burying someone’s kids,” Smith says.

violence-reverend-mark-smithDetermined to do something about the toll that gun violence is exacting on St. Louis, now dubbed by some as America’s “murder capital,” the Episcopal Diocese of Missouri is digging in with activists, academic leaders and faith communities to help understand the causes and develop solutions to prevent shootings. Last year, Smith was appointed the bishop’s deputy for gun-violence prevention to help lead this effort. The expanded duties are a good fit for Smith, who previously spent 35 years in health care, both as an academic hospital administrator and as president of the Missouri Hospital Association for nearly 12 years.

Although still early in his new role, Smith sees signs of progress. One recent initiative undertaken with Women’s Voices Raised for Social Justice is the Lock it for Love campaign, which aims to reduce suicides and accidental shootings by children by distributing free gun locks. So far, more than 1,300 gun locks have been given to local families.

Meanwhile, Smith is partnering with a self-identified group of African-American “homicide ministers” in the area who have made it their mission to be with and comfort every family victimized by gun violence and to quell the prospects for retaliatory violence. The homicide ministers have incredible street knowledge and strong credibility with both police and the community, Smith says.

“What we recognized in conversations with the violence ministers is that they are aging, their numbers are diminishing and while they have incredible street knowledge, they would appreciate the opportunity to advance and sharpen their skills. So, we’re partnering with them to recruit within both the African-American community and the suburban white community to provide skill training on issues related to psychological first aid and post-traumatic stress disorder, which we believe is at the root of much of the gun violence, especially retaliatory behavior,” he says.

Interestingly, another health care leader who was a seminary classmate of Smith — Barry Hong, Ph.D., vice chairman for clinical affairs in the department of psychiatry at Washington University School of Medicine in St. Louis — is working with him on violence-prevention initiatives.

One of the things that stimulated Smith and Hong’s interest in the gun violence-prevention initiative was a study done several years ago by the Washington University School of Medicine and the pastoral care department at Barnes-Jewish Hospital, also in St. Louis. Researchers talked with survivors of gun violence who were willing to change the dimensions of their lives that result in violence.

“They’re willing to look at going back to finish school, moving into a different neighborhood and hanging out with different folks. Where that breaks down is the lack of case management when they are discharged from the hospital,” Smith says.

He sees a real opportunity for hospitals and the church to partner with the broader community to create a seamless case management process that goes from the emergency department to the intensive care unit and back into the community. Smith estimates that between one-fourth to one-third of all gun violence victims could benefit significantly from such efforts.

Just as hospitals have become acutely more attuned to the need and ways to reduce readmissions over the past decade, Smith is hoping that similar emphasis and attention will be paid not only to the physical needs, but also to psychological and other needs of gun violence victims.

“I’m not suggesting that hospitals do this alone. But as hospitals look out into their communities, I hope that they will actively commit resources and intellectual capital to cultivating those relationships,” Smith says.

The statistics on gun violence in St. Louis are beyond sobering. Smith noted in a recent paper he wrote that the city’s number of homicides increased from 120 in 2013 to 188 in 2015 — nearly a 64 percent increase. The homicide rate per 100,000 population is more than eight times the national average (37.7 compared with 4.5).

However, Smith adds that at least 36 public and private organizations are working together to develop a more coordinated response to the gun violence crisis. Last year, the United Way of Greater St. Louis and Washington University’s Institute for Public Health convened regular meetings of these entities — together known as the St. Louis Gun Violence Prevention Collaborative — to begin developing a more coordinated response to the gun violence crisis.

Following a year of information sharing, planning and initial program coordination, the Collaborative requested the Diocese’s help in securing funding through the Episcopal Presbyterian Health Trust to retain a consultant who has been hired to facilitate the development and implementation of a governance model for the groups.

How big of an impact the Collaborative will make remains to be seen, but for now Smith is focused on making progress and measuring it the best way he knows how. “Progress is defined as one life at a time. What we have to do in St. Louis is to move the number [of homicides] from 188 to 187, and that’s doable. That makes me optimistic. That, and the goodwill of the people,” Smith says.