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MHA Today | October 23, 2020



MHA Today

MHA Today is provided as a service to members of the Missouri Hospital Association.

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Humans tend to personify. We see faces and familiar shapes in clouds, and attribute human virtues and vices to objects. It’s hard-wired into our survival systems and DNA. COVID-19 has a biology, but it doesn’t have a psychology. Nonetheless, its biology can and will have short- and long-term consequences on our psychology.

COVID-19 is known to cause fatigue. However, through the long arc of our response, there is another COVID-19 fatigue that we expect to be more pernicious. Our response has reduced many of the most human of activities and, in the worst cases, resulted in lonely deaths, isolation, a reduced sense of community and limits on our interaction with even the most intimate of family and friends.

Monday, MHA and the Missouri Department of Mental Health held a joint webinar on the behavioral health links to the COVID-19 crisis. It was eye opening. Not just about the disease, but about the disease’s influence on the behavioral health system. As evidenced by this webinar, Missourians have a proactive mental health department that is committed to the health of everyone in the state.

And their work couldn’t be coming at a more appropriate time. The American Psychological Association this week released their “Stress in America 2020: A National Mental Health Crisis” report. The report, “found that nearly eight in ten adults (78%) say the coronavirus pandemic is a significant source of stress in their lives, while three in five (60%) say the number of issues America faces is overwhelming them.” The report goes on to say that, “nearly one in five adults (19%) say their mental health is worse than it was at this time last year.”

The challenge to everyone is evident, but for health care providers it is two-fold. First, members of the hospital team have been responding to COVID-19 for months, and the significant stress related to the duration of the response, patient care and organizational dynamics, and the challenges that they feel at home as members of our communities has been overwhelming. Second, we know that Missouri was experiencing a variety of behavioral health challenges prior to COVID-19 — provider shortages, substance use disorders and significant demand for all types of behavioral health services.

As we move into late fall and winter — with reduced opportunities for time outside, socially distanced interactions and the holiday season — these behavioral health challenges are likely to compound. DMH indicates that their systems have seen an uptick in contacts to their various behavioral health intervention systems. The pressures on our workforce and communities will multiply in late 2020 and throughout 2021.

The COVID-19 crisis now is especially acute in rural parts of the state. While the virus had limited impact on rural Missouri initially, despite several outbreaks in meat packing and other agricultural processing facilities, it now has taken hold on a much larger scale. Hospitals that provide local and regional hub care for these communities are significantly stressed. And, many rural communities have yet to put strong public health protections in place to limit the spread.

In February, MHA, along with several partners, released a report, “Growing Stress On The Farm,” outlining the significant behavioral health challenges in rural communities. These challenges preexisted COVID-19, and are likely more profound today. According to our research, “Pervasive stigma and geographic barriers to accessing mental health care can prevent all who seek behavioral health services in rural Missouri from seeking help for stress, anxiety and depression. Each of Missouri’s 99 rural counties is a designated Mental Health Professional Shortage Area, and with just 3.7% of the recommended supply filled, Missouri faces the largest shortage of behavioral health care providers in the U.S.”

Collective Psychological Response To DisastersThere are no easy solutions to the behavioral crisis that is lurking immediately below the surface of the COVID-19 crisis. It will not be limited to rural communities or members of the health care family. It will, however, persist. A chart from the webinar exposes the long path to behavioral health recovery from a crisis. It is chilling.

As I’ve been thinking about where we are with the crisis — especially in our health care system and among our rural communities — I’ve been reminded of the words on the Missouri State Flag. “United We Stand. Divided We Fall.”

Humans see faces everywhere, even where there are none. We make judgements using primitive parts of our brain, even when situations are complex. We can’t often tell by the simple signals whether something important is happening behind an expression — and now that expression may be behind both a literal and figurative mask.

As leaders, we endeavor to take care of our people and our communities. We know what’s coming or even what is already here. The virus is running roughshod on our physical health in communities throughout Missouri. But, it’s also influencing our mental health. Let’s not let our work healing bodies mask the next challenge.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO



Herb B. Kuhn
MHA President and CEO

In This Issue

Missouri’s Congressional Delegation Supports COVID-19 Relief Fund Repayment Changes
MHA Produces Toolkit For Expanding Hospital Capacity
FDA Approves Gilead’s Remdesivir As Coronavirus Treatment
CDC Study Indicates Higher Risk Of In-hospital Complications For COVID-19 Versus Flu
CMS Delays The Radiation Oncology Model
HealthCare.gov Premiums Lower For Third Consecutive Year
MLN Connects Provider eNews Available
DHSS Announces New Changes For CNA Testing
Brave Of Heart Fund Available To Families Of Health Care Workers

COVID-19 Update
Regulatory News
Workforce News
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