White and pink buds on dogwood and tulip trees brighten the Missouri State Capitol grounds in Jefferson City (Getty Images).

With mental health issues on the rise nationwide, Missouri lawmakers are weighing bills that would provide pharmacists and teachers with more training to recognize the signs of suicide.

bill sponsored by Rep. Adam Schwadron, R-St. Charles, heard Monday in the House Health and Mental Health Policy Committee, would allow suicide awareness and prevention to be an option pharmacists can choose as part of their required continuing education.

Meanwhile, a bill passed out of the committee last week and sponsored by Rep. Ann Kelley, R-Lamar, would similarly allow suicide prevention training to count toward teachers’ professional development and also require that the new Suicide and Crisis Lifeline number, 988, be printed on student ID cards issued to students in 7th to 12th grade.

“With my religion, if you save one life, it’s as if you save the world,” said Schwadron, who is Jewish. “So if this legislation will help save one life then it would be worth it.”

In 2020, suicide was the 12th leading cause of death for all ages and 2nd for 10 to 14-year-olds, according to the Centers for Disease Control and Prevention.

The bills come at a time when mental health issues have been on the rise during the pandemic, and Missouri children’s hospital leaders have warned of a pediatric behavioral health crisis.

About 4 in 10 U.S. adults reported symptoms of anxiety or depression in January 2021 — an increase from the share of one in 10 adults who reported those symptoms from January to June 2019, according to a Kaiser Family Foundation analysis of U.S. Census Bureau data.

Those symptoms were especially acute in young adults between the ages of 18 and 24, with 56% reporting symptoms as of December 2020. The age group was also more likely to report substance use and having experienced suicidal thoughts.

Neither bill mandates that the training be required, but allows it to count as an approved option in each field.

Schwadron’s bill would direct the Board of Pharmacy to recommend licensed pharmacists in retail locations obtain two hours of continuing education in suicide awareness that could count toward the 30 hours needed every two years to renew their license.

Some lawmakers raised questions as to the impact a pharmacist could make in a brief interaction with a patient. Schwadron noted that pharmacists can check to see whether a person’s medications may interact negatively with others, and stressed it would also help them know how to look for the right signs.

“Even with that limited interaction they might be able to see the signs as a result of this education, that would at least raise a flag,” Schwadron said. “So they could even ask a simple question of, ‘Are you okay?’”

Kelley’s bill, which was heard in committee earlier this month and passed unanimously, would similarly allow the training, which could be completed through a review of materials on one’s own time, to count as two hours of required professional development training.

Earlier this month, lawmakers expressed support for the training to be mandatory and to have suicide prevention taught to students too.

“They see their friends dying and they want to do something,” said Rep. Suzie Pollock, R-Lebanon.

Kelley noted many schools already touch on those topics with their students. The bill would also require that starting in the 2023-24 school year, schools issuing student ID cards to 7th to 12th-graders must print on them the three-digit number, 988, that staring in mid-July will act as a new way to route callers to the national suicide hotline.

“This is the perfect time for the state to pass legislation that is complement and emphasizes Missouri’s new suicide hotline number 988,” Kelley said, later adding: “We definitely need lots more mental services for everybody.”

In his fiscal year 2023 proposed budget, Gov. Mike Parson recommended $28.5 million to help fund the transition to the 988 hotline. Missouri expects to receive more than 172,000 calls once the number is live — more than four times the current call volume, the St. Louis Post-Dispatch reported.

“We think the advent of the 988 line is a really important step toward making sure people have a system to fall into when they’re in crisis,” said Jessica Petrie, a lobbyist who testified in favor of the bill on behalf of the Missouri chapter of the National Association of Social Workers and BJC HealthCare, “and this is a really clever way to increase awareness of that, especially among our vulnerable students.”

Mental health issues among youth were already increasing prior to the pandemic, and may have been exacerbated by its onset. A U.S. Department of Health and Human Services study published this month found between 2016 and 2020, the number of children between three and 17 years old diagnosed with anxiety grew by 29% and those diagnosed with depression grew by 27%. 

The Department of Elementary and Secondary Education announced last week it was using federal relief funds to offer “Mental Health First Aid” training to schools at no cost to identify and respond to signs of mental health and substance use in adults and teens.

Kelley’s bill is named the “Jason Flatt/Avery Reine Cantor Act,” after two high school students who both died by suicide. Flatt was from Tennessee, while Cantor attended Lafayette High School in Wildwood, Missouri.

Rep. LaDonna Appelbaum, D-St. Louis, has worked with Kelley on the legislation since 2020, and said earlier this month Cantor’s mom had sent her a letter one of Cantor’s friends wrote after Cantor’s death, “and I want to read it so bad, but I don’t think I’ll get through it,” Appelbaum said as she urged lawmakers to support the measure.

Various education groups, like the Missouri NEA and Gifted Association of Missouri, and the Missouri chapter of the American Academy of Pediatrics also testified in support of the bill, which now awaits to be brought up for debate on the House floor.

No one testified in opposition or support of Schwadron’s bill, which has been filed since 2014, he said. It’s named after Tricia Leann Tharp, who died by suicide at 31 years old. Her father, Patrick Tharp, was a pharmacist from Hannibal who founded the St. Charles nonprofit Pharmacists Preventing Suicides Inc., and devoted his work to preventing suicide until his death in 2017.

Schwadron noted that his wife also works with the son of Patrick Tharp and brother to Tricia Leann Tharp, and said that, “pharmacists could make a significant impact in saving lives.”

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