[Congressional Record Volume 163, Number 82 (Thursday, May 11, 2017)]
[Senate]
[Pages S2896-S2898]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                             Mental Health

  Mr. BLUNT. Madam President, I want to talk today about a topic that

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I think is getting more attention now than it has gotten for some 
time--but still not the attention it deserves--and that is to talk a 
little bit in May, which is Mental Health Month, about mental health.
  I was on the floor of the Senate the last day of October 2013, the 
50th anniversary of the last bill that President Kennedy signed into 
law, which was the Community Mental Health Act. Through the Community 
Mental Health Act, you saw the facilities that were about to be closed, 
but the anticipated alternatives, in so many ways, never really 
developed. According to the National Alliance on Mental Illness, 
approximately one in five adults experiences mental illness in a given 
year, and one in five young people between the ages of 13 and 18 will 
experience severe mental illness sometime during their lifetime.
  The National Institutes of Health says that one in four adult 
Americans has a diagnosable, and almost always treatable, mental health 
disorder, a mental behavioral health issue, and that one in nine adult 
Americans has behavioral health illness that impacts how they live 
every single day. So whether it is the statistic that relates to one in 
four or one in five or one in nine, this is an issue that affects the 
lives of lots of people.
  Half of the children in that age group, 13 to 18, rarely get the help 
they need, and even fewer adults do. About 40 percent of adults who 
have behavioral health issues receive the treatment they need for that 
issue. I think we are beginning to make great strides on this. 
Certainly, the discussion has changed. The opportunity to treat mental 
health like all other health has changed.
  In the 113th Congress, just a few years ago, Senator Stabenow from 
Michigan and I worked to get a bill passed; it was called the 
Excellence in Mental Health Act, and we now have eight States that have 
projects going on. In those eight States--in significant areas of all 
of those States--behavioral health is being treated like all other 
health.
  The idea is really built on the federally qualified health centers 
idea, the reimbursement model, where anybody can go, and if you are 
covered by a government program, that is taken into consideration. If 
you are covered by private insurance, that is taken into consideration. 
If you are paying cash, there is a significant and rapidly declining 
amount of cash that you have to pay because your income gets smaller. 
But everybody in these States would have access to mental health care, 
just as they currently have access to other kinds of healthcare.
  At the community mental health centers that meet 24/7 standards, that 
are available, that have the staffing needs, and in other places that 
have the staff the law requires and the access the law requires, people 
can go to those facilities, and those providers will know they are 
going to be reimbursed for treating mental health like all other 
health.
  I am certainly glad that my State of Missouri is one of the eight 
pilot States in that demonstration program. In our State, we have 
been--I think by any standard--forward-leaning on this issue for a long 
time, but not nearly as forward-leaning as we should be or as people 
who look at the pervasive character of behavioral health issues 
understand we should be.
  When we passed the bill a couple of years ago, we really weren't sure 
how much interest we would get from States. There was some sense that, 
well, eight States would be all the States that would even want to do 
this, if every State that wanted to apply and could go through the 
application process did so. But, in fact, everybody in the mental 
health world was encouraged to see 24 States, which represented half of 
the population in the country, apply to be part of that pilot program--
certainly, leading by example here, figuring out what happens.
  Frankly, if you treat behavioral health like all other health, I 
think what many of these States will find--and they may all find--is 
that the other health costs are much more easily dealt with and, 
obviously, that not only is treating behavioral health like all other 
health the right thing to do, but it actually may save money to spend 
this money. People who have other health problems but who are seeing 
their doctor because their behavioral health issue is under control may 
be seeing two doctors. They are taking the medicine they need for 
behavioral health--if they need medicine for that--but because they are 
eating better, sleeping better, feeling better about themselves, they 
are also taking the medicine and getting to the appointments for any 
other health issue they have.
  Early studies indicate that, actually, you save money by doing the 
right thing and understanding that mental health isn't a topic we don't 
talk about, but mental health is just another health issue we need to 
deal with.
  We need to be sure that we have providers going forward. We don't 
have enough doctors in Missouri--or in other States--who are able to 
treat the increasing number of people who seek treatment. And as 
doctors retire in these fields, we are going to have an even greater 
shortage if we don't do something to encourage people to go into this 
field.
  There is a particular shortage in care providers who deal with 
children. Children and youth who are in need of mental health services 
and who don't receive them run a greater risk of all kinds of other 
problems, including dropping out of school, not doing well in school, 
ending up in the criminal justice system--things that needlessly happen 
because we haven't stepped forward and viewed their behavioral health 
problem as we would if they had some other problems.
  I was glad Senator Reed from Rhode Island and I were recently able to 
reintroduce a bill called the Ensuring Children's Access to Specialty 
Care Act. Pediatric medicine doesn't pay as well as other medicine for 
lots of reasons. One is that children don't have a lot of their own 
money to pay with, and often their parents don't have it either.
  This bill that Senator Reed and I introduced would allow physicians 
who want to specialize in, among other things, child and adolescent 
psychiatry to be eligible for the National Health Service Corps student 
loan repayment program. That program is generally not available now to 
doctors who go on and specialize on the theory that if you specialize, 
you are going to have more income than the general practice doctor 
might have. Those programs have always been focused on the general 
practice doctor, but if you specialize in children's health--whether it 
is, frankly, psychiatry or any other area of children's health--you are 
much less likely to financially benefit from deciding to do that. So 
this would allow those doctors to pursue that program as part of how 
they help get their loans paid back.
  Whether it is physical or behavioral health, children have a unique 
set of health needs and often a lack of ability on their own to do what 
needs to be done. Medical residents who practice pediatric medicine 
require additional training. One of the barriers they cite for not 
getting that additional training is that they are going to have to have 
these additional student loans. Hopefully, we can allow ways for them 
to get into programs that other doctors get into, to see that they 
continue to be encouraged to be part of pediatric medicine and 
pediatric specialties.
  Also, we are looking at another bill, the Advancing Care for 
Exceptional Kids Act, commonly referred to as ACE Kids. What ACE Kids 
does is treat kids who have serious medical problems as exactly that--
to have a way to look at health needs and medically complex kids whom 
you wouldn't look at otherwise, seeing that these particular patients 
don't have to go through all kinds of barriers to find a doctor, fee 
for service. Medically complex kids really need help, and I think we 
could easily design a new and different way to deal with them.
  Finally, talking about kids, I want to say one other thing, and that 
is just to mention that this particular week is Teacher Appreciation 
Week. I was a teacher after I got out of college, before I had a chance 
later to be a university president. I think teachers are always 
inclined to be teachers and try to tell the stories we need to hear. 
But when we are talking about mental health and teachers, healthcare, 
mental health, first aid are things that don't allow teachers to become 
child psychiatrists or mental health professionals but do allow 
teachers, as they

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are watching the students whom they get to know so well, to identify 
what students need help and what students don't. Often teachers get the 
first chance outside the child's home to see that they are clearly 
challenged or may be challenged in ways that are easily dealt with, if 
they are dealt with, and are really troublesome if they are not dealt 
with at all.
  So while we celebrate Teacher Appreciation Week at the very end of 
school and Mental Health Month, I hope we commit ourselves to look at 
these mental health issues for what they are. They are health issues. 
They need to be talked about. The right thing to do is to deal with 
them.
  I think we are seeing new and better things happen there, but we are 
not nearly where we should be yet. As I said earlier, when Senator 
Stabenow and I could go to the Floor on the 50th anniversary of the 
last bill President Kennedy signed and 50 years later talk about how 
few of the goals set in that bill have been met in five decades by 
society, we really have a lot of catching up to do.
  I believe and hope we are catching up, and I hope this is a month 
where people really think about telemedicine, contacts, opportunities, 
and excellence in mental health in ways we haven't before.
  I yield the floor.
  The PRESIDING OFFICER. The assistant Democratic leader.