where insurance companies can no longer impose where insurance companies can no longer adjust higher co-pays, deduct iblz, premiums for anything termed mental health. where people suffering from alcoholism or schizophrenia cannot be arbitrarily dismissed from a treatment facility, where insurers must carefully evaluate and compare medical and surgical benefits they offer and provide anyone with mental health or substance abuse treatment at the exact same benefit level as they would for medical or surgical. and where mental health is considered also part of the essential health benefits for all americans, and that is what we are going to talk about today. thanks to the effort of many people who are in this room, we have begun to enshrine these rights into law. but as we know, the current rules and regulations are written in wet cement, not stone. they are not fully fixed and this law has not been fully implemented. it won't be without

strengthening regulation in three key areas: clarity, transparency and accountability. because for insurance companies, concern with their bottom lines, unclear, undisclosed and unaccountable too often means unheated by the insurance system. we've made great progress, but right now we have interim final rules instead of enduring inalienable rights. as many of you know, these issues of mental health and dependency are personal for jim and i, but they're also personal for the hundred million americans who suffer from neurological conditions. and they're personal to their family and friends. because these are our fathers and mothers, these are our sisters and brothers. there are sons and daughters with autism and there are

grandparents with alzheimer's at increasingly and tragically, they are also our brave men and women in uniform who have returned home never to find peace. these are soldiers afflicted with traumatic brain injury and post-traumatic stress. men and women who escaped the taliban or the iraqi insurgency only to be disabled by the, quote, invisible wounds of war and held hostage by the stigma that surrounds their treatment. the signature wound of these wars have made our veterans medical p.o.w.s. pentagon officials estimate that up to 363,000 iraqi veterans may have suffered brain injuries and u.s. army vice chief of staff, general pete carelli, the champion for those in the

military who have suffered these injuries, and he's here today, thank you, general carelli, for your service to our country. [ applause ] >> so pete carelli told me, we're losing more soldiers to suicide and high-risk behavior than to combat. staggering but true. and if we continue to view these wounds as invisible, then how are we ever going to prevent their painful, invisible manifestation. adding insult to injury, stigma makes many of them feel, if they've experienced any trauma, all they should do is suck it up and shake it off. so many don't see compensation or treatment through the v. a. because they are now subject to the private insurance market, and that's what brings us here today. over half of our returning soldiers, many who are guard and

reserve, are going to get their treatment for the signature wound of the war, traumatic brain injury and post-traumatic stress, not through the v. a., but through their private employer provided private employer stands up and ensures that they get the treatment they need that is medically necessary and does not discriminate against them just because their disease occurs in the organ of the brain. that's why we're here today, to make mental health parody about trying to save our very patriots in this country who have borne the battle and who have come home. it's the least we can do as americans to make sure they're not left behind on the battlefield. [ applause ] >> let's be clear. the work we undertake today is not merely about health care,

veteran's care, science or economics politics. it's anrights. when a single person is discriminated because of a particular organ in their body, that's a civil rights issue. when we withhold treatment simply because the malady involves the brain rather than the kidney, the heart or the lungs, that's a civil rights issue. almost 50 years ago, my uncle as president said it in an earlier civil rights fight, quote, we are confronted primarily with a moral issue. it's as old as scriptures and as clear as the constitution. the heart of the question is whether we are going to treat everyone else the way we ourselves expect to be treated. whether americans are going to be afforded equal rights and equal opportunities and whether they're going to be treated as their fellow americans. because if one in four americans experiences a mental disorder and only one in three receive

treatment, we have a problem. then to paraphrase my uncle who amongst us said, we would be content to change places and be content with the counsel of patience and delay. who amongst us would accept a diagnosis of parkinson's or alzheimer's and be satisfied with an isolated and fragmented approach to care? who amongst us would stand in the shoes of someone suffering from major depression and be silent as those symptoms are dismissed as simply psychological? and who amongst us would trade places with one of our american heroes who is suffering in silence in our country today? we cannot afford to let that happen. back in 2010, i joined with my great friend garrett stagland in

launching one mind for research, an initiative to unify and focus all brain research efforts. one mind, to bring together researchers across the spectrum of brain illnesses, and we deeply believe with all of us working together, we can share breakthroughs through a united mission where we unravel the mystery of the mind together, not individually. and we're setting our sightshig. we aim to get all neurological disorders within ten years and eliminate the discrimination that accompanies them. this is a bold task and that is why we turn to none other than a four-star general, mp carelli, to lead our efforts. [ applause ] >> many of these health issues that aren't associated with the mind have everything to do with the mind.

it's your eating, your drinking, your stress which leads to diabetes, cardiovascular disease and, of course, asthma. for cancer patients diagnosed with depression, death rates are 40% higher. so how long are we going to segregate mental health from overall health? this is a civil rights issue. as real as 50 years ago when my uncle made a call on civil rights to this country, that's separate but equal, was inherently unequal. we cannot tolerate separate standards where you go down the hall for your mental health treatment. we want mental health treatment in every mental health care provider in this country. so let's banish the lingering discrimination of a second class citizen suffering from these disorders. imagine a health care system where a checkup from the neck up

is as common as taking your blood pressure, is as common as taking your temperature. imagine all the lives we could save. every physician recognizes, and pam hyde herself has said your mental health is just as important to your quality of life, as your physical health, if not more. and when go to the doctor with appendicitis or a broken bone, you will be cared for the same way, with compassion. beyond that, physicians will be trained -- what a revelation, that they're actually trained and treating the whole person, not just from the neck down -- so that we can correctly identify that a broken bone as a result of a drinking binge is as much a symptom as it is a stand-alone health issue. so that's where the work goes on. and when i look in this room, i

see that we're ready to roll up our sleeves and get the job done. jim and i asked you here today to kick off a new set of parity hearings as he talked about, and we're going to wrap them up a year from now at the john f. kennedy library to mark the 50th anniversary of president kennedy's signing of the community mental health services act. so all these hearings that you're going to organize will build to that momentum so that we can look back at the last 50 years, find out what we did wrong and make sure we correct it before we implement final regs for mental health care and before we make these mistakes again and perpetuate more misery on americans who are struggling for recovery. we are wanting to say, we deny insurance companies rights to deny us our rights. and we're going to take that message across the country in key cities. but ultimately, as jim said, this is up to you.

this is up to the advocate. and frederick douglas, the great appear li abolitionist said power concedes nothing without demand. it never has and it never will. until the mental health community is willing to stand up, be counted and demand equal treatment and care, we're never going to get to where we ultimately all want to go. so like the labor movement, like the civil rights movement, we're going to create the demand for sherry glade and pam hyde to do the work they're already doing. it's not going to happen without all of you. my uncle bobby said every time a person stands up or improves the lot of others, they send through a tiny ripple of hope. and coming through the centers of energy and daring, they bring ripples up and down the walls.

we can do this together. i learned in recovery that half measures availed me nothing. we need to be in this all the way, and with the committed audience i see out here today, we're going to be successful in getting the job done. thank you very much. [ applause ] >> thank you both for speaking here today, and now i know the part that everybody is waiting for is our questions and answers. if i can get both of you to join me up here, the questions aren't directed to either one of you, so you can decide who wants to take the questions. the first one is the original bill was passed in the 1990s but the insurance companies used loopholes to avoid parity for mental health coverage. are there safeguards in place to prevent that in this one? >> i think it would be appropriate to hear from our wonderful director of the

substance abuse mental health administration, pam hyde, who has been working on just that, and i know from sherri glade as well, but let me have our champion for this, pam hyde, say a few words about how important it is that we get the message across on mental health parity and how key all of you are in helping us so that we solve these questions that are before us today. pam, would you be good enough to come up and talk to us a little bit? let's give a great round of applause to pam hyde. [ applause ] >> thank you, congressman, both of you, for your compassion and devotion to this issue. i'm not going to do a whole speech here, although i could do that if we had the time. i just want to say that samsa is very clear that mapea, as we

call it, the law we're talking about here, is just the start. mapea calls for equal treatment. it doesn't call for the best and most appropriate treatment. i think what we're talking about here is more than that. what we understand is no law and no regulation is going to be as good as it can be unless we get the word out that it's there and that it can be used. so samsa is committed to doing that. we have developed a communications plan. we have webinars that we have started and working with some of the key target areas we want to get the word out to. we're going to build on or jump on the bandwagon of the patriots' tour and see if we can help facilitate getting information out to -- mostly to consumers who may have behavioral health issues and who may be needing treatment for those issues, and for providers, frankly, who might be interested in providing that kind of care

but don't know how their clients are going to get that paid for. so we want to focus some very targeted efforts. we weren't given any money to do this. we've tried to identify very few resources to do it and we're going to try to lead an effort to do that as best we can. is a we're playing. and we want to use this issue to understand that mapea was expanded into theal nional heale act, in fact, that's more important than mapea standing alone, because there are ways that we're using all of health care reform and trying to make sure that mental health and substance abuse treatment, addiction, recovery is in each one of the efforts that is going on in implementing the affordable care act. so whether it's the quality issues that samsa is working on

quality framework about, or whether it's the prevention efforts in which we've tried to make sure that substance abuse and mental health issues are involved, or whether it is essential health benefits, which i think sherri is going to talk about really briefly, in any one of those cases, we're trying to make sure that mental health and substance abuse is included in that. because parity is about more than just being equal, it is about being appropriate and necessary to move the nation's behavioral health being very essential to health. given the time and the question that i was asked, i'm going to stop there and just let you know that there's lots more work than samhsa is doing about these issues, and we would be very happy to be partners in these field areas and other issues as we move along. thank you. [ applause ] >> what states are doing the best job in implementing mental health parities? >> rhode island.

well, we aim to be number one, because tragically, according to pam's study, rhode island is number one in the incident rate of mental illness and addiction. but perhaps that's also because there is a lot less stigma in rhode island and we've got a lot of great providers in rhode island, so people don't have a tough time admitting and seeking help, which is one of the reasons why we might be number one, and you could look at it one way or you could look at it another way. but either way, we intend to be part of the solution in coming up with a model that hopefully other states like minnesota can follow. >> well, the honest answer to that question is that it's very difficult to quantify it, seriously. and we have some very powerful special interests, as paul wellstone said early on, he was quick to recognize our fighting

parity, and that's unfortunate. we're trying to do a better job with education. i think it's important to point out that right before we passed the bill, we had eight major insurance companies, major health plans nationally supporting the bill. came up and testified. the first one to come on board was way back in the '90s, kaiser permanente. and i don't want to get into which insurance company is helping and which is not, but we need them to understand that this is not only the right thing to do, to enact parity, but it's the cost-effective thing to do. for every dollar we spend in treatment from people who are suffering from mental disorders or addiction disorders, we save $12. we save $12 in health care costs and not having to build new jails and new prisons and social service costs. as my good friend dr. ron smith always points out, who is chief

psychiatry for the navy, is not having to buy ritalin for the children, for families that are dysfunctional and so forth. so we need to do a better job of educating as well as enforcing the new law. >> have the fears of the insurance companies been lessened or increased since the bill passed? >> well, at the end of the day, we need to work with the insurance community, because if atday, they're structuring the benefit plan, we need to be at the table when they structure that benefitso i insurance companies to join us at these parity hearings around the country and to develop that working relationship that's already getting started. because at the end of the day, we all need each other, and we need to find a way out of this together. >> i'd just like to quickly second that. we need to work in a collaborative way, and you can't continue to be us versus them or

we versus they. it needs to be a collaborative effort of cooperation and we need to find that common ground, which is sorely missing, i've noticed, in this city. >> how would you encourage advocates states regarding mental health? >> well, you know, if you go on the samsa web site and you talk to folks, it's important that you get to know your local insurance commissioner in your state. in my state, chris kohler told me that he hears during denial coverage from insurance companies, but he doesn't hear from advocates enough. so what we're sayings the advoc can't leave this up to the provider to fight for us.'t exp administration to do this by themselves. it's got to be up to us to stand up for our own and make sure that the right thing is done. and i want to acknowledge

someone who has been helping to do that, assistant secretary of health, and who has been working to get mental health incorporated, as pam said, into the affordable care act, and that's none other than sherri glade. let's hear a great round of applause for sherri glade. [ applause ] >> i just want to speak very briefly to that point. i think one of the really important things that you could do at the state level right now is influence states in their selection of essential health benefits. the way we've laid out the law, states have a choice of benchmarks between their small group plans and large employer plans and so on. one of the things that that makes possible is for states to include, if they choose, their existing mental health mandates in the essential health in the pact they choose. so for some states who have a strong advocacy influence and e health/substance abuse man dates

in place, with appropriate advocacy, i think there is a possibility for those states to choose a plan that includes those benefits as the essential health benefits plan that will cover basically 70 million insured people. >> how do you encourage we have shown many, many health employers, many, many empiricala macro level and a micro level of treating people. the average untreated alcoholic or addict's health costs, for example, are 100% higher than others who are in recovery. 100% higher. just think of that. the average person out there who

is addicted and is drugging or drinking still, their health care costs 100% higher than the treated alcoholic or a person suffering from a mental disorder. the cost the wall street journal pointed out not long ago, $30 billion sucked out of our gdp for depression in the workplace. i could go on and on with the litany of costs. what we do is show them, whether it's the new england journal of medicine study, the minnesota study, the california study, just -- i could go on and on. there have been many, many studies corroborating what i'm saying, that this, in the end, will savth and those eight companies who support parity learned that first and learned it well and >> do you think the anonymous and alcoholics anonymous contributes to the stigma against addicts? >> i didn't really have a choice

whether i was going to be anonymous or not, so i often get a lot of grief from my fellows in recovery. but at the same time i'm a u.s. citizen and one of the things phil w. did was he testified in congress. a lot of people in recovery don't know that. because it was about saving our fellows, and one of the ways we save our fellows is to advocate for parity, to advocate for enough treatment, to advocate for reimbursement. that's the way i can do one giant 12-step call is to advocate for a different system that will help millions. but if we're not politically engaged, then we're leaving this to someone else. and if we could ever tap those 20-some million people in long-term recovery in this country right now to say that they're willing to put their hand up and be a face and voice of recovery, you change this

overnight. because that would be a big difference. [ applause ] >> have you met or talked with people who have minnesota with several dozen people who have been benefitted. families who have come to break bread with me and tell me of their happy experiences. but, unfortunately, there's still more people every day who call me, literally every day, who call me who are still suffering and who can't access treatment. but there are some very, very rewarding and enriching personal experiences that have been related to me directly. >> does the u.s. government invest enough in mental health research? >> that was a softball.

obviously when we don't treat this as a real illness, we don't respond to it with the same urgency that we would have you had cancer or aids or some other disease. so what we need to do first is end stigma because stigma is what's keeping us from reaching our full potential in terms of advocacy. when we get that advocacy, then we need to focus on how we're spending our current resources so we're not dividing up our effort and repeating it over and over again because we failed to share the science across these brain-related disorders, and that, as i said earlier, is the project of one mind for research. but at the end of the day, prevention -- prevention -- prevention is the best answer of all, and you don't need to go back to the lab to be able to tell a parent that it's not okay for them to experience with drugs and alcohol. that's not just an experimental

phase. the longer they don't use or abuse drugs and alcohol, the better chance they have of living a life free from addiction and dependency. we need to get that message across. [ applause ] >> how do you see the mental health parity act helping our soldiers receive treatment for ptsd? >> first of all, stigma, stigma, stigma. again, one of the biggest challenges is there's stigma everywhere. of course, if you're a young soldier who is used to doing whatever it takes to get the job done, then you don't want to be told that you have a problem that's stigmatized, where it's treated as a moral issue and not a medical issue. but let me tell you an interesting anecdote. i rededicated the kennedy warfare center in fort bragg a few months ago, and the first

chief of staff, a green beret, told me, you know, we have the best medical staff in the military. and i said, you don't need to tell me that, general. why do they need mental health? they jump out of planes, they swim under water for two miles without breathing, they come out of the beach, they speak five languages, they take out osama bin laden and they're home by dinnertime to read to their kids. what do they need mental health for? he said, congressman, you mistake me. we don't look at mental health as a safety net. and this is the real good part. he said, we look at it as a forced multiplier. a forced multiplier. so the military has figured out that if you help address someone's preoccupations and issues, you help make them a better fighter. how about all americans who could always be made better through self-improvement? how about looking at mental health, instead of taking, quote, weak people, making strong people even stronger, and that's ultimately a message we

need. [ applause ] >> just very briefly, whenever i think of that question em bowled nd that question, i think of john in minnesota who came back, i think, from the second or third tour of duty in iraq and couldn't access treatment, whether it be the va or insurance -- i don't think he had insurance -- and he was found hanging by an electric cord in his basement. and he's one of 18 a day, according to "60 minutes." new veterans coming back from iraq and afghanistan who are taking their own lives, and when the statistics that have been shared by the military themse