[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

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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.

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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.