Extension Notes

by University of Missouri Extension

Mental Health Awareness Month

by Jessica Trussell, Human Development & Family Science Field Specialist May is Mental

Health Awareness Month. Since it is an excellent time to bring awareness to this subject, let’s look at some of the research about mental health and the challenges that we are facing. Mental illnesses are common in the United States. More than one in five U.S. adults is estimated to live with a mental illness (57.8 million in 2021). Now that number is tough to imagine, so let’s take that number down a little—1 in 5 adults in Missouri, which would be about 1,228,000 Missourians. According to the National Alliance on Mental Illness, 1 in 20 U.S. adults experience severe mental illness yearly. But it isn’t just adults facing these challenges; it’s our children.

According to the research, 1 in 6 U.S. youth aged 6-17 experience a mental health disorder yearly. So, let’s do that math again. That would be approximately 164,000 youth in Missouri. Here’s something else to consider about mental challenges, 50% of all lifetime mental illness begins by age 14, and 75% start by age 24.

I want to mention a spe- cific group of individuals who are affected by mental health challenges, and that group is farmers. I am focusing on this group of individuals because they face unique challenges, and I think it’s important to discuss them. So again, let us look at the research.

• Rural communities may have limited access to healthcare services, making it difficult for farm and ranch families to receive support when they experience a mental health crisis. Poor mental health can make it difficult to manage other everyday stressors.

• Self-employed farmers may not have insurance coverage for mental health issues.

• Farmers face unique challenges because many things, such as the weather and markets, are beyond their control. Planting time is one of the busiest and most stressful times of the year for farmers.

• Farming is a stressful business typically requiring long hours in predominantly isolated working conditions. Farmers tend to live in communities where access to mental health care is limited because of distance, stigma, or cost due to insurance status.

• Between 2003 and 2017, the suicide rate among rural Missourians grew by 78%. Hospital emergency department visits for suicide attempts or ideation grew by 177%.

I mention all these things to bring awareness to the issue that so many people experience mental health challenges, and they are our friends, our family, our children, our church members, our neighbors, and all the others in our community we don’t know yet.

Here are just a few things to keep in mind regarding mental health.

• Telehealth continues to grow in popularity among rural individuals, farmers, ranchers, and their families. Individuals can build coping skills with confidential telehealth counseling from a trusted source.

• “Missouri 2-1-1” is a free referral and informational helpline that connects people with a wide range of health and human services 24/7.

Dial 2-1-1 from any phone.

• Individuals experiencing a mental health crisis may not even realize it. Identifiers of someone who may be at risk include: a change in routine, decline in the care of animals, increase in illnesses, increase in farm accidents, or decline in the appearance of the farm.

• Stress can surface in physical, emotional, or behavioral changes depending on the person and the situation.

• Be proactive and talk to your healthcare provider. Ask about potential signs of stress, anxiety, or depression.

• Manage and alleviate your stress by taking care of yourself. Set limits on how much time you spend reading or watching the news. You can stay current on the news but take time away to focus on things you can control in your life.

• Research shows the benefits of exercise go beyond just physical well-being. Physical activities, like walking, biking, and tai chi, can help reduce depression and stress, enhance mood and overall emotional well-being, increase energy levels, and improve sleep.

These are just a few examples of what you can do to help take care of your mental health.

If you or someone you know is in a crisis, get help immediately. You can call 911 or call/text the 988 Suicide & Crisis Lifeline at 988.

To the Great Constituents of District 2,

“What counts is not necessarily the size of the dog in the fight; it’s the size of the fight in the dog.”

-Dwight D. Eisenhower

As the last week of the 2023 Regular session has come to an end, I’m still processing the entire session. I was able to get one of my bills added on as an amendment to SB 139 that makes the Hawken Rifle the Official State Rifle and that was sent on to the Governor. We truly agreed and finally passed over 62 bills and those will be sent to Governor Parson. Over the next few weeks, I will go over all the bills we sent to the Governor. I received Freshman of the Year for Excelling in Governement Accountabilty.

Budget Bills Sent to the Governor - We have sent all HB 1-20 Budget bills to the Governor. HB 14 was signed by Governor Parson back in February. The budget ended up being nearly $48.8 billion.

Providing Tax Relief to Seniors - SB 190 will provide substantive tax relief to Missouri’s older population. The legislation will eliminate the state income tax on social security benefits. It will allow all seniors regardless of their adjusted gross income or filing status to deduct 100% of their social security benefits. Also, it will help protect seniors from being taxed out of their homes. The bill effectively freezes the property tax on the home of Missourians who are 65 years of age or older. It will allow counties to adopt an ordinance that authorizes a property tax credit for eligible senior homeowners. The bill would in effect ensure seniors don’t pay more in property tax on their property than they did for the same property when they turned 65 years of age. I was proud to support and vote YES on SB 190!

Saving Adolescents from Experimentation (SAFE) Act - SBs 49, 236 & 164 is legislation supporters say will protect Missouri’s children from unnecessary and harmful sex change drugs and surgeries. The SAFE Act would prohibit health care providers from performing gender transition surgery on young people under the age of 18. Until August 28, 2027, it would also prohibit a health care provider from prescribing or administering cross-sex hormones or puberty-blocking drugs to a minor for a gender transition, unless the minor was receiving such treatment prior to August 28, 2023. A violation of the provisions would be considered unprofessional conduct and would result in the revocation of the health care provider's professional license. This was something I’ve worked on all session long. This was a huge victory for Missouri!

Promoting Fairness for Female Student AthletesSB 39 is meant to promote fairness in competition and opportunity for female student athletes. The bill would prohibit a private school, public school district, public charter school, or public or private institution of postsecondary education from allowing any student to compete in an athletics competition designated for the opposite sex, as determined by the student's official birth certificate. The bill clarifies that biological sex is only correctly stated on birth certificates if it was entered at or near the time of birth or modified to correct scrivener's error. The bill also makes it clear a female student may be allowed to compete in an athletics competition designated for male students if there is no such athletics competition for female students offered. Another bill, I was happy to vote YES on and speak in support of on the House floor.

Developing Missouri’s Workforce - HB 417 will help employers develop and retain skilled workers. The bill creates a competitive grant program that will be administered by the Department of Economic Development to reimburse employers who help their employees earn short-term certificates or credentials in vital areas for Missouri’s economy. Examples of short-term credentials that would be eligible for reimbursement through the program include manufacturing technology, cybersecurity, welding, certified nursing as- sistant and HVAC certification. It will encourage employers to train the workers of the future by offering paid internships and apprenticeships. The bill would create the Intern and Apprentice Recruitment Act to incentivize businesses to increase the number of internships and internship opportunities in the state. Under this act, employers would qualify for a tax credit of $1,500 for each intern or apprentice hired at a pay rate equal to or greater than minimum wage. Interns would have to work a minimum of 60 hours per month for two consecutive months to qualify. Apprentices would need to complete a minimum of 2,000 hours of on-the-job training and 144 hours of technical instruction. An employer could not receive more than $9,000 in tax credits in a single year and the program would have a total cap of $1 million in tax credits each year. I’m not for tax credits, as I believe we should be doing tax reductions. I was not able to support this bill.

Attracting Economic Activity to Missouri - SB 94 would help attract revenuegenerating film and entertainment projects to the state. Dubbed the “Show MO Act,” the legislation would establish tax credits for film projects starting at 20 percent of specified costs, with opportunities for additional credits as other criteria are met. The bill would allow film productions additional credits when at least half of filming is done in Missouri; at least 15% takes place in rural or blighted areas; at least three of a project’s departments hire a Missourian ready to advance in their field; or the project positively portrays the state or something in it. The film tax incentives would expire at the end of 2029 unless the legislature votes to extend them.

The bill aims to bring more music industry dollars to the state by authorizing credits for rehearsal and tour expenses for live tours and associated rehearsals. The credits would be for 30% of tour or rehearsal expenses, capped at $1 million if expenses are less than $4 million. No taxpayer could get a credit greater than $2 million for expenses between $4 and $8 million; nor greater than $3 million for expenses exceeding $8 million. Combined credits are limited to $8 million per fiscal year. The tour and rehearsal credits would expire at the end of 2030 unless extended. As stated above, I am not for tax credits, especially for Hollywood and was unable to support this bill.

Expanding Access to Physical Therapy - HBs 115 & 99 and SB 51 promote individual choice in health care decisions through the elimination of unnecessary and burdensome regulations to allow patients to have direct access to physical therapy.

The legislation would allow physical therapists with a doctorate of physical therapy or five years of clinical experience to evaluate and initiate treatment on a patient without a prescription or referral from an approved health care provider. The bills also state physical therapists must refer to an approved health care provider patients with certain conditions, including those with conditions beyond the scope of practice of physical therapy, as well as any patient who does not demonstrate measurable or functional improvement within ten visits or 30 days, whichever occurs first. I was happy to vote yes on SB 51 for expanding access to Physical Therapy, that bill was sent to the Governor in April. A similar bill that was also sent to the Governor, HB 115 & 99 ended up being more of a Christmas tree bill, which I couldn’t support.

Establishes the "Stars and Stripes Historic Region of Missouri" - SB 139 was one of the naming bills, which I was able to add my bill on to, to make the Hawken Rifle the Official State Rifle! Some of the other amendments that got added on to SB 139 :

● Stem week: This act requires the Governor to annually issue a proclamation setting apart the first week of March as "Science, Technology, Engineering, and Math (STEM) Week" rather than "Math, Engineering, Technology, and Science (METS) Week".

● State Legislator Remembrance Month: This act designates January of each year as "State Legislator Remembrance Month" in memory of all state legislators who died while in office.

● Women Veterans Appreciation Day: This act designates June 12 of each year as "Women Veterans Appreciation Day".

● Breast Cancer Awareness Day: This act designates the first Saturday of October of each year as "Breast Cancer Awareness Day".

● Stars and Stripes Historic Region of Missouri: This act establishes the "Stars and Stripes Historic Region of Missouri". The Department of Transportation may place suitable markings and informational signs within the region, with the costs to be paid by private donation.

Helping People off of State Assistance - SB 106 and SBs 45 & 90 authorize a transitional program meant to help people get off of state assistance gradually as their income increases. Sup- porters say the state’s assistance programs for low-income Missourians trap people in poverty because if they accept a raise that puts them above a program’s limits, they could lose more in state benefits than they gain from a raise. Also, this would extend post-partum coverage under MO HealthNet or Show-Me Healthy Babies from 60 days to a year. MO HealthNet coverage for lowincome women in the program will include full Medicaid benefits for the duration of the pregnancy and for one year following the end of the pregnancy. These two separate bills were in depth and had a lot of different bills attached to them. Due to not having pro-life language and having “elected abortions” in the bills, I was unable to support SB 106 and SB 45 & 90.

Missouri First Responder Mental Health Initiative Act"- SB 24 was another Christmas tree bill. Some of the amendments included were expanding Missouri’s adoption tax credit, which offers a nonrefundable tax credit for one-time adoption-related expenses such as attorney fees, up to $10,000 per child. That credit is capped at $6 million a year. SB 24 would remove that cap, that makes the tax credit refundable, and would have the per-child limit adjust with inflation.

Supporters say more than 2,200 Missouri children are awaiting adoption and the bill will help remove financial barriers to allow more families to afford the cost of adoption.

Another amendment was to modify the term "hospital" for purposes of licensure to include facilities designated as rural emergency hospitals by the Centers for Medicare and Medicaid Services. One of the other many amendments added was so qualified first responders may obtain and administer naloxone to a person suffering from an apparent narcotic or opiate-related overdose. This act allows first responders to obtain and administer any drug or device approved by the FDA to block the effects of an opioid overdose. Licensed drug distributors or pharmacies may sell such drugs or devices to first responders for this purpose. Under current law, state or local law enforcement agency staff members are required to act under the directives and protocols of a medical director of a local licensed ground ambulance service in order to administer naloxone or similar drugs or devices to a per- son suffering from an apparent narcotic or opiate-related overdose. Under this act, state or local law enforcement agency staff members would not need to act under such directives and protocols to administer naloxone or similar drugs or devices.

Also, another amendment added onto this bill was an act that establishes post-traumatic stress disorder (PTSD), as described in the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition, (DSM-5) as a compensable occupational disease under workers' compensation when diagnosed in first responders, as defined by law. A first responder shall not require a physical injury in order to be eligible for benefits, but preexisting PTSD is not compensable. The time for notice of injury or death in cases of compensable PTSD is measured from exposure to one of the qualifying stressors listed in the DSM-5 criteria, or the diagnosis of the disorder, whichever is later.

Improving Protections Against Cyberstalking - SB 189 This bill would also create the Cyber Crimes Task Force with the intent of strengthening state law to better protect Missourians who are targeted and stalked online. The task force would be made up of law enforcement, victim advocates, victims of stalking, and forensics experts. The group will work to develop best practices regarding the treatment of victims of cyberstalking or harassment and actions to stop cyberstalking and harassment when it occurs.

As the Governor will hopefully approve and sign some of the bills the legislature has sent to him, I will continue to update you.

It's a pleasure to serve and as always if you have any questions, please feel free to reach out to my office at (573) 751-4285 or email me at Mazzie.Boyd@house.mo.gov

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