[Weekly Compilation of Presidential Documents Volume 35, Number 23 (Monday, June 14, 1999)]
[Pages 1052-1056]
[Online from the 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

[[Page 1053]]

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 
    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 to talk about 
all of this; like a lot of young students at the time, I had been very 
influenced by Thomas Koontz'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

[[Page 1054]]

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 
    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 
    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 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

[[Page 1055]]

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 
    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. 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

[[Page 1056]]

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 
    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. 

[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 made available 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.