    [Public Papers of the Presidents of the United States: William J. Clinton (1999, Book I)]
    [June 7, 1999]
    [Pages 894-897]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks at the White House Conference on Mental Health
    June 7, 1999

        The President. Thank you very much. I want to, first of all, thank
    all of you for coming, the Members of Congress of both parties, members
    of our administration, but the larger community represented here in this
    room and at all of our sites.
        This has been a truly remarkable experience, I think, for all of
    us--stimulating, moving, humbling. I think it's because it is so real,
    and it has been too long since we have come together over something
    that's this real, that touches so many of us.
        This is a moment of great hope for people who are living with mental
    illness and, therefore, a moment of great promise for our Nation. We
    know a lot about it; we know a lot more than most of us know we know, as
    we found out today. And we wanted to have this conference to talk about
    how far we've come and also to look forward into the future.
        We all know we wouldn't be here today without the commitment of
    Tipper Gore. I asked her to be my national
    adviser for mental illness because she knows more and cares more about
    this issue than anyone else I personally know. She has dedicated herself
    to making this a priority of national policy and private life. And I
    think we are all very, very much in her debt.
        I would also like to say one more word about Tipper and about the Vice President, about the way they have dealt with this issue as a family
    and the gifts they have given to America, going back to before the time
    when we all became a team in the election of 1992, when they began their
    annual family conferences. All people in public life talk about family
    values. No couple in public life has ever done remotely as much to try
    to figure out what it would mean to turn those family values into real,
    concrete improvements in the lives of ordinary families as Al and Tipper
    Gore have over a long period of time.
        I sort of feel like an anticlimax at this convention--not for the
    reasons the political reporters think--[laughter]--but because the real
    story here is in the people who have already talked, in their stories of
    courage and struggle, of endurance and hope. Americans with mental
    illness should have the same opportunity all Americans have to live to
    the fullest of their God-given ability. They are, perhaps, just the
    latest in our enduring challenge as a people to continue the work of our
    Founders, to widen the circle of opportunity, to deepen the meaning of
    freedom, to strengthen the bonds of our community.
        But what a challenge it has been. Clearly, people with mental
    illnesses have always had to struggle to be treated fairly and to get
    the treatment they need--and they still do. We have made a lot of
    progress by appealing to the better angels of our nature, by drawing on
    our deep belief in equality, but also by hearing these stories.
        So again, I want to thank Mike and
    John and Jennifer and
    Robin and Dr. Burton. I thank Dr. Hyman, Dr.
    Koplewicz. I thank Lynn Rivers.
        I think all of us can remember some moment in our lives where,
    because of something that happened in our families or something someone
    we knew wrote or said, we began to look at this issue in a different
    way. I, myself, feel particularly indebted to the courage of my friend
    the great author William Styron for writing
    the book he wrote about his own depression. But I think that it is not
    enough to be moved. We have to have hope, and then we have to have some
    sense about where we're going.
        It was no accident that all of you were clapping loudly when Dr.
    Hyman showed us pictures of the brain. I
    remember when Hillary and I first met and began going together 28 years
    ago, and she was working at the Yale Child Study Center and the
    hospital, and we began

    [[Page 895]]

    to talk about all of this. Like a lot of young students at the time, I
    had been very influenced by Thomas Kuhn's book, ``The Structure of
    Scientific Revolution.'' And I began to wonder whether we would ever
    develop a completely unified theory of mind and body, if we would ever
    learn that at root there are no artificial dividing lines between our
    afflictions. The human genome project, as you've heard explained today,
    offers us the best chance we have ever had to have our science match our
    aspirations in learning to deal with this and all other issues.
        So this has been for me not simply emotionally rewarding but
    intellectually reaffirming. And I hope it has been for all of you. We've
    been at this for quite a long while. A hundred and fifty years ago we
    had to learn to treat people with mental illness as basic human beings.
    Thirty years ago we had to learn that people with mental illness had to
    be treated as individuals, not just a faceless mob.
        I'll never forget when journalists secretly filmed the nightmare
    world inside some of our Nation's mental hospitals. Americans were
    heartbroken and horrified by what they saw, and we began to develop a
    system of community care for people. Today, we have to make sure that we
    actually provide the care all of our people need, so they can live full
    lives and fully participate in our common life.
        We've worked hard to break down some of the barriers for people
    living with mental illness. On Friday, as many of you know, I directed
    all Federal agencies to ensure that their hiring practices give people
    with mental disabilities the same employment opportunities as people
    with physical disabilities. On Saturday Tipper
    and I did the radio address together and announced that Tipper will
    unveil our new campaign to fight stigma and dispel myths about mental
    illness.
        But all of you who have had this in your lives, or in your families'
    lives, know that attitudes are fine, but treatment matters most.
    Unfortunately, too many people with mental illness are not getting that
    treatment because too many of our health plans and businesses do not
    provide equal coverage of parity for mental and physical illness or
    because of the inadequacy of Government funding and policy supports.
        I have heard heartbreaking stories from people who are trying hard
    to take care of their families, and one day mental illness strikes. And
    when they try to get help, they learn the health plans they've been
    counting on, the plans that would cover treatment for high blood
    pressure or heart disease, strictly limit mental health care and don't
    cover it at all. Why? Because of ignorance about the nature of mental
    illness, the cost of treating it, and as Dr. Burton told us, the cost of
    not treating it.
        A recent study showed the majority of Americans don't believe mental
    illness can accurately be diagnosed or effectively treated. If we don't
    get much else out of this historic conference than changing the
    attitudes of the majority, it will have been well done, just on that
    score.
        Insurance plans claim providing parity for mental health will send
    costs and premiums skyrocketing. Businesses believe employees will over-
    use mental health services, making it impossible for employers to offer
    health insurance. Now, there may be arguments to be made at the margins
    on both sides of these issues, but I believe that providing parity is
    something we can do at reasonable cost, benefit millions of Americans,
    and over the long run, have a healthier country and lower health care
    costs.
        As we've heard again today, mental illness can be accurately
    diagnosed, successfully treated, just as physical illness. New drugs,
    better community health services are helping even people with the most
    severe mental illnesses lead healthier, more productive lives. Our
    ability to treat depression and bipolar disorder is greater even than
    our ability to treat some kinds of heart disease.
        But left untreated, mental illness can spiral out of control, and so
    can the cost of mental health care. A recent World Bank study showed
    that mental illness is a leading cause of disability and economic burden
    that goes along with it. Here in the United States, untreated mental
    illness costs tens of billions of dollars every year. The loss in human
    potential is staggering.
        So far, 24 States and a large number of businesses have begun to
    provide parity for their citizens and their employees. Reports show that
    parity is not notably increasing health care costs. For instance, Ohio
    provides full parity for all its State employees and has not seen costs
    rise. As we heard, Bank One's employee mental health treatment program
    has helped it reduce direct treatment costs for depression by 60
    percent.
        As a nation founded on the ideal of equality, it is high time that
    our health plans treat all

    [[Page 896]]

    Americans equally. Government can and must lead the way to meet this
    challenge.
        In 1996 I called on Congress to make parity for mental health a
    priority. I was proud to sign into law the Mental Health Parity Act,
    which prohibited health plans for setting lower annual and lifetime
    limits for mental health care than for other medical services.
        Again I want to say, since we have so many Congressmen here, Tipper
    Gore was very instrumental in that. But I was
    also deeply moved by the broad and deep bipartisan support by Members of
    Congress in both Houses who had personal experiences that they shared
    with other Members which helped to change America.
        The law was a good first step. And I'm pleased to announce, with
    Secretary Herman here, that the Labor
    Department will now launch a nationwide effort to educate Americans
    about their rights under the existing law, because a lot of people don't
    even know it passed.
        But when insurers can get around the law by limiting the number of
    doctor's visits for mental condition, when families face higher
    copayments for mental health care than for physical ailments, when
    people living with mental illness are forced to wait until their
    sickness incapacitates them to get the treatment they need, we know we
    have to do more.
        So where do we go from here? First, I am using my authority as
    President to ensure that our Nation's largest private insurer, the
    Federal Employee Health Benefit Plan, provides full parity for mental
    health.
        Today Janice Lachance, the Director
    of OPM, will inform nearly 300 health plans across America that to
    participate in our program, they must provide equal coverage for mental
    and physical illnesses. With this single step, 9 million Americans will
    have health insurance that provides the same copayments for mental
    health conditions as for any other health condition, the same access to
    specialists, the same coverage for medication, the same coverage for
    outpatient care.
        Thirty-six years ago President Kennedy said we had to return mental
    health to the mainstream of American medicine. Thirty-six years ago he
    said it, and we're still waiting. Today, we have to take more steps to
    return Americans to the mainstream of American life. I ask Congress now
    to do its part by holding hearings on mental health parity.
        The second thing we have to do is to reach out to the people who are
    most in need. Today I've asked HCFA, the Health Care Finance
    Administration, to do more to encourage States to better coordinate
    mental health services, from medication to programs targeted at people
    with the most serious mental disorders, for the millions of people with
    mental illness who rely on Medicaid.
        Third, we must do more to help people with mental illness reenter
    the work force. I asked Congress to pass the ``Work Incentives
    Improvement Act,'' which will allow people with disabilities to purchase
    health insurance at a reasonable cost when they go back to work. No
    American should ever have to choose between keeping health care and
    supporting their family.
        Fourth, with an ever-increasing number of people with mental
    disabilities in managed care plans, it is more important than ever for
    Congress to pass the Patients' Bill of Rights.
        Fifth, this year we requested the largest increase in history, some
    $70 million to help more communities provide more mental health
    services. And I asked Congress to fully fund this proposal. The absence
    of services and adequate funding and institutional support for sometimes
    even the most severe mental health problems is a source of profound
    worry to those of you who actually know what is going on out there.
        I know that I was incredibly moved by the cover story in the New
    York Times Sunday magazine a couple of weeks ago, and I know a lot of
    you were. And I read that story very carefully. I talked to
    Hillary about it; I talked to
    Al and Tipper about
    it; and I asked myself then--I am still asking myself--what more can we
    do to deal with some of the unbelievable tragedies that were plainly
    avoidable, clearly documented in that important article? This is a good
    beginning, and I hope that Congress will fund it.
        And finally, it is profoundly significant what we have heard about
    children. We have to do more to reach out to troubled young people. One
    out of ten children suffers from some form of mental illness, from mild
    depression to serious mental disease. But fewer than 20 percent receive
    proper treatment.
        One of the most sobering statistics that I have heard in all of this
    is that a majority of the young people who commit suicide--now the third
    leading cause of death in teenagers, especially gay teenagers--are
    profoundly depressed.

    [[Page 897]]

    Yet the majority of parents whose children took their own lives say they
    did not recognize their children's depression until it was too late.
        The tragedy at Columbine High School, as Hillary said, was for all
    of us a wakeup call. We simply can't afford to wait until tragedy
    strikes to reach out to troubled young people. Today I'm pleased to
    announce a new national school safety training program for teachers,
    schools, and communities to help us identify troubled children and
    provide them better school mental health services.
        This new program is the result of a remarkable partnership by the
    National Education Association, EchoStar, and members of the Learning
    First Alliance, joined by the Departments of Education, Justice, and
    Health and Human Services. This fall the Vice President and Tipper will kick off the
    first training session, which will be transmitted via satellite to more
    than 1,000 communities around our Nation.
        We're all very grateful to EchoStar, a satellite company based in
    Littleton, Colorado, and its partner, Future View, for helping make this
    possible by donating satellite dishes to 1,000 school districts, and 40
    hours of free time. I want to ask businesses and broadcasters all around
    our country to follow EchoStar's lead and donate their time, expertise,
    and equipment to help ensure that every school district in America can
    participate in this important training program.
        Now I want to introduce two of the people who are showing this kind
    of leadership: the president of the NEA, Bob Chase; and Bill Vanderpoel, the
    vice president of EchoStar. I'd like to ask them to come up and talk a
    little bit about what they're going to do. Let's give them a big hand.
    [Applause]

    [At this point, Robert F. Chase, president,
    National Education Association, and William Vanderpoel, vice president for business development, EchoStar
    Communications Corp., made brief remarks.]

        The President. Thank you both very much. Now, I'd like to ask
    Tipper to come up one more time so we can all
    tell her how grateful we are, and let me say this. You probably saw a
    little bit by the way she positioned Al on
    time and she positioned Hillary on
    time--I think I'm going to start calling her ``Sarge'' behind her back.
    [Laughter] She has driven us all. We've been on time; we've been at the
    place we were supposed to be; we say what we were supposed to say; we
    finished on time. So she not only has great sensitivity; she has
    phenomenal organizing ability, and we're very grateful for her. Thank
    you. [Applause]
        Now, I'd like to ask Hillary and
    the Vice President to come over, too.
    [Applause] Thank you all very much. God bless you.

    Note: The President spoke at approximately 2 p.m. in the Blackburn
    Auditorium at Howard University. In his remarks, he referred to the
    following conference participants: Mike Wallace, co-editor of the CBS
    news program ``60 Minutes'' and a clinical depression sufferer;
    schizophrenia sufferer John Wong; anorexia nervosa sufferer Jennifer
    Gates; Robin Kitchell, whose son suffers from bipolar disorder,
    attention deficit disorder, and learning disabilities; Dr. Wayne Burton,
    M.D., first vice president/corporate medical director, Bank One Corp.;
    Dr. Steven E. Hyman, M.D., Director, National Institute of Mental
    Health; and Dr. Harold S. Koplewicz, M.D., founder and director, New
    York University Child Study Center. The transcript released by the
    Office of the Press Secretary also included the remarks of Tipper Gore,
    Vice President Al Gore, Dr. Burton, the First Lady, Dr. Hyman, and Dr.
    Koplewicz. A portion of these remarks could not be verified because the
    tape was incomplete.