[Congressional Record (Bound Edition), Volume 161 (2015), Part 14]
[Senate]
[Pages 20002-20003]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           MENTAL HEALTH CARE

  Ms. STABENOW. Mr. President, I rise to talk about an opportunity we 
have in the midst of all the negotiations going on to do something 
incredibly meaningful, that has bipartisan support, and literally will 
address a group of diseases that affect one out of four people every 
year--one out of four people who work here, one out of four people in 
our families. A set of diseases right now for which less than 40 
percent of those with the disease get the treatment they need, but when 
they do, it is manageable and they can go on and lead productive lives. 
What I am talking about is mental illness. One out of four people every 
year has some kind of mental illness which is treatable and with 
medications and with treatment--just like any other disease--can allow 
someone to go on and live their life.
  We have started the process in public policy of doing what we call 
mental health parity by saying now that insurance can't discriminate 
whether it is a behavioral disease, mental health, substance abuse or 
physical health, but we don't yet have the services in the community. 
So what happens is we pay dearly. Not only do individuals pay with 
their lives, their livelihoods, their families, and communities pay, 
but we pay as taxpayers.
  It was interesting to me, speaking at a conference a couple of days 
ago here in DC with law enforcement and mental health professionals 
coming together, to hear about the Cook County Jail in Chicago, a huge 
facility. The sheriff there now has appointed a psychiatrist as the 
director of the jail. Why? Because one-third of the people housed in 
the jail have psychiatric problems. They shouldn't be in the jail. They 
may have committed some minor infraction because they didn't have a job 
or maybe they were on the street. Maybe they were hearing voices in 
their head and didn't hear the police officer and didn't respond in a 
way--or where it was considered belligerent. We now know from papers 
today in Michigan that studies show that people who are mentally ill 
are 16 times more likely to be killed in a year by a police officer. I 
am not suggesting that it is at all on purpose but it is because of the 
nature of the behavioral problems and what ends up happening in the 
real world when people aren't getting the treatments they need. We know 
what happens in terms of violence and people committing crimes, 
although someone who has a mental health disease is much more likely to 
be a victim than a perpetrator.
  We have people in the emergency rooms of our hospitals. I have talked 
to hospital administrators and doctors who say what we need is to make 
sure we have a 24-hour emergency psychiatric facility, a place where 
someone can go or family members can call or the police can use if they 
find someone who needs help, not the hospital emergency room and 
certainly not the jail.
  The good news is that we have started a bipartisan effort that can 
fix this. My partner and colleague in this, Senator Blunt, and I, over 
a year ago, authored a provision that was passed by the House and 
Senate to begin something called the Excellence in Mental Health Act. 
We now have in law a definition of quality behavioral health services. 
We have federally qualified health centers in the community where 
people without insurance can go and get preventive care and get the 
physical health services they need, but the health clinics can't get 
reimbursed for mental health or substance abuse services. So we now 
have a definition. We have standards for what quality behavioral health 
care, mental health, and substance abuse care looks like. We have 
standards. We begin to provide dollars so that communities can provide 
those services if they meet the standards.
  A couple of years ago when we put together money for the first step 
by saying we are going to provide money for 8 States to be able to meet 
those standards--8 out of 50--the good news was that half the States in 
the country responded and said: We want to be one of those eight 
States. Twenty-four States across our country now have signed up. They 
have received planning grants to assess their community mental health 
services, what they are doing, and how they can meet these new high 
standards, how they can make sure they include 24-hour psychiatric 
emergency services in their community so their citizens have the help 
they need as well as ongoing help for families and individuals. Twenty-
four States have said: Sign me up. We are willing to do the work.
  We have funding for eight of those States to actually be able to do 
it, to change lives; eight of those States to be able to provide 
services, treatment, hope for individual families, help for the 
sheriff, and relief for the emergency room. What we are proposing now 
and what is under consideration is to fund the 24 States. We have 24 
States that have stepped forward. Let's provide them the resources. In 
the context of what we are talking about in the budget, it is a very 
small amount of money. We could say to the communities across this 
country and virtually half of the States that we are going to give them 
the resources to meet higher quality standards, to be able to provide 
the services desperately needed for one out of four people every year 
who have some kind of mental illness. The ramifications of doing 
nothing are severe in so many ways.
  The reality is that we are at a point where we have the opportunity 
to say that as a country we are going to recognize and treat diseases 
above the neck the same as diseases below the neck and support 
communities that step up with higher quality standards and services. In 
the world in which we live, this would be a huge bipartisan victory.
  I know this is under discussion, and I am hopeful that as the 
leadership moves forward, they will join us--the bipartisan coalition 
in the House and the Senate--in saying yes to give the people an 
opportunity to live their lives, be successful, work, and manage their 
diseases in the community just like any other disease.
  I wish to say in closing that if you are a diabetic, you check your 
insulin every day. If you check your sugar and take your insulin, you 
manage your disease. It is not debilitating. You can go out and live 
your life. I imagine there are many people who work in the Senate who 
are managing diabetes. You can do the same thing if you are bipolar. It 
is a chemical imbalance of the brain. It is just a different organ, a 
different part of the body. If, in fact, you have the medication to 
stabilize and you have the support and treatment you need, you can 
manage that disease, go on with your life, be successful, work, have a 
family, and be able to live with dignity. That is what we are talking 
about. We are talking about giving people who have diseases in the 
brain the same opportunity for treatment and management of those 
diseases to live healthy, hopeful, successful lives as we do for people 
who have diseases in any other organ of the body. We have the 
opportunity to do

[[Page 20003]]

that. At the end of next week, I deeply hope we will be able to 
celebrate that we have done something incredibly important for families 
across America.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Flake). The Senator from Indiana.

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