>> >> top tier invested capital for commercial life sciences industry. with the space science discoveries alex hinder

real-estate equities is the largest leading developer on collaborative science and technology campuses. the innovation we have campuses all over the country in cambridge and as soon francisco seven francisco. there was little commercial lifeline now in the year city now we're part of the system in the past few months over half a dozen space science companies have been started. it is amazing how far we have in such a short time. >> the only the the laboratory buildings rebuilt collaborative life science ecosystems to the thought leadership programming like this one tonight.

with a lifetime community issues that have the potential to a accelerate life jiji treatments for those who need them the most. the chairman for realist tudor -- alexander equities but as a way to bring together the stakeholders' across the life science continue on to address the most critical issues of research development and global health we had eight segments including one last year you very dedicated to neuroscience that both speakers participated. is so to deliver that opening keynote that mental illness is more common than

you think one of four people in united states experience mental illness in a given year. had a bat line in 70 live with this serious mental illness bipolar or schizophrenia. it is one of the greatest health problems facing us today but has enormous social consequences according to the wa joe rolled wide depression for bipolar disease affects more than 400 million people. the social and economic costs are staggering as disorders are estimated to cost society 2.5 trillion dollars worldwide. without a better understanding of the brain that promises to continue to undermine those health

systems and pose a great burden to the global economy. it is imperative we work together to create regulatory government with innovation and research and development then we bear responsibility to lead to the solutions. is grateful for the ongoing partnership and as we all work with the stigma. said tonight to our right to introduce bob. he is sitting on the far left.

in a leading commercial for global strategy in washington d.c. with 25 years of experience in private government and non-profit sector with public policy and ran the national security program for the center for american progress continues to revise fortune 500 executives at the national security council in the treasury in the state department during the clinton administration. since 1987 after being documented with bipolar disease he is an outspoken and advocate it has worked closely to to the efficacy groups. london to guarantee parity to address medical professionals across the

united states and europe and africa. to my left end chair at the psychiatry department in the past president of the american psychiatric association. with the indians to understanding the with those related psychotic disorders is over 600 papers and edited 11 books and is the recipient of many national awards. and with that actively contributing to government policy including the mental

health care a equity act. to head with affordable care act the families of the gulf crisis in working with mental illness and psychiatry. which we will discuss here tonight. if anybody has the copy of the bookie in their chair that we will move outside to a book signing. >> thanks for coming to see me. with the hostess dialogue.

and with a career of academic psychiatry with that health care developing a been perceived the capacity that provides care in when you think about it kahan and above 20 percent of the calculation that throughout human history with lack of knowledge or treatment from the 21st century now.

and with pat -- lack of access. so to be much more poetic. >> how was it? >>. >> it was a pariah. >> "shrinks" was better. [laughter] >> that is what i said. >> so in addition to his professional powers that are enumerated. >> i will add my thanks. >> then you should be to.

from the american in psychiatric association if you know, the field of psychiatry that is one of the most difficult jobs in this country. in the second reason i am here with the role reversal to is a demotion.

so based on that with their purview of satiety signal dash psychiatry. with anxiety in eating disorders also the intellectual or developmental disabilities. they are affecting this a real estate in the brain and its recognition function. and i would just say my family for the young people this is the newspaper.

byline to ask you to say now depression is a mental illness? are we experiencing some definitions when it comes to mental illness would everybody is diagnosed in nonmilitary. linty think that is day problem right now. a lot of the critics of psychiatry say but there was the book ladies greedy

psychiatrist for coming in and is actually the truth with the reality with the notion that everybody needs a shriek with the heyday as psychoanalysis. to be looking trendy. there is the bright line between what is an illness and what is not. >> we talk about screening for depression after anxiety disorder is the most common mental disorder in the world

bank said sight 2020 depression will be the second and by that will be the first. so why wouldn't we screen for that? is specially women like postpartum have a psychiatric condition like depression. pas why would we not do that with prenatal care? in the reason for the elderly is geriatric regression is, and the highest suicide rate of any demographic our elderly males. tv screen, hypertension, diabet es, why wouldn't we do a

depression screening for the high-risk groups? >> let's turn to the book is to put the cards on the table but also it is one of the few non memoirs that is very approachable. >> i am too young. and there have been others and they're terrific but this has the medical and the personal and. yet the thing is you don't pull punches. you talent like it is the

most talked-about the biggest thing is that you say reading that interpretation of dreams but at the same time you do not go on friday is the right at one point with the intellectual desert from worthy of the century before they pushed their profession into one of the most those insured by any medical specialist. ox zero what did freud get right? >> so lot of us adventures are discovered ore produced

so is the darling by evolution? so with that neurologists by the way he studied disordered related to the brain and at the time the right is no scientific understanding and the conditions associated with it. have to even psychosis. and the research epidemiology.

lead with what the organs corresponded and just by his own powers of observation and the imagination psychology had built then invented yet. and was involved with various components and there is a process just like you grow and develop and there are some disturbances could cause you to feel like you are paralyzed that you are

constantly fearful that you were depressed eggs to come up with the way to understand this. we still use the ada to be conscious before everything was thought to be readily available. do we did knifings? with the idea to have complex with the impulses or desires this is on the order of einstein to have loyalty

and obedience. and as talking to her in the reality is there are many aspects better very useful and effective. and has nothing to do with depression or bipolar disorder is. dementia or optimism.

a bill to which were played the parents. the refrigerator mother. the results of the overbearing mother but if a cat that legacy. >> didn't submit you went to that analysis before to have that break down as they say maybe you need medication. but you refer to it in your book as a stepchild of medicine that yet your book

is full of descriptions of ideas that could be called legitimately if you entitle one section of the book there is nothing that i can fix those two questions. how much of psychiatry with that stigma problem that is attached to the illness in people who claim to be doctors perugia's think that stigma was inevitable? given that crazy part of the brain? >> i think it is 6040.

60% is due to the social culture in which it evolved a and functions. psychiatrists started off like every other doctor for the 18th-century and cardiologists actually for one of the for specialties in was called the association because they

took care of people. but what happened it was adjusted trade but a scientific discipline with evidentiary basis and then they began to take off and he could get tubers or see a stroke or that flash of dementia and there was no basis to it is to be so

compelling intellectually to think they were flawed when i was in medical school with my supervisors they wed yoko they forgot everything they alerted medical school. psychology of the mind. so psychology has really gone overboard. then the first was given in 1929. end he would take the blood of soldiers from the tour of duty in comparable areas in inject that blood into those

patients. he did that to induce a fever because the systems temporarily improved. it is a phenomenon. but it sounds barbaric. but the is were individuals head tertiary systems in the grain produced the psychosis in worse susceptible to hypothermia. but then nothing happened after they got malaria. metaphors they eddy lobotomies so of this sounds by barrett -- for barrick but the guy who'd discovered

duse's portuguese neurologist they were desperate for those who were completely out of control. put that cultural context is of little more complicated. to explain or alleviate symptoms. so with smallpox or tuberculosis in then you develop a treatment that people look for psychiatry to do that but there is one other thing.

those that affect the parts of the greater the mental function are so intimate to who we are as an individual so that you are not you. with the reality in the relationship to shape the foundation to under state and the world. and makes difficult for people to suspend their own beliefs. so betted is a false belief about something is completely inaccurate that nobody talks about it. so you talk about your eggs

id talk about the aggravation of fear would you say to somebody you are obsessed? it is harder to accept that. how does somebody in the military say i have ptsd? and that is why they haven't been able to develop that from ptsd. >> now we have it financed within his head difficult and unworkable cares the age of which there is a general consensus is a combination

of drugs and talk therapy. . .

a part of it in a human relationship. you think about it all of the physician-patient experience inc. whether you are having a surgical procedure, your cardiologist, withhold care financing the way it is the human aspect of it gets a short but there always will be to kind of take a pill at the end of the day. in the psychiatric treatment and there's medications and the so-called modular therapy. the most extreme example is

electroshock therapy but now we have to correct stimulation and get into thinking that many mental disorders or circuit-based that if you get a pill altering a narrow transmitter technology that may be not the most effective way to stabilize the disorder. it's highly likely that what this represents is an over activation of a part of the brain where you have with the record gets stuck or plays the same tune or the same words over and over there's a circuit there is a circuit that keeps

reverberating and you can't stop so the question we have seen in the symptoms of parkinson's piece kind of approaches will be helpful basically having to drill down to. so there's three different modalities and they are potentially usable and it's important to say they are sort of psychotherapeutic or an aspect of it is more in trouble than any other. >> let's stay on. in your book you gave a number of cases to those you've treated. why don't you share with the

audience hear the case of someone with whom you succeeded him as someone who didn't think i'd. >> the stories are numerous. i could go on forever. there is a good friend of ours whose an elegant and attractive and sophisticated woman who suffers from current depression but she did is didn't take her medication because she later gained weight. it's one of the best hospitals and so she went there and she

was suicidal and when her husband was beside himself. but then he transferred her and treated her with a sort of adjustment in a long period of time but she is now gallivanting around the world in an exciting and glamorous life as happy as a clam and it probably wouldn't have happened if there have been the sophistication of the modern 21st century psychiatry that i think people should be able to avail themselves of that. in the book it starts out with an introduction these are all real stories like the daughter

of a celebrity 20-years-old, went to all these new age treatments and treated her and she got better and they went their own way and she relapsed and the epilogue tells the happy ending of the story so this didn't exist 50 years ago but it exists now. on the other hand the occupational hazard there were better treatments for everything so we don't have a treatment for alzheimer's disease. we don't have to treatments for autism the treatments for autism and there are still people with other conditions that the minority of people. every doctor has cases that haunts them.

the one that probably resonates the most was a surgeon that i treated. finally his mother would drag him in and in two months he was much approved and better. usually the trade that is treatment is you treat until you get symptomatic remission and then there's a first episode for the relapse into remission but he didn't want any of it and it

had side effects. i relented to allow him to stop earlier. usually when people have to sometimes they call you or they come back and tell you. one night i remember i came home and i got a phone call from an emergency room in the hospital where the patients took an overdose so he basically couldn't acknowledge it and the wife either didn't notice or didn't force him to come in so it was on an impulse.

the other case that i like to tell you the most stigmatized and devastating conditions was the borderland personality disorder, terrible condition that affects people and causes them to have tumultuous relationships. we took on and treated the disorder in the early 20s and to resuscitate her work with her for about a year and i talked to be talked to her multiple times a week.

this didn't work out very well. after the book came out and, actually it wasn't in the book. then i get this e-mail ... last night i read your article that the suicide of robin williams and i recognized your name. you probably don't remember me but between the ages of 30 i was very ill and made many suicide attempts and was frequently hospitalized. one was because of the large overdose. you were assigned to the my dr.. you probably didn't see it that way, however eventually with the

treatment i was able to get myself together. i got married, enrolled in nursing school and graduated valedictorian. i've worked in the psychiatric hospital and when i look back at just how mentally ill i was earlier in my life i never would have thought that it would turn out so well. i'm very fortunate to have a pretty happy life healthy life and i just wanted to let you know. so this didn't exist before and for so many it doesn't exist now but because it's not there because they can't find it when he can't have access to it. >> i'm going to ask the folks here to pass out cards for questions. they are in front of you in case you have questions right them down and we will collect them. while people do that would switch from the personal to the

political because you made a nice little segue your self. let's talk about a couple of issues that have been raised. first we have to talk about the presidential campaign. of all of the years i've been involved in the politics i can honestly say this is the one where more candidates need more than ever before. [laughter] in any case i guess we should be positive and constructive unlike the candidates and i would ask you if you have time with the next president, what would you suggest as it is increasing drastically as a lot of people would say, what would you suggest that he or she do to

improve the lives of those with mental illness? >> i had an opportunity to do something like this very recently. advising one of the candidates the upshot was a very political strategy would say we should make it a signature issue in the campaign and upon the election to handle the blue ribbon committee to develop at the hands of plan to reform mental health care and financing in the country and deliver in the first 100 days even though it's not something that identified the economy or terrorism or control

or global warming and the key issue i think that this would designate everyone experiences it but nobody wants to talk about it. so, the good news is that a was a lot of things if you have als or alzheimer's or pancreatic cancer there isn't that much that can be done to wait for the next. we can make a huge difference we just don't provide it in an accessible way. so i think this is really the only way that gets the attention for some individual that is mentally ill and is not treated.

these are like the tips of the iceberg that occur whether it is homelessness or the number of mentally ill people in prison or the rise of the rape to domestic violence or mass violence that is occurring. the rate of suicide in the country hasn't gone down in over a century. it's decreased by 50% in the last half-century so we don't take it seriously. it's not a random events. it occurs 90% of people. many of the people, the majority have seen health professionals in the month prior to committing suicide. there is was a story in the news

recently about this navy seal committing suicide after ptsd after being in the tours of duty and loss of colleagues at high risk so it was a lot of social and political will more than the lack of knowledge and capacity. so, what is the motivation for the political candidates to take this on it's not what good it will do you put how much harm. >> was interesting to me is if you are seeing some people in congress and some candidates because they want to foolishly -- of course i know i have no opinion about this but not restrain access to firearms because they want to stay there they are now turning to mental illness and mental health as a

solution. and they are proposing to pour a lot of money into mental health treatment. and i find myself conflicted because for a long time and i've been on the side of those and even though some of us feel that the reason behind this is a false pretense should we just cannot accept the fact to make more money. >> my two years have made me very cynical. it's hard to overstate the cynicism of what drives behavior

from the government. the president had a series of executive actions as to what is that the government interested in, mass violence and suicide ptsd. other than that, nobody cares. there's four different bills in congress addressing mental illness. they are all the motivation was newtown connecticut but they are still sliding their way through the legislative process. for something to be done in response to addressing the violence perpetrated to the

executive actions that are the executive actions? restrict access to guns for strict background checks, the rapid background check system but then he says we are going to focus on mentally ill people. we are going to put money into the mental health care system, that's good i will come back to to the nanosecond that the that in a second but the other way as we are going to have background checks the equal validity if you are ever hospitalized for a mental illness or if you are on a security they will be moved into the national immediate background check system.

any any precipitous occultist will tell you the crime and substance abuse so why don't we do checks for people that have been two aa. there is in there you should say you should just accept that discrimination but since there's money attached to it what is that going to do? what do you know what it is going to? >> it's so the government doesn't take care of people's healthcare. they don't provide health care. hospitals, cities, counties. there is no of care system. it's always been disenfranchised

so they fund the services in various states. it is a derelict agency that is given a bonus programs instead of treatment of the mentally ill so it will be used in ways that are inconsequential. the research budget that funds most is $1.2 billion annually and they budgeted 3.6 which is just wasted. if you go on the website and you luck at the section that says evidence-based treatment with 265 different types of treatment, there isn't one

listed. how can that be? how is the government going to allow that? this is getting $3.6 million a year. >> they don't put the money there. i will remind you someday. [laughter] >> there is a question he or she i think from the handwriting of asks you to talk about addiction and american psychiatry for helping to remove the stigma to bring about our treatment. the dual diagnosis i guess is

the fancy term for these kind of things. it is growing in this country. >> that is a medical phenomenon and cultural phenomenon. historically it isn't recognized in the psychological flaw and there's all these so-called groups that develop to try to help people and they have that finally we have a very good scientific basis for understanding how addiction develops and what we know is probably 50% start as a

psychiatric disorder who are self-medicating and that is the dual diagnosis constitutional vulnerability to addiction in other words you expose them to the substance not everybody is going to have the same motivation to repeat the use and answer the dependence varies but what happens is after you use it if changes your brain so if you break the angle and it heals. so it is [inaudible] if changes as a result and it's

how to identify people that may be at high risk but also how to reduce those effects that's the scientific challenge and so now not only do we have the problem to focus on the way to conceptualize the problem that the issue is getting enough funding and research into getting people to speak up to access treatment. you've got the clinics that are here but not necessarily in the standard academic medical center and if you go for the treatment for alcohol or opiates you can't necessarily build the two

different types of treatment so there's these bureaucratic issues that need access to it. there's a lot of questions about that and a lot of discretionary income. we have a culture that is encouraging but then you have other things like the statistic that came out a few months ago that although the survival and above longevity and the humanity in countries like the united states is going better and better and it is growing longer and longer.

switch now encouraging them to be engaged in these harmful behaviors. >> or thinking that it is one of the -- bacon is one of the four basic food groups. [laughter] >> .com to back. >> this is a noncontroversial question. and the catalogue of functions you do not list gender. it's one of the controversies regarding the categorization of mental illness. do you have a position in this controversy? the >> sexual identity and identification is sort of a fundamental issue that is fairly neglected. the whole biology and orientation is virtually

unstudied. now we appreciate that you recognize the area of lgbt issues whether it is same-sex marriage, childbearing. it is enormously at the same time as healthcare and having an understanding of evidence of a scientific basis for understanding how to address these issues because there hasn't been a concerted effort by a good scientist and clinicians to focus on it but this is the beginning. we at columbia have established a position that focuses on

health, gender and sexuality into the development of the knowledge base as a scope of healthcare services specifically for the constituencies in the l. gpt community for what may be other constituencies in the populations now attempting to be developed. ..