quorum call:

the presiding officer: the senator from new york. mr. schumer: i ask unanimous consent the quorum be dispensed with. the presiding officer: without objection. mr. schumer: madam president, i ask unanimous consent the e.p.w. committee be discharged from further consideration of s. 166 and the senate proceed to its immediate consideration. the presiding officer: the clerk will report. the clerk: s. 166, a bill to designate the new interstate route 70 bridge over the mississippi river connecting st. louis, missouri, and southwestern illinois as the stan musial memorial bridge. the presiding officer: is there objection? without objection, the senate is -- the committee is discharged and the senate will proceed. mr. schumer: i further ask that the bill be read a third time and passed and the motion to reconsider be made and laid upon the table with no intervening action or debate. the presiding officer: without objection. i ask unanimous consent the senate proceed to the consideration of h. con. res. 14

which was received from the house and is at the desk. the presiding officer: the clerk will report. the clerk: house concurrent resolution 14, permitting the use of the rotunda of the capitol for a ceremony as part of the commemoration of the days of remembrance of victims of the holocaust. the presiding officer: is there objection to proceeding to the measure? without objection. mr. schumer: i ask unanimous consent the concurrent resolution be agreed to, the motion to reconsider be laid upon the table with no intervening action or debate. the presiding officer: without objection. mr. schumer: madam president, i ask unanimous consent the senate proceed to the consideration of h. con. res. 20 which was received from the house and is at the desk. the presiding officer: the clerk will report. the clerk: house concurrent resolution 20, permitting the use of the rotunda of the capitol for a ceremony to award the congressional gold medal to professor muhammad eunice. the presiding officer: is there objection to proceeding to the measure? without objection. mr. schumer: i ask unanimous consent the concurrent resolution be agreed to, the

motion to reconsider be laid upon the table with no intervening action or debate. the presiding officer: without objection. mr. schumer: madam president, i ask unanimous consent the senate proceed to the immediate consideration of calendar number 15, senate resolution 12. the presiding officer: the clerk will report. the clerk: calendar number 15, senate resolution 12, recognizing the third anniversary of the tragic earthquake in haiti on january january 12, 2010, and so forth and for other purposes. the presiding officer: is there objection to proceeding to the measure? without objection. mr. schumer: i further ask the committee-reported amendment be agreed to, the resolution as amended be agreed to, the committee-reported amendment to the preamble be agreed to, the preamble as amended be agreed to and the motions to reconsider be made and laid upon the table with no intervening action or debate. the presiding officer: without objection. mr. schumer: madam president, i ask unanimous consent the senate proceed to the consideration of senate resolution 74 which was submitted earlier today. the presiding officer: the clerk will report. the clerk: senate resolution 74,

supporting the goals of international women's day. the presiding officer: is there objection to proceeding to the motion? without objection. mr. schumer: madam president, i ask unanimous consent the resolution be agreed to, the preamble be agreed to and the motion to reconsider be laid upon the table with no intervening action or debate. the presiding officer: without objection. mr. schumer: madam president, i ask unanimous consent that the appointment at the desk appear separately in the record as if made by the chair. the presiding officer: without objection. mr. schumer: madam president, i ask unanimous consent that when the senate completes its business today, it adjourn until 10:00 a.m. on tuesday, march 12, 2013, that following the prayer and the pledge, the morning business be deemed expired, the journal of proceedings be approved to date and the time for the two leaders be reserved for their use later in the day. and that following any leader remarks, the senate be in a period of morning business until 12:30 p.m., with senators permitted to speak therein for

up to ten minutes each, with the time equally divided and controlled between the two leaders or their designees, with the majority controlling the first 30 minutes, the republicans controlling the second 30 minutes. further, that the senate recess from 12:30 p.m. until 2:30 p.m. to allow for the weekly walks meetings. the presiding officer: without objection. mr. schumer: madam president, we expect the chair and ranking members of the appropriations committees to make their -- the appropriations committee to make their opening statements on the continuing appropriations bill tomorrow at 11:00 a.m. we expect to begin consideration of the bill tomorrow after the recess for the caucus meetings. if there is no further business to come before the senate, i ask that it adjourn under the previous order. the presiding officer: the senate stands adjourned until senate stands adjourned until

coming up, the communicators, featuring matt thornberry on the president's cyberexecutive order. after that >> last week on the communicators michael daniel was our guest. mr. daniel is the president's cybersecurity coordinator and talked about the order the president recently issued. this week we have two members of congress to discuss the order and get reaction. joining ossifies is

representative mac thornberry, and past chair on cyber security. >> when you look at the president's executive order from february 2013 what's your knick -- initial reaction? >> it's okay. there are some thing that need to be done with an executive order but some things can only be done with legislation. so part of my reaction is i wish the president had put as much effort into get getting some legislation pasted and then the checktive order. it could potentially take some momentum out of the effort to get legislation passed. >> host: how similar is the president's executive order to the task force recommendations that you made last congress?

>> guest: some things in the executive order are exactly as we recommended that the administration do. for example, the federal government being more careful about the computers it buys, and having higher standards with its purchasing power, is a good and helpful step. we talked about having voluntary standards for private industry so they could know what they needed to do they could tell how close they were to reaching certain goals, and i think that's the direction that the executive order wants to go. what we don't know yet is the standards they'll come up how they're enforced, and there's some anxiety about the president doing too much rather than voluntary inincentives to get market forces working. >> host: what in the definition of critical infrastructure? there is agreement there?

>> guest: well, i think its kind of one of those things, most of us know what some critical infrastructure is. electricity grid, et cetera. exactly how the administration chooses to define specific industries, and then what comes with that, i think we don't know yet from the exec tv order. the executive order sets up a process that is just beginning, and will take several years to complete. so that's why, on its face, there's a lot that i think a lot of us think is going in the right direction, but the way it's implemented is going to tell us a lot about whether it's effective or not. >> host: representative, we want to play at of mable daniel, the white house cybersecurity authority last week talking about federal regulations. here's mr. daniel. >> if they believe that their regulations are not sufficient

in that yeah, they could in their russian impose new regulations or executive actions that would require infrastructure to be brought up to that level, but i think for the most part it will be a voluntary process for companies to participate. >> host: representative thorneberry? >> guest: i think he was referring to existing regulators of industries can put new requirements to improve cybersecurity in the industry it already regulates, and that general approach is exactly what we recommended in our task force report. you don't need another regulator to come in and regulate the cyber security part of the electricity industry. they have existing regulators and you need to work through them to improve cyber security, and i think that's preferable. i also believe we can't -- we got to be careful about too much

emphasis on direct regulation. remember, this -- these are threats that come at us at the speed of light, and the threats change just about as fast. so the idea that too rigid a government regulation to solve this is wrong. you need industries keeping up on it on their own of the. >> host: what about when it comes to liability issues? >> guest: the key concern for liability is, if an industry has threat information it would like to share some of that information with the government, there's a fear that they could be sued by shareholders customers for sharing information with the government. so this is one of the areas legislation is require. you still have to have privacy

protections. don't want to give away people's personal identifiable information, but there has to be a way for information-shearing, the government sharing with private industry and private industry sharing back with the government. that's the only way our country can be more secure. but there's going to have to be some changes and protections in the law in order to facilitate that sort of exchange. >> host: there are limitations on information sharing between companies? >> guest: sure. absolutely. there are now antitrust laws limit some of that. liability laws limit some of that. some of the regulations from the regulators limit some of that. and, again, this is always a balancing act. so, you don't want companies in the same industry to share so much information that you get into seriousable trust issues. on the other hand we don't want

to just let the theoretical be the enemy of the good. so, for example, there's been a lot in the news about a tax coming against major u.s. financial institutions. they need to be able to share that information about those attacks so they can better protect themselves. and so making sure that there's not legal liability or other legal concerns facilitating that exchange is part of where we need to go, i think: >> host: max thorneberry, when it comes to cybersecurity, how do you see the role of the federal government protecting private institutions such as banks, et cetera. >> guest: well, i think that's evolving question. on the armed services commitee i had hearing two years ago and i asked this basic questions. if a bunch of bombers were coming to bomb refineries we know what we expect to the federal government to do. if it's pacts coming through the

internet, we don't know want to expect. so i think the role of the federal government in defending the country in cyberspace, especially against sophisticated state level actors, is evolving where i do think the government has to be actively involved in defending us. and a secondary role is the federal government facilitating the kinds of protection and defensive measures we can take for ourselves, and that companies can take for themselves. so i think those are the two roles, protecting against sophisticated actor and encouraging a higher state of security. >> host: i want to play a little about more from michael daniel last week talking about the private sector. >> one of the question is, exactly what its the

government's role in providing cyber security to the private sector? at what point does the government intervene? under what conditions? i think all of those are still questions that, while they are much more well developed in the physical realm, we're still trying to figure out the rules of the road in cyber space. >> host: how will the rules of the road be developed? >> guest: the only way they can be developed is in consultation with congress. there is a good deal of thinking and effort going into this area. the administration has been talking with us. we also have to talk about what is the military role versus what is civilian role. department of homeland security, et cetera, and there's a lot of complex issues to work our way through. ...

it happened so quickly, it is not the sort of thing that our government and our systems are set up to deal with. >> host: the cybersecurity order emphasizes the department of homeland security. are you in agreement with the emphasis on vhs? >> guest: i think the dhs has a very important role. absolutely. in deciding what that role is and especially the department of homeland security relating to other regulators as we were just discussing, it is a key part of this discussion. we cannot let, in my opinion, the department of homeland security become a second or even third regulator on a lot of these industries. it will bog everything down so much that we will never be able

to get to where we need to go. >> host: what about the mandatory report attacking the u.s. industries? >> guest: it was very disturbing. because they gave a great deal of speth at 72 a number of large-scale efforts to steal information from u.s. companies. we have talked about this going on for some time. the report gave more specificity to it, name names and so that made it more noteworthy. it is a snapshot of what is happening now.

it is a threat to our national security, our economic security, and that threat is going to grow in sophistication as well as overall quality in the future. >> host: cybersecurity legislation and some of the entities we have seen, there is the government and the reporting standard and whether or not they meet the threshold. >> guest: there is no doubt that some private industries have much better cybersecurity. there is no industry that cannot be penetrated by state-level actors. so it seems to me, only by

having private industry and a volunteer shift and the private industry involving critical infrastructure with the government, can we really protect the nation and our jobs and our security in the way that we need to. >> host: as the subcommittee chair on intelligence and a member of the armed services committee, what level does cyberthreat become cyberwarfare? >> guest: i think people are grappling with terminology. i do not know there is an agreement on that. certainly it is possible that through cyberyou could have physical consequences, you could destroy a building, you could destroy infrastructure, you

could affect the safety and even take lives just through the internet. clearly when you have the physical consequences or when you destroy data, reach through the internet and destroy it through another computer, that has physical consequences as well, that is a form of cyberwarfare depending on who it is. but it is in flux and there's not agreement on it. >> host: we begin this conversation and you mention legislation. beaufort sea legislation in the 113 congress, and if so, what is the process? >> guest: i think so. in the house we passed for bills dealing with cybersecurity last year and had hopes that the senate would be able to have their own version. unfortunately, the senate was

not able to. i think that we are going to go back in the house. we are going to take another look at the bills that we passed last year, there could be some other legislation that we could pass. i hope that we can take cybersecurity in bite-size chunks. i think that is more politically feasible and it probably means that we are going to do a better job when we don't try to do everything at once. we have to come back and act. we cannot just continue to do nothing. the threat is growing. it endangers us. >> host: mac thornberry, thank you for being on the communicators. >> guest: you are welcome. >> host: president jay rockefeller who is the president of the transportation committee joins us now.

thank you for your time. the president now has an executive order on cybersecurity. what did you make of what he put out? >> guest: it is good and, you know, he did it out of frustration. it was very good but what he can't do is provide kind of in a legal framework for all that you have to do in cybersecurity. there is a lot of congressional action that must take place. we actually passed the bill that was a full cybersecurity bill of everything we are doing. the basis of the executive order. that the president can only do so much on the legislature has to come through. we got dragged down into the chamber of commerce politics and it was sad.

now we have a new crowd this year, more enthusiasm, less partisanship to begin with. and i am very hopeful. >> host: what is going to help you satisfy this with something that needs to be passed in the senate? and then he turned back what is different this time around as far as the procedure goes and what you want to get from it. >> i think politically the chamber of commerce may be less involved. there were almost several responsibilities for the fact that we couldn't get certain things going. it was very much against the national interest, but this time i think they have been around for a long time as part of the situation and we finished talking about it, we finished wondering what is going to happen. things happen every single day that are destroying our intellectual property.

so we have to come through. >> so many things in voluntary in nature. many say that the measures become mandatory. have you satisfy those concerns? you never satisfy concerns before something has. people always a assume the worst. in other words, you can't just say, just go do what you want. i have met with the businessmen who i know very well and who i like very much these companies i know very well. and i have asked them about cybersecurity and the certitude of their safety of doing the right things.

i can tell by body language, i can tell by the way that we talk, i can tell it by the interest. you have a problem with this. >> host: was the republican side concern about this? >> guest: everyone wants to look at the worst case scenario. it has nothing to do with the chinese and others simply bankrupting this country. financial services have shut down air traffic control and they can affect our water system, affect our electric grid. that is what people should be scared of. everything else is secondary to that. because of the danger of that, it has been for the last three

years. it is defined by all of the intelligent military people. there have to be standard. we were very good at coming together with the private sector and the entrepreneurial perspective. they are a really smart agency. we have to have standards. >> we have to have people stop hacking us. >> guest: part of this is

sharing a standard of cyberthreats. how do you set this up without being able to release the information? >> guest: we actually had to pass a bill right after 9/11 allowing the fbi and cia to talk to each other. still people are slow to leave their jurisdictions. >> host: what assurances do you provide? >> guest: we provide a level and standard of excellence. we do what's right. >> host: a previous member says they passed cybersecurity and

looking as they consider work on the health care side, talking about what the house is proposing a mess. how does it match up with this on the senate side? >> guest: it does not match. it is really important. the public sector and the private sector to disclose to each other that they have been hacked into. at one point i got so frustrated about this that i called up mary schapiro at the securities and exchange commission and i had no idea to do it except i just decided to on whim. i said anytime a companies hacked into, they simply must report that they are hacked into. that is of interest to stockholders. it's like safety. people have to know that you're running a safe line and a cybersecure operation and that

it affects the bottom line. >> host: so sars information, what is missing? >> guest: what is missing is all the rest. >> host: the standards and followings? >> guest: we really haven't completed a lack of math and science in general, particularly in the area of cybersecurity. we just don't have a lot of people who really know what they're doing. i don't mean to denigrate anything. it is just part of the american education process. and it is a problem. they should start in kindergarten, teaching people about cybersecurity. so someone will be able to set those standards without being defensive about it and do it with a common process of protecting america.

everybody benefits by doing this cooperatively. and everybody loses if we fight and end up not doing it. >> host: what about the international community? now that we have stories about the chinese, how do you get them involved in this? >> guest: they play a huge role in probably a major role. but they are not alone. on the other side, there are people within estonia and russia and all kinds of places, anybody who can work with computers can find a way to hack. >> host: have you make the case with them? >> guest: it is a hard case to make. you must have standards that protect you from those attempts. those attempts will never cease even people for their amusement. you must keep the intellectual property safe.

>> host: have you had a chance to talk with senator mccain about cybersecurity and in his interest and working alongside you on this issue? >> guest: i have been in many meetings with him. he was overwhelmed as unfortunately everyone seems to be by the absolute resistance to doing anything at all. if you were a republican, it was really hard. because the chamber of commerce says that we are going to come after you. i think it would be natural for him to have an interest in the u.s. government and cybersecurity. i think private industry is cybersecure. there is no good side to being unprepared. >> host: as far as her game plan going forward, it do you see a bill coming out?

>> guest: i think there is a possibility of that. maybe we will just do part of it. maybe we will do information sharing. but i would much rather go with all of it. because if we segment ourselves into these compartments, and then you lose your momentum for the big picture. >> host: so you must take a peaceful approach? >> guest: the pieces are hard to solve. it is absolutely critical. >> host: have you ever thought maybe we need to leave this out? >> guest: it makes americans aware that this is a terrible

problem that we are facing to try to get people on board. but what he did was really good. he was trying to get us going. >> host: the one thing you would have seen, the version you would have liked to have seen would've included one? >> guest: included what our bill had, which is standards for technology getting together, which is not a regulatory agency getting together with the private and public sector and health and security to a certain extent in this is discussing what we should be doing for our sectors. for our energy sectors and water sectors and trends trans protections -- transportation sector. >> host: senator jay rockefeller

from west virginia. the chairman of the transportation committee. thank you for being with the communicators. >> guest: thank you. >> c-span is brought to you as a public service by your television provider. >> coming up on tuesday, all five fcc commissioners will appear before the committee at 2:45 p.m. eastern on c-span3. coming up on c-span2, the discussion is made about funding for violence and mental health funding. verse from a discussion on the investigation on the accident that strikes some as conference

thursday and then a discussion on the accident. >> i think that one it comes to the controversy. she doesn't get distracted by the details but they are not important. how is what is happening in afghanistan and packing what they might be doing in the middle east? how is this happening and impacting what they are trying to do in asia? i think she had a good sense of what is the big picture. of course, she's surrounded by people who are helping her. she has staff, and that allows her -- and i talk about it, it allows her to stay focused on what really matters.

>> watch "after words" on booktv on c-span2 this weekend. >> tuesday, paul ryan releases his 2014 federal budget proposal. we will be live from news briefing starting at 10:30 a.m. on c-span. >> last week, and house energy subcommittee heard from violently and mentally ill children.. many experts took part in this 2.5 hour forum. >> good morning. thank you all for attending this forum called after newtown, a

national conversation on violent and mental illness. today he are here to learn and love and show compassion. the families of those with children who have violent mental disorders as well. since i became the chairman of the oversight committee, we began reviewing the common factors in many mass tragedies, which is the underlying mental owners. the lessons for americans from the horrifying tragedy in connecticut is that we had better take off our blinders and deal with such illness or we are sure to face the same problem again. it is not only what is in a person's hands that makes their acts of violence, it is also

what is in their minds. tragically over the course of recent history, society has dealt with individuals suffering from mental illness is it equipped with such blinders. a will for ignorance motivated by fear. this has resulted in some shockingly counterproductive and cool practices to the mentally ill. we have locked them in prisons, we have quarantined them as contagious. we have sent them to workhouses and burned them as witches. fifty years ago we released him out of hospitals by reason that we mistook for compassion. too many of them ended up on the streets without decent acts of treatment. the mentally ill should be receiving care in a community setting. but with many who have mental illnesses, the institution was a disaster. the after effects that we are recovering from today. now, too many fill our prisons and are left as homeless.

the vast majority of americans are nonviolent and in fact, much more likely to be the victims than the perpetrator of violent acts. that is why the subcommittee is working to identify what resources have been devoted to those among the mentally ill. the severely mentally ill who are not being treated. even more importantly, what fraction of those resources are actually reaching the individuals. a few years ago when this committee was reviewing my legislation, which was signed into law in 2008, we explain how mental health blooms into a problem if goes unaddressed. the chronically ill person untreated doubles in risk. it also increases the risk of heart disease and other diseases. our current system is wasting billions of dollars. yet while there have been calls in recent months for the need

for increased funding and mental health, this is something we need to look at and the truth is that annual total spending for the mentally ill is now more than $141 billion. there is a 14% increase in what we were spending when president kennedy proposed paternity help build to take the place of mental health hospitals. it has not been accompanied by quality of mental health services. the crisis that we find ourselves in, however is not just a question of funding. rather the current situation demands more intelligent targeting of available funds toward the most promising research and treatment. funds must reach lehto of families and doctors affected. we hope that today's forum will be able to allow us to improve our efforts to identify the severely mentally ill early on and assist them in seeking treatment effectively. i want to thank the parents were with us today.

many are going to be with us to share their stories to have a child who suffers from mental illness or other mental disorders. i'd like to extend my deepest sympathies to those of us children. i think you for taking the time to be here and be able to share your stories with us. your story should help other families and hopefully spur action. for the members here today, we are here to listen and learn. we will hear real-life stories of what america does not want to hear. a kaiser finally family foundation study noted that 70% are needed to be taken out of the shadows and into the light. now, understand this form is just the first step.

as i have said from the vast majority of people are not violent. this committee is committed to addressing the difficult but necessary questions of how we can stop violently mentally ill from acting out and get him treatment before they harm themselves or others. we will continue to meet with parents and families and patients who suffer from severe mental illnesses as we try to make sure that a tragedy like newtown, connecticut, does not happen again. i would also like to thank the ranking member, diana degette, for her bipartisan effort as the subject matter deserves. i would like to give the ranking member an opportunity to give brief remarks. >> thank you very much, mr. chairman. thank you for your work and dedication for addressing mental illness. as i was just saying to mr. pete earley, it is not based a

discriminatory choice. it can strike anyone. i want to thank our participants today. thank you for helping us to understand this issue. and also michael fitzpatrick with the national mental alliance was talking about patients and their families. i would like to add my thanks to the three panelists who are parents of children affected by mental illness, mr. pete earley and ms. pat milam. your children are so lucky to have you advocated for them. and also i express my deepest condolences at the laughs of your son matthew.

>> i express my deepest condolences at the loss of your son matthew. twenty-six lives were lost at newtown. once again we come together to ask how this happened and what we could do to stop it. all of us had been there before. but this time was different than all the others. in the month following newtown, we have information and have begun to engage in an in-depth conversation about our views on violence and guns and how we respond to mentally ill communities. reasonable solutions are on a number of fronts to keep these killing machines out of the hands of individuals that are disturbed. we can all agree that the

perpetrators of many of these mass killings, including newtown, connecticut, and overwork, colorado, and tucson, arizona and virginia tech and columbine were actually in my congressional district where a young man suffering from serious mental illnesses. yet they did not get the help that they needed and lives were lost as a result. we know that many, a lot of mentally ill individuals do not receive appropriate treatment. because of the stigma associated with these illnesses today or because of shortages of treatment or simply because they lack adequate health care coverage. the numbers are stark. the typical delay between psychosis and the start of medical treatment is 100 weeks over two years.

for those living with a serious mental illness, approximately 40% do not receive treatment in the past year. those numbers are simply unacceptable. i think we need to be clear, most violent acts are not committed by people living with a serious mental illness. most people living with a serious mental illness are not violent. but if we can reduce gun violence by improving the mental health care system, so that we are more certain of diagnosing and treating violently mentally ill individuals, we can and must do so. we have already taken some steps to solve this problem. the affordable care act will extend health care coverage to tens of millions of americans who would otherwise be underinsured. but i think it is now clear to all of us that we can do more.

mr. chairman, this congress should be focused like a laser on reducing gun violence. comprehensive improvement to the mental health care system must be an important component of the efforts as they benefit millions of americans. thank you for calling this one today. i look forward to hearing from our witnesses and their continued cooperation on this issue. >> thank you, diana degette. >> thank you, mr. chairman. i have a full statement for the record and i apologize for my boys. i'm getting over a bad cough and cold. but that can be prom because i am here to listen. let me just say that you, doctor murky, mr. chairman, there is no one better qualified with your professional background to chair the subcommittee and examine this in connection to violence. i have no doubts that your partnership with the ranking member, diana degette, will

thoroughly explored this major issue of the day. in the days following the tragedy in newtown, connecticut, the chairman and i discussed his leadership role in unique ability with his background to really try to chart a course that can be bipartisan and make a difference in the lives of americans down the road. i welcome not only this forum today, but the work that can continue to be done in the months ahead and i yield back my time. >> thank you, mr. chairman. the ranking member is going to make a brief statement. >> thank you, sir, for holding this forum and leaving the conversation on how we can help these individuals. i commend your leadership on this issue and i am pleased to work with you to educate the congress about mental illness and to craft solutions to the many challenges that we face in

addressing the needs of those who suffer from these illnesses. i also welcome our panelists, including those who are here to testify. pete earley, pat milam, i know how hard it must be for you to share your family's experiences. especially in the case of mr. pat milam. he has suffered such a loss. we must not view those as suffering from mentally being ill as necessarily violent. but we must provide high-quality health care in the safety of our communities. we know that there are too many impediments with those living with serious mental illnesses that they face with being diagnosed and treated. the affordable care act will help expand coverage, but it won't solve all of the problems. there is an unwarranted stigma

attached and there are shortages of facilities and caregivers to provide treatment. i appreciate the panelists sharing their expertise on these issues and i look forward to working with you and others. our colleagues on both sides of the aisle, to find solutions to these problems. i would like to start off with the democrats on one side and republicans on the other. to learn together and work together. >> thank you. >> i would like to let the members know what the format will be. this will not be the traditional order. we will hear from experts and the families and the questions are to be directed towards formal hearings and our topics now. this is from people who have lived it. first, doctor thomas insel.

he is appointed to lead the department of mental health. prior to his appointment, he was a founding director of the center for behavioral neuroscience and his focus is complex social interaction. next we have doctor harold koplewicz. he graduated and completed his residency at the westchester division and he has a degree in psychiatric research. next we have a research psychologist at graduated from mcgill university and founded

the stanley medical research is one of his competence. his most recent book talks about mental illness. doctor michael welner frequently diagnoses the psychiatry problems of individuals. he has piner's research of evidence and determination of depravity of individuals. next we have mr. pete earley. he is an author and journalist he spent six years at "the washington post" and has

authored 13 books. his books, a father search to america's mental health illness was a 2007 finalist for the pulitzer prize. he recounts his efforts to get his son treatment for bipolar disorder. he works to advocate for mental health reform. then we have pat milam, he is from louisiana. he is an advocate for mental health reform and has covered advocacy efforts began after his son who was diagnosed with schizophrenia and bipolar disorder, committed suicide in 2011. throughout his efforts to get his son the treatment that may have prevented this tragedy, he encountered numerous obstacles to getting care. he was a parent of a son with a mental disorder and he is joining us from boise, idaho.

we also have a post written by liza long. she is now devoted to continuing a conversation of the hardships of caring for tablet mental disorder. finally, michael fitzpatrick, a social worker from virginia. prior to taking the role that he is in currently, he has focused on the policy direction of nami. he held senior management positions in nonprofit agencies and private health and public health sectors. he has been msw from boston college. let's turn to some of her parents to tell the story briefly and we will go from them first. first we'll start with pete earley. >> thank you very much.

thank you very much for having me here today. my son was the face of mental illness. i am grateful for each and every one of you for being here and for paying attention to this important subject. thank you. how would you feel if someone you loved kill themselves? my college age son, michael, asked me that question when we were speeding to fairfax county virginia, he had been diagnosed with bipolar disorder and a doctor had put him on medication, but my son stopped taking him pistols. when i picked him up that morning, he had been wandering around aimlessly for five days in new york. he was convinced that god had him on a special mission. my somewhat laugh one minute and begin solving the next and i pleaded with him to take his medication and he screamed that pills are poison, leave me alone. when we got to the hospital, the emergency room nurse rolling her

eyes while mike talked gibberish about god having him on a mission. we were there for four hours and my son said, i've had enough, i'm going to leave. and i said hang on, and i raced outside. i grabbed the doctor and i said, please come in, and he said, look, you seem like a nice guy, but i really can't do anything to help your son. virginia law that at that time was very specific. unless a person had posed an imminent danger to himself or someone else, he could not be forced into treatment or required to take any help. my son had told the nurse that he thought those were poison. the doctor said there was nothing he could do. in fact, i was told bring your son back after he tries to kill you or tries to kill someone else. so i took my son home and for the next 48 hours i watched him sink deeper into a mental abyss. at one point he had tinfoil wrapped around his head because he thought the cia was reading his thoughts. he slipped out of the house

early one morning and he broke in to take a bubble bath. luckily, no one was there. it took five officers to get them out. when they did, they took him over to a mental health center and i raced over and the policeman said, sir, before you go in there, let me give you some advice. even though your son said that he had a note and 10 mental illness and he's off his medication and he's picked him up in a house taking a bubble bath, unless you tell the doctor that he has tried to kill you, he will not meet the criteria to get treatment. and i said, my son has not threatened to me. and he shrugged. i feel was no great pride that i did lie. to get him in the hospital. twenty-four hours later they called me because they thought

he wasn't a danger. then he was charged with breaking and entering and destruction of property. what happened to my son was not an aberration. they're more than 400,000 people with bipolar disorders, schizophrenia, and major depression. a half million on probation, more than a million go through the criminal justice system every year. the los angeles county jail is not a treatment center. you have heard people say those with mental disorders are not always violent. the majority of them are not. many times, the few that are, such as the virginia tech shooter and the tucson shooter have warning signs. yet the parents are helpless to stop him because of civil rights laws that ban them. the cause havoc when applied to some of the brain disorder. i loved my son, i wanted his rights protected, but no father should never be told bring your son back after he tries to kill

someone or kill you. changing our commitment criteria is a much needed first step. but it will do absolutely no good if you have nowhere to get treatment. when my son had his breakdown, fairfax county, one of the richest counties in the nation, had a two week wait to get into a treatment center. the six-week wait to get a case manager, and an 18 year wait to get housing if you had a mental illness. that is shameful. since my son's first breakdown, he had been shot twice by the police with teasers. i hate to admit this, but i will, because it is a prominent feeling. especially among parents. there was a time when i wished my son had not been born because of how much he was suffering. but today my son is doing great. he has a job, he works on his own, he pays his taxes, and if

he you were sitting there before you, you would not know that he had a mental illness. he is one of the fortunate ones who finally, after nine years, got the meaningful treatment that he needed to recover. so don't tell me that we can't help people with mental illnesses. i have seen it. this is not a problem of us not knowing what to do. it's a problem of us just not doing it. all of the pain that he endured, all of the pain that my family has suffered, all of the tax dollars that have been wasted, and all of the fear that he caused others, it could have been avoided. none of this should happen. why do we treat those differently than their bodies? why do we treat the head differently than other mental illnesses? we tell them that they are sick but we are not going to help you until you become dangerous. then we blame and we punish them

when they become dangerous. so you tell me who is the crazy one. [applause] >> thank you. we now recognize mr. pat milam. >> thank you, mr. chairman. ladies and gentlemen, i am not a public speaker and this is going to be tough for me. so i hope that you understand it endures me a little bit to go through this. my wife and i, debbie, who is here today, has gone through a lot. i'm going to try to give you an example of just a short period of our life. a six-month period of time. i'm going to paint a picture to you what the misery is like, what the horror is like. keep in mind that i don't speak just for us today. because i can tell you that through this tragedy since october 2011, everywhere i go, every expert, every person that

i talked to, it's like, oh, that is news? we have heard that. i had a friend had an eyeball out. it's not something that is rare. it is happening every day. unlike most of the people in here, i am middle class. it is not a matter of asking for federal government funding. we have an insurance policy that we paid every month and we thought it was there to protect and give the best medical coverage to our sun. if not, we were proud to pay for the coverage. to give you a background, in april 2011, matthew is doing good. then he started getting paranoid. he started seeing things. as steve mentioned, a lot of kids, a lot of young men become paranoid and see things. he went to his doctor and told his doctor that i'm going crazy. he had seen a psychiatrist for six years. the same psychiatrist. he said i am seeing things, i'm

going crazy. three weeks later he drove himself to the emergency room at the local hospital. walk into the hospital and said, i want a brain scan because my brain is leaking that i am dying. they believed him enough to give them a brain scan, but at the same time, they put him under a commitment order in louisiana because when the doctors came back, he asked them to prove who they were. i mean, that is just not a sane thing to do. so he went to see the doctors more and more. he went to see the doctors, and i have the medical records, so this is unique for me. he didn't know if he was living in the program. he thought he was living in a the program, a computer program. the fbi, the cia, he thought

aliens were coming to get him and we had not discovered who was living under the earth and we should look at that. he is telling the doctors during his visits all of these kinds of things. other than that, he said he loved life, so they let him go. he tried to commit suicide for the last time. he wanted to go back to a rehab and he was doing really well. he was doing fine, he wanted comfort, he swallowed a bottle of pills. i can't tell you the horror it is to have a child behind you, going down the interstate highway, trying to get him to the hospital and he tells you that if you stop the car, i will jump out and kill myself with the trucks behind us. that is a nightmare scenario for parents to have to live through.

we made it that night, but they treated him in a few weeks later, they let him out. so we think, okay, he is home again, he is home again. we think that we've made it this far. i leave the house for about five minutes. a black car drove up in front of the house. my wife, thank goodness, was having breakfast with matthew. matthew immediately saw the car and went crazy, he didn't know what to do, he went in the bathroom and drink bleach and then he grabbed a knife out of the kitchen and cut his throat. luckily i was two blocks away and i got home and he didn't cut the carotid artery all the way. blood is everywhere in the house. i want you to know what a parent goes through. i had to chase them down and as i chase him down, he is saying

dad, you don't understand. the more you chase me, the more my heart will bleed, the more the blood will pump and the quicker i will die. they took into the hospital, we saved his life, he lost 2 liters of blood. a week later, they let him out and they give him pills. then he goes back to his regular psychiatrist. after we got the records, the psychiatrist said matthew was an extremely high risk of suicide or other bad outcome. i would've assumed that if the psychiatrist saw that, something would be done. see you again in two weeks, they said. two weeks later, the doctor writes the same note, matthew is an extremely high rate of suicide. at this point in time, my son

and i were not getting along well. so i can only assume that i might be or my wife might be facing a bad outcome. we go along until october. october 6. excuse me. october 6 was the day i was home for a little while. i decided to check his room. he was terrified and scared to death that the fbi, the cia, that everybody were coming to get him and that the dog and i were protecting them. so i go into his room,

everything looks normal and fine. he had passed his drug test and everything was great. i find propane tanks like you have in the barbecue pit, i find gasoline cans and players and later torches and nails and hammers. i am terrified again. i am terrified. i called the local police. they come out, they come up and see everything. the police department were nice and compassionate and wonderful people. but they told me it is not against lott to have that in her their house. call us if you have any trouble. so they left. when my son came back from walking the dog, i confronted my son. trouble ensued, they were going to let him go, they said there was no reason to keep him. he was in the hospital for seven days. loose knitting still, i brought

him five affidavits from myself, from workers that were working for me, i brought him a letter from her psychiatrist friend of mine that said if you let him out, he will kill himself. i brought them pictures of the flares and pipe bombs and six or seven documents that i felt would prove that my son was going to kill himself when he was let out. the last day before discharge, they said your son is fine. they explained to me the role of a psychiatric hospital setting and basically their interpretation in my interpretation is to stabilize in the least efficient. they had checked with the insurance company, they let him go i can't tell you the words that i'd used, but bs with some of it, i was enraged they were going to let him out.

they said that he had formed a good bond and was going to take his medicine who happen to never talk to his original doctor. he was about to kill himself and they never controlled it. matthew came home a week later. he made breakfast and asked me if i wanted some eggs. i told him no. i gave him a hug and told him i loved him. he said he was going up stairs to get ready for outpatient. he went upstairs, he opened the propane tank and he had made a bomb of a shotgun shell. one shotgun shell. gasoline tanks like you would have around your house and propane. he locked the door, we couldn't get in, at which time he made a fuse out of sparklers, i'm sure

most of kids have, and he made a bomb and killed himself. one point i would like to add is i talked to the fbi about this and wanting to propane is equal to about 33 pounds and 10 pounds of dynamite. it would've leveled the house and the neighbors. one last comment i will make is good people will die today, good families will be destroyed because we are not doing anything about this now. we ought to have done it yesterday. i look forward to the committee and i appreciate everyone being here and letting the me tell my story. [applause] >> thank you we are now going to turn towards more the one who is joining us from idaho.

thank you for being with us today and let's go ahead and talk to about your story. thank you. >> thank you, thank you for giving me the opportunity to address you about what it was like to be the parent of a child with a mental illness. on december 14, 2012, the world changed. the night of the sandy hook shooting, i wrote a blog post that included the shocking statement that i am adam lanza's mother. i am not adam lanza's mother, i am michael's mother. i love my son, but he and i and other parents and children like us need help. my son has been diagnosed with

several conditions. including a cornucopia of pharmaceuticals to control his unpredictable rages. we have not found a combination of treatments and medications to manage his condition. when i asked michael what he wanted me to tell you, he said that i am not a bad kid. tell them that i want to be well yet we continue to manage medical illness through the criminal justice system and too often the only way loving parent can get access to services is by having their children charged with a crime. my son, while on probation, he received an array of services, including therapy and coping

strategies. once he completed his probation, the services went away. i thought it was the only mother in america was living in this kind of fear. i learned that i am far from alone. parents like me live in all kinds of fear. will my child be bullied for being different? will my child be the bully? will i be blamed for my child's explosive behavior? we live in fear of that unpredictable behavior. how will i know if my child is going to explode? how lucky my other children and myself save? what about school and the community and we live in fear of the future. will happen one might son had -- what will happen when my son turns

18? parents like me are struggling physically and emotionally and financially. mental illness is so hard to talk about. because of the stigma, for parents and children, it is very real. but as long as parents suffer in silence, the magnitude of this problem will only be recognized after tragedies like newtown, connecticut. i wrote in my blog but it's time to talk about mental illness, and it is time to act. but we need help from you. access to community-based resources, early and consistent intervention, increased funding for the individuals with disabilities act, as well as funding for counselors and interventionist. we need increased research funding for effective treatment, and most of all, we need a national commitment to end the stigma that surrounds mental

illness. as long as we keep treating mentally ill children in prison, it will be difficult if not impossible for us to achieve true help for mental health. it is truly a bipartisan issue, a problem that keeps millions of american children and their families from enjoying life, liberty, and the pursuit of happiness. as a nation we must explore better ways to provide a better life for children and family and community. thank you. [applause] >> thank you, we appreciate that. >> we have all heard these very moving stories from these parents. i would like to start this dialogue with talking about this. let me start off by asking

doctor harold koplewicz. you have referred to it as an epidemic in america. could you talk about this? clearly these parents are not alone. could you comment on this? >> i think america really does treat the illnesses above the neck differently than they do the other illnesses below the neck. we have 15 million children and teenagers, people under the age of 24 years old, who had a psychiatric disorder or serious learning disorder in the united states today. less than half of them get any help. that is an accessible. once they do get help, it is questionable how effective the help really is. there are several big problems that must be addressed and one that was just talked about is the stigma. this country has tackled things like cancer and aids and many movements have made it possible

for us to cover other illnesses, yet others are so ashamed thinking that it is their fault, their child's fall, somebody's fault. not the fact that these kids have a brain illness that prevent them from doing what they are supposed to do. until this nation speaks up for kids, literally says this is real and common and treatable in the same way that fdr cackled polio or the way that bush and clinton tackled aids, there is no way that these problems will resolve. when you are afraid that you can't get the help, you won't get it. as the ranking member tells us, it takes two years from the time you get symptoms to the time you get help. and i think that the last time i was here, we talking about something as simple as a rash. if anyone had a rash on her arm today, it would be two or three hours before we put some cortisone on it. if we couldn't wear our shirts, two days later, we would be

seeing our practitioner. if we were still scratching, we would see a dermatologist. get it takes two years to get that kind of hell. the other problem that we have is the access to care. so we don't treat mental illness is equal to physical illness with our insurance policy. the system is inflexible. it is really disconcerting. if anyone started to have chest pain right now and complain about chest pain and if it's radiating down their left arm, immediately dmso comes out. on the other hand, if we acted like we were disturbed and yelled and cursed, we would call the police. the ems is not trained to take care of the diseases above the neck. so right away we have parents that are forced to lie or get their children into the largest

mental health care system, which is the juvenile justice system, the other thing is there are not enough people doing this work. you have 7500 child psychologist in the united states, 15 million children who have these disorders. the math just doesn't work. the only way that that is going to work is a pediatricians and primary care physicians who are the primary people to take care of these cases, they have to be better trained. there is never a better time to do that. you have equitable health care act, you have the ability to say to people that unless you are certified and have some kind of education, whether it is online in these kinds of disorders, you won't get reimbursed at this rate, so we have to be re-embraced at a lower rate. or you get reimbursed for higher rate. in addition to that, we have to be sensible. we have to find social workers or a number of individuals who want to be trained and work

under the supervision of a psychologist or psychiatrist. we can be innovative with that. the last thing is we are not doing enough research. he clearly, we have stopped investigating new drugs for the central nervous system. and the national institute of mental health needs more fun to look at children's mental illness. 75% of all psychiatric illness occurs before the age of 24 years old. 50% before the age of 14 are sold. it means that the biggest bang for the buck, the biggest return on investment your investment is to try to identify these kids early and treat these diseases effectively as soon as they show their face, not after years of symptoms. >> thank you, doctor. letting the members know, if you want to be recognized, ask clarifying questions and we will just keep those in order.

starting off, is mental illness treatable? parents talk about a need to call the police. if we look at the overall cost, what is the cost of doing things through the criminal justice system, can you give us some insight into that? >> i will try, and thank you, mr. chairman. thank you for doing this. i think that this is, in the 10 years that i have been meeting with members of congress, i think the first time we have had this kind of a form to have this kind of a conversation is extremely important and long overdue. the specific question about what we lose by moving us into the criminal justice system, there is most always answer is what you have heard already from the parents that are here that you are talking about.

people who are not getting optimal treatment. there are treatments, they may not be as good as that we like, that but there are treatments. just as in cancer or heart disease, they don't help everyone as well as many. we do need a new generation. some of them will be in the psychosocial wound. but what we have is good. but it's not good enough. a very important need is to figure out how to get the next generation of medicine together. what we lose in terms of outcomes, as you mentioned, it is obviously much more expensive to try to do this through the criminal justice system, but it's expensive because it doesn't work very well. what you end up with is a series of repeated visits and peter probably knows more about this than anyone.

it is just not the way to manage any serious medical problem. the criminal justice system would be the first group of people to tell you that. this is not what they are looking for. but we do not have at this point a system that is there to be able to address the needs. this is what we are currently forced into. but the community resources, not crisis centers, so we are often forced to respond in a way that is often severe. >> i think we need to be a little bit more clear about the definitions of what we are talking about. a lot of what you will hear about today is a group of people about 5% of the population, these are people who are truly disabled and much like the young people that you just heard

about. having a psychotic illness, hallucinations, delusions, mostly being a danger to themselves and possibly a danger to others. definitely in need of aggressive treatment to be able to help them get through this psychotic episode. for many of them, this becomes a chronic illness with large costs, just like you see what diabetes and hypertension. the difference here, and you have heard this in each of the stories that we have heard about today, what makes these disorders so vexing and quite different than diabetes or hypertension is that at the very core, for many people with these illnesses, there is a loss of insight. they don't realize that they are ill, and if they do, they reject the notion that they need help. you have heard that in each of these stories. that is what makes it so difficult to contend with. that is why we have become not just individual disorders, but

that is why it these are problems that involve the criminal justice system and it has been so difficult to get our arms around this. these are issues that you talk about when you worry about diabetes and hypertension and other forms of heart disease. issues in which people can be there a own best advocate. here you are talking about parents trying to advocate for their children, children not being able to advocate for themselves. >> it seems that the diseases on the wrong side. usually if you have cancer, the patient and doctor on one side. fighting with the disease. here the patient is often with the disease, saying that i am not sick. and the doctor and the family on one side. the disease affects judgment and their ability to it except help. >> sir? >> thank you, mr. chairman. this is wonderful, thank you for

doing this. thank you to all of our witnesses for coming. it is powerful. i have worked on health issues for many years, and all of the things that have been set are things that we know. things that we work hard to address. i want to hunker down on some of these issues regarding the violent offenders that we have seen lately regarding people who have mental illness. one thing i heard from people in my district, we learned a couple weeks ago when we had a briefing that some of the mental illnesses, bipolar illnesses, they can lead to violence and mostly suicide and violence against themselves, but sometimes violence against others. ironically, it starts to manifest itself among men in the late teens and early 20s and women in the mid-20s. that is right about the same time when they turn 18.

so the parents don't have -- we have been hearing this from some of our witnesses today. so you have a kid who is 19 or 20 years old who suddenly started saying that, you know, the caa is controlling and things like that, when the parents tried to get help, they are told that you don't have any legal ability to do anything. you can't get some kind of a hold on them in a mental health facility and all of this. my first question, the experts can answer it. are there legal barriers in state or federal law to help these young people who are exhibiting mental illness at the kind of help that they need? as the doctor says, they are not on the side of their parents or doctors. the second question is, what kinds of things, and it's

related, what can we do is as we start to look at our health care policy on a national basis to start to really focus on some of these violent young offenders who are exhibiting mental illness? >> let me ask for a response to that. >> first of all, i would like to thank you for inviting me to participate in a really meaningful program. i would like to knowledge the importance of the stories we have heard today. hearing them for the first time, and as a clinician, and i am a forensic psychiatrist, have a slightly different orientation than some of the others here. you have to hear every story as if it relates in no way to other stories that you have heard before. i have found that a common

element is a lot that could easily be changed. the three of you have actually come up with something that could very easily be remedied at the legislative level. what am i talking about? first of all, commitment law. it is such that you have parents and loved ones who are forced to lie in order to get treatment. we just heard about the difference between the medical model and the mental health model. in the medical model, if a parent is concerned and they say, my child is sick, no one says, let's see if the doctor says they are sick. no, the parent says, i'm caring for this child. i am the person who may one day, god for bid, buried his child and i think that my child is dangerous and i am frightened. the law says that is not good enough. the mental health professional,

even of the best training, has the power to decline rather than the parent who can give stories like what we heard was more detailed of any clinical history that we will ever get in a emergency room. you could change that law and a minute to allow for caregivers to say who defines dangerousness. that is right on the panel today. secondly, how can we as mental health professionals help more? this gets back not only to psychiatric illness, but i can tell you as a forensic psychiatrist, i would not generalize mental illness, but i would say it is the most relevant symptom to newtown, and it is paranoia. let's just say you are interviewing a paranoid patient. what kind of history are you going to get?

so the family is essential as an informant. but to have the law says that you can't talk. let me get this straight. as a family member, you're going to take the patient back. but you can't have access to the doctor whose well-meaning efforts to provide care have to be handed off to you and could be a patient that is barely held together, with no owner's manual for mental illness and no interim manual for professional training, have a nice life, good luck. as a legislator, you could change that overnight. why is it that parents are not empowered to impact decisions about dangerousness? why is it that parents -- maybe not parents, but just financial caregivers or custodians. if it is a developmentally

disabled population. why is it that there is a natural open line of communication where people can get clinical history passed off to them. these are solutions that could immediately be enacted. i would like to give others a chance to speak, so i only want to add one thing. those of you who have access to this proceeding, you may watch it one day. your cells may have struggled with mental illness. never forget the pain of this, because you may feel suicidal. but somebody loves you. when you go, you will ruin him forever. think about that while you're here. think about that pain on so many people who'll love you forever and when you are here and gone. don't do it. thank you.

>> thank you for the opportunity to be here today. clearly, what you have heard today is we need a more diligent mental health system. there is no single court in existence today. what we have found was tremendous variability from county to county as we move across the country in terms of what services are available. to have the laws are barriers that we prevent families from having information that they need. families and caregivers see things first. so part of our intent here today, is to have the ability to have families access the system and you need to take a look at the hepa laws. as well as laws that relate to health records generated by

university centers. many families and individuals experienced mental illness for the first time when they are 17 years old to 20 are sold. many of them on college campuses. so we need to take a close look at this. the issues around the laws of this country, our local affiliates, over the course of the year, we get thousands of calls from family members who find their loved ones in the criminal justice system being blocked for admission to inpatient units, the reality is today that we have fewer inpatient units then we had four years ago. what we need to do is it's a

grave disability and need for treatment. we need to allow people to get diagnosed and get the treatment that they need. looking at the laws is absolutely essential. as well as the workforce issues. in 55% of the counties in this country, many of them are not psychiatrist. so how do you get here want to get out of the hospital? you get referred to? and whose services are the right services? are we funding the most effective evidence-based services that make a difference? there is only 1 dollar in this country to fund services to those with mental illnesses. but we need to make sure that we extend the dollar in a way that really gets the job done. >> i just wanted to add that i am an optimist.

in my professional lifetime i have witnessed mandated treatment of six offenders go to zero and 60 in a matter of years. i've also witnessed that it construction of the department of homeland security, virtually from scratch. i absolutely believe that if we create a growth industry, not only of child psychology, but a treatment for the mentally ill, those who need to be kept in a facility where ongoing work can be done so that it is not a revolving door for them. >> one quick follow-up. the other thing that i didn't

say, people support education. what you have is an 18 or 19 or 20-year-old, their peers have gone to school, military, gone on with their lives, they are working, they are connected with the treatment system. for most families in this country, we did not grow up with a psychiatrist, but a general practitioner or clergy member. most people when they experience mental illness and their families, they talk to their clergy first and then their general practitioner. it takes him a long time to get into the mental health system. >> okay, let's go to mr. pete earley. >> thank you, very much. i am a great believer in learning from previous events.

in virginia we had the virginia tech shooting and i'm glad to see the congressman here. i was appointed to rewrite that meant a lot. and we changed it, we changed it to substantial likelihood of danger. and we thought, this will really make a difference. the legislator passed $42 million in new appropriations. and we thought this would make a difference. the next year the legislator cut $50 million. i was just in dubuque, iowa. they were telling me that they had people with mental illness in emergency rooms 24, 48, 36 hours because there's nowhere to go. my own son had to wait for hours to find a bed.

we need to change the commitment process, but you just can't change that if you don't back it up with services. because there's no place to go. >> [inaudible] >> i could just follow-up on what you are saying, and what makes it worse, we actually have a hospital that is dedicated to mental health in many ways. but they don't have enough to open up the floor is. >> thank you. >> thank you and i appreciate all of our panelists for participating. thank you for the family stories that were shared as well. pete earley and pat milam. i appreciate you and your wife being here. all my condolences for your son, matthew.

and the experience he went through, we talked about this in the testimony. the fact that the treatment center didn't talk to your primary care physician, and it seems like with mental and physical illness, there is a different approach of how it's done. my mom battled cancer for 12 years. over the course of that period of time, you saw a different evolution of how doctors treated physical illness in working to help cure not just the medical treatment, but having the family interacts with that process of healing. bc a similar approach on the mental illness side or some problems and barriers that keep you, the parent, when you're somewhat come home, did they talk to you about what you are seeing in your son? did they tell you to work on these things? they would say he is done and he's back to you again.

>> in my opinion, the doctors don't want to talk to you. i've i have been told by other doctors that there is no box to check for insurance visit. when my son was put in a psychiatric facility as an inpatient, his primary doctor was at the same facility. his doctor never talked. i'd like to get the answers to that one day. i don't know how you can find out the most information you need about a patient that suicidal war that has weapons of mass destruction at his house without talking to his primary care physician. without finding out the background. he also would have found out that matthew was not going to take his medicine.

as many schizophrenics, they don't take their medicines. he could have learned a lot from that. they let him out against our wishes, and he agreed to go to an outpatient clinic, many are smart enough to learn after six days that, okay, let me out. but also the releasing psychiatrist from the hospital, they never contacted the outpatient service. i asked them why and i was pulled off the record that it is a function of money and we don't get paid to contact and follow-up. for the other thing is we bring it up is that diplomatic is a major problem. there are many questions on heads up. my sun sign a medical release. so the doctors could talk to

him. we didn't know that, because the doctors when talking to us. just because a release is signed, the other question i have asked and no one can seem to answer this question is if a patient sign the release, then he cancels that release, then he reinstates it -- there has to be a paper trail on that. because i can't seem to find one. there doesn't seem to be proper rules on how that works. ..

the committee sent a letter to secretary to ask her to clarify when you ask someone violently mentally ill or has been through a commitment with the law that would not be able to purchase guns. a lot of times those records, the states have not released them climbing hipaa. i think it's a judicial issue. quite frankly . >> mr. chairman, let me say as someone here when we wrote hipaa. i don't think hip prevents those records being i divulged at all. i think people are

misinterpreting it. [inaudible] >> mr. chairman, also -- for inviting us and it's important to look at severe mental illness as a factor in the tragedies we're looking at. we heard a lot about gun control. guns are a major part of the problem. untreated mental severe illness is a big if not a wig -- bigger part of the problem. i want to focus on the single biggest impediment that we talked about was the fact severe mental illnesses are different with people severe physical illnesses. about half of them have an impairment of the understanding of the fact they are sick. the reason they have that is because they have damage to the parts of the brain we use to thinks about. in this sense, someone with schizophrenia or bipolar or severe depression is not exactly like someone with cancer.

the laws don't reflect this. about half the people with schizophrenia have impaired awareness of the illness. we're not talking about dime. we're good at diagonal. we're talking about a part of the brain affect the. the part we use to think about ourself. we see this in alzheimer's. it pair entires your ability to understand you are sick and need treatment. we heard this earlier, certainly occurred in all of those. we have studies that show that the brains of people with sits freon ya and some with bipolar disorder, when you look at them, there are changes in the brain of the people who have the impairment compared to those who don't have the compartments. last year i reviewed 18 studies. 15 of the 18 showed significant differences in particular part of the brain that we use to think about others. there's two other studies i know that come out in the last year. 17 out of 20 studies looked at

this show the brain is different. the laws do not reflect that. unless we have treatments that reflect the fact that we are dealing with people who don't understand they are sick, then the treatments will not be effective on it. example, my sister who had sits freon sits -- never understood she had schizophrenia. do you think have it and she would smile and say i know you think i do. why do they keep you in the hospital twenty five years? i don't know. i had a cold when i went in the hospital. i don't know why they kept me all that time. it's a problem that unless you actually deal with it in the laws and treatments, we're not going go anywhere. thank you. >> thank you -- [inaudible] mrs. ska schakowsky from illinois. >> we have been talking about

potential solutions. i want to say there are a couple of bills i have i don't want to go in to them. one has to do with mental health on campus. it's fifteen years this month that one of my best friends' son at 20 years old committed suicide on the harvard campus. popular, doing well in school, no one could figure it out, clearly, obviously mentally ill. and she had asked me at that time, isn't there something we can do to provide more help to college campuses? to identify and through to scare treat the problem? so i wanted to just degette some reaction to that. the other, doctor talked about expanding the availability of mental health professionals. i have legislation that would allow clinical psychologists not have to be -- not expand their scope of the practice, not to

have to be under supervision of a physician to afford -- to offer that service. what you thought about that. and finally, i wanted to say something to dr. welner, i was looking at your -- the end of mass murder, the documents you proposed, and what you can do as parents. it says, first, teach your children to take personal responsibility. the child who is instilled with taking ownership and responsibility is not inclined to blame others and will never come close to the pattern of blame that generalize to those he has never met. it feels to me, with that kind of statement that somehow it adds to the feeling of blame and responsibility without recognizing and stigma without recognizing we're talking about mental illness, not just how we

as parents teach our children that, you sometimes these things -- especially with the huge mass murder situations go beyond that. it doesn't -- it doesn't feel good me. it seems to add to the stigma idea. >> you want to add to the question? >> all right. i think there's an important piece here. let's remember that the suicide rate in this country for people between ages of 14 and 24 is 5,000 people lose their lives this year. 600,000 will make a serious enough attempt they go to an emergency room to degette -- get. the brain is mushy and starts pruning itself people who have psychologist illness it overprunes. and there's a reason why other rental companies don't let you rent a car until you are. it's not because they are

neuroscientists they have figured the accidents people have between 18 and 24 are significant if they wait the brain looks better and we calm down and suicide rates drop. it's particularly important that college mental health be an important component to this. and it's not that harvard causes this or the university of maryland where i went. it's the stress, obviously of being separated from your parents. it's the genetic disease that is coming out that shows its appearance that the crucial age. the real problem, i think, the fact we don't let colleges share information with parents. so that when a kids starts showing symptoms, the important piece you can reach out to the family and say, your son is in trouble. or your daughter is in trouble. when you think back to virginia tech, it's the attitude the professors have. if someone sat in the room and bleeding from the nose continuously someone would say there's something wrong here. you have a clotting problem.

you can't come back to class. or if you were coughing you might have to be checked for tv. there was a men menacing individual people sat by the door afraid they would be able to run out. clearly that has to be corrected. colleges can share that information with parnls. -- parents can you imagine. if your son is -- kid is on citizenship and he lost it because he's mentally ill and doing bizarre things. that's the first thing you degette -- get. letting psychologist are you talking about prescribing a medication? i think the more important part we should think about is there is something we can do if we think about the school of

psychologist and socialwork, only 20% of those studies have shown are educating people on evidence-based treementd. you get your swork degree or doctorate in psychologist, and you learn about psychotherapy, you might learn about an lettic theory. you are not learning about the most cutting edge cognitive behavioral therapy, the stuff we know has evidence, psychosocial intervention that can make a difference. and there is no certification program. there's no licensing that says this is what is required in medical school there are certain things you must teach people to get the medical degree. >> i want to keep this moving so we can get a lot of member's questions in too. doctor, you commented on what mr. schakowsky. how do we identify those and protect those at risk and prevent them from taking the next step of violation? >> congressman schakowsky i appreciate your question. we haven't heard anything about

the newtown type of individual here today. and you have actually asked the question that introduced it. and the point for my experience and what we learned from the literature is that a great number of people who carry out mass killings don't have a psychiatric illness. they a personality disorder. what is common to all is that they have a brewing resentment and blame and externalizing responsibility to others. now, if you -- tack on a paranoid condition and full blown psychotic per nowed -- you have an individual how he relates to the world who has a scrottic condition on top of that. for those who are along the path of increasing isolation because they get in to a way of relating others. it's their fault, what parents can do at an early age, every parent in america asks how can i prevent the unthinkable from happening? the idea of how a child relates to the world one can actually

make a difference beyond nature. some things nature -- the last quick point i want to add to what doctor said, in my professional experience in dealing with these cases, the mass killer and risk population is actually harder to treat and manage than even individuals with psychiatric conditions who have denial or struggling at the different stage. it's a unique and difficult population. i'm concerned that what we need in the psychiatric and behavior science field is better training. we have to incentivize better treat people to deal with the most difficult population rather than make qualifications available to people who might not otherwise have an opportunity to be nominally in charge. we have got have mental ill seals. that is the population treaters that need to be redirected and focus to the high-risk individuals. because a lot of them are in

treatment with people who care, and somehow they crawl in to the cracks so they can act on a homicide l "fantasy". >> doctor burgess? >> holding the hearing. first off, let me ask a housekeeping question. since it's not a hearing. are we able to submit -- there's a lot of questions a lot have and won't have time to get to erg. will we will be able to submit questions for response. >> sure. if that's okay with the panelists. i would be glad to pass them on. >> i think it's an important part of continuing the dialogue and the feature. mr. earley. i wonder if i can you. thank you for sharing your story with us. he prefaced one of the comments for people watching this at some point in the future, you told us a very compelling story, i think it had the positive ending, but i don't really know how you got there.

so since we should be able solutions. can you share with us how you got the positive ending? >> absolutely. thank you very much. my son finally got the community meaningful service he really needed. he got a caseworker that took a tremendous load off me. i could be the parent. can you imagine every conversation i had with him before that he would laugh i would go is he off his ?edz if he cried i would go is he off the meds? all the sudden i can be the parent again. i had to become the parent instead of the -- i had to learn to teamwork. he got him -- it's not rocket science. what do people with mental illness want? a purpose in life, they want someone to love, and they want to be somewhere where it's safe. the worker said, look, we're going get you in to housing. because living with your father apparently at your age isn't really smart thing. so the guy at the housing with two people with schizophrenia and said, why don't you take your meds?

do you know my son had seven stris only two bothered to learn the name or symptoms. they figure the med, stick a bill and let the social worker who is cheaper dot work. treating mind requires treating the heart. i didn't like the weight gain. let's try this. he became compliant. what do you want to do with your life? i don't have to be in the building? my son has never been on disability. i taught that. he said no. my son became what is called a peer-to-peer support specialist. he is actually paid by fairfax county to go in to jails and prisons as part of a jail diversion team and help people with mental illness get out and get their lives together. he is an amazing success story. he's been stable for six years. and it's because people took the time, the effort, and gave him the services they needed to move forward. now he pays taxes. >> so he's become one of those

mental health seals that doctor welner referred to. >> most people with mental illness can get better. you have to give them high school and -- hope and the tools to do it. the ones with severe mental illnesses require more. but most can get prevent. >> what prevented the intervention of a mental health caseworker at one of his earlier interventions or er visit? >> my son and i fought about this all the time. it's -- even if you doctor torrey put it so well. even if you can cognizant to realize you have a mental illness. who wants to admit that? who wants to admit your brain is impaired. he fought that and fought that and fought that until he ended up being arrested four times and tasered with the police and all the sudden the reality set in. and a doctor told him every time you are having a significant break, you're killing part of your brain. and that finally did it. but how each person greets that,

reaches that is -- i wish i would be a rich man if i knew how to do that. but he finally realized it. when he did, we had the services in place to get him the help he needed. that's why services are so crucial. >> and i don't disagree with that. mr. chairman, i would -- i feel obligated to point out it's a cautionary tale here as well. i mean, i grew up in '50s and '60s i remember the state schools and hospitals in texas. those were criticized and i think by the federal government because warehouse individuals providing no meaningful treatment. i have an article from 1990 "new york times" indicating the abuses of the group scald strike substitute of america that hospitalized adolescent for the one-month period their insurance would cover. it was lucrative business for that entity. they didn't really help anyone. i don't know some of the

difficulty you had mr. earley because of the reaction that we someone took legislatively to that abuse and that fraud that occurred. i remember those clinics those facilities, my home state of texas, they were quite predominant, quite rampant at that time, obviously the justice department required them to come up with all kinds of fines and people got in trouble. and as a consequence, then i practiced obgyn. it was difficult get someone to a treatment facility. nobody wants anything to do with it. people got in trouble. they were doing things wrong. there's no question about that. and mr. chairman, i'll submit this 1990 "new york times" article for your . >> i appreciate it. yes, sir. mr. earley . >> nobody wants to go back to the old days. and you have to realize that those kinds of facilities should and should are been closed down absolutely inspect virginia today, if you go through the

involuntary commitment process. if you become the inmy and make your son go to treatment. the average length of stay five days. do you know the therapeutic level of my son's drugs is five weeks. the other thing i encourage you to remember is this, yes, we closed them down. we have moved people back to the community where they should be, but if you read my book. we're putting anemia sub standard nursing homes and they are homeless. they are in the jails and prisons. your state reports studied how the economics of this and how much money your state was wasting because of people in jails and prisons who could have gotten help. if i -- pull it off the top of my head, i think for every $7 spending on incarceration -- it was costing $7 when services would have cost $1. >> yeah. i don't disagree. we should be about solution. we need remember some of the pitfall of the past. >> absolutely.

>> thank you, doctor. mr. braley.. [inaudible conversations] >> my district. mr. chairman, there's a insurance company called u.s.a. aid that sales the products to members of the military and their families. and they have a marnghting campaign right now where they have ads on tv that show people they say mindless earned and they identify a specific battle or a moment in history when their families started using that product. my understanding of mental health was earned when my dad came home after seeing a friend of his vaporize bay shell burst. when i was in high school had two severe bouts of depression. i learned a lot about how people respond and don't respond when someone is suffering from a severe mental illness. one of the things you learn is that in addition to the compassion that family members bring, there's always

resentment. resentment because you can't find solutions to problems that other people don't understand. and i appreciate my colleagues comment about some of the past abuses which have created the current legal system we have that is creating these obstacles. because it used to be that putting someone in an institution involuntarily could be used for punitive measures by husbands, who are upset with their spouses, and by families who were tired of dealing with problems they could not solve. we have to remember that right now these issues are dealt with on a state by state basis. we have to 51 different solutions. and that is why this is such a difficult challenge to solve. we know that individual states have legal proceedings, like a guard yam ad litem m that the

opportunity for greater access to involvement and the care of a loved one, but those are cumbersome proceedings. we don't know how question expedite that under the circumstances we have heard from the families today protect the rights of the patient and get parents more involved. but i can tell you when i talk to mental health professionals in law enforcement officials in my district, we came back to the same problem we dealt with in the aftermath of 9/11. that's the issue of interoperability how interested organizations that are concerned about solving the problems cannot communicate with each other. and it seems to me that if we're going get to the root cause of how we solve the problems we're talking about today, we have to bring in state officials who are involved in making these decisions on a day-to-day basis and come up with constructive solutions that are going get people more engaged, more

involved, and in a more timely fashion than we have been. i think it's a much deeper problem than saying we can -- come up with a solution by clarifying the intent of hipaa when it's being interpreted by state law official and the different jurisdictions. i want to thank all of our panelists. it's been very illuminating. i think you have really put a fine point on why this is such an enormous challenge for us to take on. >> ask a couple of parents to -- if you can come to it briefly. what experience in term of the barrier was? >> well, my personal opinion is the doctors use hipaa as a weapon. they don't want to talk to you. they don't want to talk to you. you know, i tried one way communication. i must have sent 300 e-mails, picture, and text with finally the realization that the doctor was not going return the calls.

you know, i even -- last day of three day of his life sent a fax to the ceo begging him for help. look, i don't need to know anything about my son. help me save his life. no response. i'm told day in and day out that hipaa, hipaa, hipaa, we can't talk to you. >> can you comment on that -- in term of cchtialty laws and preventing people from communicating in yourson's case? >> caller: i'm fortunate. he explained exactly why i'm concerned what happens when my son turns 18. right now my son is 123. hipaa is not an issue for me. it's certainly on my mind for all the reasons he articulated so well. >> thank you. i might add and other members want to check it out in their states. i know, in pennsylvania 14 is age maturity. i wouldn't let a 14-year-old do

much of anything. >> thank you, mr. chairman. a couple of things. although there seems to be consensus here. there's two issues one is commitment and the other is the ability to understand commitment of an adult family member. number one, and number two, the ability to get information about the adult family member. two different issues. so mr. earley i'm about to reference you. you may want to -- i'm sorry? there's seems to be an consensus we have two issues. one the change of the commitment law to allow adult family members to be committed and secondly the hipaa law. there's almost a consensus these need to be addressed we in your book you do a great job, and torrey you as well reference there there's not consensus on this. there are activists and maybe there is somebody here that would agree with that. who would oppose changing

current commitment law and potentially absolutely oppose changing current hipaa laws. no that said, even throw there seems to be consensus. because of you i understand there's not. how to we address it. secondly, dr. torrey, after that's addressed. you have been a sharp critic of -- and so you also proposed federalization blocked granting federal dollar to states. if we're going federalize funding, don't federalize control. so i would like you to comment upon that perhaps mr. earley speaks. mr. earley? >> no one wants to be -- have their rights taken away from them. and it is a slippery slope. that's we really have to watch. if you look at the history of where this law came from, you'll see that it came from what mr. burgess was talking about. people arrested for having a mental illness. they were stuck in an

institution and the brain scrambled and said congratulations you're cured. and the civil rights movement switched over and said you shouldn't get arrested for a mental illness. you should have rights. and most of all, they targeted involuntary commitment because they believed in putting someone in one of the institutions was worse than letting them on the street. they made imminent danger with the criteria. we have to have safe guards. i want to protect my son. i know, how people with mental illness have been treated in the country. i'm say that the imminent danger criteria is a criteria. [inaudible] >> absolutely. [inaudible] >> we actually looked at having matthew committed

conservativeship. my fawrnl who is an attorney prepared the documents. we realizedded in the condition he was in, the rage he had potentially a time bomb. that it would take us literally two months and probably $20,000, which wasn't the problem. but two months he would have had a court hearing and would have scheduled for doctors and would have had another court hearing. that can't work with a person that has been potentially violent. [inaudible] i thought my son would take his life the minute we told him, by the way we applied we were going have you committed today. >> it turns do you the men i. it they say, he's not danger to himself. at this very minute, they say we're not going commit him. who takes him home? believe me, they are not happy.

i think the dangerous criteria is a false criteria about what mike said earlier to make it wording to get them to the treatment center and build in more safe guards if there are parents who are trying to dump their kid or people who don't need the help. you can get them out maybe have a three scrisk psychiatrist -- we have barrier here when i think we should have it after you get it someone who may need help in to treatment here. >> louisiana has something like that. i'm aings in -- physician in louisiana. you went through the process and still wasn't adequate. so i think we're working toward it. i'm not sure we're there. >> yeah, i was in baton rouge. again it's the other side. you are short on hospital beds. you are short on facility. >> yeah. respond to that too. >> thank you. as he said, these are state commitment laws. i think we shouldn't be under any illusion that the federal

government or this group of any group in the federal government can magically change all of these state commitments laws. these are state laws i think properly so. i think what we can do is use the federal money that is already available out there to provide models to that we urns what proper treatment would be and can be. yes, you are correct, i have been a severe critic of it. it i don't think they are doing the job they should. that includes several hundred million dollars in a block grant that goes out. i can argue it can be used very well to provide models on how treatments can use for instance outpatient treatment -- awareness of the illness and we know decreased hospitalization decreases violence and saves money. this is a proven way to keep people such as we're