House measure aims to boost suicide awareness and prevention, promote 988 Crisis Lifeline

      The Missouri House has taken time in the waning days of the session to pass a bipartisan effort to address suicide awareness and prevention.

Representative Ann Kelley (Photo: Tim Bommel, Missouri House Communications)

      It sent to the Senate House Bill 2136, the “Jason Flatt/Avery Reine Cantor Act,” which would require public schools, charter schools, and public higher education institutions that print pupil identification cards to print on those cards the new three-digit number for the National Suicide and Crisis Lifeline, 988. 

      “988 is going to be our new mental health suicide hotline beginning in July, so this is going to encourage school districts to get that out there to the public so that we can start using that,” explained the bill’s sponsor, Representative Ann Kelley (R-Lamar)

      The bill also contains provisions meant to equip and encourage pharmacists to identify possible signs of suicide and respond to them.  This includes the “Tricia Leanne Tharp Act,” sponsored by Representative Adam Schwadron (R-St. Charles).

“This would allow the Board of Pharmacy to create two continuing education credit hours for pharmacists to take, to allow them to apply that to their continuing education credits in suicide awareness and prevention,” said Schwadron.

      The bill was amended to make sure all pharmacists can participate in that continuing education, regardless of where they work.  That change was offered by Representative Patty Lewis (D-Kansas City), who said, “All licensed pharmacists, whether they work inside the four walls of the hospital in an acute care setting or in retail pharmacy [would] have the opportunity to participate in the continuing education to address suicide prevention because there’s such a great need.”

      Bolivar representative Mike Stephens (R) is a pharmacist, and said he and others in that profession are well-positioned to be able to identify and work to prevent suicide.   

Representative Patty Lewis (Photo: Tim Bommel, Missouri House Communications)

“I think it’s an important thing for pharmacists at every place along the way to be informed and be a part of this process, be aware.  I know in my own personal practice you have intimate contact with patients and you see them during their treatments and there are times that you feel like things aren’t as they ought to be but [you’re] not sure what sort of interventions are appropriate.  I think this will be very helpful,” said Stephens.

Similar language will allow teachers and principals to count two hours in suicide-related training toward their continuing education.

The bill advanced to the Senate 142-0 after several members spoke about their own experiences regarding suicide.

Festus Republican Cyndi Buchheit-Courtway told her colleagues that every seven hours someone commits suicide in Missouri.  It’s the tenth leading cause of death in the state and the second leading cause among those aged 10 to 34. 

“When you think about age 10 all the way up to 34 this is covering all of our children in schools and college when they first get out of school and they’re finding their first jobs or meeting someone and becoming a family, and I think that anything that we can do to bring awareness to this issue is just incredible,” said Buchheit-Courtway.  “Mental health awareness is so important to so many of us here.”

      Representative Dave Griffith (R-Jefferson City) said he knows of a 14 year-old who committed suicide two months ago, just south of the capital city.

Representative Adam Schwadron (Photo: Tim Bommel, Missouri House Communications)

“He did it because he was being bullied in school and he felt there was no other way out and he couldn’t talk about it.  It became very obvious to that community the need for us to be able to talk and have some kind of tools in our hands to be able to prevent these types of tragic events,” said Griffith.  “The suicide prevention hotline number, I believe every school will put it on their cards.  There’s no reason for them not to do that.”

      Representative Rasheen Aldridge, Junior (D-St. Louis) told the body, “One of my good friends in high school, best friend … who is also between that age that the lady talked about, only in 10th grade, committed suicide … it takes a toll on loved ones, it takes a toll on friends, it takes a toll on people that love that individual and all individuals that have committed suicide.”

      The legislation stems partly from the work of the Subcommittee on Mental Health Policy Research, of which Lewis is a member and Buchheit-Courtway is the chairwoman.     

      The school-related provisions of the bill would take effect in the 2023-24 school year.

Republican plan would allow pharmacists to prescribe birth control pills

The sponsor of legislation that would allow pharmacists to prescribe birth control pills says his bill is both pro-choice and pro-life.

Representative Shamed Dogan (photo; Tim Bommel, Missouri House Communications)
Representative Shamed Dogan (photo; Tim Bommel, Missouri House Communications)

It’s pro-choice in the sense that we are trying to give women more control over their reproductive health and over their family planning, and it’s pro-life in the sense that the bill is intended to reduce unintended pregnancies and abortions,” said Ballwin Republican Shamed Dogan.

He said House Bill 233 could help reduce Missouri’s unplanned pregnancy rate by as much as 25-percent.

HB 233 would let pharmacists prescribe oral contraceptives to those 18 or older regardless of whether that person has a previous prescription.  Those younger than 18 who have evidence of a previous prescription could also be prescribed the pill by a pharmacist.

The legislation is projected to save Missouri money, and Dogan said it would save women money and time by negating the need for some visits to their doctor.

Several groups testified in favor of the bill, including the Teen Pregnancy and Prevention Partnership.  Its Executive Director Meg Boyko said HB 233, “would just be one step in the right direction to lowering barriers to access to care to those teens so they can take responsibility of their health and their health outcomes and prevent teen pregnancy.”

Representative Cora Faith Walker (D-Ferguson) said a similar plan in California didn’t have the results backers hoped it would.

“This is just a different barrier.  By making it behind the counter, making it a requirement for pharmacists to write the prescription, it just kind of shifts the barrier,” said Walker.

“We’re a different state than California,” Dogan responded.  “I think one of the issues that we might have that they don’t face nearly as much is rural folks … I think the fact that many people in rural areas don’t have access to a doctor in the same way that they have a lot more pharmacists in their areas … Yeah there’s still somewhat of a barrier, but it’s not nearly what the barrier is right now.”

Dogan said he favors making birth control over-the-counter, but noted such proposals have not been adopted in states that are more politically progressive than Missouri, and he doesn’t feel such a bill would be likely to pass in the Missouri legislature.

Shannon Cooper testified against HB 233 on behalf of Blue Cross/Blue Shield and the Missouri Coalition.  He said their primary concern was that without the need for a prescription, women would make fewer visits to their doctors.

“Under the [Affordable Care Act] and insurance policies, we provide a free exam once a year and we feel like for a lot of the invincibles that we talk about who don’t think they’re ever going to be ill or have any problems, when they receive these birth control pills and the prescriptions that does drive them back to the physician to get that exam,” said Cooper.  “I think we all know that early detection of any type of disease is one of the best cures for that disease.”

Cooper also expressed concern that HB 233 would allow up to a 12-month supply of birth control pills to be prescribed under certain circumstances.

“We feel like there will be certain individuals who could take advantage, get that supply and then drop off our policies with that 12-month supply,” said Cooper.  “Obviously there’s a cost concern there.”

Others expressed concern that allowing a 12-month supply could lead to wasted pills, such as in cases in which a woman only uses them for a while and then stops for some reason.

Representative Mike Stephens (R-Bolivar), himself a pharmacist, said he hopes the proposal represents a larger effort to expand the availability of medical services.

“If there is a saving grace to the health care system it must include a greatly expanded role in health care delivery and health care access by a wide variety of health care professionals,” said Stephens.

The committee has not voted on HB 233.

Last year similar legislation was passed by the House 97-50, but stalled in the state Senate.