[Congressional Record Volume 170, Number 126 (Thursday, August 1, 2024)]
[Senate]
[Pages S5755-S5757]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                 National Minority Mental Health Month

  Mr. President, I have been in the Senate now for 18 years, and I am 
proud of the progress that we have made in dealing with mental health. 
I served in the Senate with the late Senator Ted Kennedy as he fought 
for mental health parity. So that once and for all we would find that a 
person who suffers from mental illness would get the same type of 
respect, attention, and coverage as someone suffering from a physical 
illness.
  We recognize that mental health is an illness, and mental health 
parity was important. We have made progress. During COVID-19, I was 
very proud that we had bipartisan efforts to expand telehealth to 
mental health because we recognize that access was critically important 
and that during COVID, getting access to healthcare was particularly 
challenged.
  And then in the Safer Communities Act, which we all supported here, 
we provided help to our children in our schools suffering from mental 
illness. So we have made progress. We have made progress. But more 
needs to be done.
  I rise today to urge my colleagues to recognize that we have just 
completed July as National Minority Health Awareness Month. So I want 
to comment on the gap that exists in regard to mental health services 
and our minority communities.
  This July, the U.S. Department of Health and Human Services Office of 
Minority Health is focusing on improving mental health outcomes for all 
communities through this year's theme: ``Be the Source for Better 
Health.''
  Let this month--and all month--serve as an opportunity to bring 
awareness of these mental health challenges and recommit our efforts to 
tackling longstanding health disparities in the United States.
  Unfortunately, the subject of mental health is surrounded by stigma. 
About half of all people in the United States will be diagnosed with a 
mental health disorder at some point in their life. Mental illness can 
have a devastating impact on the individual as well as their 
surrounding community.
  Racial and ethnic minorities often suffer from poor mental health 
outcomes due to multiple factors, including lack of access to quality 
mental health care services, cultural stigma surrounding mental health 
care, discrimination, and overall lack of awareness about mental 
health.
  Today, because of deep-rooted inequalities that exist in our society, 
including those in our healthcare system, communities of color continue 
to face health disparities that result in poorer quality of life and 
lower life expectancies when compared to their White counterparts.
  According to the Kaiser Family Foundation 2023 analysis, 39 percent 
of Black or African-American adults and 36 percent of Hispanic Latino 
adults who reported fair or poor mental health were less likely than 
White adults to say that they received mental health services in the 
past 3 years.
  In our country, we are incredibly fortunate to have the National 
Institute on Minority Health and Health Disparities at the National 
Institutes of

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Health. And I was proud to help create that division of the national 
health system. Our national health status depends on our ability to 
improve health of all communities and eliminate mental health 
disparities.
  The stigma surrounding mental health poses challenges for communities 
of color. Among adults who receive or try to receive mental health 
care, Asian and Black adults are more likely to report difficulty 
finding a provider who can understand their background and experiences 
compared to their White counterparts. Hispanic adults also reported 
being afraid or embarrassed to seek care. These are circumstances that 
we have to acknowledge and we have to deal with.
  Suicide is one of the leading causes of death in the United States. 
Certain groups have disproportionately high rates of suicide. Between 
2011 and 2021--those 10 years--the suicide death rate showed a 
substantial increase among people of color. There was a 70-percent 
increase among American Indian and Alaskan Native people, followed by a 
58-percent increase among Black people and a 39-percent increase among 
the Hispanic population.
  Thanks to the Biden-Harris administration, 9-8-8, the Suicide and 
Crisis Lifeline, has served as a resource for over 20 million callers 
looking for support in times of distress. These numbers are to be 
commended. However, overall awareness remains low, particularly among 
Black, Hispanic, and Asian adults.
  The Kaiser Family Foundation reported that immigrant adults--those 
with limited English proficiency--were less likely to have heard about 
the 9-8-8 number compared to U.S.-born and English-proficient 
individuals.
  A 2023 Milliman Report found that over half of the U.S. populations 
live in counties that are entirely designated as ``Mental Health 
Professionals Shortage Areas.'' The mental health provider workforce 
has not increased. The country has less than a third of the 
psychiatrists needed to meet provider shortages. The national average 
self-pay cost for someone who does not have insurance is over $170 per 
visit. These out-of-pocket costs that individuals can face can serve as 
a barrier to care.
  This is simply unacceptable. Stigma, cost, and provider shortages 
prevent many individuals from receiving necessary mental health care. 
We must act to improve access to high-quality, evidence-based mental 
health care services in our country.
  Maternal mental health has been a persistent issue that has deeply 
affected individuals of families across our Nation. Depression, 
anxiety, and substance use disorder are the most prominent 
complications of pregnancy, childbirth, and postpartum. According to 
the CDC, one of eight women experience postpartum depression, and 50 
percent of them are untreated.

  While maternal mental health disorders impact all women, there is 
evident disparity in the rates at which certain racial and ethnic 
groups are affected. Women of color are three to four times more likely 
to experience complications during pregnancy and childbirth and die 
from these complications than White women. Despite this alarming 
statistic, these mothers of color--and Black mothers, in particular--
are still less likely to receive both a diagnosis and treatment for 
these disorders.
  Many factors affecting mental health and well-being later in life 
start during childhood and adolescence. Certain social and economic 
circumstances, such as experiencing a trauma, which is all too common, 
particularly in minority communities; economic circumstances, again, in 
the underserved communities and minority communities; lacking a support 
system; and having limited access to healthcare leave racial and ethnic 
minorities and American Indian children and Alaska Native children and 
adolescents at an increased risk for many mental health problems that 
are preventable.
  Children and their families lack access to high-quality specialty 
child and adolescent behavioral health care. There is currently a 
shortage of inpatient child and adolescent psychiatric beds. We say our 
youth are our priority, and yet we don't provide the beds for the 
mental health services for our children.
  According to the American Academy of Child and Adolescent Psychiatry, 
there are over 1.3 million children under the age of 18 in my State of 
Maryland but only 386 practicing child and adolescent psychiatrists. 
This means that, for every 100,000 children, there are 28 professionals 
covering them. Unfortunately, the number of counties in Maryland that 
had no child or adolescent psychiatrists available has increased from 6 
to 9. We only have 24 jurisdictions in our State, and 9 of them have 
zero help for child psychiatry. This is simply unacceptable. Children 
should have access to a full range of prevention, early intervention, 
and treatment options within all mental health care systems.
  The time to act is now. The lack of behavioral health services in 
Maryland and the United States prompted me to help introduce the 
Medicaid Ensuring Necessary Telehealth is Available Long-term Health 
for Kids and Underserved Act in 2022. It is a long title but an 
important title. This bipartisan legislation offered guidance to the 
Centers for Medicare and Medicaid Services to increase access to 
behavioral health services and treatment via telehealth.
  Also, in 2022, I voted to help pass the Bipartisan Safer Communities 
Act, which included a provision to allocate funding to support school-
based mental health service providers.
  I am proud to have supported the Health Equity and Accountability Act 
since its introduction to the Senate. This comprehensive legislation 
aims to address health disparities throughout our healthcare system, 
including eliminating structural barriers that contribute to mental 
health and substance use disorder inequities.
  Older adults' mental health needs are often forgotten or thought not 
necessary. In 2020, the Kaiser Family Foundation found that one in four 
adults aged 65 and older reported anxiety or depression. Among Medicare 
beneficiaries, older Hispanic adults reported the highest rates of 
being diagnosed with mental health conditions. The number of 
psychiatrists accepting Medicare has declined over time--greater need, 
less providers, particularly in minority communities. We must find ways 
to expand mental health resources to older Americans in our Medicare 
system.
  I was happy to reintroduce the bipartisan Telemental Health Care 
Access Act. This legislation would eliminate certain restrictions or 
remove barriers to telemental health services for Medicare 
beneficiaries. While this legislation increases access to mental health 
care, Congress can always do more. Underserved communities and older 
American adults may experience barriers to telehealth access. We have 
to make sure that is available.
  It is one thing to provide the services; it is another thing to make 
sure there is access to the services. People need to know about it. 
They need to know it is available. We need to have providers that 
participate in it need. We need to have reimbursement systems that 
recognize this. All of that has to come together. Unfortunately, when 
we look at the underserved communities and minority communities, it is 
much more of a challenge.
  Behavioral health equity is the right of all individuals--regardless 
of race, age, ethnicity, gender, disability, socioeconomic status, 
sexual orientation, or ZIP Code--to access high-quality and affordable 
healthcare support.
  Mental health affects the lives of so many Americans. As a nation, we 
have made great progress in better supporting individuals and 
communities. So let us, at this time, honor the National Minority 
Mental Health Awareness Month, which was held in the month of July. Let 
us commit to working together to improve mental health care for all of 
our country. The United States has an ever-changing cultural landscape. 
We all know that. We must continue to find ways to make sure that no 
one group gets forgotten. We must prioritize health equity every month.
  I urge my colleagues to join me as we continue to improve behavioral 
health for everyone in the United States and work together to ensure 
the elimination of health disparities.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Hawaii.
  Ms. HIRONO. Mr. President, I want to start by thanking my colleague 
from Maryland, Senator Cardin, for pointing out the need for mental

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health services in our country and the disparities that exist in our 
country in providing such services. I thank Senator Cardin.