Ran Barzilay

Conflicts of Interest Ran Barzilay serves on the Scientific Advisory Board and reports stock ownership in Taliaz Health, with no relevance to this work. All other authors have nothing to disclose. Data Availability Statement The data reported in this study are deposited in DbGaP (https://www.ncbi.nlm.nih.gov/gap).

Abstract Suicide is the second leading cause of death for American adolescents and young adults and is transdiagnostic. Suicide risk is impacted by genetic and both distal and proximal environmental factors, particularly stress exposures.

Mental health is shaped by the complex interplay of genetic and environmental factors, each contributing to individual differences in risk and resilience. While genetic influences are increasingly well-characterized, understanding the role of environment is critical for several reasons. First, environmental exposures are potentially modifiable, and if proven causal, they offer actionable targets for interventions aimed at preventing or mitigating mental illness.