[Congressional Record (Bound Edition), Volume 147 (2001), Part 13]
[Senate]
[Pages 18142-18143]
[From the U.S. Government Publishing Office, www.gpo.gov]



                         MENTAL HEALTH RESPONSE

  Mr. WELLSTONE. Mr. President, I rise in this Chamber to talk about 
the extraordinary mental health needs of the American people, and 
especially people of New Jersey, New York, Virginia, Washington, DC, 
and Pennsylvania in the aftermath of the September 11 attacks.
  I thank Senator Kennedy for holding an extraordinary HELP Committee--
HELP is Health, Education, Labor, and Pensions--hearing on this topic 
last week. I am grateful to Senator Warner for his invitation at the 
hearing to have some suggestions about some mental health initiatives 
that could be part of this DOD authorization. Senator Warner is to be 
commended for his recognition that there does need to be some 
legislation that responds to the short-term and long-term needs of 
people who have been affected by these tragic events.
  Many Senators are working on this issue, and I am sure the Presiding 
Officer, the Senator from New Jersey, is one of them. I am pleased to 
also do this work.
  I want to talk a little bit about some of the witnesses. Carolyn 
Pfeffer, who is a child psychiatrist at New York University, noted that 
in retrospect what should really have been in place was a plan and a 
program in every school for how to respond to the disaster, along with 
prompt and effective public education for parents to help them 
understand how to talk to their children--in other words, she was 
saying, right after September 11.
  She said that what is needed now is ``aggressive work to identify 
children who have suffered the most severe stress; training of mental 
health professionals in how to respond to the unique needs growing out 
of events of this kind; government funding and leadership to assure 
resources are available to these children who need help.''
  She said we must do all we can to prepare for the unprecedented 
strain on our mental health system and to assure that private insurers 
will encourage appropriate treatment rather than establishing 
artificial limits on what we can provide for people.
  Dr. Spencer Eth, the vice-chairman of the department of psychiatry at 
St. Vincent's hospital in New York, also spoke at the hearing. St. 
Vincent's was the hospital where the largest number of victims of the 
attack are being treated. Dr. Eth is also a nationally recognized 
authority on the psychological effects of traumatic event. He gave 
moving testimony about his experiences with providing treatment for 
emergency workers, and he said, ``Never before have the gaps in the 
mental health system been more apparent.'' He urged the committee to 
recognize that ``the magnitude of the public's need for traditional 
therapies, outreach to schools, businesses, and communities . . . is 
unprecedented. . . . He stated, ``We must obtain the funding required 
to reach everyone at high risk and everyone who is already suffering, 
regardless of health coverage, language barriers, and physical 
disabilities.''
  Dr. Kerry Kelly gave what was probably the most searing testimony 
about her own experiences with her onsite work as chief medical officer 
of the New York Fire Department, minutes after the attacks. She 
testified that, ``the selflessness of these men and women [of the New 
York Fire Department] is what made them heroes, but it's also what 
brings me to these hearings today to urge your approval of funds to 
provide for the psychological and counseling need of our members and 
their families. As we get further away from the events of that day, the 
officers, firefighters, fire marshalls, emergency medical technicians 
and paramedics, will have to cope with delayed reactions to the trauma 
they experienced. And from day one, the men and women of the New York 
Fire Department and the families of those who were lost have had to 
endure a tremendous sense of grief.'' She said, ``The emotional well-
being of our department requires intervention to provide stress 
debriefing, bereavement counseling, and continued psychological support 
of our members, our families, and the children affected by this 
event.''
  Dr. Carol North pointed out that 2 years after the Oklahoma City 
bombing 16 percent of children 100 miles away still reported 
significant posttraumatic stress memories related to it.

[[Page 18143]]

  We know one thing for sure: It is a mistake to believe that such 
events, of September 11 and after, cannot have a lasting impact on the 
mental health of those men, women, and children who have experienced 
them. We should not repeat the mistakes that were made in the aftermath 
of the Vietnam war when the trauma experienced by veterans was ignored 
and trivialized until well after the optimal time for treatment was 
passed.
  We have learned from the outstanding research which has been funded 
by the VA and the NIMH of the severity of the disorder and the 
effective ways it can be treated.
  Let me summarize the case for this amendment of which Senator Warner 
and others have been so supportive. Let us give respect for what people 
have experienced and help them deal with this now in a manner which is 
appropriate to their individual needs. Let us help those families who 
have survived the loss of a loved one and may also now be dealing with 
preparations for a funeral or memorial without ever receiving any 
remains of their loved one.
  Let us recognize that traumatic grief is real and has unique features 
that go beyond our usual understanding of death and loss. Let us help 
the emergency workers who stretched their bodies and minds to deal with 
this horror and lost so many of their friends and colleagues as well.
  Let us help those who escaped with their lives but now suffer from 
serious injuries and many other losses of their own. Let us help those 
who made it out safely but who feared for their lives and witnessed 
such horror and are now dealing with the multiple losses of friends, 
families, colleagues, and their jobs. And let us help the children who 
must now try to understand what they saw, what they have lost, what 
their parents and teachers are going through, and what the world means, 
while we all struggle to do the same and try to regain our sense of 
safety.
  I am not saying that mental illness is widespread or an inevitable 
consequence of the event. But after hearing from the experts at this 
hearing, we should not underestimate the severe impact of September 11 
on people's sense of identity and safety and how the multiple losses 
and horrific experiences they went through have the potential to affect 
them for a long while.
  Let me talk a minute about posttraumatic stress syndrome which can 
have such lasting effects on the minds and hearts of those who suffer 
from it. Here I draw from some experience because a lot of my work, 
especially back in Minnesota, is with Vietnam vets who are struggling 
with PTSD. We know from research that the brain chemistry can be 
altered by such experiences, and we know that the day-to-day struggle 
to deal with the frightening flashbacks, intrusive thoughts, loss of 
sleep and many other symptoms can lead to severe problems and an 
inability to function if left untreated.
  I will never forget a letter from a 10-year-old girl in Pope County, 
MN, who told me that her daddy was a Vietnam vet. He went into the 
shower in the morning. He had been doing fine. This was many years 
later, about 4 years ago. She said: My dad came out of the shower and 
he couldn't talk to anybody. Please help my dad. That was PTSD from the 
Vietnam war.
  Treatment can help people with PTSD, depression, anxiety, and a lot 
of other illnesses. What we want to do with this amendment is provide 
States $175 million in flexible ways to deal with the needs of the 
citizens. We want to have training programs for licensed mental health 
professionals. We want to have expedited and increased research funding 
right away so we know what to do. The Secretary of the Department of 
Health and Human Services is authorized to set up a disaster research 
clearinghouse so that information can quickly be made available to 
schools and public health agencies during times of crisis.
  Funding is authorized for $50 million for trauma treatment centers 
for adults and children to provide services for people who are exposed 
to such traumas.
  All of this will make a huge difference. This came up last week. I 
thank Senator Kennedy for his leadership. There are a lot of us who are 
involved in this effort. Senator Warner is one. I cannot emphasize 
enough to other Senators how important it is that we try to pass this 
package.
  Today, we were scheduled to bring up the Mental Health Equitable 
Treatment Act. This is legislation on which I have been working with 
Senator Domenici. More important than that, there are 63 or 64 Senators 
who support it.
  One or two Senators objected. I am disappointed to say the least. We 
could have had this legislation on the floor. We could have had debate 
and some amendments, and it would have passed.
  The legislation did two things: It ended all discrimination in 
coverage. It is civil rights legislation. It just says no longer can 
any health care plan treat someone who is struggling with this kind of 
mental illness differently than someone who is struggling with any 
other kind of illness.
  My God, this is 2001. It is long overdue.
  The second thing I want to say--I will not try to put one agenda on 
top of another, but I want colleagues to know that the second thing 
that happens from this legislation--which is why it is so important--is 
that the treatment follows the money. When plans now provide coverage, 
you then see an infrastructure in our country which doesn't exist now 
as it should to provide the care for people. Kay Jamison, who has done 
brilliant work and writing in this area, said, ``The gap between what 
we know and what we do is lethal.''
  There is September 11, and there are all kinds of people trying to 
deal with this trauma. There are all kinds of other men, women, and 
children who don't get the care they need. This is a piece of 
legislation that has some urgency. There is no reason to delay any 
longer. One or two Senators objected.
  I hope this will be on the floor soon, and I hope we can pass it. I 
think the President will sign it. I think it is a bipartisan effort and 
it is a good thing to do and it is the right thing to do.
  I yield the floor.

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