[Congressional Record Volume 155, Number 82 (Wednesday, June 3, 2009)]
[House]
[Pages H6093-H6099]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     SUPPORTING MENTAL HEALTH MONTH

  Mrs. CAPPS. Mr. Speaker, I move to suspend the rules and agree to the 
resolution (H. Res. 437) supporting the goals and ideals of Mental 
Health Month, as amended.
  The Clerk read the title of the resolution.
  The text of the resolution is as follows:

                              H. Res. 437

       Whereas the mental health and well-being of people in the 
     United States is a issue that affects not only quality of 
     life, but also the health of our communities;
       Whereas the stigma associated with mental health continues 
     to persist;
       Whereas more than 57,000,000 people in the United States 
     suffer from mental illness;
       Whereas approximately 1 in 5 children and adolescents has a 
     diagnosable mental disorder;
       Whereas more than a quarter of our troops suffer from 
     psychological or neurological injuries sustained from combat, 
     including major depression and post-traumatic stress 
     disorder;
       Whereas more than half of all prison and jail inmates 
     suffer from mental illness;
       Whereas major mental illness costs businesses and the 
     United States economy over $193,000,000,000 per year in lost 
     earnings;
       Whereas untreated mental illness is a cause of absenteeism 
     and lost productivity in the workplace;
       Whereas in 2006, over 33,000 individuals committed suicide 
     in the U.S., nearly twice the rate of homicide;
       Whereas suicide is the third leading cause of death among 
     people between the ages of 15 and 24;
       Whereas in 2004, individuals age 65 and older comprised 
     only 12.4 percent of the population but accounted for 16.6 
     percent of all suicides, and the rate of suicide among older 
     people in the United States is higher than for any other age 
     group;
       Whereas 1 in 4 Latina adolescents report seriously 
     contemplating suicide, a rate higher than any other 
     demographic;
       Whereas studies report that persons with serious mental 
     illness die, on average, 25 years earlier than the general 
     population; and
       Whereas it would be appropriate to observe May 2009 as 
     Mental Health Month: Now, therefore, be it
       Resolved, That the House of Representatives--
       (1) supports the goals and ideals of Mental Health Month in 
     order to place emphasis on scientific facts and findings 
     regarding mental health and to remove stigma associated 
     therewith;
       (2) recognizes that mental well-being is equally as 
     important as physical well-being for our citizens, our 
     communities, our businesses, our economy and our country;
       (3) applauds the coalescing of national and community 
     organizations in working to promote public awareness of 
     mental health and providing information and support to the 
     people and families affected by mental illness; and
       (4) encourages all organizations and health practitioners 
     to use Mental Health Month as an opportunity to promote 
     mental well-being and awareness, promote access to care, and 
     support quality of life for those living with mental illness.
  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
California (Mrs. Capps) and the gentleman from Nebraska (Mr. Terry) 
each will control 20 minutes.
  The Chair recognizes the gentlewoman from California


                             General Leave

  Mrs. CAPPS. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from California?

[[Page H6094]]

  There was no objection.
  Mrs. CAPPS. Mr. Speaker, I yield myself such time as I may consume.
  I rise today in strong support of House Resolution 437, supporting 
the goals and ideals of Mental Health Month. I would like to thank my 
colleague Congresswoman Napolitano for her leadership on this issue. 
This resolution underscores the importance of mental health for the 
overall well-being of Americans, the health of our communities and the 
Nation's economic strength. It's an opportunity to commend the 
important work of health practitioners who, together with national and 
community organizations, are so dedicated to the promotion of mental 
health. These practitioners, these organizations, work tirelessly to 
improve awareness of mental health issues. As a nurse, I especially 
welcome this opportunity to recognize the contributions of so many of 
my colleagues.
  Over 57 million Americans suffer from mental illness. Mental illness 
is the leading cause of disability in our Nation; and when left 
untreated, mental illness is a leading cause of absenteeism and lost 
productivity in the workplace. This resolution knows that mental 
illness disproportionately affects a number of groups, including the 
elderly, adolescents, young adults, minorities and now, most especially 
we note, our troops returning home from combat. Despite the prevalence 
of mental illness in our society, this resolution appropriately 
highlights the stigma still associated with many of these conditions 
and that the stigma persists. Even though we have passed mental health 
parity legislation, we have so much more work to do to fully realize 
equal benefits for mental illness prevention and treatment. For this 
very reason, it is important to support the goals and ideals of Mental 
Health Month while also working to reduce the stigma associated with 
mental illness.
  I urge my colleagues to join the bipartisan sponsors of this bill in 
supporting Mental Health Month.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TERRY. Mr. Speaker, I yield myself as much time as I may consume.
  I, too, rise in support of House Resolution 437, acknowledging the 
month of May as National Mental Health Month.
  Mental health has been recognized by Congress for over 50 years and 
has continued to raise awareness in our communities and lower the 
stigma associated with mental disorders. I would like to express my 
gratitude to the national and community organizations working to 
promote public awareness of mental health and providing the proper 
information for families affected by mental illness. Your work is 
critical to increasing the quality of life for those with mental 
illness. I would like to thank the author of the resolution, Mrs. Grace 
Napolitano, who was a classmate of mine, for her leadership in helping 
Americans while addressing mental disorders. I encourage all of my 
colleagues to vote in favor of this resolution.
  I reserve the balance of my time.
  Mrs. CAPPS. Mr. Speaker, it's a pleasure to yield to the author of 
this legislation, our colleague from California (Mrs. Napolitano) as 
much time as she may consume.
  Mrs. NAPOLITANO. I thank the gentlewoman from California.
  I certainly am very grateful that this has been put on the agenda, 
and I'd certainly like to thank Chair Waxman and Ranking Member Barton 
of the Energy and Commerce Committee for promoting this resolution.
  Every year we recognize in the United States May as the National 
Mental Health Month. Now today with House Resolution 437 we do so with 
great joy and sometimes with great trepidation. Mental health is an 
important issue that deserves attention year round. For too long 
there's been an associated stigma with mental health. You don't want to 
talk about it. You don't want to hear it. You don't want to see it. But 
we must continue to work to remove the stigma, the barrier to 
knowledge, to make more awareness available and increase access to 
mental health services both to our military and also to our young men 
and women, whether it's at the schools, at the universities, in the 
different areas where it's more prevalent. We have found that early 
detection, intervention and assistance is very key to being able to 
have productive citizens in this area. Our U.S. Surgeon General has 
estimated that over 57 million Americans suffer from mental illness, 
and it affects everybody. It crosses boundaries. It does not rise to 
gender or political parties. It is affecting everybody. It does not 
discriminate.
  One in five children in the United States has a mental disorder. This 
is according to the U.S. Surgeon General's report. And fewer than 20 
percent of these children receive the mental health services they 
desperately need.

                              {time}  1200

  Seventy to ninety percent of those treated do experience reduction of 
symptoms. So we know treatment is very effective. We just know that we 
don't have sufficient funding to allow for that treatment to be made 
available to everybody that needs it. And based on the Surgeon 
General's report, suicide is the third leading cause of death of young 
people ages 10 to 24. We are losing a lot of youngsters who will not 
have an opportunity to provide us with their knowledge, expertise and 
support in the future years of America.
  Mental illness also disproportionately affects minorities. In 1999, a 
study done called ``The State of Hispanic Girls in the United States'' 
said one in three was reported considering suicide in ages 9 to 11. 
Currently the Hispanic rate for young girls remains the highest. 
Although it has been lowered somewhat, it still remains the highest 
percentage in the United States of attempted suicides.
  And a new study just recently revealed that fifth-graders who believe 
they have experienced racial discrimination are at increased risk for 
depression, attention deficit disorder and other mental health 
problems. And unfortunately, Hispanics are three times more likely to 
have those symptoms. And blacks, African Americans, are twice as likely 
to be affected by these symptoms.
  Then we go into our troops, our soldiers, our returning veterans. 
More than one in five Iraq and Afghanistan veterans will suffer from 
mental health conditions, whether it is PTSD, depression, even 
traumatic brain injury. There is increased news coverage on this. It 
happens every day. We hear and we see the reports about the effect it 
has on some of our men and women who have gone and served two, three, 
four and sometimes as many as five deployments. We continue to bring 
that to the forefront because we owe those servicemen and women the 
ability to be able to assimilate back into society and help them by 
delivering mental health services that they will desperately need not 1 
month, not 5 months, maybe not years, but maybe somewhere along the 
line they are going to be able to have somebody help them out.
  We must educate ourselves. We must educate our families. We must 
educate our loved ones what may happen to a returning veteran, how to 
recognize it and how to refer them for help and assistance in being 
able to deal with the symptoms that will not enable them to keep a job 
and be able to be productive citizens. They need to learn the symptoms 
of post-traumatic stress syndrome.
  Families are also impacted, wives, the children, the separation, the 
long separations of the father or the mother, whatever the case may be, 
from their parent, the primary care providers and all physicians, 
nurses, psychologists and psychiatrists must also learn how to be able 
to recognize PTSD, which is a little bit separate than trauma, to 
ensure that all these men and women receive the care they need. The 
most common problem in the military culture, of course, is the fear of 
how this will impact their military career. And I'm glad to say that 
some of our military leaders are beginning to recognize that this is an 
important way to be able to help their men and women in service remain 
in service and be a part of their troops or their units. And we must 
continue to bring that forth and be able to assure them that they will 
not lose their ability to be able to be promoted.
  We must train those military leaders and educate them, the doctors, 
the corpsmen and the nurses on how to treat PTSD and ask the soldiers 
to identify signs and symptoms of it with mild TBI, traumatic brain 
injury, to reinforce the collective responsibility

[[Page H6095]]

to take care of each other. All of us must work together to ensure our 
troops, who have given so much, are taken care of. And at home, our 
economy, as pointed out by my colleague, Mrs. Capps, has caused 
struggle. So have our minds. The recession has taken a toll on our 
families. Economic uncertainty is causing stress, anxiety and 
depression. The worrying about losing their homes or their jobs, 
worrying about the children and the retirement, if they are going to be 
able to retire or has their retirement fund gone somewhere.
  It affects not only the quality of life but also our U.S. economy. 
Major depression is the leading cause of disability in the United 
States. The National Institute of Mental Health reports that serious 
mental illness costs the Nation at least $139 billion a year in lost 
earnings alone. So we must continue to have businesses know that 
including them in the health provision of services will help them be 
able to cut down on lost productivity in other areas. Again we must 
remove the stigma. We must remove the barrier to knowledge and bring 
more awareness and increase mental health services. Again, early 
detection and intervention and assistance is key.
  I encourage all my colleagues to support House Resolution 437 to 
recognize May as Mental Health Month. We all know of someone who 
suffers from some kind of debilitating disorder. Even women with breast 
cancer; knowing that they have an issue with cancer is disabling. We 
must recognize also scientific facts and findings, increase awareness 
of services and how it affects the quality of life, the health and 
well-being of our communities and our economic stability. Let's work 
together to improve our lives and ask for support of House Resolution 
437.
  Mr. TERRY. We greatly appreciate the gentlelady from California's 
comments. And it was very striking that out of the age group of ninth-
grade to eleventh-grade young ladies in that demographic that one in 
three would contemplate suicide. That is just stunning.
  The Energy and Commerce Committee has a real asset on mental health 
as well as an advocate for treatment, awareness and education in the 
gentleman from Pennsylvania who is our resident psychologist on the 
committee. We use him a great deal.
  And I would yield as much time as he may consume to the gentleman 
from Pennsylvania (Mr. Tim Murphy).
  Mr. TIM MURPHY of Pennsylvania. I thank the gentleman from Nebraska. 
And, Mr. Speaker, I also want to thank my friend and colleague from 
California, Grace Napolitano, who has been a great advocate. And I'm 
pleased to serve with her as leaders on the Mental Health Caucus. Her 
passion for working to bring awareness to our Nation and more treatment 
to those with mental illness is truly commendable and admirable.
  With 57 million people in this country suffering from mental illness, 
it is no small problem. With one in five children and adolescents, with 
somewhere between 17 percent to 24 percent of our returning soldiers 
affected with mental illness, it is of great concern to us. 
Unfortunately, the problem that so often comes up with mental illness 
is not that it is not diagnosable, for it is. It is not that it is not 
treatable, for it is very treatable. The problem is for so many, the 
chosen treatment and approach to mental illness is denial. What we do 
is we deny its significance, we deny its existence, and therefore we 
deny the treatment to so many.
  In some ways, we have not advanced beyond those Puritanical days of 
the Salem witch trials, where prejudice haunts the ability to get help, 
so people who have need of mental health treatment avoid it, families 
are not supportive of it, employers oftentimes will dismiss employees 
without understanding what it is, and quite frankly even here in 
Congress people have an awareness that is, well, dated, to say the 
least, when we do not understand that the way we need to approach 
mental illness is to vigorously approach it and treat it.
  In the workplace, when mental illness is something that is part of 
someone's treatment insurance plan, we find that it actually saves 
money for employers because those employees get back to work. When we 
find that employees are denied mental illness treatment, and may I also 
add Medicare for the longest time also did not cover mental illness 
treatment, we find people worse. People who have chronic illness have 
twice the risk of mental illness. People with chronic illness, which is 
75 percent of our health care cost, have twice the risk of mental 
illness. And yet for many years, Medicaid didn't cover it, and many 
insurance plans still do not. When you have a chronic illness and you 
have mental illness combined together, the health care costs double. 
They double. And it is important that we treat this with all of the 
tools possible.
  Unfortunately, many times mental illness is treated only by 
pharmaceutical approaches. Some 75 percent of mental illness drugs are 
prescribed by nonpsychiatrists. That is unfortunate because I'm sure 
that many heart surgeons with their cardiac patients would not be very 
happy if noncardiologists treated the heart patients. And it goes on. 
But unfortunately when insurance plans do not pay for it, that is the 
only recourse.
  There is one particular group of folks suffering from mental illness 
that have been mentioned a couple of times here, and that is our 
returning veterans from Iraq. Initial studies have suggested that some 
17 percent of combat veterans may suffer from post-traumatic stress 
disorder. More recent studies suggest that of those who are coming back 
who actually experienced combat, those numbers may be as high as 24 to 
25 percent. The military has made remarkable advances in dealing with 
suicide and depression and post-traumatic stress disorder in our 
returning soldiers, and with good reason. Right now, more soldiers die 
from suicide than from combat. It is also something that is 
contributing to those soldiers who have returned who have some mental 
health problems may actually engage in highly risky behavior, driving 
fast, more drinking and more drugs, which leads to further problems for 
families and more undetected mental illness.
  The Navy, for example, has established programs where they actually 
send teams of Navy psychologists and sociology workers out to see where 
they can return with the veterans and work with them while they are 
onboard ship, helping to identify problems, screen them and get them 
involved with the help they need. The Army is also advancing in this, 
as the Marines and the Air Force, and that is good, because over the 
last couple of centuries in our country, if you look at the pictures, 
the photographs, the drawings and the paintings of our military, the 
ships have changed, the uniforms have changed, the guns have changed 
and the weapons have changed. But the soldiers have remained the same. 
Over the last century, we referred to such things as ``combat fatigue'' 
or ``battle fatigue.'' And for the longest time, soldiers were treated 
with ``three hots and a cot'' as a method of treatment. But now we are 
recognizing that teams of mental health professionals in the theater of 
combat are very helpful.

  Recently the combat stress center in Iraq at Camp Liberty came 
literally under some fire, however, when one person they were treating 
allegedly walked into this combat stress facility and opened fire. He 
had had his weapons taken away, but then on his way back after he was 
dismissed from there and told to come back later, he took someone's 
gun, came back and opened fire. Two therapists and three people waiting 
for care were all killed. It is worth noting that one of those people 
waiting for care stood up and tried to stop him from killing others, 
and that person was killed in the process. So even in the course of 
trying to get some help, we have somebody who stood as the hero.
  I had mentioned early on that denial is a huge problem, and it is 
important that all of us understand post-traumatic stress disorder and 
acute anxiety disorders in our returning veterans. Because whether you 
are a family member, you are a friend or you are a member of the 
American Legion or the VFW, it is the responsibility of all of us to 
look out for these returning citizens and help them get the help they 
need.
  Watch for these symptoms:
  Recurrent and intrusive distressing recollections of an event, 
including images, thoughts and perceptions such as seeing a comrade's 
dead body or experiencing flashbacks of the sounds of explosions and 
screaming;
  Recurrent and distressing nightmares of the traumatic event;

[[Page H6096]]

  Intense psychological distress when exposed to cues or reminders of 
any aspect of the trauma, such as the backfiring of a car or an 
explosion that could set someone off again;
  Extreme physical reactivity, such as racing pulse, sweating, and 
intense fear, when exposed to any cues or reminders of the trauma. This 
could even be set off in Vietnam veterans or World War II veterans when 
they watch a program or a movie on television;
  Persistent avoidance of any reminder, not wanting to talk about it, 
avoiding any thoughts, activities, places or people, of the traumatic 
event;
  A general numbing in responsiveness, such as the person feels 
detached and estranged from others and may have little range in emotion 
and few strong feelings. Oftentimes this is a concern raised by spouses 
when their spouse returns home from combat, and they say he or she is 
just not the same anymore. The emotions are blunted. They have less 
ability to show the depth of emotions, less interest in the children.
  They may also have a sense of a foreshortened future; having come 
close to death, they may see their own death and problem as imminent 
and may engage in more risky behavior.
  They may have hypervigilance. They may be constantly scanning the 
environment for danger, even when there are no problems. They may be 
driving along the highway, if they were perhaps the driver of a Hummer 
in Iraq, they may be constantly scanning the road to see, are there 
problems ahead?
  They may have an exaggerated startle response, especially to sudden 
movement or loud noises. They may have poor concentration, irritability 
and anger. And anger is an important symptom that we need to pay 
attention to for depression and anxiety disorders and post-traumatic 
stress disorder for veterans. And of course they may have disturbances 
in one's ability to sleep.
  Many times the veteran will work towards self-medicating, alcohol and 
drugs, and, of course, keep that quiet from others too. They may find 
themselves not sleeping at night but having a job where they sleep a 
lot during the day so they can hide this from others.
  But what is so important, as I said in the outset, is that denial is 
not appropriate treatment, and that the rest of us do not get engaged 
in denial too. It is absolutely essential that we support our returning 
veterans no matter what. Regardless of someone's political views, we 
need to stifle our own comments and understand they were doing what we 
asked them to do. They were following orders.

                              {time}  1215

  And, quite frankly, they were doing it pretty darn well. And they 
accomplished their mission, and we're happy to see them returning home.
  But, that being said, the silent battle that our veterans continue to 
fight, that invisible, silent battle that goes on inside their own 
heart and in their own mind is something that we need to be reaching 
out and paying attention to. And as we look at Mental Health Month, as 
we have just come back from Memorial Day, as we continue to see the 
yellow ribbons fly from trees and posts in every hometown of America as 
our soldiers return home, as we continue to send our notes and our e-
mails and our care packages to our veterans, let us remember that we 
must continue to reach out for the veteran who has borne the battle, 
for their orphans and for their spouses and for those persons who have 
come back with that silent problem of the posttraumatic stress disorder 
and other disorders. We will work with them. We will help them. And God 
bless our veterans. And again, I thank the sponsor for this bill on 
Mental Health Month.
  Mr. TERRY. Mr. Speaker, I ask unanimous consent that the gentleman 
from Pennsylvania (Mr. Tim Murphy) may control the balance of my time.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Nebraska?
  There was no objection.
  Mrs. CAPPS. Mr. Speaker, it is with great honor that I now yield as 
much time as he may consume to our colleague from Rhode Island, Patrick 
Kennedy, who has championed this issue for as long as he has been a 
Member of Congress and really made us very much aware of the need, and 
then the passing of the resolution for the legislation for mental 
health parity. And I now yield time.
  Mr. KENNEDY. Mr. Speaker, I would like to thank the gentlelady from 
California (Mrs. Capps). Thank you for all your good work on health 
care. As a former nurse, you know full well of the challenges of making 
sure that we have adequate supply of providers and how important it is 
for us to address the needs of those with mental illness by making sure 
that there are enough providers out there who are adequately educated 
in the field of mental illness. And I appreciate your cosponsorship on 
the Child Work Force Reduction Act, which will address the need of 
bringing in more child and adolescent mental health workers into the 
workforce field to deal with children and adolescents who need mental 
health care, because right now we're at a critical stage in this 
country with respect to the need for our children to gain access to 
providers willing to take care of those special needs that children 
have in the area of mental health. And nurses and doctors are in great 
need for those reasons. And Lois Capps has been really one of the 
champions in the area of trying to provide greater numbers of nurses 
and professionals who can take on the enormous challenges ahead.
  In addition to that, Mrs. Capps, you've been very helpful in 
recognizing the enormous boom that's going to happen with our aging 
population. We're going to have a baby boom generation that's going to 
become a senior boom generation, where so many of our baby boomers are 
going to be elder boomers. They're going to be elderly, and the demand 
for new nurses is going to be extraordinary. And we don't have, right 
now, the necessary populations of nurses to deal with that.
  Many people write off senior citizens' dementia, if you will, as part 
of growing older. They say, Oh, Grandma. Well, that's Grandma. That's 
the way they are when they're nonresponsive.
  Well, frankly, I certainly don't want to be treated that way when I 
grow old, and I dare say anybody watching this doesn't want to be 
treated that way when they grow old. And the fact of the matter is, for 
most older people, it isn't dementia that leaves them isolated and with 
their heads down; it's depression. It's depression. And who wouldn't be 
depressed if you're a senior citizen and you've lost your life mate 
after over 40 years of marriage, if you've had to pick up and sell your 
house because you've no longer been able to afford it any longer, if 
your children and grandchildren are scattered all across the country 
and very rarely visit you any longer, if now you're confined to an 
elderly-only high rise. I would imagine that would be pretty depressing 
for a lot of elderly people, and for many of them, it is depressing. 
And so we are working on the Positive Aging Act, which will address the 
needs of our senior centers and the needs of our seniors with regards 
to that.
  But I also want to acknowledge my good friend and colleague, Grace 
Napolitano, who has been so wonderful in her efforts to lead the charge 
of the Mental Health Caucus. And Grace Napolitano has been a terrific 
champion for making sure that our young people are also included in on 
these issues of mental health because she has seen in her own 
neighborhoods, that we may talk about war overseas and the 
posttraumatic stress that our veterans suffer when they go into harm's 
way, and they come back and they're suffering from reconciling all this 
violence to the new world they're coming back to, and they have to 
readjust to the main life of everybody else, and they have to somehow 
come home, and a lot of them suffer from PTSD. Well, you can imagine, 
these are adults. These are fighting men and women, the men and women 
of our Armed Forces, and they have adult coping mechanisms. And even 
adults, with adult coping mechanisms, have posttraumatic stress 
disorder.
  So imagine what a child is facing in a barrio in East Los Angeles, or 
in a borough in Upper Manhattan, or a neighborhood in South Providence, 
or Pawtucket, Rhode Island, imagine the coping mechanisms that the 
children are going to need to have in those areas when they see 
violence in their own hometowns. In a very real way, they are suffering 
from posttraumatic stress, while not even having to go

[[Page H6097]]

overseas to go see a war because the war that they are seeing is in 
their own backyard. They are seeing gunshots in their own backyard on a 
regular basis.

  We have 36,000 people killed by firearms in this country every year, 
a far cry from the number of people that have been killed in action 
over in Iraq.
  You know, this is a situation where it's not a small wonder that 
there are so many kids in this country who are acting out and who are 
having trouble with their own mental health needs and posttraumatic 
stress.
  So, Mr. Speaker, we have a lot to do with addressing the mental 
health needs of our people, both seniors and children and, of course, 
those who suffer from serious mental illnesses at the same time.
  So this is Mental Health Week. We need to raise awareness of mental 
health. And the most crucial part of destigmatizing mental health is 
for people to go online to any of the National Institutes of Health, 
National Institute on Drug Abuse, National Institute of Mental Health 
and so forth, National Institute on Alcoholism, and look up the 
studies, because you will see the biochemical makeup and breakdown of 
the brain and how it operates differently for those who are at high 
risk of being alcoholics, or at high risk of having a propensity to 
have a bipolar disorder or not, or having depression, or those people 
who may have other diagnosable mental disorders. It's quite striking 
that what you'll see in these videos that are a result of these MRIs, 
these new x-rays of the brain, that you cannot dismiss the notion that 
mental illnesses are physical illnesses. And we know that for a fact, 
because if you simply give people who were in total depression before 
certain medications, it's amazing how they blossom in their abilities 
to now live more functional lives after they've taken the medications.
  So why we would ever treat the brain unlike any other organ in the 
body is beyond me. The brain is an organ in the body just like every 
other organ of the body. But unfortunately, in this country, in our 
health care system it's treated as if it's something separate.
  What we need to do in health care reform is make sure the brain is 
treated holistically, as part of the body. And in any health care 
reform, it's got to be reimbursed holistically in terms of the rest of 
the health care package.
  I thank Representative Napolitano for introducing this resolution in 
support of the goals and ideals of Mental Health Month. I rise today to 
speak to those goals, and the need to integrate them into health care 
reform.
  According to the Institute of Medicine, together, mental and 
substance-use illnesses are the leading cause of combined death and 
disability for women of all ages and for men aged 15-44, and the second 
highest for all men. When appropriately treated, individuals with these 
conditions can recover and lead satisfying and productive lives. 
Conversely, when treatment is not provided or is of poor quality, these 
conditions can have serious consequences for individuals, their loved 
ones, their workplaces, and the nation as a whole. Tragically, 
individuals with serious mental illness have a life expectancy of 25 
years less than the general population.
  The World Health Organization defines health as ``a state of complete 
physical, mental and social well-being, and not merely the absence of 
disease or infirmity.'' As we work to reform and reincentivize our 
health care system, we must ensure that it is a whole-body initiative, 
recognizing that mental health is integral to overall health, and that 
optimal overall health cannot be achieved without this.
  With this in mind, we must diligently work to ensure that when 
crafting health care reform, we create a health care system that treats 
the whole person. Health care reform policy should support and 
encourage practices that fully integrate mental health into primary 
care. All providers, and in particular primary care doctors, must be 
trained and adequately reimbursed, for providing comprehensive and 
coordinated care--care that approaches health as a whole body 
initiative. Primary care physicians must be given the resources needed 
to adequately address the mental health needs of their patients. 
Innovations, like medical homes, are working to improve quality and 
contain cost, but the primary care workforce is not sufficient to meet 
the country's needs.
  Over the last two decades, fewer medical students are choosing 
primary care for a number of reasons, including reimbursement issues. 
Payment policies do not adequately compensate doctors for the time it 
takes to coordinate care, provide case management, or address mental 
health and substance abuse issues in the primary care visit. Specialty 
providers and other physicians must likewise have training on mental 
health and substance abuse problems and be trained to provide 
collaborative care and case management, and be reimbursed accordingly.
  For the 45.7 million Americans without health insurance (a number 
which has grown due to the recent economic downturn), we must create an 
affordable, quality health care system in which all Americans are 
covered. Providing coverage alone, as it exists now, is not a solution 
onto itself however. The coverage we provide for all Americans must 
include the full spectrum of evidenced-based mental health care, 
including both treatment and prevention services. Mental health 
coverage should not be subject to restrictive or prohibitive limits 
when formulating coverage determinations on the frequency or duration 
of treatment, cost-sharing requirements, access to providers and 
specialists, range of covered services, life-time caps, and 
reimbursement practices.
  The expansion of insurance coverage is not the same as ensuring 
access. Lack of insurance is only one of the many barriers to care for 
those seeking mental health services. Those with coverage also face 
financial barriers to care due to prohibitive cost sharing 
requirements, limited access to providers, and denials of coverage for 
mental health conditions. Once all Americans have health insurance, 
coverage must provide for access to affordable, high quality care. 
Current barriers to care within the health insurance system must be 
eliminated, and mental health coverage must include access to the full 
spectrum of evidenced-based care for both prevention and treatment of 
mental health conditions. This includes, but is not limited to, access 
to and choice of doctors who approach health as a whole body 
initiative.
  Other reform measures necessary to create a system best posed to 
treat the health of the whole body include: instituting rules for 
standardized payments; ensuring that clinical necessity is the 
determinant of patient care; replacing underwriting with a ``community 
rating'' system that would set premiums based on age and location 
instead of health status of the individual; requiring that any denials 
of coverage be transparent and subject to a meaningful and independent 
review process; promoting and incentivizing mental health prevention 
programs; integrating mental health consumers and providers in emerging 
health information technology systems; requiring the regular use of 
standardized, objective and uniformly applied clinical outcome 
measures; and improving coordination among social service sectors.
  Further, in order to truly achieve the above stated principles, we 
need health care reform that addresses the underlying, systemic issues 
in our current system. We are the only industrialized country that 
treats health care like a market commodity instead of a social service. 
Thus, care is not distributed according to medical need but rather 
according to ability to pay. Cost savings cannot be discussed without 
acknowledging that 31 percent of all health care expenditures in the 
U.S. are administrative costs. The average overhead for private 
insurance in this country is 26 percent, compared to 3 percent for 
Medicare. The majority of doctors and Americans support a single-payer 
health care system, yet this option has been dismissed by many 
policymakers as unrealistic. As elected Representatives of this 
democratic system, we are responsible for representing the views of the 
public. Therefore, it is imperative that we keep this option in the 
discussion of health care reform.
  I hope to work together with my colleagues to institute these 
critical changes to our nation's health care system. The American 
people deserve nothing less.
  Mr. TIM MURPHY of Pennsylvania. Mr. Speaker, I would just like to add 
a few more comments here. We have no more speakers, and I'll close with 
that. But it has to do with this.
  As I discuss the issues of our returning soldiers, it is important I 
add this element too, and that is that we need to reflect to them a 
tremendous sense of hope. Many times soldiers in theater and after they 
return home are hesitant to talk with anybody about their symptoms for 
two fears: one, if they're in theater or combat, they worry that it 
will prevent them from going back to their unit. If their deployment is 
ending, they are worried that it will delay them from coming home; and 
they also are concerned that it will affect their promotion, their 
advancement, their continuation in the military, and they don't want to 
let their fellow soldiers down or themselves.
  What our military is working on, however, is making sure they 
understand that our duty as mental health professionals is to make sure 
they're back to full form, and, in fact, that is something that's a 
change of how the military has handled this. Whereas, in the past 
someone would be pulled out

[[Page H6098]]

of their unit if they could, now the work is to get them back on their 
feet as fast as possible, but making sure they're not adding risk to 
their fellow soldiers.
  Along those lines, it's important we send the same message of hope, 
whether it is someone who is a veteran in battle, or perhaps a veteran, 
as my friend from Rhode Island just pointed out, someone who has faced 
the same sort of problems in their neighborhood.
  There are also genetic aspects of mental illness that may have very 
little to do with environment. There are parts that have to do with 
other neurological problems that occur.
  Overall, our advance in the mental health field has grown 
tremendously. It may be that you cannot necessarily do a CT scan or a x 
ray or a blood test to diagnose mental illness, but it is diagnosable. 
It is treatable. And we have to make sure that part of this resolution 
for Mental Health Month and the goals and ideals is to help our Nation 
understand that it is diagnosable, it is treatable. We need to come to 
grips with it and deal with this in a way that understands that the 
science and the technology and the medicine behind mental health 
treatment gives a lot of hope for the future.
  And with that, Mr. Speaker, I yield back the balance of my time.
  Mrs. CAPPS. For all the reasons that have been cited by the many 
speakers, and in strong support of House Resolution 437, I urge my 
colleagues to support this resolution.
  Mr. PAUL. Mr. Speaker, I certainly support efforts aimed at removing 
the stigma associated with mental health, increasing public awareness 
of the need to support those with mental health problems and their 
families, and the other goals of Mental Health Month. However, I am 
concerned that certain language in H. Res. 437 appears to endorse all 
of the recommendations of the New Freedom Commission on Mental Health, 
even though certain of the commission's recommendations threaten 
individual liberty and the wellbeing of American children.
  In particular, the commission recommended that the federal and state 
governments work toward the implementation of a comprehensive system of 
mental-health screening for all Americans. The commission recommends 
that universal or mandatory mental-health screening first be 
implemented in public schools as a prelude to expanding it to the 
general public. However, neither the commission's report nor any 
related mental-health screening proposal requires parental consent 
before a child is subjected to mental-health screening. Federally-
funded universal or mandatory mental-health screening in schools 
without parental consent could lead to labeling more children as 
``ADD'' or ``hyperactive'' and thus force more children to take 
psychotropic drugs, such as Ritalin, against their parents' wishes.
  Already, too many children are suffering from being prescribed 
psychotropic drugs for nothing more than children's typical 
rambunctious behavior. According to Medco Health Solutions, more than 
2.2 million children are receiving more than one psychotropic drug at 
one time. In fact, according to Medico Trends, in 2003, total spending 
on psychiatric drugs for children exceeded spending on antibiotics or 
asthma medication.
  Many children have suffered harmful side effects from using 
psychotropic drugs. Some of the possible side effects include mania, 
violence, dependence, and weight gain. Yet, parents are already being 
threatened with child abuse charges if they resist efforts to drug 
their children. Imagine how much easier it will be to drug children 
against their parents' wishes if a federally-funded mental-health 
screener makes the recommendation.
  Universal or mandatory mental-health screening could also provide a 
justification for stigmatizing children from families that support 
traditional values. Even the authors of mental-health diagnosis manuals 
admit that mental-health diagnoses are subjective and based on social 
constructions. Therefore, it is all too easy for a psychiatrist to 
label a person's disagreement with the psychiatrist's political beliefs 
a mental disorder. For example, a federally-funded school violence 
prevention program lists ``intolerance'' as a mental problem that may 
lead to school violence. Because ``intolerance'' is often a code word 
for believing in traditional values, children who share their parents' 
values could be labeled as having mental problems and a risk of causing 
violence. If the mandatory mental-health screening program applies to 
adults, everyone who believes in traditional values could have his or 
her beliefs stigmatized as a sign of a mental disorder. Taxpayer 
dollars should not support programs that may label those who adhere to 
traditional values as having a ``mental disorder.''
  In order to protect America's children from being subject to 
``universal mental screening'' I have introduce the Parental Consent 
Act (H.R. 2218). This bill forbids federal funds from being used for 
any universal or mandatory mental-health screening of students without 
the express, written, voluntary, informed consent of their parents or 
legal guardians. H.R. 2218 protects the fundamental right of parents to 
direct and control the upbringing and education of their children.
  Ms. WATERS. Mr. Speaker, I rise in support of House Resolution 437, 
providing full support of the goals and ideals of Mental Health Month, 
which is recognized annually in May. I commend my colleague, and fellow 
Californian Rep. Napolitano, for acknowledging the importance of this 
measure and presenting it before the House.
  The first Mental Health Act was signed in 1946 after it had been 
determined that soldiers who fought in World War II had returned with 
severe mental health issues. Still today a significant portion of 
individuals who suffer from mental illness are troops who suffer from 
depression and post-traumatic stress. Shortly after the act was signed 
the first Mental Health Week was developed. Eventually Mental Health 
Week evolved into the Mental Health Month program that we are 
celebrating today.
  Legislation regarding mental health has been developed in the past to 
prevent health care discrimination. Patients experienced grave 
inequalities because mental health was not considered a legitimate 
issue, as too often mental health is viewed as a minuscule issue in 
comparison to physical health. Many people may not know that more than 
57,000,000 individuals in the United States suffer from mental illness 
and H. Res 437 will not only raise awareness of mental health 
conditions but also aid citizens in their ability to combat stress to 
promote a healthy lifestyle.
  Unfortunately, every year mental health illnesses go unrecognized and 
untreated, and Mental Health Month was developed in an effort to 
prevent such circumstances. This May, Mental Health America has 
promoted a National Children's Mental Health Awareness Day, to educate 
the general public about the realities of mental health. Mental health 
illnesses affect all age ranges, and House Resolution 437 lends its 
full support for communities to promote positive youth development, and 
help families cope during times of hardship. The United States 
Department of Health and Human Services utilizes necessary funds and 
manpower to advocate for the rights and services of mental health 
patients. It will continue to provide Family and Community Support 
Programs to aid those adults and children with serious mental 
illnesses.
  Mr. Speaker, this measure is particularly important to the well-being 
of our citizens and I'm pleased to add my voice in support for this 
legislation. I will work diligently with my colleagues to ensure that 
the goals and ideals of Mental Health Month are recognized as notable 
issues. This is a significant step in raising awareness, and promoting 
healthy families and communities.
  Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, I rise today in 
support of House Resolution 437 which recognizes the goals and ideals 
of mental health month.
  Mental health issues affect many members of the population, altering 
their lives and the lives of their families. Over 57 million American 
citizens suffer from mental illness, and it is one of the leading 
causes of disability in our nation. In addition, people who suffer from 
serious mental illnesses die on average 25 years earlier than the 
general population, many of them from diseases that could be treated if 
diagnosed early.
  Approximately 6.7 percent of the population is affected by Major 
Depressive Disorder, and more than 90 percent of people who commit 
suicide suffer from a depressive disorder before they take their lives. 
Post Traumatic Stress Disorder has become one of the most serious 
mental health illnesses, with over a quarter of all U.S. troops 
suffering from the disorder. H. Res. 437 stresses a desire on the part 
of either those suffering from mental illness, or the families of those 
suffering, to seek help.
  As a registered nurse, I have seen firsthand the affects that mental 
illness has on individuals and their families, and I understand fully 
the importance of maintaining and advocating for mental health. This is 
an issue that affects many of us in some way, and we need to ensure 
that there is no stigma attached to mental illness so that those 
suffering can and will get the help they need. I ask my fellow 
colleagues to join me in recognizing the goals and ideals of Mental 
Health Month and supporting this Resolution in order to raise awareness 
for mental health issues.
  Mrs. CAPPS. I yield back.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentlewoman from California (Mrs. Capps) that the House suspend the 
rules and agree to the resolution, H. Res. 437, as amended.
  The question was taken; and (two-thirds being in the affirmative) the

[[Page H6099]]

rules were suspended and the resolution, as amended, was agreed to.
  A motion to reconsider was laid on the table.

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