[Weekly Compilation of Presidential Documents Volume 34, Number 26 (Monday, June 29, 1998)]
[Pages 1186-1188]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Excerpt of Remarks During the Family Re-Union VII Conference in 
Nashville

June 22, 1998

    The President. Is there any kind of national organization of people 
like you, who are working for family-centered care everywhere and 
advocating it?
    Julie Moretz. There is. There actually is--the Institute for Family-
Centered Care, as matter of fact. And there are also a lot of family 
support programs, such as Parent To Parent, because, as anyone knows, 
parents need to be around other parents who have gone through similar 
situations. And there is a lot of support out there and I do encourage 
parents who have been through situations like this to get involved. And 
that is one way parents can get involved.

[[Page 1187]]

    The President. Don't you believe that recovery rates are better when 
there's family involvement when the people are in the hospital, whether 
it's children or parents or siblings?
    Ms. Moretz. There is no question about it. Daniel has had at least 
47 doctors--that I can count--47 doctors come in and come out of his 
room at some given point over 7 years. And I have to recognize that we--
David and I--we are the constant, and his brother and sister, we are the 
constant in his life, and we are the ones that can help to promote and 
facilitate his health care. Yes--and I have to say that his health care 
has been extremely wonderful. Obviously, he wouldn't be here today if it 
wasn't. So, thank goodness, and we are very proud of the health care 
that he has received.

[The discussion continued.]

    The President. If I could just reinforce something Tony said--and I 
thank you for everything you said--you may hear this in the debate in 
the Congress when this comes up this year. There may be some who really 
don't want this to pass who say, ``Well, look, a lot of companies are 
embracing these principles anyway.'' If a company is willing to say all 
the things Tony said, if you've got to go to an emergency room, you can 
go; if you need a specialist, you can have it. The doctors can't be 
gagged; they can recommend whatever good care is. If you have a problem 
with your plan, you can have an appeal. If you have all those things, if 
he does that, why should somebody else be able to put him at a financial 
disadvantage in whether his plan can make money as compared to their 
plan by simply not following the same thing?
    It would be even--it's even more unfair to the good HMO's and the 
good managed-care operations in this country not to have this 
legislation, because if they go out and do the right thing, then other 
people who are unscrupulous can come in and try to undercut them by 
appearing to offer the same service at a lower cost. So he just made a 
terrific argument for why this bill ought to pass this year--by doing 
the right thing and because he's doing the right thing.
    I thank you very much.

[The discussion continued.]

    The President. I would just like to thank you for what you said. I 
hope that this order that I'm signing today will deal with that by 
essentially telling all the Government agencies that, whenever possible, 
they have to work through people like you to do the outreach--because--
well, this weekend Hillary and I spent some time with some friends of 
ours, and one of them commented that he'd just been to a high school 
graduation in northern Virginia where it was announced that the 
graduates, just a few hundred kids, came from 70 different national and 
ethnic groups. That's just one high school. We have so many 
communities--the Asian communities, alone, if you think--from Southeast 
Asia and all the different language groups, that a lot of these people 
are, as you pointed out, two-thirds or more, are working people; many of 
them, their first language is not English, and if there is not some 
affirmative attempt to reach them through someone they know and trust, 
their children will not get on this program. I don't care how many 
flyers we put out or PSA's we do or anything else.
    This is very valuable, what you've said, and I think we need to work 
a little harder on it. But I thank you for being here.

[The discussion continued.]

    The President. First of all, I'd like to thank you for the work you 
do. And I'd also like to thank Mrs. Gore for being our administration's 
leading person on mental health issues. If it hadn't been for her, we 
wouldn't have had a strong mental health component in the child health 
insurance program or the mental health parity legislation. And I'm very 
grateful for that.
    I'd like to ask a question which may be a little unfair, because I 
know you haven't been prepared for it exactly, but I'm sure you've 
thought about it. I just got back from a very moving trip out West, and 
you may have seen it. I visited Springfield, Oregon, where they had one 
of the many, many school shootings we've seen. And I've been studying 
the facts of all these cases, and it does appear that in each case or, 
in most of the cases where we've had these terrible tragedies--I might 
add, against a background of dropping juvenile crime overall--that there 
was some kind of early warning. And

[[Page 1188]]

I wonder if you could recommend to me, because the Congress wants to do 
something on this, everybody is interested in this, this is--how do you 
think we ought to deal with children who--6,100 kids were removed from 
school last year for bringing a gun to school. I'd be very surprised if 
more than 10 percent of them got some sort of comprehensive mental 
health analysis as a result of it.
    We have--goodness knows how many kids made threats that they had no 
earthly intention of doing anything about it, but in one of these school 
shootings there was an explicit threat made beforehand. What advice can 
you give us about what the role of mental health ought to be and, sort 
of, early warning systems, preventive care, and that sort of thing, and 
particularly--like I said, I don't want to put you on the spot on the 
Springfield thing, but it's very much on my mind because of what was 
told to me out there about the facts, and because the young man did have 
a gun in the school the day before and was sent home.
    Sheila Savannah. Well, one of the responses that we have pulled 
together is we have a family resource center in an elementary school and 
so we work with the teachers. And we've had to a lot of training of 
teachers, of youth development workers, of child care workers, to really 
identify the early signs of mental health needs.
    There are so many children with unmet needs. And so often those--
their activities get interpreted as behavior problems, as discipline 
actions, and we don't ever stop and do a strong assessment of what are 
the needs of these children.
    Children that carry guns are afraid. They really have very strong 
reasons for carrying them. And we work with a lot of children that have 
been suspended or expelled because they've been carrying weapons to 
school, and we've been real fortunate in Houston. But I know it's of 
growing concern because there are so many children that don't think that 
they'll live to see 20. And so those are kids that carry guns to protect 
themselves.
    Or, we've spent a lot of time and a lot of prevention efforts that 
focus on children being okay. And so I've seen a lot of children who 
suppress their emotional disturbance. They see violence on the streets; 
they see violence in their homes; and rather than being emotionally 
disturbed, they're being trained to be okay. And so when children 
respond that way, their sensitivity becomes dull, and they can act out 
in those kinds of ways that really hurt humanity.
    And I think one of the things we need to do is make sure that 
everyone is well aware of some of the signs of mental health needs and 
really work to make sure that we remove the stigmatism to receiving 
mental health services.
    The President. Thank you.

Note: The President spoke at approximately 2:15 p.m. in Langford 
Auditorium at Vanderbilt University. In his remarks, he referred to 
discussion participant Anthony Watson, chairman and chief executive 
officer, New York HIP Health Plans. Julie Moretz is chair, Family 
Advisory Council, Medical College of Georgia Children's Medical Center, 
and Sheila Savannah is executive director, People in Partnership, a 
nonprofit organization that consults recipients of mental health 
services.