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Schupp pushes for mandatory suicide prevention training for primary care physicians


JEFFERSON CITY, Mo. — To combat the high rate of suicides in Missouri, Sen. Jill Schupp wants to ensure more general care doctors are aware of potential warning signs and treatments.

SB 444 would require general and family primary care physicians complete at least two hours of suicide assessment, management, referral, and treatment training in order to become licensed. This training would also be needed in order to renew a license, as well.

As Schupp noted, multiple organizations — such as the American Foundation for Suicide Prevention (AFSP) — offer free or low-cost training programs physicians could take to be in compliance.

According to data from the AFSP, twice as many people die by suicide in Missouri annually than by homicide — about one person every eight hours. Suicide is the 10th leading cause of death in the state, according to the organization.

“We have been working hard as a legislative body to put in place different classes, different opportunities for people to learn how to deal with helping people understand the signs and symptoms [of suicide] so we can lower these numbers,” Schupp said. “What we know is a primary care provider is the person most likely a person who is contemplating suicide will see.”

AFSP also contends about 45 percent of people who die by suicide visit a primary care physician in the month before his or her death; additionally, approximately 77 percent of people who die by suicide visit a primary care physician in the year before.

“This legislation can take us in a step in the direction of ending suicide and saving the lives of so many Missourians of all different categories who are continuing to take their lives,” Schupp said.

Schupp advocated for her bill before the Senate Professional Registration Committee Monday afternoon. No supporters were able to attend the hearing in person, but Schupp did submit multiple letters of support from doctors and mothers who lost children to suicide to the committee.

Dr. Shanthi Kumar, a primary care physician in Chesterfield, Missouri, said her youngest son died by suicide in June 2018. Because depression can seem like general irritability in teenagers, Kumar said she thought her son just had a bad case of “senioritis.”

“As a physician and mother, I missed the warning signs in my son. He had seen his pediatrician for physicals every single year and had never been screened for depression,” Kumar said in a letter obtained by The Missouri Times.

“Until my son talked about suicide, I was not aware of suicide prevention training for physicians,” she said. “With this illness so prevalent and rising to epidemic levels, I think all physicians need to have current and ongoing training on this subject. If schools are training every staff member including cafeteria staff and janitors, shouldn’t all physicians be trained?”

Linda Fehrmann, president and field ambassador for the Eastern Missouri chapter of the AFSP also advocated for SB 444. Fehrmann, a licensed counselor who lost her son to suicide, said it’s “imperative that we train professionals who are likely to encounter suicidal individuals to recognize risk factors and warning signs for suicide as well as how to intervene with the individual.”

“Training primary care physicians to recognize risk factors and warning signs for suicide can result in a visit to the doctor’s office becoming a critical opportunity to connect persons at risk to care,” Fehrmann said.

Those who spoke in opposition to SB 444 had a common fundamental complaint: the state legislature mandating physicians’ training. A representative for the Missouri Academy of Family Physicians praised Schupp for working toward suicide prevention but maintained opposition to the state mandating the training as well as expressed concerns about just who would be considered a primary care physician under the bill.