[Congressional Record (Bound Edition), Volume 155 (2009), Part 14]
[Extensions of Remarks]
[Page 19645]
[From the U.S. Government Publishing Office, www.gpo.gov]




             ENHANCED EDUCATION AND TRAINING FOR PROVIDERS

                                 ______
                                 

                        HON. PATRICK J. KENNEDY

                            of rhode island

                    in the house of representatives

                         Tuesday, July 28, 2009

  Mr. KENNEDY. Madam Speaker, the America's Affordable Health Choices 
Act of 2009 vitally enhances the provision of mental health care in our 
nation. Perhaps most importantly, the legislation includes mental 
health and substance-use disorders benefits in the essential benefits 
package. It is because of the precedent set by the mental health parity 
law, fortifying the civil rights of those with mental illnesses, which 
lead to the clear recognition by the bill that optimal health cannot be 
achieved without the inclusion of mental health and substance-use 
disorder services. I am pleased to have worked with the Committees to 
have accomplished this victory.
  This bill also bolsters the provision of primary care in our country, 
and in particular prevention. However, if mental health and substance-
use disorders are to be included as an essential benefit, we need to be 
sure that our Nation's physicians, both primary care doctors and 
specialists, have the behavioral health training and education 
necessary for them to meet these new provisions. Current medical 
education, and in particular continuing medical education, does not 
include enough behavioral health components for physicians to 
adequately meet the mental health needs of their patients. Substance-
use disorder education in particular is rarely offered as a separate 
component of education, leading medical school graduates with a lack of 
confidence in their skills to screen, assess, or provide the needed 
interventions to their patients, according to the 2005 National Academy 
of Sciences' Institute of Medicine (IOM) Improving the Quality of 
Health Care for Mental and Substance-Use Conditions report. This report 
also found that even in preventative medicine, most substance-use 
education focused solely on tobacco.
  The recommendations from this report were so essential for the health 
of our Nation that I developed legislation based on them--the Improving 
the Quality of Mental and Substance Use Health Care Act. These issues 
are now more pertinent than ever as we craft a reform of the current 
system which will greatly increase the access to mental health care for 
Americans. Sadly, a recent study showed that barely a third of 
Americans with mental illness get proper treatment, and that most 
people who do get care obtain it through their care from primary care 
physicians. Yet about two-thirds of U.S. primary care physicians 
reported in 2004-05 that they could not get outpatient mental health 
services for their patients--a rate that was at least twice as high as 
for other services, according to the Commonwealth Fund. It is more 
crucial now than ever that physicians receive the proper behavioral 
health training--we cannot increase access without arming our workforce 
with the tools needed to meet this challenge. I therefore respectfully 
ask the Committees' and my colleagues to ensure that this essential 
education and training is included in the workforce and education 
enhancements sections of this bill.

                          ____________________