but the interpreters were critical. i mean, to navigate the more sensitive things, to work with jim and the sort of understand who was who. we had three very talented interpreter suit, interestingly, were brothers and all were very different, different personalities, could use the men different situations, and i am proud to say that none we are in the process of getting all of the visas to come to the united states. one of them, the youngest ones unwed, ride your in january with his wife for a few months. we are expecting the second one any time. back.

we're working hard to make that happen so that the will of a place to come to, a refuge in case of whatever may happen. the interpreters are very much at risk. they viewed death threats and serious potential risk. it is the least we can do your show our thanks to them for all that the reference. and the will to say one other word about the final brother. he was in a medal of honor battle for which a u.s. staff sergeant and special forces posthumously receive the medal of honor. and he -- a captain he pulled out was given a letter that said that his behavior in that battle was just the same as in a of a number. some of these aren't ordinary people. these are people who have sacrificed tremendous amounts.

you might not think of it, but they also suffer from some of the mental foils of having served in a war. we really of the block. >> you are you working for? >> i am just an author. i'm independent. >> at the time? >> previously was working for the "washington post". >> were you on assignment? >> no, and that's important. ethically it would not have been appropriate for me to cover jim once i get into our relationship this is a work of narrative nonfiction, biographical, and it allowed me to really bright a much richer story that had i been under the constraints of journalism.

the classical pianist drolen dahlia how to play jazz. i had to go well outside my comfort zone to write about myself, to write more about our relationship. i was told that only through doing that would i be able to bring the american readers along with me. so it was necessary but not easy to do given my training. >> the second part of the question kaelin the constraint of conventional journalism. how was your will different cuffing jim's story verses a few recovery for the wall street? >> i would not have headed for the "wall street journal." all of my journalistic skills were right there. i did not lose all my powers of observation and documentation

when i became in that relationship. i would say that what happened was it really gave me, again, much richer story, much more insight he was thinking, the stresses, so many things i would never learned as a reporter. first of all, could never have gotten access to that unit. very occasionally they allowed journalists access to special forces teams were perhaps 24 hours. it is extremely limited paribas on the organization from the inside. thus of this organization from the inside. and if anything it made me more critical. i didn't their relationship have some sort of glossed over happy view of things. i saw it in the nitty gritty as it is. so i think it -- i consider that

somewhat of a service process to for for the special forces community to have been there and the argument of those for them to use in the future because they really don't have people doing a sort of thing. ba. >> i would imagine that the special services people did not have family with them. >> no. been there are occasionally people in the military who are related or who find themselves in the san location. there are military couples. actually quite a few. but, no, they could not bring their families. that was another thing. it was an unusual opportunity for and the show, tried to increase the comfort level with. it actually made us safer because of what it showed to them about how much we trusted apart from the fact that acted

by communicate with the women and establish relationships would not have were barely existed. >> a very high risk factor for viewing something like that. and i -- what was the motivation for presenting yourself to that level of risk? there is patriotism. there is an opportunity to do something. do you think to risk 12 guys to want to risk a low of one that is with you is quite a large leap of faith. a large leap of faith. and i believe that when you believe passionately in something you are willing to

take extra rares. i believed this was something the has merit for the future. it has merit as an example, and i agreed it is it is not always worth taking those risks. in my early career as a journalist what caliber things. you know, was the story worth mean risking my life which i did it again and again. i. effective once we get involved in these situations i feel their is a commitment to have people on the ground who can actually know what's happening because there's so much distortion in this country of officials not really knowing what's going on. and i felt very much that no one really understood what was happening on the ground. so if we're going to go to these places, and with billions of

dollars, if we're going to exhaust more than 2,300 times as we have of u.s. service members killed in that country that we better care and up to understand it and to know about. >> did you have to get the military a sign of? >> no. i made official requests of the book offers for permission to coverage about. i was turned down. so i did not gain approval. it was not authorized. journalists do not a lot. it is not as though we are --

journalists did not ask people to the vault, supply information the way of the did not go places that were not supposed to be we would be much poorer and more. so i took risk to do that. jim took it risked. again to win all boils down to something that we very much believe. >> if you receive back from the information, how much did that contribute to the book and your overall experience? >> a great deal. you know, the great thing about this book is there are only a few people who are even mentioned his name and not in the book. i had great cooperation from general patraeus and others in his chain of command you did grant the interviews about this

topic. and the only people whose names aren't and are people whose jobs are too sensitive or, you know, in one case to rest for there to fraud because of their career considerations. there is not much on background. i really do name names. it expects will -- with going to be brutally candid. >> special forces people were there which with us. >> yes. >> the answer to question. there were about -- i mean, at different times other than jim maybe two or three offish. there was an experiment going on which was unusual which was where the first, the. it did not have enough special forces. conventional troops and use them to augment our special forces a

woman. so the majority of the soldiers were not trained in special forces, did not have any special skills with a mission, and it's really, to jim's credit, he worked with them, they embraced the mission. and i have to just mention a couple of them are right here in this room. i'm so thankful for you to come out. they did incredibly well. in some ways they were better than special forces. they really completely understood what it was about the relatively short about the top. >> have you had contact with other special forces groups? >> yes, i have. i did cover them. and what is unique about special forces is that their core mission, their original mission is to partner with indigenous

forces. you have a small team with 12 individuals supposed to partner with about a battalion sized element of foreign fighters of several hundred. their task organized with communications, intelligence, all weapons capability, medics to be able to leverage those indigenous forces. i thought that was a great mission. also -- art was impressed by the fact of those soldiers did have the language more than others. there were trained for that. the problem i found was about there are often not used to carry out missions. they're often used in direct action russians, raids, ones that do not use those skills. in many respects what happened in afghanistan was the mission that he helped design about half

of all the special forces of the country. after of them were back to their core competency. >> tell us about the title. >> well, it refers to the spartans which is a warrior culture, a culture that generally studied. he very much identified with the way that they would fight together, the way that the men would cypress themselves for one another. the camaraderie, the willingness of dive for one of the was what they used pirelli the team. spartan was his call sign for the majority of his team's comanche design special packages for them. in some ways that mentality and

that each dose, that ancient code of honor relates to very much to the postions are described. they're is a connection then. that is something that identified him. >> i can't help but think that you have had such an adventure here. i mean, your day-to-day life was so different than it is now. you have any comments on what your plans are now? >> well, i would like to continue writing. as i said, this is an ongoing story. it never ends. and i will say again that the arrival of the interpreter to live with us, very, very special because that is the connection.

and it was so rewarding to be able to help them begin to get settled and receive what they are encountering in this country. i guess they should say that we almost feel as though we have our own small tribe of people, our own families your, the afghans we grew to love and know so well. we are very happy. i don't feel frankly that i have come to grips with all that happened so far. you know, there's a lot in the book, a lot of hardship and difficulty that i have not talked about here. we want people to take away the positive examples from the book. it was very, very difficult. i think our still trying to our relief fully digest what happened. >> i would like to ask you an opposite question. did you feel the part of any

afghan rejection or not liking you being there or opposing the mission that you were trying to accomplish? if so, what were some of those experiences? >> other than that taliban and to attack this, no. i really would have to say. clearly different people have different motivations. some of the more wary people were in the afghan government. they were a little bit reluctant to have the tribes in power the way that they were. so they were somewhat standoffish at times, although they never were in any way hostile to me. you always have someone with a strange personality. there are a few of those. i was amazed at the extent to which they accepted me. the tribal leader who'd jim had met in 2003, he treated gym is a

son. when i got there he told me, you must follow postion law. from that point on when he saw that i did and what i was he treated me as is dollar and wall and so i cannot -- it is almost hard to believe and comprehend the extent to which we were accepted, but it happened and it is possible. >> and other rivers question. i am wondering what it is like for the afghanis to come to the u.s. >> well, speaks very fluent english, colloquial english, spent a lot of time with americans. i will say that i will never forget the expression on his wife's face when we met them at the airport. it was one of utter shock and

terror. she had never been outside of the protective wall for home where, you know, she lived with her close family. and it was very difficult for her. i think she was very homesick. at the same time she does not speak english. so i think it was just a huge cultural shock. over time she became -- i mean, we would practice english with her. she obviously felt somewhat relieved when she gets in the house. she showed, you know -- she became a little bit more outgoing. she started going on walks around the neighborhood. it snowed. when it snowed that time we were up there sliding and the hillside. and lo and behold we noticed this figure of the window. it was a night. it was someone watching.

although while later she had never seen snow before car comes out there and bounced on the hill a few times. you know, i think that because it needs to do, and it did take the lead in showing her round. it is not an easy transition, but i think that we were just so happy to be able to provide a welcoming environment for her. that is an a tough transition. >> what is it like to come back to seattle or the u.s.? how you a similar. talk a little bit about how that makes you feel. >> well, there was a time because i was pretty much constantly warring afghan clothes and my head scarf of that. it was on.

i sort of corn to those things, kong to those cars. it was a little bit of a barrier between myself and other people. i would wear those clothes and a travel. i notice that people actually would treat me more politely in some ways. and i think that in making such a transition there is, our river very vividly coming back. it was all that i could do to try to keep everything and pay for awhile well and made a mental adjustment. i remember after the invasion, which are was part of, coming back and for some strange reason to farming, have been spending weeks with the violence of the explosion. and, you know, i remember vividly the feeling of solid ground under my boots.

the first drink of cold water that i had. i get to kuwait. i have flown out on a flight full of body bags, stepping over them to get to a seat in the carpet. lo and behold, they put me, because there's no other room, in a presidential suite. and all i could do was open of an m murray, in military packaged meal and sort of lie down and just the whole night i was seeing sandstorms. i just couldn't -- you know, it is not easy. at the same time i have done in a lot. i have learned to do it. i am sure that i have some degree of ptsd because of what i have been through. people cope with it differently.

i expect that we will do that. i'm looking forward to that because he has all of that tactical knowledge. he will have things the senate. >> what about the transition from the united states to living in a postion village for an american funeral? how were you able to manage that cultural shock?

>> it was difficult because i was used to having a little bit more freedom. there're a couple of aspects to it. again, at the line to walk behind jim. i needed to do that for his image in the eyes of the tribal people. i -- that clothing was encumbering in the beginning. i felt like i was tripping over my pants. it was funny because when i initially showed out i had this outfit from this after a market in virginia and i thought would fit in. we go out and were walking around the village of these light, go talk to those women. of. i walked over. i later found out she said collier were arranged clothing.

they were wonderful. they -- a lot of the women there and made clothing from me by hand. before i knew it everyone was showing up with either made, and make or purchase clothing. i spent some time. the village was a little bit easier for me. as the velvet of time in a big urban compound behind walls. i was very -- felt very cooped up. i got a sense of not being able to go out. there were certain times of day it could go up on the roof and pique over. it is pretty constraining. the same time i did it willingly because i knew that i had to show their respect in order for them to accept me. i pretty much members to the

idea. >> i keep thinking of your everyday life, just the conveniences' we have. the washing machine. get the food for dinner. what was your day to day life like? >> we have rice and beans and beans and rice. i was desperate to get fresh fruits and vegetables but is it really did not have the. tomatoes or such a treat. once in awhile we got watermelon we have to wash clothes by hand pretty much. there were, you know, it was just out hofstadter's type bathrooms. and i hate to say it, but i actually loved it. that is just the way and. >> that's fortunate. >> it helped.

>> is there hope? >> well, i think that -- i do think there is a great risk of afghanistan once as it inevitably will be all this foreign aid coming to an end, there is not really a budget to support their current security forces. i think that after some time just as we saw after the soviet vacation and afghanistan could fall back into the kind of ethnic conflict and regional conflict that existed under the mujahedin or that it could fall back easily to the tell them. that is obviously not a foregone conclusion. there were some elections that took place. the first could lead to the first democratic transition in afghanistan's history which is a

major step. we also were encouraged when we went back to find that the trouble security forces have held. they have maintained even though they no longer have a very up close you the support. so far so good. as they have traditionally there were securing their areas. so again, i think it is just very early to tell what might happen. it has a history of all lot of conflict and violence. i am not sure that what we have established there in the security forces the we have established a going to be able to control or prevent a civil war.

>> thank you very much. [applause] >> again, thank you so much for coming. thank you so much. if you would like ticket books signed a will clear of the stable. all right. thank you. let me know if you have any questions. >> tomorrow night in-depth. the other 05 on fiction books, several best sellers.

.. want to paint another way you have just made him into a political dissident and somebody who might have otherwise been apolitical. if you tell boy scout troops that they're not allowed to be boy scouts and now they have to the young pioneers which is what happened in a number of countries and one group decides

they don't like that so they form a secret underground waste at troop which absolutely happened three the underground doubts were important in poland during the communist period you have created another group of political opponents from apolitical teenagers. next president obama announces initiatives to raise awareness of sports concussions. then pennsylvania congressman tim murphy discusses the results of a recent examination of federal programs that address mental illness. >> president obama hosted a youth say fence -- the president amounts

commitments from the public and private sectors to raise awareness and treat and prevent concussions. the present is joined by young athletes coaches and parents in the east rim. this is about 20 minutes. [inaudible conversations] >> ladies and gentlemen the president of the united states accompanied by tory belluci. [applause]

[applause] >> first off i want to sing thank you all and good morning i am victoria belluci. i'm here today to share my personal experience with concussions from playing soccer in the impact of my life. it is vital to further educate the public on the emotional physical dangers of concussions and i'm honored to have been invited here to share my story in hopes of raising awareness of concussions. many change throughout my life when my passion for soccer's a concentrate i started playing when i was four years old and when i was eight i -- when i was 14 i walked onto the soccer field for the first time as a freshman unaware of how my life would change in the years to follow. in four years i had the honor of leading my team to three state championships appearances for

regional titles three conference championships while being awarded individual honors like athlete of the year and receiving a scholarship to play division i collegiate soccer. the other side to my story began in my sophomore year when i went out for a header during a game and got my first concussion. thinking it was only a headache i play the game the next day and mistake of many athletes make. a fall during the game cost another severe concussion and started my battle with head injuries which i'm still fighting to this day. during the next two years experience for more concussions which altered my ability to perform in the field as well as in the classroom. simple tasks like lucas, assignments and socializing with my friends became increasingly difficult. it was also emotionally draining trying to learn how to live with everlasting impacts of my concussion and to adjust to life without soccer. concussions have drastically altered my life but the experience has page paved a new path for my future and taught me

not to take anything for granted. stories like mine are two common which is why would like to thank present, for shining a light and concussions and the severe impact they can have on a young athletes life. but that being said i more than honored to introduce our next speaker the president of the united states mr. barack obama. [applause] >> i'm so proud of you. good luck. [applause] >> as a dad -- torres parents are here and i have to imagine they are awfully proud of this remarkable young lady and we really appreciate you taking the time to introduce me. i want to welcome everybody here to the white house. i want to thank members of congress who are here. we have got leaders from

america's sports and medical communities especially young people here like tory who did such a good job sharing her story today. all across the country there are millions of young athletes just like tory who spend their weekends and summers on baseball diamonds, soccer fields and put in extra practice to make the varsity or maybe earn a college scholarship. most of them are not as good as tory was at that her sport. i certainly wasn't although i have the same enthusiasm. and for so many of our kids sports are just something they do. they are part of their identity. they may be budding scientists are entrepreneurs or writers that they are also strikers and linebackers and point guards and that's a good thing. first of all the first lady thanks everybody needs to move. and obviously there's a huge public health interest in making

sure that people are participating in sports but sports is also fundamental to who we are as americans and our culture. we are competitive. we are driven and sports teaches us about teamwork and hard work and what it takes to succeed not just on the field but in life. i was a basketball player. as i said not as good as tory was that soccer but i learned so many lessons playing sports that i carry on to this day even to the presidency. still when i need to relax and clear my head i turned to sports whether it's a pickup basketball game and a much slower than i was just last week. [laughter] or mental -- more sedate pastimes like golf or watching sportscenter. and more than that as a parent michelle and i have always

encouraged our girls to play sports. one of the greatest transformations i think in our society has been how young women have been finally given the opportunity because of title ix and now you see unbelievable women athletes who are getting the same exposure and experience and outlets for sports all across the country. and malia and sasha are part of that generation. they take for granted, of course we are playing sports and they played everything from soccer to basketball and tennis and track. so sports are important to our life is a family just like they are for families across the country. the reason we are here today though is all across the country parents are also having a more troubling conversation and that's about the risks of concussions. there is a lot of concern but there's a lot of uncertainty.

as tory's story suggests caution caution -- concussions are not just a football issue. they don't just affect grown men who choose to accept some risks to play a game that they love and that they excel at. every season boys and girls were getting concussions in lacrosse and soccer and wrestling and ice hockey as well as football and in fact the center for disease control reports that in the most recent data that's available to us young people made nearly 250,000 emergency room visits with brain injuries from sports related injuries. 250,000. that number obviously doesn't include kids who see their family doctor or as is typical don't seek any medical help. before the awareness without their when i was young and played football briefly there were a couple of times where i'm sure that ringing sensation in

my head and the need to sit down for a while might have been a mild concussion at the time he didn't think anything of it. the awareness is improved today but not by much. so the total number of young people who are impacted by this early on is probably bigger than we know. now i say this not to scare people. we want our kids participating in sports. i'd be much more troubled if young people were shying away from sports. as parents though we want to keep them safe and that means we have to have better information. we have to know what these issues are. and the fact is we don't have solid numbers and that tells me that at every level we are all still trying to fully grasp what's going on with this issue. last fall a comprehensive report found that there are too many gaps in the my understanding of the effects of treatment for confessions.

researchers are still learning about the causes and consequences of these injuries. communities are wondering how young it is to start tackle football for example. parents are wondering whether the kids are learning the right techniques are wearing the best safety equipment or where there they should sign up to have their kids participate in any full contact sports at all. we have got some outstanding scientists here today like francis collins the head of the nih. there may be tests that at some point we can do to see if there's a particular susceptibility to concussions. some people's brains may be more vulnerable to trauma than others are. we don't know that yet but there may be some evidence that is worth exploring. so with all these questions swirling around as a parent and as a fan and in discussions with

a lot of other parents and fans who happen to be in this white house we decided why not use our convening power to help find some more answers. today we brought together the president of the ncaa the mls commissioner senior leadership from the nhl and u.s. soccer and the nfl and nfl players association. we have also got some of the nation's foremost brain experts. we have doctors who work with kids every day from all over the country. we have got leaders in pop warner and little league under armour and espn participating in members of congress like joyce beatty tim bishop and bill pascrell all who have taken great interest in this. because we are all here and are looking for information even if we may not agree upon everything the one thing we can agree on is that sports are vital to this country and its responsibility for us to make sure that young

talented kids like tory are able to participate as safely as possible and that we are doing our job both as parents and school administrators, coaches to look after them the way they need to be looked after. that's job number one. the good news is across the country people eagerly signed up to participate here. they recognize this as an issue that is worth paying attention to. we have seen all 50 states pass laws requiring concussed athletes to get medical clearance before they return to play. folks from usa hockey bands checking before 12 years old. in march the nfl donated $45 billion to usa for the wall for the heads-up football program which emphasizes coach training and player safety. on our part this administration has spearheaded a public

awareness campaign for parents and athletes and coaches and school staff called heads up. check it out at cdc.gov/ concussion. that is where we have compiled a lot of the best information available for parents. and while the number of concussions reported among young athletes has risen over the past decade one reason is likely because players coaches and parents better understand symptoms of these injuries. still there is more work to do. we have got to do the better research better data better safety equipment better protocols. we have to have every parent coach and teacher recognize the signs of concussions and we need more athletes understand how important is to do it we can to prevent injuries and admit them when they do happen. we have to change a culture that says up. identifying the concussion and being able to self-diagnose this is something that i need to take care of.

it does not make you weak. it means you are strong. at the same time i want to point out that this is not just a matter of athletes. you will notice this a guy here ray odierno who is not only the leader of our army but also somebody who plays football and i don't know if he still plays although he could but as a leader of our armed forces he sees the effects that injuries have have him brave men and women who serve in uniform and all of those who care about them. that's why he raised here. i have seen in my visits to wounded warriors dramatic brain injury is one of the signature issues of the wars in iraq and afghanistan. the thing is the vast majority of mild traumatic brain injury

cases in the military occurred outside deployment so even though our wars are ending a dressing this issue will continue to be important to our armed forces. as part of a new national action plan we announced last year we are directing more than $100 million in research to find more effective ways to help prevent, diagnose and treat mental health conditions and traumatic brain injury. because the more we learn about the effects of brain injuries the more we can do to help our courageous troops and veterans recover. and that obviously gives us more information about her kids as well. today i'm proud to announce a number of new commitments to help us move the ball forward on this issue. the ncaa and department of defense are teaming up to commit $30 million for concussion education in the study involving up to 37,000 college athletes will be the most oppressive concussion study ever. our service academies army-navy air force and coast guard have all signed up to support the study in any way that they can.

the nfl is committing $25 million of new funding over the next three years test strategies like creating health and safety forms for parents and building on the program piloted by my own chicago bears to get more trainers at high school games. the nih is announcing the next step in this partnership with the nfl. they are dedicating 69 of the nfl's previous donations towards studies and clinical trials to examine the chronic effects of repetitive conditions. the national institute of standards and technology will invest $5 million to explore the development of lighter and smarter and more responsive materials for protective equipment and i want to single out the new york giants chairman steve tisch who is here and donating $10 million of his own money to expand the brain sport program at ucla to prevent study and treat concussions and dramatic brain injury and youth.

so all these new commitments are terrific and we want to thank everybody here for participating. [applause] so just to wrap up so you can hear from people action up there talking about these efforts are going to make a lot of difference for a lot of people. from soldiers on the battlefield to students out on the football field. take the levine family from rockville maryland who are here today. where did they go? there they are right there. cheryl and jason levine have three boys who when you look at them you know right away they are brothers. isaac sidney and ruben. they have loved ice hockey since they were young. when he was seven years old sidney suffered on moderate concussion on the ice and a few years later isaac suffered a more severe concussion and again. both boys had headaches and they started struggling in class and

started acting out. isaac's concussion kept them out of school for a while and as you might imagine cheryl was horrified as she put it. you only have one brain and that's a good line. you want to make sure that you are treating it right. fortunately with the help of doctors both ways health and behavior improved in sydney was back on the ice 10 weeks after his concussion. he's hoping to play varsity next year as a freshman and last winter isaac played forward as his high school team won the state championship. now cheryl and jason could have pulled their boys out. it was such a scare and had their doctors recommended it that's what they would have done but they knew like millions of kids across the country kids love their sports. so cheryl and jason educated themselves on the issue and with their doctors blessing and the support of the coaches and teachers they are encouraging their boys to lace up those gates and to get out on the ice.

as cheryl said my kids are going to go on and play in the nhl. i hope they know that by the way. [laughter] but what i'm worried about is getting them through their teens while having fun in building confidence and doing things they want to do obviously within certain limits. that's some good parenting by cheryl. that is what today is about. to give parents information they need to keep their kids safe and let's encourage our kids to get out and play the sports they love doing it the right way. that's not a job just for parents but a job for all of us and that's why the public-private partnerships like these are important. in a few minutes i know many of you will take this discussion a step or there with his panel of experts moderated by pam oliver which we are grateful to her for but i want to thank all of you for coming here today. for your contributions to our your contributions to our kids future and most will i want to thank the people who are here particularly tory for highlighting why this issue is so important. by the way torre although is not

going to be playing soccer when she goes to college she is graduating. she does intend to stay involved in the sport and understand is going to be doing some coaching of some four and 5-year-old's this summer. she is going to pass on some of the knowledge, hard-earned knowledge that she has learned. that's why we know she's going to be a terrific success in whatever she chooses to do. thank you everybody. [applause] [applause]

>> my son paul was in the hospital at children's national. we were waiting to have his open heart surgery and he had been diagnosed with a five congenital heart defects and had to have surgery. part of waiting for the search and to come back from overseas was being the hospital realizing these other families were there and you're in the trenches with them. this family, maggie's family, maggie had been through nine surgeries in nine months various different problems.

as daunting as our situation was we were really feeling for them. we are in the waiting room every day walking past maggie's bet on the way to paul's bassinet and the day of paul's surgery we came in and maggie's family wasn't there. she had passed away the night before. it was really hard to imagine that the family had spent so much time waiting for her to get out of the hospital and she didn't make it. so we went into surgery that das first open heart surgery of three. as we are sitting in the cardiac intensive care unit watching through a clear plastic bandage. my son's heart beating which was a moment in and of itself the nurse comes over and says you have a phonecall. they brought me the phone and it was maggie's mom checking on paul's surgery.

the strength and the grace and the fortitude it took for a mother who had lost her child the night before to call and check on our child i think was a moment that we will always remember. u.s. representatives tim murphy the chair of the energy and commerce oversight and investigations subcommittee held a briefing today on an investigation of federal programs that address severe mental illness. the committee began its program more than year ago in the wake of the mass shooting of schoolchildren in newtown connecticut. representative murphy is a practicing clinical psychologist who's sponsoring legislation that aims to overhaul the current mental health system. this is about an hour and 10 minutes.

[inaudible conversations] >> good afternoon everyone. i'm congressman tim murphy chairman of the oversight and investigations subcommittee. i want to welcome staff members will be coming in and out and others will be visiting today. thank you. last weekend a young man known by his family to be mentally ill killed six people and himself in another awful episode of mass violence. before there was elliott rogers there was adam lanza in newtown jared lochner in tucson james holmes in aurora colorado and

aaron alexis at the washington navy yard and therefore many victims. there was also another young man in a mental health crisis in extended patient care before he injured his father. all had untreated or undertreated serious mental illness. all spiraled out of control within a system that lacks the basic mechanisms to help. many had parents who were pleading for more help. violence among persons with mental disabilities is far more likely to be self directed. the mentally ill sadly are more like to to be the victims of robberies rapes and other crimes for the mentally ill are times more likely to be in jail then in the hospital. that's because the seriously

mental ill and counter law enforcement after they refused medical care. what takes these painful episodes so confident is the reality that so many tragedies involving a person with a mental illness are entirely preventable. for example 34 states elliott rogers family would have been able to ask a court to order an emergency psychiatric evaluation in california law says they cannot. the families know when a loved one is in a mental health crisis in and their condition is gravely deteriorating but as my subcommittee report describes the families are shut out from being part of the care delivery team. as i wrote two weeks after the shootings in newtown quote the lessons for americans from the horrifying tragedy is that we had better take off our blinders and deal with such illnesses or we are sure to face the same problem again. it is not only what is in the persons hands that makes this fact violence, it is what is in his mind. so how many must die before we

finally deal with our broken mental-health system? in the nearly year and a half since i've been investigating america's broken mental-health system as the chairman of the house subcommittee on oversight and investigations even with my 30-year background in clinical psychology i've been shocked to learn just how much our country is failed those with serious and persistent mental illness. a report reveals that the current mental-health system does not respond until after crisis has occurred because we did not empower parents patience clinicians law enforcement and others to stop it from happening. even in the face of these tragedies we have been too uncomfortable to have knowledge this because the last bastion of stigma concerns those with serious and mental illness. between january 2013 in march of this is the min and oversight investigation held a dozen public forums hearings and expanded several hours determining how federal dollars devoted to research and

treatment and mental illness are being prioritized and spent. the committees probe focused on three areas of critical public policy interest. one the scope of society's problems that is untreated mental health. three how federal resources appropriated for research into the treatment of mental illness are being spent. we heard from the director of the national institute for mental health experts and the hipaa privacy of rule interviewed hundreds of parents providers patients law enforcement officials to get the most accurate and up-to-date understanding of the root of the failures of the current mental-health system to begin to identify legislative path to reinvigorated rebuild the system. briefly here are our main findings. first families have been shut out from the treatment team. an inability of a individual experience was honest to recognize they have a mouse for neurological condition obeys the

importance of family and loved ones to get treatment. it occurs in 40% of persons with serious mental illness like schizophrenia and bipolar disorder. two health care providers often misinterpret the health information and accountability act the hipaa privacy rule leaving family members in the dark about essential and timely information about their loved one's condition. in some case heard by the committee the lack of understanding of the hipaa privacy rule is so pervasive the family was told they could not even get information through the doctor. three there's a critical shortage of psychiatric beds providers and treatment options for persons with the psychiatric crisis. we are not referring to any model that brings back the asylums of the last century. we cannot and will not do that. we don't want to go back to any chronic disease the way things used to be when we didn't understand this illness but for those who need acute intensive

therapy there are not enough places and not enough doctors or community support for them. number four a person with metal illness must be homicidal or suicidal before given treatment. it's like denying a patient care until after they have a heart attack. number five federal resources are not targeted towards serious as what it is like schizophrenia bipolar disorder and major depression. these individuals who deny seriousness of their needs are at the end of the line across the spectrum of services. number six legal advocates and anti-psychiatrist activists have used federal resources to block care for the hardest to reach patients. and number seven and finally we know that proper intervention can be very effective are fighting help to those with serious mental illness to keep them independent holding jobs in recovering printer port provides a path to rebuilding our motel system and taking mental illness

into the bright light of hope and recovery because where there is no help there is no hope. towards that end i've offered bipartisan help in h.r. 3717 that addresses the concerns. this afternoon we are joined by several experts who should be familiar to those following the committees work on mental illness over the past year. ed kelly to my far right is the father of a son who is at schizophrenia for 15 years. he's also an advocate for mental health reform. his efforts to obtain the best revenge for his son was repeated repeated -- repeatedly stymied in no small part due to misinterpretations at hipaa by those responsible for some scare. next the founder and executive through the policy organization in the early 1980s he and his wife became guardians for sister-in-law who at schizophrenia schizophrenia. he is an advocate for mental-health reform for 30 years. to my left dr. michael welner founder and chairman of the

forensic panel. he's a forensic psychiatrist and courts have invited to examine the most complex cases for notorious killers in america. dr. welner a true innovator in the world of psychiatry has been on the leading edge of them eliminating mass murders for the last decade. thank all of them for being with us today to offer their insights and continue the findings of a year-long investigation to address the shortcomings of our current mental-health system. i would like to welcome a couple of my colleagues. the doctor from the state of georgia, and an attorney from the state of virginia. welcome to you both. what we will do is if some people want to grab a seat you are welcome. just leave a couple of center seats for those in congress. we will now begin with mr. kelly to talk for five minutes.

make sure your button is on. >> thank you comes in. >> thank you khan cement. a few housekeeping items read my name for sapolis ed kelly and i'm a parent of three children one of which has paranoid schizophrenia and we have been going through virtual madness for 15 years. more importantly this is a different setting than the past. there are more cameras and on the off chance my son sees this i want to tell him i love him and i'm doing this for him because i believe in him. that's the risk we take what we do this. our resume as a family covers 15 years in dealing with her son dissenting into a madness which is impossible to describe in those 15 years include over 30 hospitalizations in seven different hospitals in four counties in the city.

15 years of the revolving door of trouble with the law dealing with the courts dealing with states attorneys, dealing with hospitals and social workers and everyone engaged somehow in the mental-health system. years of judges ridiculing us and saying we are not going to warehouse your child to make your life easier years of core services of good people who want to provide great services to our son and they are saddened because what they were committed to do they can't do because he does not want them to. when i tell you that we are committed to this battle we are committed to this battle and i'm about to tell you about an army that's committed with us. more importantly our son refuses help. his illness refuses her help so as a result we have watched for 15 years more and portly since he was 18 which was 11 years ago we watched the law support his delusions. my wife has served on mental health advocacy boards and i

will tell you with all due respect to mental health in america believe reason she left is because she was shocked and angered by how they have refuse to believe that everyone won't volunteer. to such an extent you are willing to do just about anything. he would think he was cia a u.s. marshal a veteran of those gulf wars and did not believe we her wear his parents for three years. he has lived under bridges boarded up or when this from inside the home. he has been beaten and robbed abused and is unafraid homeless crawling into shelters at his own intentions. if you think that someone after 15 years is voluntarily going to have treatment i ask you how many years is enough? i have spoken in front of federal and state hearings in last year i had the pleasure and

privilege of being part of the state of maryland's department of health mental hygiene's continuity of care program which is a five month exercise to examine and i want to with all due respect asked for forgiveness for what i'm about to say. for five months we focus on one topic. had we deal with the most seriously mentally ill 18 and over? after these hearings and after that, no do you care there's one painful fact that has emerged that i'm a share and that is the groups did not care about my family. they did not care about my son. they only care for their own needs. if you have a group that you can serve and serve well why all means i wholeheartedly support you but don't treat the seriously mentally ill who don't believe they are ill in the manner that you think they need treatment. you are putting at risk in putting my wife or risk in putting our neighbors at risk in many of when this room at risk. i have reached out to these

opposition groups in no small measure in the past five months in 2013 and asked them for one inch of movement 1 inches support to carve out a different set of rules for the central -- the seriously mentally ill. not only is their movement to make something happen together because the enemy really is mental illness i've been ridiculed told my testimony is anecdotal which pretty much saying i'm lying. there's something happening and in no small part because of congressman murphy's efforts. this bill is doing something different this time and is not the tragedies in columbine and virginia tech and everything else. when i first started testifying if you set up here in my situation you wouldn't either. you are pouring your heart and soul out in front of complete strangers. i've seen people crumble fall to their knees and cried trying to get out their story. that's why you don't have a lot

of people doing this but now they are feeling emboldened and there are 7 million families who share our plate. if you don't think that's a large number we get -- 19 immediate family members within 30 miles. 30 in her neighborhood and her sons friends. that's easily 50 people times 7 million people that are affected and many take the people that are handcuffed and can provide treatments with social services. it's unimaginable how many people are involved. i wanted to lay the pain of standing here and talking to each of you is far less than the pain of accepting that it will never change and that's why i will do whatever he can to support this bill. hipaa needs to change. her family has not known where her son was. arson our son has been released and found an ridges and garbage cans in unknown places because hipaa can tell us he has been released. imagine you cannot control when your child is released. they can't confirm if he's there or not mr. kelly. he's been in several different hospitals.

he has no transition a medical records so every time he goes into a hospital he's a guinea pig and the only voice that the doctors listen who are those of his delusions and psychosis. when he gets released we are not involved in that and that's why we need a ot. first of all if you don't make a ot in alternative the only hope is then the hospitals. for 15 years we prayed and waited for the laws to accept that we were right that her son was -- and every time we did that we are at risk. if he doesn't get into the hospital and he doesn't have any ot what happens? i want to tell you what happens. this is were i wrap up. the signs of serious mental illness when you're in a downward slide are subtle at first. the family see it first. but we are not listening. the poor family that drove out from california you heard on the radio i can imagine.

we are the first ones of knowing we can tell when the delusions and voices are taking over and we can see his personal hygiene declined. the next thing you know he leaves then he disappears. no baths no showers no shaving no haircut tattered clothes and into short aunts this person has had reared down to here dirty can imagine what he smells like. he has tattered clothing and he has not eaten and looks like he's lost 40 pounds. he's been sleeping under bridges going through garbage cans at his own choice and then walks through neighborhoods and shopping centers and scares the hell out of people. if you want to talk stigma that's where stigma comes from. that's the face of mental illness and that is what happens to someone who is not treated. then what happens? the support network starts to pull back. usually it's too painful to watch and sometimes they are

afraid but now that person becomes isolated and they become frustrated and angry and now you have psychosis loneliness isolation anger and then they self-medicate. you wonder why things in california happen? that kid knowledge in a 120 page document how isolated and frustratefrustrated u.s.. that was his mental illness talking. i guarantee you if you set those parents and here they could've predicted this long ago that our system refuses to accept that families can play a major safeguarding role. when our lawmakers are making decisions they need to make decisions without fearing the wrong things. don't fear the threats of unconstitutional to. don't fear the threats of lawsuits because those groups don't care. you need to care because this could happen to your child or your child's child. try that one. i know a person who is trying to help their child with their

child going through the same nightmare padawan to make it public plea to senator mikulski. get the appropriation money in place for this first part of the bill to pass. it's been made law. it just needs to be funded from an ao g. grant program. he did it for alzheimer's and you can do it for the rest of the mentally ill population. if your mom was under rich you would want to take care of her. lastly when you put your head on the pillow beside ask yourself how important this law would be to you if this law was -- if one member in your family have this going on. he could be the next family. it's growing like crazy. i don't have an explanation for it but i'm asking you to care and i want to leave with this one comment. you are asking too much of the families. if the families ever give up you are in deep trouble. thank you. >> mr. chafee. >> wow. to ed's point of jared loughner

and james holmes we are identified bye bye the mental-health system is needing treatment in both cases ferber kept their parents in the dark before the tragedy so what he's talking about is important. this is also new to me and i want to thank the congressman that are here and mr. murphy congressman murphy what you are seeing is something different going on. we have had tons of governmental health bills. this is the first one that focuses on the elephant in the room which is how do we get people know to have serious mental illness in particular adults. there has been a lot of effort with adults and veterans. we agree with the majority of the report. we are not advocates for mental health. we are not advocates for improving the mental health of

all americans. what we are is advocates for the most serious mental ill. not all mental illness is serious. 20%, 100% of adults could have their mental health improved and that is where a lot of federal money goes. 20% of adults over 18 have a diagnosable mental illness. that's the people in this room and your co-workers on prozac or zoloft that are doing quite well but only 4% have serious mental illness which includes the 1% with schizophrenia and 2% with bipolar and some other individuals. my one messages we have to stop ignoring the most seriously ill. we can't go on pretending that they don't exist like the sampson funded groups want us to do. until the 1960s virtually all mental health expenditures were spent on the most seriously ill because expenditures went to

state psychiatric hospitals. after that at the request of the mental health industry the funds are now spent on all others. as a result of this shift from focusing on the seriously mentally ill to trying to improve the mental health of all others 164,000 are homeless and 300,000 incarcerated. the disproportional number of them are people of color who cannot get treatment. i get calls from people that they can plead for treatment for their adult children known to have serious mental illness but the mental health system turns them away. we know how they fund everything else. we do know how to treat the most seriously mentally ill to see that they get treatment. we have to prioritize spending. this is one of those issues where it may not be that we are not spending enough.

we spend 130 billion and the amount is supposed to go up to to -- what we have to do is start sending the seriously ill to the head of the line. we have to replace mission creep with mission control. if we do that we can start to address the problems we see. ed talked about hipaa and i won't go into that. there are some i hate to say it's an unpleasant truth there are some seriously mentally ill people that need to be in hospitals. we do not have enough hospitals for them. we need more hospital beds. this build doesn't ignore that. it recognizes it in search to fix fix it. if we can only do one thing i want to cut spending. stop samhsa them funding anti-treatment advocacy and stop empowering that. you can see a lot of information on our web site how they do

that. samhsa is the biggest problem we have. we have to recognize that some people are so sick they don't know that they are sick. when you see someone going down the street screaming at voices only they can hear yelling that they're the messiah it's not because they think they are the messiah. they know they are the messiah. the illness tells them they are the messiah and as the messiah there never going to volunteer for treatment. we have to recognize this reality. most importantly we have to expand the use of this outpatient treatment for a very small group of the most seriously ill. earlier i talked about four or 5% being seriously mentally ill. there is a small subset of that group who don't recognize their ability to get the need for

treatment who already have multiple arrests, multiple incarcerations, multiple incarcerations, multiple instances of homelessness associated with going off on. treatment that was made available to them. what ayotte does is for this tiny group of people after full of due process and including a lawyer it allows judges to order them into six months of mandated and monitor treatment in the community. it's been proven to reduce violence serious violence 66%. homelessness hospitalization incarcerations 74% each. peer support and trauma informed care do not do that. consistent with the spirit of --

a aung t prevents us from meeting inpatient commitment incarceration or hospitalization that allows people to live in the community. it is perhaps the most humane thing we can do. it's an off ramp before jail. it's like putting a fence at the edge of the cliff rather than an ambulance at the bottom. the committee heard from police chiefs sheriffs judges homeless advocates parents and children of the serious mental health report. the only opposition comes from the samhsa funding mental health industry. that is the only opposition. there basing their opposition based on stuff that is not fact. it aot does not take away everyone's right. it's an appropriate way to protect the individual who can't help themselves and public safety.

it does not force people to care. 80% of those enrolled in aot said helped him get well and stay well. research shows those who received aot integrated in the community and perceive less stigma than others. the police chief said it best when he told the committee we have to mental health systems today serving two mutually exclusive populations. community programs serve those who voluntarily except to and seek treatment. those who refuse are too sick to treat -- seek treatment on terror to become law enforcement responsibilities. mental health officials especially samhsa seem unwilling to recognize or take responsibility for the second more symptomatic group. ignoring them put patients the public and police at rest so i think represented murphy. i think the congressman is

supported and i especially support my fellow democrats. i'm about as liberal as you can get that for too long we democrats have failed to recognize the unpleasant truths like not everyone recovers. sometimes hospitals are needed and left untreated there is a small group of the most seriously ill who do become violent so what i say is we have to pass h.r. 3717 and move from a system that requires tragedy to one that prevents it. on our web site you can find more information. thank you. >> thank you. dr. welner. thank you chairman murphy mr. kelly appreciate hearing from you and learning from you and i want to thank the members for coming and those of you who are here today appreciate you taking the time. there comes a time when denial

is no longer possible. we have reached that time. many of us and perhaps most of us are here now because of that denial. think about it. because we have denied that serious mental illness unmanaged can go away just because you will it to, what is the difference between serious mental illness and just mental illness? it's serious enough to warrant treatment and it doesn't just go away because we deny it exists or we have urged our gaze. we are here because we are in denial that serious mental illness doesn't go away just because hospitals close so the people who are in the hospitals get discharged. where did they go? we are in denial because the biggest institutions in the world in america are now prisons

congratulations. you have the right to remain silent. feel better now? that you are not in an institution which could benefit for modern medicine. forget the sanitariums. there is more than just a reason overregulation and accountability the congressman murphy speaks to for why we are not going to go back to to this akai tree of old and this is where psychiatry need to step up. this is in your father psychiatry. we have better treatments. we have our accurate treatments. we have more precise treatments more humane treatments more research treatments. we spend a bazillion dollars in previous administrations on the brain and we actually have something to show for it other than when you contrast that with the money we have spent on wars. we have a windfall from the decade which can be treating people who need serious treatment for their serious

mental illness. it is humane and it's digestible and it's allocable. it's not savagery. in one flew over the cuckoo's nest it's outdated at this point a shirley temple. it's time to get past that thinking. it's quite antiquated but we are in denial. it's not just about serious mental illness but about crisis mental health which is what brings us here today. we have heard already about schizophrenia and bipolar illness. i'm here to tell you as a forensic psychiatrist and i've interviewed mass killers who have spoken to me at lincoln i've interviewed people who have carried out crimes that we think are unthinkable and sometimes they are psychotic and sometimes they are not. much as we hate to admit but one thing they all have in common is that they are in crisis. we are here because we are in denial that if someone gets

discharged from an emergency room or hospital the crisis goes away. magically. we are here because we are in denial that if someone decides someone is not dangerous enough to be hospitalized that means the crisis will just go away. we are here because we have denied -- forget that you are -- how many of you in this room know someone of suicide was made that choice and is made that choice. people make permanent choices because they want things to be dramatically different and they may be in crisis and the world may be a lack and there's a blackness that they can endure. you know and i know it's people who are still here for reading them that if they had just gotten it right here in the right intervention at the right time from the right people that they would be here with us today.

do we feel so much better that they have the rights 6 feet under room temperature? does that make us feel better? does that make us a better society? i will let the members answer. this is a crisis mental health bill. it doesn't direct itself at every single person who is head of diagnosis. it doesn't direct itself intrusively. directs itself as mr. kelly pointed out to the individual who is in a place at a moment in time who lacks the insight to recognize that they are in a place where they about to make a catastrophic choice. you cannot let the crisis run the situation. this is why one has leadership. members of the house of representatives are leaders chosen by the people to lead not to placate. doctors are chosen. doctors are trained to make choices that may be difficult and sometimes and i can tell you this is the clinician who

started my career treating the violence. imagine if you will do scenario that i experienced of someone that i knew to be violent as an unarmed person not owning a gun. putting the gun thing aside for moment. someone who might have no qualms about being violent in feeling that person was on the cusp of being violent. should i commit him or should i not because the repercussions might be you are so ingrained feel so betrayed that his next violent victim would be me. no decision that a kludge nation makes to commit someone forcibly is made without great ambivalence because we are on the front lines. i in new york city where if and if you follow the news in new york know about a psychologist. we have our own safety issues. we don't see patients behind bars. we see them in private rooms and we are exposed. i have had patients of my room

in my office get violent. one guy beat the hell out of this -- i had to hold one down while i called the ambulance to come. many have those kinds of experiences you recognized your vulnerable but you've also have to preserve and protect the alliance with the patient. of course we try to negotiate a voluntary resolution but sometimes it's not possible especially with the person in crisis who denies that there is something wrong. now then you reach the point where denial is no longer possible. isn't that why we are all here? work i love vista has loaned the doors off of is the denial that someone carries out a mass killing that they snap. he made it quite clear that he

was contemplating at least before way back in 2012. can we now dispel the idea that ochocinco all we have to do is get these people help and this will never happen. he was getting therapy. he was getting therapy from before woody woody allen was geg therapy and guess what happened? he still in therapy but a mass killer is so invested in the life choice. we may think it's irrational but that's our world and a person it makes an unexpected book choice that's his world. he so invested in it that he will pull it together in such a way that police who may be very trained income, not just one policeman but multiple policemen and sit down and say nice boy, have a good day, take care.

but the parents know. the families know and sometimes a relationship is frayed and as a doctor you draw history for from most folks and you rely upon it. i tell you as a physician with the person who is in crisis and i feel i can help a person in my office if the crisis is not resolved what happens in the person goes out the door in the family will need an auxiliary safety net but hipaa says i can't talk to the family because the patient is not imminently dangerous. so the family has no idea what's happening. it's a betrayal. this is a law that is a betrayal of the sacred relationship of intimacy of a family that would do anything for a loved one more than his doctor. it's not fair. it's not right. i'm i am plenty confident in my

ability to assess a person an emergency room whether they are a danger to themselves or others but i could see you for example and you know you don't want to come into the hospital. you do now what treatment. you are looking at the world the way you want to look at the world and we are going to agree to disagree and you know you have to tell me no doctor we just had a misunderstanding that's all or i had a little bit too much to drink but i'm okay now or i was just crashing from that cocaine. i feel better now. i will get into detox. can you give me that card for a referral? but the family that i'm not allowed to talk to says she's going down the drain. somebody do something. this country is full of people who have fought in their head -- spot in their head somebody do something please. somebody do something please before the suicide before the

self-injury, before the homelessness before the child under the bridge before the loved one who gets the tar beat out of them before the next beating from the abusive husband before the next father who is used up within the home because his 7-year-old is too mature to articulate. somebody do something. hipaa is a wall that stands in the way of crisis situations. i want to underline this just to dispense with the political distortion. we are talking about crisis situations where the doctor can make an elective decision. this person is going to walk out of my office. i'm not going to commit them but this is a precarious situation. i need help. pipa will not let me help my patients. i have the better care that i want to combine with better love

in the humanistic profession and that law will not allow me as a psychiatrist. i don't know any psychiatrist who doesn't go through that experience and who would not feel that they trust themselves with the latitude to make a decision when something is in a crisis. if you don't have the confidence with your doctor go pick another doctor. it's a free country but if you trust your doctor you trust him to make that appraisal. if we come to appreciate how denial brought us to this situation with all these police officers who went to check out this one individual who did a disgusting thing in california, let's call it for what it is, that it's a familiar pattern. the family expresses concerns. the family smells it before he looks into it. the person in a mental health

crisis does not want help or lacks the insight or is invested in the bad outcome. let's stop for a minute here. people who carry out mass killings these are premeditated crimes. they are invested to make them happen. they will pull together and do everything they can to protect your agenda. you have someone who could not hold down a job keep themselves in school couldn't be selfish enough to maintain a personal relationship but what he could do is write and stage manage a production for youtube. that was the best possible, the best possible camera angles that he could have ever someone from the director and that's not saying any for thing flippant

about the family. it's the same thing that joy sung lee and his silly gunplay that he sent to abc. do you think that's how he looked? that's how we get there in the first place. the point is he has invested in becoming a different person. because of that we have to appreciate that of someone smells trouble and the dangers of catastrophic we have got to trust families. we have got to trust families to know there is trouble ahead. we are not giving families the wherewithal to be involved. i respect psychiatry's capabilities. i personally believe family seemed to be directly involved with loved ones. we have core systems and we have the ability for judges to sort it out but we also have a revolving door of commitment here the people we are familiar with. how does that go when someone is able to get care and able to get help and the family impetus and disregarded? and left with no safety net.

the person goes into the hospital where they have a strong incentive to discharge them as strictly as possible because there aren't enough beds as congressman murphy has so properly and courageously pointed out. the crisis wants out also so they know exactly what to say. if they don't know what to say they ask the other patients. say this and just say this and you will get discharge. they get discharged and as mr. kelly pointed out they go right back to the family. what happens to the family? the family loses confidence in psychiatry. that happens at times the family will say what's the point? then the family loses confidence in mental health the person with serious mental illness or crisis has lost to treatment and then there's a bat up time. outcome. i want to get their abutting opportunity to ask questions and i'm just going to make a couple of very quick points and then open the floor and allow

everybody to get involved. there's a certain amount of talk about safety. let's take two hypothetical people that are walking down the street and let's take up only who looks for a week person to prey upon. those folks are identical twins and they both have a serious mental illness. one takes his medicine and one doesn't. the person who is taking his antipsychotics is not experiencing side effects because his medicines are easy to take in the person who is not taking his medicines is experiencing symptoms. which one do you think is going to be stigmatized? now let's put both of those folks as job applicants. which one do you think is going to get hired? which one do you think is going to be able to pass the class or thought of as more intellectually capable?

it is the denial of illness that is responsible for stigma. it is the denial of treatment that is responsible for stigma. it is a disrespect for psychiatry and what is has accomplished that enables stigma no medical specialty has to encounter the diversity psychiatry has. you have pediatricians who promote vaccinations and they are never stigmatized for causing a public health problem. you have psychiatrist and treatment that have to contend with a budget, a budget that is controlled by folks who are anti-psychiatry. i respect holistic medicine as much as the next person.

you should see the diet my wife has me on but be that as it may be would not have holistic medicine control the budget of medicine and surgery in the united states. they are different perspectives. nothing against the organizations involved. without said i realize the members have a difficult choice but i also realize we have a full room and we have a nation watching. for that reason i want to underscore do you think you are tired of the? are you tired of the atom lands of's or the jared loughner's. do you think you are tired of this clown in california looking for his 15 minutes that everyone will see him in a different way? well so are we. people are doing something about this. if it matters to you we have an election in the end of november. ask yourself are you going to go to the ballot box and you are going to make a choice. would you vote for someone who ran on iraq or dan said he would not change commitment laws to make sure that adam lands a's

mother could get treatment in the community? would you vote for person like that? would you hold your elected officials accountable and officials accountable in which he wants to run on a record saying you support laws to keep chosun lee's parents from knowing he's going down the drain? would you vote for somebody who would run on a record saying jared loughner shouldn't get forcible treatment? would you vote for someone like that? would you think he was not putting political concerns above your own? of course it matters to us. and you know why? because if we are in denial because now we say it always happens to somebody else in someone else's family but guess what? you have to hate everybody to kill anybody. i don't think gabby giffords -- i don't think anyone in california ever thought it would happen to them when they were afflicting on newtown.

i don't think anyone who works in this building forgets that it was 16 years ago that russell westin tried to get into the u.s. capital and shot and killed two officers and got into congressman tom delay's office shooting before he was subdued. let me tell you i didn't forget either that it was a physician who saved his life. doctors are trying to help solve this problem and i think we are advantaged and we are blessed that a psychologist has thrown his energies the way congressman murphy has and i encourage you to dial her congressman and to tell them that you feel it is important and it's imperative for us to change commitment laws to enable people who need help your and crisis to get help before they are dangerous and the families he involved in a

way because families know and families love and families can keep us safe. thank you. >> thank you doctor. i want to recognize martial black and of tennessee bill johnson of ohio. we have few minutes before we have to go to votes and i want to see if my colleagues have any comments or questions for the panel that have come up. >> we need to move forward on this legislation. thank you doctor and thank you to the rest of the panel who are here. this is such an important issue. it's timely. the only way we are going to be able to do it is if we have now on good legislation that will help empower families and patients in their mental health pursuit. >> thank you.

i want to question the panel is because one of the questions that has come up in this whole issue of denial we have heard some people say there is no such thing and i call it nonconsensus reality. in a brief comment dr. walmart is there such a thing or is it nonconsensus reality? >> we are still learning a lot about it. briefly the physiological appreciation of annas ignazio is one of person suffers a stroke on the right side of the brain they neglect the entire side of their body. and so one learns just from that if from one single event one could actually be of the belief that part of them doesn't even exist so there's a physiological basis for denial of illness and that's where annas ignazio originates. there's a lot of thinking within

psychiatry that for those who are rational to the degree that they are psychotic that there something going on with them physiologically that resembles it but in a bit of a holy grail no one has captured it but guess what? everybody in this room has denial of something and so the question is at what point are we talking about physiology of a psychological conflict as opposed to an actual physiological illn? .. ..

>>

so you will continue here and i will see is people have questions. >> thank you. so part of this bill that representative murphy has put forward to integrate behavioral health with primary-care. maybe even in the er setting saying that you would not have much trouble if they had warning signs. mr. rogers manifestos suggests an aggressive and violent incident brought to the er with it -- they were the final straw. so there is a the suggestion of telemedicine as of way to

bring mental health professionals in line with er care. however they have a competing bill or another bill that was before word strengthening mental-health in our communities act with 40 co-sponsors and it seeks hhs awards for behavioral health sciences in primary care settings. how did you think that plays with telemedicine? is it better? i appreciate your input. thank you gentlemen. >> i think those bills have telemedicine in them but somebody who thinks the messiah will not go to the primary other than a psychiatrist. it is a comparison of what

bill barber proposed with the co-sponsors including democrats and republicans. i think those are supporting the bill have been misled by the mental health industry. i am a liberal democrat but when it's the pelosi said she once up bill supported by the of mental health industry finn the barbara bill got it gives more money without requiring them to serve the seriously mentally ill. we cannot pretend they don't exist. telemedicine was related to the primary caretakers access to a psychiatrist who don't live in those areas for consultation. >> i will add to the response.

i have mixed feelings about telemedicine but what congressman murphy has been attempting to underscore that has not come across clearly, there is of serious shortage a terrible shortage and above all the serious shortage is a needed specialist. what do you do? and immediate fix to those who have needs and then on served areas. we use technology to ramp up the solution and i view telemedicine as the bridge. not a long-term solution but it needs immediate resolution. the solution is on a national level we have got to turn the behavioral sciences into a growth industry. if we can spin to a basilian dollar is getting people to like obamacare just to

promote obamacare so people would experience it to be warm and fuzzy forget your feelings about that but just the promotion alone, if we spend one fraction of that budget to promote behavioral sciences for how wonderful it is i could tell you this is a psychiatrist to give someone their life, hope that can restore their sole. to give them some sense of a future. what's an amazing gift i went to medical school i picked psychiatry and i made that call. the recent others don't is because psychiatry should be promoted go play obamacare is promoted. people should say i want to be a psychiatrist to make sick people well and be a crisis psychiatrist for the mental health equivalent of the navy s.e.a.ls if we

look at people in crisis to recognize how meaningful is to a broader society for someone who was fragile to help carry them through to a place with a strength we have enormous contribution. if you can invest to make mental health attractive and the doctor patient relationship attractive. if patients appreciate mental health care and has an impact. maybe they can. so much with the pharmaceutical industry it demystifies the treatments. and they say ask your doctor may be solutions exist. if you want to mental-health you have to invest and promote otherwise to have

the of mental health system that does not believe in itself. >> as the chairman of the forensic panel we will wrap up bin 10 or 15 minutes. >> if you don't mind i will ask a question with trap doors. please answer but i would not give you a follow-up. >> the elephant in the room. everybody is afraid of severe mental illness but are collected rise and pick out three quarters in this room that you fear it. it is scary if you have ever been 2 feet away from psychosis it would scare you away.

when my son is psychotic there is no reality. sow fear is big. though hollywood movies have gone to great blanks to make sure we stay afraid. also reconsider the saying even if we did the right things we don't have the money so why bother? at the state and federal level that is what is going on. we know it is needed but we don't have the money. so why bother? if you have burnout i know social workers who just gave up. emergency room physicians to get overwhelmed to make a three minute decision without the ability to consult with the family. i have a good friend 30 years. perkins in springfield and will testify because the

things that they do to release patients with early the way that we treat them now that she is retired she can say whenever she can you think the veterans administration scandal is bad? this is big spin again with voices of america. >> ideas want to make sure i am understand correctly that you feel your son needs to be hospitalized because he needs to protect himself you have not been able to accomplish that? >> in five minutes you cannot tell the story so what people need to know whether schizophrenia ward different things you are not that way all the time.

you go there a spike of up for a dam. then you can sit down word fall to get them under control but it used to be with madison he had to take a pill in the morning in the afternoon. he would not do that and he would hide them then day invented the dissolve gold tablets but then he said i would not take that every day. the longer he went without the medicine the more his symptoms deteriorated that is when you need to get them into the hospital when they are dangerous. but the laws and standards of what gets you in the hospital are hot so you pass the moment of safety they do try to get him in. you cannot starter dave. he fail you fail did finally

get him and then finally you succeed he is safe. he gets treatment then sometimes released prematurely and the cycle starts over. then it starts again so get him into care when he needs the care. he was kept in one hospital for one year because the hospital refused to give him medication. which is worse? that you went to hospital and did not take the medicine or he had to be there for one year? that is public record. >>. >> and i am the sister of the of brother i know for your coming from. i have spent their. the system is really broken

and that is what i have a career that i have to trying hard to find solutions to come up with programs to engage people. i also commend representative barbara. but when i am asking the panel is how to rework together of those who really want to change the system? i have spent that parent. mr. kelly knows better. but so changing the laws is not change the culture or fund the program. but unless we work together

the matter how we change a commitment laws we still are not there. how do we get the money to get it to change of culture? >> i want you to hit it second to. >> if i mislabel i apologize senate that is why i asked. for like your son and my daughter and my brother that is what they talked about with that suicidal tension. >> my question in to you is, i do you believe everyone will eventually seek treatment voluntarily? that is the mantra of mental

health. >> it is not. but i don't want to get into a debate with you. sometimes i myself have committed people including my brother in people i work with. supply segment that is incorrect. >> i will set aside a guest room i will work side-by-side with you to do whatever we have to rely have been reaching a four years steve mccready to join together. >> just before i got word the web cast is not hearing some questions. i want to repeat the question. you have a different perspective that offered with legislation so how can people work together to get more money available to solve these problems? >> i would save money is great but we have to

prioritize the most seriously ill. you talk about suicide. most of the money that goes to suicide prevention advertises public relations there is zero evidence advertising not to commit suicide is effective most goes to colleges college-age students federalese likely to commit suicide if you want to use evidence based practices suicide is most common in first degree of relatives and those who have previously attempted suicides to be reduced cyberspace to to get treatment based on science rather than and what feels good to do the advertising. likewise refund an awful lot of sideshows that congratulate you for doing outreach but if you do that to friend and was seriously mentally ill stand outside

the shelter or jail or hospital you will find every one you need the idea talking to the pta and going to the school to tell people how to identify people who need treatment, of parents paid for treatment so we have to prioritize and that means cutting programs where the bill proposed by murphy comes from. >> it uses of fund for evidence based program san there is an entrenched group said was to prevent that. there are groups who are getting money to prevent mental illness. we do not know how to prevent its purpose to anybody knows how they deserved the nobel peace prize. if government is funding prevention. that is what the murphy bill

does that is what is in gendering the opposition. >>. >> i will just say something. i buried a sister. i appreciate from a number of levels. i hope god comforts you. on a daily basis as a forensic psychiatrist not only dealing with death but also people left behind a and the shards of glass that are shattered from the story that cannot be reassembled. i have learned a lot and to practice over 20 years with responsibilities on my shoulder i have worked more death penalty cases to say i don't know why i am still in

tact. are watching violent movie than i cannot bear it. i say this because it informs my perspective. i had more than my sheriff gun violence. i am not saying they are irrelevant but a lot of the focus verses mental-health is appropriate and politically driven and we will work together this either/or or searching cases that is prevented by of resolution of certain done laws and instances that those problems but that is what brought them here. but you cannot try to exploit the gap in the system but if we experience a tragedy on a national level then hugh takes credit

for the bill that passes? >> no. every petty don't jump out once. >> appreciate francis tournament of the bow she -- but i've lived it. and in the worst ways to triple to bring someone down zero but i said somebody help me. not what i went into psychiatry steve make you say i am a. >> just like just like gabby difference. it can touch any of us. god bless you should never

have to go through this. in either questions? best but have the community-based treatment for mainstream three new acre tract off maurice the down but changed the rules. >> i feel like directing antiques auction we will adjourned. think you for coming and your attention. my colleagues will stay up

if you want to speak to us privately. think you. >> i join in to google during the height of the first boom in the late 1990's. is seems like ancient times but it really was not that long ago. at the time i was newly married and my husband and i decided to buy a house. we could barely afford the mortgage so we decided we would rent part of our house and the garage. thinks to a mutual friend we

rented the garage to to graduate students use just started a company looking for office space. they seem to ninus. [laughter] there ideas sounded kind of crazy. back then no one had heard of mary page or the new company with a funny name. google? what? what does that mean? kit doesn't really matter as long as you pay the rent on time you can build that here. >>

[inaudible conversations] has spent a good morning. chairman of human rights committee and the co-chair of the china commission. speaker john boehner and gas are the strongest and most valiant human rights defenders of the of world. so many men and women to have put their lives on the of wind on behalf of freedom and human rights in china.

welcome to members of congress. and steadied warrior who have worked our human-rights issues for more than 30 years. great to have him here as well. we're here to remember the 25th anniversary of tenements were last night in a bipartisan vote passed resolution 599 of respected of solidarity to honor those whose struggle for democracy and human rights in china and to continue to put their lives at risk. a remembrance we will begin with the invocation followed by a moment of silence. given by a massacre witness and survivor now serving as a chaplain in the united states army. that led to his arrest for

19 months. he joined in estates are be in 1994 it was commissioned to thousand three. he served in iraq and currently stationed in fort corded georgia. [applause] >> let us pray. almighty and the everlasting god with heaven and earth rethink you for the opportunity to gather together. we thank you for the men and women in to defend our nation and those who make the sacrifice. we pray also for all who do work for the cause of freedom and democracy and as

we remember 25 years ago from the tiananmen square massacre. for those who died and continued with their memories. if you continue working set up comes the freedom for all people. made the of llord bless us your today and all of us leaders and socks with courage. it's a good thing now was. in your name we pray. eight men. now we go to one minute of silence for remembering is for those who died in tiananmen square massacre 1989.

thank you. >> speaker boehner thank you for bringing yes together to bring a bipartisan effort that it was the extraordinary sacrifice by those of peaceful democracy activists who rallied with

over 400 cities in china for almost two months in 1989 with a heroic quest to be free. some preferred to look beyond or trivialized the slaughter by chinese soldiers the memory of the dead and wounded as well as the jailed and tortured requires us to honor them, respect their opposite -- aspirations and we commit to this struggle. 25 years ago a generation of young chinese believed there was a serious chance their governments would greet them with the open hand of friendship rather than the of clenched fist and the systemic reform was possible and replaced dictatorship. and the ubiquitous display tanks to turn that dream into a bloody nightmare despite the military gains the ugly spirit of government repression continues today behind

closed doors. china's government is one of the most egregious of the world with religious believers and practitioners are persecuted with impunity. hundreds of millions have been forced to aborted there pregnancy as the '01 child per cupper policy anytime the missing daughter's and a leading cause of an explosion in a life reconsidered" is to make a human history is filled with those that matriculated because courageous people refuse to capitulate. the 25th eight but it must repair ties the struggle for

she rights and freedoms. but all of those who bravely struggled for freedom will someday be celebrated in beijing. is my honor to introduce one of several which students students, when the government's crash the contest she was named a of the 20 most wanted students. i remember watching her and others getting passionate speeches is in tiananmen square. she. >> she sat to us but this was what was going on in the square how we need to stay focused.

earning over master's degree and m.b.a. from harvard work to business and later founded a group that speaks on behalf of the girl child that is victimized. she also co-founded those for student peters. please welcome. [applause] >> thank you so much this is a special day and defense. to five years ago on the morning of june 4th but watching them moving towards us, we're risking our lives hoping americans will come to help us.

today we rejoice but they q speaker. and democratic leader policy and the chairman and our faithful friends. but he made this happen. >> 25 years ago power struggle for freedom came at great cost. some of us spend months and years in hiding. we lost much, of families families, possessions, educa tion, freedom, and even our lives. the dream of a free and

prosperous china admiring the former leader with the three or former for china we saw a brutal abuses abuses, corruption in high places. and inequity everywhere. we wanted to change. so we cried out the country is our country in the people is our people if we don't act, who will? the past 25 years after the massacre turning into an economic dictatorship with no political reform. however, i despite the approval of freshen and

religious persecution. it is undergoing a powerful and unprecedented spiritual growth. the issue then hurt cannot be satisfied by materialism alone. to save man does not live on bread alone but every word that comes from the mouth of god. so the tanks and troops crushed our movement but it could never crush our dream for a free china. the tanks and troops can stop the demonstrations but it could never erred stop people tusis prayers for justice and freedom. we are the spirit with there is liberty. so today just as i did 25

years ago i call to the leaders of china for freedom to embrace political and spiritual reform. there is no force on earth to bring freedom but it's not even the communist china. thank you again to members of congress who passed a resolution yesterday. thank god bless you and china and god bless america. [applause]

>> speaker, thank you for bringing us together. congressman smith thank you for your leadership as well as our dear friend be run on the floor together yesterday i am honored to be here with a few of my colleagues. mr. mcgovern the chair of the human rights commission and we're honored annette's is with the san thank you for the leadership of your family. and think you'll. for staying true to the memory and message of tiananmen square. i speak for many members who cannot be here today when i say what an honor it is to stand in front of sees heroes.

>> but to but those that gave their lives or were imprisoned after tiananmen square as well. my colleagues? twenty-five years? but to have the message of hope that in time will bring progress, 25 years ago people grows up in tiananmen square to demand their rights and dignity and respect. they want an end to corruption and to talk about spiritual reform of

expression and assembly and demonstrating peacefully when tanks came rolling down the street to use the square precarious today we talked about the of man of but in china today most people say don't have the foggiest i tea and the what does it? >> that is the color they had. today's bad image is the challenge to the conscience of the world. 25 years later this spirit endorses but the challenge remains.

into remainder of world all their present nobel peace prize laureates and present and exercising their rights and i acknowledge the others who courageously are imprisoned. they intimidate the family is with impunity in the human-rights situation i know the air and fire pollution that justice is for pressure reagan with have grievances. but the heroes of tiananmen square and the allies continue the struggle with unmatched courage. we must support them and remember the spirit of tiananmen square is alive and well and the leaders and

know it and they fear it to of come together to honor our commitment. we know we will do is all moral authority with no place else in the world if we do not speak out against a human rights violations in china by this time fighting say economic giant. we still freaked out together toward knowledge there has been a dark chapter in the past but we're hoping for brighter chapter in the future. to the people of china freedom loving men and women everywhere the message must

data saved your cause is our cause. we can never forget tiananmen square made the memory forever inspire us on behalf of democracy not just china butter freedom throughout the world prior very pleased to yield to our speaker of the house. [applause] john boehner. >>. >> let me thank leader policy and zero colleagues for being here today. thank you for their presence here today to organize all of this. but to do a simple thing all of the a very powerful thing is to remember. some chinese leaders were

nervous how to react do tiananmen square. there were banking on that and still are. today those popular tidies block is 19. of measure covered against the courage it takes for the innocent man tooted a sign on his chess set says amy your guns here. or, the heart that it takes for the woman who saw hundreds die to you now say i forgive if the soldiers who stormed a the square. they want us to forget this you cannot overcome the past by ignoring it. so therefore we stand here together. we will never. >> it is coincidence of history the day that poland

held. >> this is the first reelection. >> nearly every seat that it could but as historians have observed what is even more remarkable is the communist recognize the victory at all because once they did everything fell apart. . .