is their home to the idea behind a shelter, and emergency stop-gap -- what we aim for is a more permanent and targeted solution. permanent housing is not only more to maine, it is more cost- effective. -- not only more humane, it is more cost-effective. host: this congress need to approve this plan? guest: it was authorized by an act and we have a bipartisan support of this plan by the president and congress. host: anthony love, thank you for spending time with us. that does it for today's "washington journal." let me tell you what we're covering today on c-span. here is the headline in "the new york daily news," "a royal welcome." queen elizabeth is addressing the u.n.

she is expected to talk about unity and peace. the president is meeting with the israeli prime minister, their fifth meeting could go to c-span.org to find out when we will be airing the press conference for that and the rest of our schedule. thanks for watching. we will see you tomorrow. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010] . .

to cut the israeli prime obama today. they are expected to meet later today. we will take that event and show it to you later this afternoon on c-span. -- we will tape that event and show it to you later this afternoon on c-span. another world leader, queen elizabeth ii is in the country. she is a new york city this afternoon. we will have that live starting at 3:00 eastern. later, the queen heads to ground zero for a touur of the site. david cameron will hear from opposition beginning at 7:00 eastern, live on c-span2.

>> c-span is now available and over 100 million homes, bringing you a direct link to public affairs and non-fiction books. created by america's cable companies. >> oil spill clean-up efforts continue in the gulf of mexico. a look now at the situation in grand isle state park. >> i am from louisiana.

i have lived here all my life. i am down here working on the oil spill. i have done and our mental work for the past four years. i am down here cleaning up. and we really do feel like we're making progress. we want to gleanings of. >> how long have you been down here for? >> i am going into my six week of working. >> how did you come to be at grand isle location? >> i traced the oil. we chased the oil to grand isle. this is where it happened. this is where it started off shore. >> what types of things have you

been doing? >> i have always been on a beach cleanup. then we have boat operations and plant operations. i have been on the beach cleanup for the past six weeks that i have been here. >> what do you usually encounter? what do you do? >> you are breaking up and shoveling up all of the tar balls and backing it up and take big beting it. getting cleaned up. when we hired on, we hired on to work. anytime you have a disaster like this in environmental work, you are here for the duration. you are working seven 12's.

we have zones 1 through 14. i work on zone 14. the group of people i am working with are all wonderful. they're great people. the yellow buses are taking workers down to different zones. they are taken workers back over to elmer's island. and to the difference surrounding areas where we are working. that is what all the buses are for. they are work buses. they come in and pick us up and transport us. and they take us, drop us off. >> there seems to be a pretty

robust operation going on. what do they have in the facility? >> they have everything in the facility. they have tents set up for the chow hall. they have 10 set up for supplies. we go in and set up and clean up. it has been a really good operation, i sink. it really has. >> do you think that the government and ppr doing enough to clean the oil -- and bp doing enough to clean up oil? >> i stayed there doing everything in their power. it is such a big disaster. they are doing what they can do. they really and truly are. i know a lot of people do not think they are, but through a process of elimination.

you do what you can do what you can do with. i had a camera and we came down with cameras. we have the camper set up in the campground on islands. we're fortunate. we're not having to stay in tent city, which is set up for the workers now. tent city is not bad, but if you can have a camper down here, that is a lot better. all of the hotels are full. you are talking about a seven- mile long island, so there are not that many places to stay. >> what has been the hardest part of the work? to go seeing the devastation. -- >> seeing the devastation it causes. everybody should pray and have faith.

the local coast commander thad allen will be briefing reporters later said at 3:00 eastern on our companion network, c-span2 today. officials from the defense and veterans department took part in the discussion looking at the mental health and counseling service to returning war veterans. according to a recent study, the number of veterans returning from iraq and afghanistan with mental illness is increasing. this is a to our discussion that took place in washington on friday.

meeting next door with dr. hyde is lingering a bed. i see people continuing to co symposium. i am john bradley. i am a consultant to the national alliance of mental illness and particularly to the nami concern of veterans affairs and their acute concerns about this war and what is happening to our combatants and veterans. we have a wonderful panel of experts here today. i will not bore you with what i think -- i would rather you hear directly from them. i would like to proceed. thank you cspan for beginning to cover this. i hope the larger audience of cspan as this as a learning opportunity. this is a highly important subject and very topical.

our premise for today is a question, really. can be enormous mental health care costs systems and behavioral health care systems of the department of veterans affairs and the military health- care system respectively, can't they play together, can they work together, can they help our combat and population, our veteran population challenged by mental illnesses to improve their lives and move toward recovery? nami, we have seen examples where that can come true in a local environment. the issue is, can it come through -- to systematically and generally so we can naturally tell that it is happening? in that regard, there is no spattered -- better speaker to begin with a bent elspeth cameron richie md.

he is the primary mental health advisory to the u.s. army surgeon general. over the past two-three years has become the face of behavioral health care in the military services. i had the pleasure of appearing on a panel with her in the mental health colchis -- caucus. i found her to be a superb spokesman for military the april health care and also someone who has an innate understanding of the challenges surviving for combat. colonel richie is a graduate of harvard university and also attended george washington university and as war -- or at walter reed and uniform university of the health sciences and is eminently qualified richie has published over 130 different publications in this field and the field of forensic. we welcome her to this panel. [applause]

>> it is a real pleasure to be here. i want to enlarge the promise to start with. i know that the dod and the army can work with the va. we do it all the time. ira and i go back a long way. since we have nzami here, how can we also engaged all of you an hour together. one thing i hear a lot is frustration. i hear people saying that they want to help and how can they help. they send their donations in and they offer and it does not get to the people they want it to. that is for all kinds of reasons, but the promise i will have with you all today is that there is definitely ways that you can help and what we need to do, partly this afternoon and in the future is to have a way that you all can provide us with what we need and we can help with what you need. i have to start every talk i do

with a little bit of history. the history is to emphasize that all wars produce psychological reactions. we have studied them from world war i, world war ii, and so on and so forth. what we see in general is that the sooner we can initiate treatment, the better. some of the treatment, much of the treatment has nothing to do with mental health. it has to do with leadership, with cohesion, with unit morale, with people feeling now richard and taken care of. however, mental health and behavioral health or whatever we called these days the family has a place. it has been almost 10 years since 9/11. i was walking through the pentagon yesterday with a colleague and i was pointing out the memorial chapel and i was reminded about how much my life and all your lives have changed. we have been out were continually, in my opinion, since 9/11. i am not sure whether we have

had a chance to process that. one of the good things about 9/11 was that we as psychiatrists and psychologists were working throughout the pentagon in a very upfront way with the people who were lieutenant colonels and colonels and who are now three-star generals i will speak army here. i can tell you that the army gets it. our three and four-star generals are so interested in the mental health, the suicide rate, a traumatic brain injury -- weak are always going over to the building to try to work with them. they are really interested in this subject. this war or war is have been going on for a while. it has been numerous multiple deployments. it has been numerous exposures to severely wounded soldiers. for us and the medical field working with detainees and iraqis but one of the things that is terrific about this war

is the strong sense of support from the american people when i walked down the street on connecticut avenue in uniform or if i fly somewhere, people come up and thank me. that is a wonderful feeling. as one of the things i think is so positive for our military to bed. however, there are still definite issues that we have to deal with. one issue which comes back to the issue of dod and va is held integrated are our programs. we recognize there are numerous programs and how do you integrate those programs. we struggle with that. is not easy. it sounds easy to be on the same page but when you get to with the devil is often in the details. we are a volunteer army and we know we are going to war. we know we are going to deploy. we are seasoned and tired. i like an old-fashioned term

called battle scarred. soldiers do not like to be called victims. they can understand what it is like to be tired. back in world war two when we used the term battle fatigues, we go round and round with the words but the concept is there. many people have taken a look at us and i am not listing them all but certainly many people have criticized the system that has been good. we found many areas to improve. we have been given quite a bit of money and that has been helpful, thank you to congress for that. we spent that money wisely, i think, mainly in hiring new providers so access to care is much improved. nevertheless, we have a thousands of wounded soldiers and we have the major effects on the families that are. so are we tend to think of the families of those who are deployed but the families of the wounded and the deceased are

still important, too. let me broaden desperate there is a concept of the nuclear family, the children of the soldier. it is apparent to the soldier, two brothers and sisters who are often teenagers, nieces and nephews. the extended family is critically important. to remind you there is a range of deployment-related reactions. i will define ptsc for you in a moment. i think you all recognize this, everything from kicking the cat to actually taking one's life. the ptsc diagnostic concept to reiterate, post-traumatic stress disorder was not considered a diagnosis until well after the end of the vietnam war. as we look in retrospect, we see that every war has had an influence on that. by definition and the diagnostic statistical manual, it is a traumatic experience that leads

to feelings of fear and helplessness. i don't like that definition. i am trying to change that. the reason for that is our soldiers are very well trained. they do not react with fear and helplessness. they pick up their weapons and lay down suppressing fire and grab their wounded comrades and go on. that does not mean that experiences and there are often multiple ones after being at war for so long and some of the ones, don't have a cumulative a fact. you also have a range of different systems, re- experiencing the physical arousal. what is often the most difficult is the numbness per they come back, and they don't necessarily connect with society. they connect with their buddies who have been there but especially for the guard and reserve who are getting out of uniform, it can be very disconcerting another thing about soldiers is they don't like to seek treatment. they would much rather go on and do it. it is of and the mother, the

white, the child that pulled them in. here is a challenge for all of us and all this i don't just mean that military and a va, i'm a nationally, how you reach out and engage with a soldier or veteran who does not want to see a shrink? i am a big believer in barbeques and memorial services. barbeques and pick them to get people together to play softball and baseball is a way to engage where you are not sitting around in a room talking about feelings. soldiers still like that, believe me or memorial services because soldiers want to honor the memory -- memory of their fallen comrades. by definition, ptsd has symptoms which don't necessarily cause impairment. in our soldiers, you hear the term signature wounded in the

war a lot. traumatic brain injury or ptsd. i like the idea of the blast as significant -- as a significant weapon of the war. the ied or whatever causes theptsd, the amputations, the blindness, the blast and cause a multitude of things. what we have in many cases with our soldiers is multiple impairment and they all have to be addressed, not just one. i want to talk a little bit about where ww have been, where we have been and where we are going where we have been, we have been doing surveillance like you have never seen before. i don't have time today to present data but we have more data than we have ever had. much of it is available on the web if you googled mental health advisory team or are epidemiological consultation team, it is all there. we have had difficult with

access to care. that is improving. we have had difficulties with stigma which is a complicated subject. we have had a rise in suicide rates that you are familiar with. we have been doing a pretty good job as the service is working together, army, navy, air force, marines working together with the department of defense and the va. we have an of balding comprehensive health strategy. we have set up a number of different -- we have a number of comprehensive health strategies. one of the things i have found after being in uniform for 24 years as an army psychiatrist is that this is hard and complicated and complex. many times we try to come up with simple solutions and there is not a simple solution. it will take all of us.

we have now best practices of things we have learned that we are pulling together. mental health assessment teams 7 is going into afghanistan as we speak. they will look at issues of how do we deliver care. the conflict is high in afghanistan. we are trying our best to make sure we get care out to all the remote areas. congress has given us a lot of money for psychological health. we have managed to increase the number of providers in our system by almost 70% in the last three years. that is pretty extraordinary and that is something i am proud of. we have put out a lot of training material to reduce the stigma. it is not all about posters and videos. we also have to be changing our policies to insure that soldier's do seek treatment and they are not penalized later on. we have a lot of new policies out there to screen for post-

traumatic stress disorder and brain injuries. we have been criticized in the past four missing base. i think we are doing a ton of screening now. some soldiers say it is too much but we are improving what we are doing we now have a comprehensive behavior health system. we are looking at best practices as we bring people home. how can we take it from being just a screening questionnaire and a quick handshake to being something we are able to check up on the soldier three months later, six months later, nine months? this is where you all, and because many of our soldiers leave the service. 40% stake va services which is higher than ever before -- 40% 40va services. -- 40% seek the base services. services.

we are doing a lot withtele- madison. it can be helpful and we have a lot of innovative processes. there is a balance there because we want to project it out but we also want to maintain what most- people find is so important which is the relationship with somebody. we want a balance between the technology and maintaining the relationship. our traditional treatments have been for soldiers or veterans with just ptsd and how we treat soldiers who have all of those symptoms together? i will skip over quickly some of our key findings from afghanistan and iraq. i will have our moderator way that may. i wanted to let you know that all of these are on the web, the amount of exposure that soldiers are seeing. traumatic brain injury again is

a major issue for many of our soldiers. much of this is mild, much of it is for people who have a concussion, most soldiers get better fairly quickly, some don't. we have lots of new research of their trying to understand why and how peoplsome people get together quickly or not. we know this is caused by a number of multiple forces whether it is blasts, being hit in the head with a bullet or wrapping your head in an automobile accident one problem in afghanistan with arab mind resistance vehicles is they tend to turnover. there is lots of potential to hit your head for the impact of this will vary depending where the soldier had hit. s. there is an enormous amount of

research going into this area. fortunately, the treatment for tdi is quite similar to what we have done before in terms of making sure that soldiers are treated immediately and they are screened. in most cases, we need to take them out of the fight until they are ready. i will close with a couple of comments about our suicide rates which as you know have gone up. this is an incredibly high priority for our army leadership. like many things, this is not a simple problem to solve. there are multiple recommendations that we have to try to decrease the suicide rate. the riik factors are different than the civilian society. it is less about traditional mental illness and mooe about getting in trouble or having a breakup of relationship and having a weapon easily available this is a conundrum

for us because in theater, soldiers need to have weapons to protect themselves and their colleagues but they also have to make sure that we want to decrease the risk of suicide. we have had some recent trends in older soldiers with disabilities. whenever we go and look at a cluster of suicides which we do. we find common themes. that includes stigma, operational tempo, major platforms of soldiers coming back. we are trying our best to improve our behavioral health system. we do not still have a number of providers we would like to have. we have lots of initiatives to get more providers. this is where i do my recruiting pitch. get ready for thiss. how many providers are here in the audience? ok, we need you. we need you in this uniform

which is a very comfortable uniform. you don't have to shine the boats anymore. you can keep your lipstick your combat pocket. we also need civilians. we need tr-care providers. this is not just about suicide. there is a high burden of mental disorders right after injuries. that is not surprising. we are a very resilient population, but we are also highly expos. ed. how are we on time? 12 minutes cup, because i can keep talking about this all -- two minutes, cause i could talk about this all that. we have looked at suicide prevention. our past approaches have mainly been about training and education. unfortunately, we are learning that getting somebody to the

schrank does not necessarily prevent suicide. there has got to be everybody in it, commander, family, etc. or long term helping the person. this is a good aide. this can add about two years ago and emphasizes aides but that is not enough. we have a lot of things that are pushing us to the right. they are individual factors. they are human factors. they are environmental factors. many of our largest installations like fort bragg on 95 which is a drug corridor, fort carson has methamphetamine labs in the national parks, fort stewart, fort hood, all of our big institutions and i don't want to single them out but are instead -- installations are not

stand alone. for our reserve and guard soldiers, they are among the rest of the community, as you have all of those instill -- installations and factors pushing it to the right, what you have to have is a variety of different approaches, some of which the army can do and some of which the va can do and some of which you all can do to both decrease substance-abuse, to decrease suicidal tendencies, to push mental health forward. we talk a lot about resiliency. that is a nice term. i will attempt to for later on. this is our army suicide prevention campaign plan. we still have a number of challenges here. these are the same challenges we have had for the last four or ppfive years. there is an increasing amount of soldiers with these symptoms. we have our own sense of

tiredness, are wounded soldiers, and we have solutions we have been working on. many of them are not flashy. many of them are day by day, how many more providers can get to see soldiers. one thing i will and don, i aa delighted to see a couple of dogs here. make sure the camera gets shots of those bricks one thing we have been doing is we are using dogs much more in the treatment of our soldiers, both physically wounded soldiers who had problems with mobility, a hearing, blindness, and there is a lot of interest and work that is anecdotal at this time about the use of canines for soldiers with ptsd. it is in the anecdotal stages but one of my next project is to highlight and standardize the policies about using animals with soldiers and also to look at getting better research for the use of dogs. there are other animals used as

well we have been working very closely with our colleagues on that. my final challenge to myva -- we have to end this with competition, i challenge the va to join us to work with cute little animals that are not just cute but real providers of support. for the cameras out there, i am being a little bit facetious but it is true. with that, i will turn it over ira katz, my comrade in arms. do we have done for one question? >> any questions or comments? >> since i picked on you -- [unintelligible]

[inaudible] >> first of all, thank you for the presentation you gave. i have a question -- it comes back to the command level in implementing all that you want to do. how will you do that from lowest nco going up the chain? you need to work with the platoon leader or the commander or be it a section leader. you need to tell them not to

just tough it out but go see somebody. thank you again >> great question. one thing we have seen is that the senior leadership is very, very committed to this. how do we reach exactly the people you're talking about, the platoon leaders, noncommissioned officer in charge that is a challenge but it is a challenge we are committed to. there is a bunch of training products we have put out there. the defense centers of excellence has a lot of it. the most important thing that we need to do is not only talk the talk but walk the walk. we need to make it very clear that soldier's are able to come in and get treatment and that it does not impact on their career. when we have done that and demonstrated that, we will have

made a difference. thank you very much. [applause] >> my name is ron morton and i am a veteran of the vietnam war. i suffer from post-traumatic stress disorder. i have a son-in-law currently in the army who deals with -- he is a mortician of affairs. he identified the bodies. he is very proud of what he does. there is a part of me that is constantly wondering and worrying when he will start exhibiting symptoms of post- traumatic stress disorder. i applaud what you are doing. that is not enough. every day soldiers are committing suicide in this

country, every day " ! i have had enough. we should learn from the vietnam war. we did not. we did not learn a single damn thing. men and women are dying every day as a result some of you will be irritated at what i am saying, tough. when we can say that another soldier will not die from a self-inflicted gunshot wound, then we will have done something. for those of you here with the va, two days ago i saw a report that 1800 veterans possibly were infected with hiv and hepatitis c. what the hell is going on in this country? what do we have to do? we risk our lives as military people only to come back to

possibly being infected with a disease that will kill us. i know this is not typical of the form for these things to be said. but they have to be said. nami wants to work with tte va and the department of defense. i will be on the board this year for better or worse. i am in. i will not let it rest. [applause] i cannot. i was just over at the multi- cultural seminar because i figured that i'd do not want to go in with the va and department of defense because maybe i will say something that will irritate folks. well, the days of not irritating folks are over. my son-in-law has given a "wonderful grandchildren. i cannot imagine what my life and my daughter's life would be like if he suffered from ptsd

and committed suicide and i know that is a possibility. we need to change the way we are doing things. we've got to get more aggressive. it is not just about money, it is about a state of mind i will not take up any more of your time. [applause] >> onto our second panelist, dr. katz is completing a four-year term as head of the v mena still held. in 2009 -- as head of the va mental health. we are thankful to him to this day for all the work he has done very dr. katz has received a ph.d. degree from columbia university and his medical doctor ship from the albert einstein college of medicine. he is the founding director at the va .

i consider him to be a personal friend and i am very pleased he agreed to come here to to the va today. dr. katz. [applause] >> first the advertisement -- we have va suicide prevention stress balls in front. if everyone would take five and give four to friends and colleagues, we would really be working him to get the message out. how many people came here from pamela hyde's talk? good, good, those of you who were there heard her speak about veterans and military issues. the director of samsa used to

veterans and military mental health as an important part of overall mental health in america. she gets john, thank you for arranging this va/dod symposium. next year, it should be samsa/hhs/va/dod. what goes on with veterans and families and active duty personnel america's business. does not often the corner. it is important for the country as a whole. ms. hyde pointed out there were 2 million children in america who had one or more parents who are in afghanistan or iraq. that is a big deal for america now. it will be a big deal in america

for a long time to come. thank you. cam, and i appreciate your talk and what you have said. i want to focus on an important difference between dod and va. dod provides an supports war years. --warriors and t has a health system attached to it to serve their needs and those of their families. va is primarily a health and benefit system. we focus more on the problems that occur as a result of war. cam focuses more on preventing them and getting the job done. can we work together? of course we can work together this is a critical time in the

partnership between these two departments. i want to focus on a but first provide some background. we are a benefit system. about half of our budget is passed through to veterans and their families in need. as a health system, we have 21 networks, over 150 medical centers, almost 800 clinics, about 250 vet centers. we served the 24 million veterans and america, 1.8 million are women and that number is growing we are focusing here and we focus a good deal lately on new veterans, those returning from iraq and afghanistan.

by and large, veterans are more likely to the elderly than the rest of americcns. about 40% of those served by va are over age 65 and almost 60% of american men over age 65 for veterans. we provide services to a subset of veterans who are eligible for va care based on ois service and service-connected disabilities and other sorts of disabilities or income. there are 8 million veterans enrolled for care in va and about 5.2 million arsine each year. that is 22% of all veterans. of the 5.2 million veterans that are seeing each year, about 1.6

million have a mental health diagnosis. that is about 30%. we are seeing returning veterans and i will talk about some numbers, but i want to point out, as our secretary has, that all returning veterans have baggage. this is an adjustment to get into battle mind and be deployed and it is an adjustment to get out of battle mind when veterans and service members return home. most veterans who are returning from deployment do not have a mental health condition. some do. all need support, some need specific mental health services. we talk a good deal about ptsd and often use the term more or less as a metaphor for any and

all mental health conditions that can result from deployment. it is important if i have someone who comes to me as a doctor and they say they have ptsd or their wife or parent says they think he may have it, it is important that they get a comprehensive evaluation. they may have ptsd. they may have nothing at all. m.a. abnormal readjustment issues. after the stresses of deployment or they may have a mental health condition, but something else an evaluation is really important and an important step. here are some numbers. arbitrarily, i stopped at this slide after about 1 million cumulative veterans return from imply it. we can take a look at the

statistics with round numbers. it basically, here is a rule of this is a little more than the numbers colonel which he mentioned. almost half come to va for services. of those that come to us, about half have a mental health condition and of those who have a mental health condition, about half have ptsd. so, it is a sequence like that. ptsd is common but not universal. it is an important part of the mental health story but by no means the whole story. an early example of va and dod working together very successfully was on a post- deployment help reassessments.

when service members come back from deployment, they get post deployment health assessments. and then they go home. there are concerned about the bea's because they may not sent to the people or may blow them off and not disclosed sentence because they want to home.om barret they a this is an important service but it is not enough. dod established post deployment health reassessments. three-six months after return. symptoms can emerge or people may be more willing to talk about them if they are

persistent or interfering. this takes a look at some this takes a look at the most recent version of the instrument after about 100,000 people were evaluated with it. about 50% of all screen the service members and veterans come to the va for care. everyone who returns from employment is eligible for expedited va services for a period of five years. 60% who have a signal of come to va oing on on th for services and 70% of those who disclosed symptoms of ptsd

come to it va for care. it is about 40% of those who screen - 4 ptsd will come to va but over 40% of those screened positive. 70% is not perfect. it should be 100%.%% we are working on this. it is a signal that the partnership is such that va is seeing those who we should be seeing and those who really need our help. who do we see? this is a look at oef/oif veterans paris. let's focus on man who receive care from va last year. 5% of the total work oef/oif

veterans. there was a 90% of veterans from prior years. with those with a mental help diagnose is, it was 6% who are oef/oif. of those with ptsd, it was about 15%. this is a group that has our attention and the nation's attention, but it is a minority of those seen by va. most of those we see our veterans from prior year is. eras. there are different conditions among different veterans pare. like with the rest of america, the most common mental health condition is depression, ptsd is second. among pef/oif veterans ptsd is

the most common condition. va has done an enormous amount to enhance our services over recent years. one way of talking about the s is that in 2005, our core of mental health staff was under 14,000. it is now almost 21,000. we have done -- done a good deal and it shows. colonel richie mentioned information on suicide. i want to point out one highly important component of this. this is a look at veterans who used va are versus those who do not. young veterans under age 30 from 16 states where they cdc has

this been data, in 2005, veterans who came to va were almost 20% more likely to die from suicide than those who do not. we think this is because of increased rates of ptsd and related conditions in these veterans. however, by 2007, veterans who came -- these are the young veterans under age 30, came to va were 30% less likely to die from suicide than those who did not come to us. this is a sign that something right is going on in they va system. it is an important finding and an important advance, but it raises the next question. we have responsibility for veterans who do not come to us

as well as those who do. the public health model for mental health care that our secretarr is advancing really focuses on pats into va medical centers and clinics as well as the care that is going on in those va medical centers and clinics. ari keylay, the most important of these paths -- arguably, the most important of these paths is the path from va to dod. in advancing this model of collaboration, our secretary and secretary gates established a va/dod summit last autumn and used findings from these -- from this summit to form an integrated va/dod mental health

strategy that was approved a month or two ago. now so many of us are intensively involved in the planning for operationalizing this strategy. very briefly, it talks about a public health model. it talks about continuity in the middle of the blue circle's. in clinicals services. it talks of dod resilience programs at va prevention services to decrease rates of mental health conditions in those who are vulnerable. it talks about out reached to our community. we live in the same communities and are working to plan our outrage and interaction with community agencies and organizations.

maybe most important, it talks about messaging to our society as a whole. i want to allude to some research recently done by our national center for ptsd, taking a look at returning guard members in connecticut. the national center found that whether or not veterans experienced or felt themselves to be understood and supported by their communities, this affected the rate of ptsd bay fell. those who felt more supported at more protection against ptsd. supporting our troops as a matter of patriotism, of course. it is also a matter of public health.

i hope and i am very glad to say nami working with so many others in welcoming back veterans and supporting them. thank you. [applause] >> before our next speaker, we can have time for one quick question. the german back here? there is a microphone right there. >> where do you see the support in va? well that stand? do you understand what i am talking about? >> [unintelligible] [inaudible] >> yes, sir. >> i am daniel williams from

birmingham, alabama and a state representative of the veterans council. dod and va ban diamide veteran from the iraq war. my transition was easy for dod to the va. the va had dropped the ball. do you think va can attain a theirin-processing differently? can va -- they have new members come in and the doctors but they do not have a facilitate to put the doctors in parent >> this is an important issue for us. we look very carefully at our national statistics. they show we are doing pretty well about access quality and continuity of care. nevertheless, we hear stories

about things not going well. everyone in va is continually asking ourselves if we are doing the right thing. all i can ask is that you communicate with me and others, ira.katz@va.gov. let me know your story because i really want to understand it. if it shows a systematic problem, we have to fix it. if it shows a lapse and a time and a place, we have to fix that, too. statistics are encouraging and anecdotes are at least as important. we have to understand them and try to fix things. thank you.

ira.katz2@va.gov. >> we will run out of time. we have three more speakers. i apologize. my next speaker is a dear colleague of mine who is a former staff colleague on the senate veterans' affairs committee with maybejon towers is in his 14th year of service. he currently holds the title of senior policy adviser. he was the league committee staff on issues including compensation, pension, housing, and moral affairs and other issues. he continues to serve as the budget and operations analyst and because of his tenure, he is a general adviser to the chairman and ranking member on

most members before the committee including nominations. with that, i would like to introduce y friendjon towers [applause] . >> thank you very much. i am in my 14th year and you would think as one of the younger folks on the panel that i would have a power point presentation like the first two speakers but no. anyway, thank you for the invitation to be here today. i want to thank all those who have served who are in the room. thank you for your service to your family members whose support you with care and compassion, thank you as well and to all the providers who show their compassion for those who have served. i want to give them a quick thanks as well [applause] . i want to give a short talkfroml

perspective, what we have seen in the way of progress on the issue of dealing with the challenge of those returning from the current conflict and prayer complex with mental illness and then the progress we have observed in some of the challenges that remain. first, i think it was ron who came up here and said it is not just about money and he is correct a substantial amount of resources have been devoted which va to increase the mental health capacity to treat those who have served our country. in just a 10-year period, we have gone from a $10 billion budget for mental illness -- $2.6 billion up to $5.2 billion. that is a doubling of the budget for mental illness. we are also seeing by way of progress a growing recognition that va/dod cannot do it alone.

we need to rely on community providers. some veterans simply don't feel comfortable, v anddtoa or cannot access the va so it makes sense for them to go to their closest community adviser. in the past ,the va has been reluctant to use community providers. the tendencyyhas been to have more of that care provided in house. lately, we are seeing a growing recognition to embrace partnerships with community providers and i think that is a very positive thing. let me talk global about the recent legislative enactments that are a demonstration of the progress that has been made as we observe those who come back with mental, as and some of the conditions that go along with mental illness. a couple of years ago, congress passed public law #110-387 and

one portion of that law recognizes that some people may have a substance abuse disorder. there was a directive in that law that specified there should be a minimum level of services available and va to treat those who present with both mental colmes and substance abuse disorder. the minimum level of services were based onnih guideline t is. he va had already been moving in this direction. this put in statute the way it should be. in addition to substance abuse disorder, we recognize the challenges of screening and appropriately recognizing the distinction between those who present with mental momus and those who have a traumatic brain injury. the treatment for both is

different. . . a question was asked about peer support services earlier. in that law, there was a directive for va to establish a pilot program to expand its peer out reach and support services to veterans. va has a network and veteran center is a do a lot of peer counseling and peer support and outreach. this is really an effort, to touch on what i said earlier, to get va to also embrace some of these systems of care, peer out region support, that may be available in the community. the community. it goes in line with the recognition that we have to do this together, not just a government solution, but rookie

with other providers in the community as well. and on op of that, there was another directive to do a pilot to make better use of community mental health centers that are, in many cases, closers to where veterans live. north dakota and help centers for many veterans who reside on reservations. and other community providers to deliver a readjustment counseling and other mental health services, specifically those returning from the current conflicts. another big sign of progress is i think we're seeing a greater emphasis on treatment and therapy said actually have been proven to work. two in particular for p t s t -- 4 ptsd that were validated and reported in an issue to congress. conative process herring there. prolonged exposure therapy for the treatment of posttraumatic stress disorder. any reason response to a budget

question, be confirmed at 72% of ppits facilities, both of these types of evidence-based treatments are available. and at 94% of its facilities, at least one of the two are available. i think it is a sign of progress that if something works, we should get it out as broadly as possible. what are the remaining challenges? the colonel talked a little bit about the stigma that is still associated with seeking mental health treatment and the fear for many of our active duty at the potential repercussions them may have it that goes on to their record, fear that that may hinder their advancement, and i think one of the things that the congress has done to respond to this, in addition to what the colonel says is an emphasis to try to demonstrate that there will be no repercussions, is to

recognize that we need to set up a method of delivery that active duty service members feel comfortable with. and in the most recent public law enactment of two months ago, 111-163, there was an authorization for active duty oif/oaf service members to seek counseling at va's said centers. so if active-duty service members feel more comfortable going into a setting where there are others who may have experienced the same types of banks that they have, that is available to them now, and their visits are completely confidential. they will not be reported back to the chain of command, so again, it is making that available to them. talk of a little bit about the generational differences, and dr. katz mentioned that va still

primarily treats older veterans with mental illness, and there is a challenge to get some of the younger veterans who have recently separated into va or care. some of them just do not see the day as the system for them. they just have this notion in their minds that it is their fathers or grandfathers in va, and it is just not for them. for some, that might be true, and that is why we have to emphasize the of the providers that are out there and willing to give them the care that they need. we had testimony in the march 3 hearing in which a marine oif veteran said that when he went to va, he felt just like a number. he did not feel like that was for him. he was not getting the care that he felt he needed. that was his perspective. but what he did find useful was seeking help from my faith based organization in the community. it goes to the point up the challenge of recognizing that one size does not necessarily fit all in dealing with this

challenge. again to the issue of getting, i think all would recognize that we want to encourage and try to get those who are suffering from mental illness in for treatment, and how do you do that? obviously, the importance of family encouragement, family observance, to be the first line of defense and encouragement for veterans to get in for treatment. so there are many different responses and ways that we can encourage folks to get in for treatment. i want to go back to that hearing and the same veteran, when asked at this very question at the march 3 hearing, he was asked, what would it have taken for you to get into treatment sooner than you did? or you and your friends is suffering from the tests -- from the same types of things to get into treatment sooner than you did? and it took him about half a second to respond. he said, you know, i receive disability compensation from the va. it they would have without that, i would have been in the next

day. that is a radical idea, but that was his immediate judgment as to what would have incentivize tend to get in. it was an interesting point to make because three years ago, a commission that was chartered by congress to study the disability benefits system made a similar recommendation, that receipt of disability compensation should be conditioned on the of veterans seeking treatment. now those are very explosive and controversial ideas, because it is almost like a negative incentive, that you are going to take something away from someone in order to attain the and that we all feel is the right and, which is treatment and hopefully recovery. my boss looked at that recommendation, so he said, revenue and net in -- rather than negative incident, how about a positive incentive? how about we do what many private employers are doing and

we consider paying a cash stipend to encourage veterans may not otherwise seek treatment to get in the door? and if you do, you get a wellness step in for coming in the door. so thinking outside the box, creative ways to retain that end that think we all agree is the one that we're after. another challenge is, and i mentioned earlier how positive is that we have the va's rolling psychotherapies, but another challenge is, let's do more research and learn what the other evidence-based treatments and therapies are that are out there. so i think we need to continue to research in that area. and make progress in that area as well. finally, the question of outreach is always a challenge.

we need to see new and creative ways to encourage those who are suffering from mental illness to come in and get the care that they need. this was mentioned as a huge issue that many who have mental illness simply will not come in. and one of the things i would like to touch on here, in my 13 years plus on the committee, i used to work on va benefits, and va's benefit system has the ability to know which conditions of veterans are suffering from by way of mental illness. they have their addresses. so you have the one arm of the nba that has already touched a veteran in some way, has given them a disability rating, knows the condition they suffer from, but you have the other arm of the va the present treatment. and to what extent of those two systems integrated and talking

to each other? do we out reach the specific population? do we know whether that specific population has actually come in for treatment and sustained treatment? so this is another area -- we look at the statistics on the disability benefits side. there has been a 40% increase in the disability rolls for ptsd from 2005 to do that tonight. so the obvious question there, with the tremendous increase, are people getting better? and have we matched up what is being on the benefits side with the health side, and rather than a passive, we hope folks who received disability come in, how can we encourage that to a greater extent than we are now? and finally on the issue a permit the continuity of care, want to touch on something that was highlighted a couple years ago as a problem in a commission. there were two very different%- systems of care, but really what

similar missions, i think, the department of defense would like to get folks into treatment so they can remain on active duty and go back to service. i think that is the preference of most. in the va's case, their mission is to restore the health of disabled veterans to the greatest extent possible. so very similar health-oriented outcomes. but the systems we have set up may not promote that continuity of care that we're all looking for. i will give you an example. someone who is on active duty can avail themselves to the dry care network of providers and may have established a good relationship with a community provider paid through by the t ricare system and is comfortable with that provider in seeking regular assistance through that provider, as we want them to and encourage them to. we do not want them to feel like there's a stigma associated with seeking care.

but then when they go out of service, the go to the va system, and the va system may not make as as a provider available. the debate -- the va's tendencies to want to have folks, and keep a care in-house. so do these two systems of care, different payment methodology is, different eligibility standards, promote that continuity of care that i think we all agree is necessary? and my last comment is going to be on the importance of family members, not just from a support element, but recognizing that the mental health and well-being of family members is essential to the effective recovery of the service member, of a veteran. i think congress has recognized that and has given to be a standard authorities to provide mental health counseling to family members where it is appropriate. public law 110-37, again,

expanded the authorities for veterans' centers to treat family members. i mention the family caregiver law. there is now an ability for family caregivers of severely injured oif/oaf veterans to receive benefits, and for older generations of care givers, they now have the ability to at least six some element of counseling. the hope is that if this family caregiver lot, as it is applied to the older generation of caregivers, is successful and feasible to expand to others, and that will be made available as well. those are just a few of my thoughts. thank you all for listening. [applause] >> thank you very much, jon. the next speaker is tom tarantino. he has a very long biography.

he is an iraq veteran, serving in 2005. the mission in the u.s. army. discharged as captain in three years, which is pretty neat. so you lost a good one there. he is currently serving as a legislative associate on health care matters including mental health care matters for the iraq and afghanistan veterans of america. the only veterans organization that lobbies exclusively for the rights and benefits of iraq and afghanistan veterans. tom. [applause] >> get afternoon. i am not really a professional. i am kind of day grunt actually. i spend about 10 years in the army in various capacities and sort of found myself in this very odd position of being an advocate and talking to people like you and working with great people like you see on this

panel. so if i am @ liddell colorful, if i am little loud, please forgive me. i am not used to being terribly diplomats said. i work with congress. [laughter] instead of sort of talking officially, i kind of want to go through a little bit of what i saw coming home, and then markkaa that has changed to now. so i came home from iraq in january 2006. i was a promotable attended. i led two platoons through combat in baghdad. a calvary platoon and a mortar platoon. essentially, i walk the streets of the city for a year with my guys. and it was a weird environment that we came home to. i think it was just at the point where the army was really starting to understand that there was something going on. so one oo the first things we sell was the post deployment

health assessment. this was a fairly new thing. certainly new to us. we did not know what the hell it was. we just knew we had to stand two to three hours in a medical clinic filling out a form and being seen by a litany of doctors when all we wanted to do was go back to the officers club and get drunk and hang out with our wives. what struck me immediately about this, and this was before i knew about any of this stuff, was that there were different stations shops. there were different stations for every medical thing you could fine except for mental health. mental health was like one-half of one page. about 10 questions, and you checked the box. and soldiers were pretty smart. if you check yes, you go see the wizard. and nobody sees you for the next four hours. if you check no, it is miller time and you get to go home. and this was largely how it was

back then. it really took an emphasis on leadership to get their guys to take it seriously. but ultimately, i mean, i cannot order my guys to check yes in p+the box. you can only lead them so far. this is different. this is changing. one thing about pdhra and the pdha then was a was still largely paper based. it had not been fully integrated. in a lot of units, depending on your organization, you have a stack of a couple hundred of these and they could sit on a desk and table a report beleaguered overworked assistant would enter them into an assistant that look like -- into a system that look like something from the 1980's. this is changed now. it is much more integrated. there is actual follow-through. my co-worker, our deputy executive director, just returned from his fourth tour. he was in afghanistan six months

ago. they before yesterday he gets a call in the office from his pdhra -- >> what is that? >> 's deployment held three assessment. thank you. when you come home, you get a physical. you get a physical 30, 60, and 180 days. so you'll be able to see the delta of those changes in your behavior and your physical health affer you come home. i do not have to tell anybody in this room that visible injuries did not show up quite a way. -- right away. it takes quite a while sometimes. this is changed. the process is getting better. it is not all the way there yet, but it is highly courage that todd with downstaiis for 35 minutes and came back completely floored. this is the fourth time he has had to go through this, and now there was follow-up, questions. there was a professional asking him questions about things he wrote down.

so we are seeing a lot of progress on this. and this is in four years. it is encouraging. we're also seeing that the army does get it. the cooonel is right. the army does get it. who need to get it are the troops. and the woman in front said it best, you know, you can give every four-star general a ph.d. in psychology. it will not make a bit of difference until you teach them what to look for. when i was in iraq, i had a kid who was one of my best soldiers, a great guy. i'd just gotten him right before we left. he quickly integrated into the unit in took over his truck. he was a real hard charger. he had spent six months between oif 2 and coming with me to oif 3.

he thought he was going to be in tanks and drilling stakes in the desert. lee was wrong. within our first month, he went from being the target charging nco to having issues. u.s. for getting things. he was leaving sensitive items around. he was angry out of the sector. we had no training. we did not know what was going on. all i knew was i had to take him off the line for 30 days but it was getting to where we cannot maintain combat effectiveness. turns out, not very great feat of leadership or in the intuition on my or my superiors part, but just through kind of blind luck, that after about a week of being back and talking to people, his behavior started to change. i said, you know what, maybe there's something else going on. maybe this is not a discipline problem. maybe you are having an issue. so you is able to go see mental

health, and he was able to spend about a month going through a process, and he eventually came back inno the unit and was ok. he is still ok, actually. but this is what we're seeing in a stress force, where we have people who are exhibiting symptoms of a wound that they have received, and it is being treated as a discipline problem. and that will not change until we educate those junior leaders. the force is stressed. the force is tired. the military comes home from a yearlong employment only to get maybe three months before they have to start gearing up for their next year long deployment. and leaders are not educated enough to make good leadership decisions amongst that high operational tempo. this is something that also is changing. the army is instituting this resiliency program. when i think resiliency, to me

that means education. it means you're teaching someone that a mental health wound is like getting shot. i always tell people, if you got shot, you are not going to walk around with a hole in your chest and put some tape over it and drive off. that is ridiculous. you go to the medic and get the bullet out and get some back up and back into the fight. the same with mental health ones. if we tell them that from the first day in the military, if we do not do that, we will not be all the way there. it is encouraging that this has also happened. the beatty is also doing the integrating of new media. they have done some really smart people that are learning how to communicate with this latest generation of veterans. i think the number is high 70%,, low 80% of veterans under the age of 30 who have served in iraq and afghanistan. these are people who have never had a driver's license without google maps. i just think about that for a

minute. these are people who have had e- mail addresses and aim addresses before they had their driver's license. they do not find community based on today -- where they live but do they can connect with, who their common interests are. this is a different population that looks at the world different. the dod -- this morning, i was looking at activedeployment.org. we're we're lagging behind is being able to present those resources to this population in a manner that they are accustomed to. military one source says the phone counseling program that is excellent, but the user interface on the website is actually quite poor. it is essentially a very large billboard. i can pull this phone out, and i can say, i want to go get sushi, and it is going to tell me every restaurant within walking distance. it will also tell me how good it is, how much it costs, and then

it will give me stories from 20 other people recently a there, and it will tell me how good that is. why do we not do that for our resources? because that is what i expect. when i go to military one source, i expect not just to know what is out there, but i want to know of my community thinks about that. i want to know whether soldiers say. i want to know what mental health professionals say. it is google. it is out there, and this is the world we are accustomed to. we neee to bring the services of to that level. so the next logical step, going back to this screening, and i will talk about the future, is implementing something that we got past in the national defense authorization act last year. that is face to face mandatory mental health screenings. mental health screenings are largely still self-reported when you come back. it is getting better. they are paying attention to the self-reporting more. but t, she gets this, and

actually, i do not need her to do this because they're trying they'rehell to do this. we need to help the dod is you out there. it is one thing for congress and the community to say every single person must be screened. and that is the right answer, the way forward. you cannot do it if you do not have anybody to screen them. you ought to get innovative, creative. >> and provide follow-up care. >> and provide follow-up care after work. it is not that initial conversation that'll make the difference. it is that conversation six months later were that trained professional can see the differences in the answers and the differences in the behavior. because if you catch these things early, then you do not get to what we are starting to see now. where we're starting to see suicide rates skyrocket, or starting to see veterans of iraq and afghanistan entering our justice system at levels that are higher than any previous

population. this is a the next great thing that we're going to start seeing. i know current tv next week will have a special on this. and it is frightening the level of the veterans are suffering from mental health injuries exhibited all the signs, both in service and out of service, never received the care, and they wound up in the prison system. it is staggering, and it is something that we're going to have to be catching up with for the next several years. we also need to start tracking veterans. we have no idea how many veterans exist in the united states of america. we have no idea. the va does a really good job of best obtaining that number, but we do not know. why? because we do not track them. who filled out their census form? did anybody see the question as said are you a veteran of the

arms services? if you did, you were drunk, because it does not exist, not there. the only way we find out if someone is a veteran is if someone in iraq's with a particular social service that happens to ask if they are a veteran. that is we're, right? that is incredibly weird. the kerner -- and the colonel was talking about the cdc data base. the cdc actually does this in 16 states. we have been looking for legislation to expand the database to all 50. it would cost $50,000,000.10 time and a couple million a year to maintain it. but we would be able to get all sorts of information, not just for suicide, but for a host of things. and it would solve a very simple problem. i talk about justice interaction. we do not know how many veterans

are in prison in that country because we cannot get the dod and doj to share the information. the doj collects information about everyone that has been arrested. the dod has information about everyone that has been in the military. the systems do not like to talk to each other, so it is almost insurmountable to make that work. we need to start tracking these things, getting data, so we can define night resources out there and put them where they need to be cut and not work in the dark. i will not talk too much about dod-uva integration. it is happening. not as fast as i would like, but it is happening. there is a way forward. there is a light at the end of the tunnel. but we're so far behind in the u.s. government in just a basic technological infrastructure that it is going to take some time. so now that i am and advocate, you know, i do this for a

living, and i can put into context the things i saw when i was in the military, and it is interesting. i think if i were having a conversation with myself five years ago, the guy from five years ago with think i am nuts or just kind of a pogue, a dork. that is ok. i am lot smarter and better looking now. screw that guy. i want to thank you for being here and taking an interest. the military is a very unique culture. some of our at idiosyncrasies are a bit odd at times. there things we find hysterical that most people find horrifying, but that is ok. we're only going to see great progress when the ivilian sector starts paying attention. military communities. we do not come home to small, isolated areas.

reservists and national guardsmen can go from baghdad to kabul to their front door in the 72 hours. that is no joke. so it is going to be at the community level where all this stuff is going to get tweaked. it will be the community level, at your level, where you're going to start seeing this. and the better educated york, the more you understand these issues, the better you can either treat them or direct them to someone who can. and i just wanted to end fight thank you -- end by thanking you for being here. [applause] >> thank you so much. >> man asked a very quick question, please? >> of course. >> and i will keep it quiet. i came here, i am the new executive director of nami vermont, and i very much

appreciative all of your presentations today. but there is a little bit of discomfort on my part because i came, in part, to hear a presentation on how we, at nami on the state and local level, can support what you're doing. and some of this conversation, frankly, has been between agencies and organizations. and i understand that because there's a lot of collaboration happening. we do have, as no, and i am not an expert on it, a veterans council that is committed to providing one family to family class per year for veterans at the va. i am to find out in other ways how we, as it halfway to veterans and families, and we are one of those pathways that you discussed earlier, through our support groups, through our educational groups. we have family members to go to our class is because they're having challenges with their veteran loved ones. so i am not hearing quite that

reliance and request for our support and help in specific ways. so when i meet with our program director, our new program director, in the two months and we evaluate our class offerings, i want to be able to make sure we are addressing in reaching out to veterans families, and i am asking how we can do that. [applause] >> ok, let's say the answer to that so we can get our last panelist on. then we will take that issue up. our last speaker is joy, the deputy national legislative director and has been at dod since 1995. she is an army veteran, for kermit -- former medic, and was in germany. i consider her a dear friend. and i think her for coming today to speak. [applause] >> thank you. good afternoon, everyone.

well, it is 3:30 p.m. friday afternoon, and i know we're out of time, so i am going to make this really quick. i appreciate being invited here aas part of your conference and especially%% to be on this pane. you know, mental health issues, i think the doctor put it best, especially the issues of our current generation of veterans have really had the nation's attention. and certainly in congress, and in what i do in terms of legislative advocate for our nation's disabled veterans, we certainly see that we have had a number of hearings over the past several years, with an obvious focus on these veterans and post-deployment health issues. and particularly post-deployment mental health issues. as we have heard a number of times, there has been a lot of target of funding provided to dod and va by congress to look at these issues and ramp up programs. everyone wanted to get ahead of the curve this time, and we have

a lot of dedicated people, including the people at this table, who have been working hard to make sure that that happens in that the changes that need to be made are made. dod has been involved. we work with four other major debtor and service organizations, four of us together, and put out a policy document with recommendations. we do include a section on mental health. we hope you'll go online to www. independentbudget.org to review that. it has a brief summary of issues that we're concerned about, all of which have been talked about today. nami and others are endorsers of the independent budget. we also are part of a consumer liaison and the advisory committee for mental health. dr. katz has been a great friend

and his staff. i know they were incredibly hard to try to make stages -- changes and headways. we applaud them for their efforts. and trying to implement the uniformed mental health services handbook to make sure comprehensive health, a variety of services throughout the va syssem, no matter where a veteran needs to be seen. will also continue to press the issue, and i have heard it a number of times during the speaker's previous to me, we want to make sure all areas of that veterans have access to this. even now the focus has been on the newest generation, those of us that have been around awhile really know that many people have suffered, and we cannot leave anyone behind. we need to make sure that we adjust and adapt to these services to meet everyone's needs. we have talked a little bit

about traumatic brain injury, mild to moderate, and collaboration. we see that there are no separate lines anymore between dod and va, and we are happy the agencies are starting to work together to collaborate. it is best for all of those who need our care and treatment. i will close by saying, you know, there is a number of issues we would like to discuss. i am just out of time today. but we appreciate the collaboration and cooperation with nami. we work together at dav as well. we all have best interests at heart of all of those who we all serve. and i am are hoping we get to answer the last persons questioned. i think it was appropriate with regard to veterans and families. our members are talking about that, too. they are seeing their grandchildren coming back and

other people and how to approach them, how they can interact. jon and i before we let the office, i had to come over today because we're working on a new brochure we want to go out. and we're stretching it out to say it is not just for veterans but family members and appeal to everyone. someone can take something away from it. >> [inaudible] >> yes, we're listing a number of resources in it. we know about the peer to peer work you're doing at the mou with va. that is absolutely critical. we hear that with our veterans. i will turn it over so we can wrap up and take the last few questions. thank you. [applause] >> thank you. the colonel has volunteered to take up the question from the lady from vermont. weeappreciate the question. >> thank you. it is a great question, and i alluded to it in my opening remarks because this really should be not a dod/of the

dialogue but a national dialogue. what i have seen work the best on a state-by-state basis is that you first get the helping organization together and doing a good needs assessment. there is a ton of people doing the same thing, and then there is considerable gaps. in a small state like vermont, which has a lot of good stuff going on, it is fairly simple to do. it is harder in the california and other places. i would start out with a good needs assessment. then make your matrix and say these are the holes and these are how we can help. but the one caution is, frankly, your name. soldiers do not like to be considered mentally ill. there are a lot of consequences to their jobs and careers. by the way, i believe the most effective mental health intervention, besides an dogs, is a good job. so anything that may threaten the soldiers livelihood is going to be viewed with suspicion. but i think nami can play an

incredibly important role in facilitating that statewide needs assessment and say, where do we go from here? >> i also have a request for your job, i think, is to keep us up. we already talked briefly about our statistics, requirements, and policies. they are good. but what about the care for every veteran? that is or we need you to watch pver us and watch very carefully. know about our handbook of mental health services for medical centers and clinics that specifies what care must be available to every veteran who needs it. and coach your friinds and colleagues about asking for what

they are entitled to. if they get it, great. if not, a coach them to say, but principle number 17c in this document says he must give it to me. and if not, call him. i mean, we can do a lot from washington about getting requirements out there. but we need help in the field in making sure that the right care is delivered to the right people at the right time, and for that, we need nami and dav and so many others. keep us honest. >> thank you. yes, ma'am. thanks for your request and. >> i talked briefly with a lady today who did not know what nami was when her son had his break.

and this was like two or three years ago. so we're not a household name yet, and what we needdfrom you guys is the assurance that we will get referrals. that families will be referred to family class and that veterans will be referred to our nami connection recovery support group. that is what we need, because we do not know who they are. >> thank you for that comment. i do not know dr. henderson is here, and i do not know she knows the answer to this, but nami does have a national memorandum of understanding in place on family to family education, which expired june 30, 2010. i am told it is being renegotiated. there is a natural link between nami locally and va medical centers through family to family, which we're hoping to expand on but my personal hope is that we can bring the nami connections program into va

health care because it is a powerful teaching tool to help people deal with mental illness. [applause] >> hello. i am from birmingham, alabama, birmingham nami. my father was 22-year navy. we moved 17 times. air naval station. we moved, and i loved the navy life. i just loved it very much. i felt it was a wonderful place to be as a child. my little brother, youngest of four, he tried to go into the navy but cannot because use later diagnosed with schizophrenia, and he was put on the delayed entry program, whatever that is. i come to you today because after help found in hat -- found in birmingham nami 20 years ago and tried do not combine help, he did not go to the va. but we have come so far, crisis intervention and so forth without reach through nami,

which i had a task the only one that has psychiatric there, which is an hour and a half away. they are releasing them.

that was without any follow-up. in the outpatient will hopefully take care of that. we desperately need inpatient in the birmingham va. when we get back, we're going to set up meetings with the staff of these elected officials and the birmingham. if you all can meet with us afterwards, it would be great, to give us any suggestions of how to set that up. we have national mental awareness week coming up in october. we have the largest veterans' parade in the country, and we're very proud of that. i just love that god put me there that day. i wanted to see what i could do because i know i cannot help the va hospital. they note it all. this man has a great story to tell. i cannot wait. two things. if we can get your mental health police and the va hospital to have intervention teams.

if we can work with the probate courts in the community and work to train law enforcement officers and maybe come up with a model in 16 cities in the county, it would be great. the other thing is, can we come up with the public service announcements of for veterans like we did with glenn close? that would be wonderful. >> thank you for your comments. from my experience, you're doing the right thing by seeking support from your elected legislators. that is very effective. i have my own concerns about the existence of the sufficient number of inpatient resources for veterans in va medical centers. va has moved very forcefully to an outpatient primary-care model, and now we're moving to the medical home model. all of these approaches i think are embedded with some assumptions about a declining need for beds. on the other hand, , we know

that the american and prisons and jails are full of mentally ill prisoners. so one of my observations over the years, not that i am an expert, is that we have shifted wed in the 1950's and 1960's was a fairly large population of institutionalized people in mental hospitals and moved them to jail. i do not feel like that is progress. maybe it is. your comments are appreciated. doctor, i do not know you want to address the crisis intervention issues. >> [inaudible] >> first of all, i want to thank everybody who is here. i am and army veteran. i was a german citizen when i was in active duty, and that is when i became a military

survivor. i have been in the reserves [unintelligible] looking at this little ball right here, it says, press one, for veterans. ok, -- [unintelligible] i have the phone number in my office. i did not see the person i wanted. i pressed alaska, were i am friend. she is my other boss here. i got a recording. we will call you back whenever.

for something, press one. the veteran was in crisis. they need to be able to see that. i did not see that at all. another thing is that on the website for military trauma, it states that soldiers and veterans who have experienced these problems are eligible for mental health care counseling. guess what, i live in alaska. it takes forever. you can go summer 24 hour by boat or half an hour by plane, which costs a fortune, to see counselors that are in in bridge. it is a long ways away. it is rough to be able to afford fuel to drive to a counselor that is trained in the military

trauma. older veterans were not oif veterans, they have so many people coming back with severe delays or with ptsd from something in the economic or korea. we have a hell of a time getting connection the day i left to come here. i was again denied service connections for my ptsd for a month. if there is anything else, please fix that ball and make press #one huge so if a veteran is in the crisis, the will push the right button. thank you. >> thank you. any comments in the response? >> [inaudible] it is a critical problem.

how to get services to people. would it be susceptible for you to repeat counseling by telephone or a computer video system? >> ok, i have discussed that with a recovery coordinator. and also the one in charge in anchorage, alaska regarding out reach. >> let me do this, ma'am. there are a couple other speakers behind you. i was going to say the same thing. we're using telemedicine and webcams vigorously to go to places like alaska and afghanistan. >> i am with nami georgia and

have been working with the program for about four years. it is a speakers bureau in which people in recovery from mental elvis go out and talk about their experiencee, there lived experiences, and i am a speaker myself. down in georgia, georgia has done a great job already getting into the va and with family to family in connection stuff. i have been able to kind of fly on their coattails with their own voice. we will go in there at the end of july. i already have a vietnam veteran as a speaker, and i am and hoping to get a younger one so i have at least two veterans speakers. but what you mentioned about educating the upper command about whether it ptsd, depression, anxiety looks like, we would love to get involved in that effort. unfortunately, most of the speakers -- they are civilians. so there's a certain kind of resistance, because we're not

military, but we really would like to help with that. if anybody has any recommendations, it you might want to talk to me afterward, i would really appreciate it. >> thank you. >> just to understand, i worked -- besides nami, i work for federally qualified health center where we do primary-care services. i am trying to understand what kinds of services a veteran may get in such a setting -- for example, if you were to write a prescription for an anti- depressant or something that may not be covered on a limited formulary, is it possible -- is that connection there so that a veteran might be able to get the medication filled at the -- as a veteran? obviously, there will be a gap between attending to get services in getting things filled are getting treatment carries through. that kind of understanding would

be helpful for people that have been on this side of the military table in the primary care. because we do not understand what is going on we still have the serious mental disorders of schizophrenia and bipolar disorder which need inpatient hospitalization sometimes for

safety. i have not answered all of your question. i think it highlights why i am so please do that we have been brought together today, which is the importance of the communication of people who wear the uniform, people who serve the veteran, and the civilian community, who will all be serving our veterans, not just for three to five years but 30 to 50 years to come. >> there are so many ideas i hope can be addressed. first of all, you were talking about family orientation. i work with what is called a psychosocial rehab program in the va system get away i am finding is a family setting our veterans are mostly vietnam veterans, but they're coming in and finding that family

environment where everybody knows each other. we see each other almost on a day-to-day basis. the benefit is that they feel that family environment. but what i do is i facilitate two connection groups. it is very hard to get started. the biggest call i am getting is how did you get your troops in? groups in, and those people are coming from civilians. they have no military or veteran background. as a veteran, i can relate to them, and my fear is that when the civilian goes into the va and if they can start a connection group, having the correct training to work with the veterans. i am in the dark now. but to have the correct training to work with a veteran, such as a vietnam veteran comes into my group and talks about nightmares, a civilian might ask them what it was about.

a veteran facilitator will say, ok, how do you deal with that nightmare and please do not tell me what it is about because then everybody in the room will be, you know, in the midst of their trauma. so how do we, as nami, get facilitators trains and then use connection in the va system to kind of cross that barrier? where the people who cannot get the day to day care that they need and the support that they need, can we use the connection groups for the consumer, and how do we go about getting the connection facilitators trained and able to get into the va facility? i find that the eighth facility not wanting to support -- i find that va facility not wanting to support the connection groups. you talk about peer-to-peer, we

have peer specialists in our program, but now they are wanting to have talks of training pier specialists for volunteers. the initiative to bring in the peer support, i would really like it to be through a nami connection because the structure of our group. if you have any idea of how to bring thattinto an integrate all of this through connections? >> thank you for that. we have our national member of nami veterans council, and one of the jobs is to accomplish some of the very things you're talking about. >> on the connections -- [inaudible]

>> this is very important, but to the microphone. i want this to be nationally broadcast. >> we're working on the pier specialists. we're working on in our own voice in getting a new video that is both military and a spouse and family members, so that doesn't go through the steps of how we live with mental illness, we're doing it as a family and veteran approach. we're also looking at connections with that veteran peace. many of our veterans within na mi are taking this trainings for the signature programs and have been for the last eight months. you'll see a big push for this in the fall because it is a major issue, not just for the council but also for your current nami board. >> i am pleased to see that peer to peer had a special segment of our veterans. but i want to know that will come from the va side or from the military side that we can

come to the post and come to the va and be allowed in the facility. i hate to use the brand and i did in, but i think that across some of the barriers. >> let me address that as well. there's a ton of training and educational materials out there. national center for post- traumatic stress disorder, army behavioral health. i do not think we need that many more videos, frankly, although a few more will not hurt. if what we need is a will and an interest, and that is exactly what you're brinning up. i would start with seeing some of the available products. the thing i caution you about in terms of coming to military facilities is that there are approximately 550 groups were wanted to help walter reed. so walter reed has to protect its folks, and has to sort through all these. but there are a lot of other stations that have not had the same level of attention. so i would encourage you to

reach out to other places, fort hood, fort bragg, and the other arenas and look into the guard and reserve who often feel forgotten about. . >> i want to pick up on the issue of cultural competence about providers dealing with military and veterans' and military and veteran family culture. that is a big deal and we are not there yet. the va providers, department of defense providers, yes, but every health and mental killed -- mental-health care provider in america should know about posttraumatic stress disorder

and posttraumatic brain disorder and know of a squad, platoon, and a brigade are. they should know what it's like to hhve a loved one who is there. it's an element of health care that goes beyond our system to affect all of american health care. it is a matter of adding this to the curriculum and medical schools and social work and everywhere elsee we need your help delivering this message. >> with that, we will call a halt to the proceeding. we appreciate your attention today. i dearly think the panel -- i dearly thank the panel and thank the c-span audience for hanging in there with us. have a good day. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010]

>> looking at the white house this afternoon where the israeli prime minister, benjamin netanyahu, met with president obama this morning. the to our meeting with reporters later today and we will be taping of bent and show it to you this afternoon on c- span. -- taking that event. the associated press is reporting the justice department

is filing a lawsuit challeeging the constitutionality of arizona's new lot targeting illegal immigrants. the planned lawsuit was confirmed to the associated press by justice department official with knowledge of the plan. the official did not want to be identified before a public announcement planned for later today. queen elizabeth the second is in the country today. she is in new york city addressing the united nations. we'll have that live for you starting at 3:00 p.m. eastern. later, she will head to ground zero for a tour of the site. tomorrow with "prime minister's questions." david cameron will hear from the opposition starting at 7:00 a.m. tomorrow on c-span2. >> c-span is now available in over 100 million homes, bringing you washington your way. a public service created by america's cable company -- cable

companies. >> a look now at protesters' expressing their opinions about bp in the wake of the gulf of mexico oil spill. >> we just saw a flyer for a protest/rowdy walk. we wanted to participate because i'm very angry at bp and would like to express that in some way. there is not much way to do it right now through the political process. >> it do you think bp and the federal government are doing enough? >> i do not think bp is at all. they're trying to hide it through the dispersants, hide the amount of oil being released

to limit their liability. it is a smart business practice on their part and it is killing us out here. >> hello, everybody, how are you doing? thank you for coming. it's hot but we are going to take care of that. we have a water balloon flight coming up. >> there is a lot of conversation about whether it should be the week or the weekend in his this is for. this for the population of new orleans. a lot of people say you are not going to make bp flinch, but this is about the population and letting them know where these people live, that they can do things about it, that they should not, i believe personally wait for other people to act for them, that they should take direct action. it's very important and want to

say this is not a violent action we are taking, but it is emphatic and directed and organize. >> i work with the emergency committee to stop the gulf oil disaster. >> why did you decide to come to the protest today? >> hour emergency committee is supporting -- another group called this, we are supporting all forms of political protest against this will disaster. bp and the government have proven unable and unwilling to stop the catastrophe and the people have to act. this is why we started our organization. we want to encourage, support and magnified all of the protests against this disaster. we have issued demands the need to be met, including stop drilling, stop using

dispersants, use all means to stop the disaster. the whole truth and all of the information has to come out. people need medical care and compensation for any loss. that is what the web site is about. we support and are joining with the folks here today to say that this has to stop. >> [unintelligible] was the first dispersant used on the event. now they cannot recall. they have started using 9500. there are several reasons why we the people demand stop the dispersants now. stop the dispersants now. >> i am a resident of new orleans. this is my home. i am not leaving.

i was an environmental scientist tracking these dispersants since the beginning. that is what i am here for. i was a vendor at the french market but business is dead there. now all my energies go into the oil war, especially concerning dispersants. >> according to the cdc, have a direct quote about the use of dispersants. according to the cdc, you are exposed to dispersants for a long time are many times, making cause central nervous system damage to your blood, a kidney, liver and leave a bad taste in your mouth. i'm excited. stop the dispersants now. >> i'm sure the bp is doing all the bp can do. but this is not where bp lives. this is where we live.

it should be up to us how this is handled, up to the environmental scientists and private sector to get in with all of the new technology. we're going to make mistakes, we might as well make them for the right reasons instead of protecting how many gallons bp will have to be fined for. >> we need to wake up and force any entity that has any input into this. we need to demand our resources get put into something positive because this is a nightmare. we are writing history. if you're going to write history, we darn well better write some good in there. this has to be a turning point. >> [inaudible]

>> you can find out more about the gulf of mexico oil spill at our website. you will find congressional hearings here in washington and field hearrngs in louisiana. there are briefings, speeches and related web pages. we also have a live feed of video from the oil spill from the ocean floor at our website. the gulf coast response incident commander, that allen, will be briefing -- thad allen be giving a briefing later. we looked at summer nutrition programs for children earlier on "washington journal." journal" continues. host: jim weill is president of food research and action center, looking at the status of some and nutrition programs for children. what is the status?

guest: not worse -- not good and it got worse in the summer of 2009. low income children need good nutrition in the summer as well as in the school year. both hunger and obesity spike in the summer for kids because they are not getting the nutrition they did during the regular school year. only one out of six kids, our study shows, and get a summer lunch for everyone in six to get a regular school lunch. host: kids who would normally get a school lunch from the federal government or a school year are not getting it in the summertime. what of the factors? guest: the little is out of reach, but the bigger problem is there are not enough places doing it -- not enough schools, churches, profits. the recession brought down the numbers serving, as a state budget cuts and budget problems% reduced the number of places open for kids in the summer. host: it is the state government that pays, not the federal

government? guest: the federal government pays for the food but the food is provided in programs. it is not delivered door to door. if so, unless there is a parks and recreation program open to give kids exercise or mentoring or what ever for a summer school or school-based program or a church-based program or a boys and girls club or police athletic league, when those programs are not open, kids to not get fed. host: the denver post front page about this says sort of the opposite. thereehad line -- colorado's summer lunch program reaches more low-income children. as people are losing their jobs they are seeking out programs like the summer lunch program. guest: there are some states that went up in the summer of 2009, and i am sure some states are doing better this summer as well, and colorado is one of them. that would be great.

what matters a lot is the efforts of state, if the colorado department of education -- doing a lot of outreach, if they are making sure there are a lot of sponsors for the program. host: what is the role of federal government in this program? guest: it pays the full cost of the meals, a couple of meals a day -- providing breakfast and lunch, for example. in the school-based and non profit based in city based programs. so, the federal government pays the full cost and sets minimum nutrition standards. they could be a little better but it could be -- but they are decent. the rest is up to the private sector, nonprofits or the city or county governments. a host: what is the impact of a decrease in children accessing these nutritional programs in the summertime? guest: the studies show, as i indicated, there is more hunger

among kids in the summer and also the nutrition they get in the summer is worst during the school year. they are eating fast food, eating less healthy food because that is all the parents can afford often bear the -- afford. a lot of evidence that healthier food is more expensive. they are not eating as well and not eating as much, so they are suffering and all sorts of ways. also the fact they are not in these programs means there is more summer learning loss. a lot of the difference between low-income kids and more affluent kids in terms of education comes from what is called summer learning loss. more affluent kids are in some programs that keep them in school that poor kids are not. low-income kids are hurt in many ways, educationally as well as nutritionally. host: you testified about this issue last week. we are airing that hearing on c-

span 3 right now. the secretary testified as well. who testified beyond the secretary and what was said? guest: this is a hearing the health education and labor committee had on school lunch and school breakfast, wic program and summer and afternoon school food. a pediatrician testified, a chef testified, someone from top chef, and a retired general testified. there were all sectors represent -- represented. the overall thrust was that the attrition programs can be made much stronger, both -- nutrition programs can be made much stronger, both in the quality and the number of kids brought into the program. the fact that we are reaching only one out of six kids in the summer suggests there is a lot to be done to reach more children with the benefits of the summer food program.

host: a retired general, did he make an argument this was national security issue? guest: the military has found that they are losing a lot of recruits -- i forget the exact numbers -- the majority of the kids and show up to volunteered to get into the service are rejected for health reasons. many of them related to nutrition reasons and obesity. host: we want to get your thoughts on the summer nutrition programs for children. you can start dialing in now. the first phone call -- william, republican line. randy, go ahead. caller: good morning, c-span. thank you very much for taking my call. jim, love these summer nutrition programs, having personal experience with one run here in hampton roads area in newport news. i have a unique business that

is a mobile fitness center that was used as a critical mass in public housing complex here in newport news. sadly, though, the not-for- profit -- a little unsophisticated and we were not able to reach a modest fee for my service which afforded the calories out component of the meal program. one of the things i did notice, though, in my several visits -- turned out to be pro bono because of this misunderstanding -- i found that the food that the children were receiving was nothing glorified -- more glorified and corn dogs, chicken nuggets, canned fruit salad. i run a first-class program -- i ended up with 30, to 40 children at my facility on site -- they spent far more time with me in the fitness program, which enable -- enabled me to mentor

burning calories and involve the whole neighborhood. it was not just the children but there were grandparents, great grandparents, cousins, all goals, and the other members of the public housing community that were able to participate. i really applaud the efforts here in virginia. i think we need to step it up, though, and i only hope that the professional groups, the for- profit sector would get into the business of fostering programs like the traditional not for profit and ngo's have done in the past. i ttink if we had a professional approach, we could save a lot of money and deliver a better product. guest: he makes a couple of different points. one, certainly the nutrition could be better in these programs. there are federal standards, but they should be higher standards. a few years ago congress cut the

amount of money it pays for each kid's summer lunch, so that was bought -- not helpful. their efforts to increase reimbursement. the study shows better than what kids are eating our own, certainly, unfortunately better than what they normally get at home. in school years the food is better than what kids bring in a brown bag. getting physical activity into the summer programs is also incredibly important. all kids need physical activity year round and they need structured play, and doing that in the summer is important. the nonprofits and these public agencies that are the bbneficiaries of these federal food dollars, and also typically who run the programs, are allowed to contract with for- profit providers for food or activities or what ever. i don't know the particular

problems in virginia, but it is certainly possible for them to contract out some of the services. host: rich on independent line from new york. caller: sir, i would say to you that you are and enable our of irresponsible parents. are any of these kids' parents investigated for alcohol abuse, drug abuse? they are not feeding their kids and not taking care of their kids, it is their responsibility. you liberals are the ones that let them be bad parents. as far as federal tax -- the taxpayers foot that bill, which it lost right over, and you did not mention that. thank you. good day. host: your response. guest: it is certainly true that the money is provided by the taxpayers. and it is a great investment because it helps kids in school and it helps kids learn and it helps kids stay fit and it helps kids stay out of trouble. i forget the first point he made

-- host: that the parents should be responsible for their children. guest: most of these children are from working families. the parents are working one or two jobs. they are out of their home because they are working. the majority of low income parents with children in the school food program, summer food program, are working. so, it is not that they are not taking care of their kids, it is that they have low wages, not enough money to pay for good child care and programs in the summer and it is a way for them to take care of their kids with a little bit of help. host: does your group tracks hulbert and the lack of food with our nation's competitiveness -- track honegger and a lack of food with our nation's competitiveness? -- there are studies that show food and security, the government phrase of those struggling with hunger, hurts

children and therefore the nation's competitiveness openly in a bunch of ways. it reduces kids health. it causes anemia and other health problems. it drives up hospitalization costs. it hurts kids in school. they learn less. they are less attentive, their behavior is worse. all across the board -- when kids are hungry, adults are hungry -- but particularly when kids are hungry, it hurts their performance. and it hurts their long-term productivity and ability to work. host: how much money is the government spending on nutrition programs, particularly summer nutrition programs? guest: the summer and attrition program is about $100 million in the scheme of things. it is a relatively small3 the government spends more on the school lunch and school breakfast during the regulaa school year than it does -- host: how much is that?

guest: off the top of my head i don't know, but all the programs together, about $20 billion a year. host: is that lower than recent years or higher? guest: hire right now for a couple of reasons. one, the programs are connected to inflation, so when food prices go up, the costs go up. but the recession has added particularly to the school lunch program, hundreds of thousands of kids to the program. host: louisville, kentucky, democratic line. mary, good morning. caller: i would like to congratulate you, sir, because you are using american tax payers to -- top -- tax dollars to help americans. . we need to have our children eat during the day.

a lot of parents to not have money to send their kids to summer camp. everyone is not rich in america, so congratulations. host: 20 show you something from a recent study you put out about the summer nutritional program. this is the percentage of change in children participating in the summer programs from 2008 to 2009 trade the top five states, the percentage has gone up. -pthe bottom five states, the percentage has gone down. next to that is children in 2009 per 100 children in free or reduced price school year national programs. you can see the top five in the bottom five states there. as we go to our next phone call, we're talking about the summer nutritional programs. program -- weill about the

summer lunch program. caller: i wanted to share my experience at the grocery store and how difficult it is to pay for your own food. it is very difficult to keep healthy, especially on a tight budget. my wife and i, for various reasons, to extend our life, decided we wanted to eat healthy we tried to get a loan modification to keep our home but they explained to us the money that we used for food was above the national average. we had a modified it, but it was just little things. i have been trying to find things without complex sugars, genetically modified organisms.

that is one thing i want to know about. in this program, or you educating children also on gmp's and how dangerous -- gmo's and how dangerous they are? host: do you know the average spend on groceries? caller: that is the them. they never told me what that was. we were spending approximately $700 a month between myself and my ife. host: and you have produced it down to what? caller: about $400 a month. we are trying to pay the mortgage. host: jim weill. guest: we certainly think summer

food and school food programs, to serve healthier food than they are. i understand the struggle you are having tried to get food for yourself. wages stagnated for so many americans. so many people have trouble putting healthy food on the table. the gallup organization has been asking in their polls and there was a time in the past year where you had trouble throwing food for your family. in 2009, 18% of households said that there were times when they could not afford food for themselves or their family. so this is not a narrow struggle for a small amount of people in the country. this is an increasing problem for the individuals with low

employment. host: republican line. debbie. caller: my sister works for a summer food program. it is no different. it is a chicken nuggets. it is catered in. it is only three hours of pay that is wasted by the taxpayers. host: what about preparing the food, serving, and cleaning up after? caller: i told you, and it is catered -- you, it is catered. most of the people who are there are already low income and are on food stamps.

the people at the grocery store, they have two come the phreecarts full of food. it is a fleecing. guest: is true that many of receiving food stamps. every study shows that those stamps are there enough to get you everything you need. food stamps are not enough to get you through. it is true, many families participate in both programs, and that is great for the kids. host: illinois.

caller: tte average person in this country that is on food stamps and gets $99 for one person for one month. with our country supporting these conglomerates not to grow the farm land -- most of them are owned by outside entities. the largest place where we can grow rice, outside of china, is right here in arizona, but we are told we cannot. we have 60% more growth of rice compared to china, right here in arizona. republicans and democrats are all crux of the federal government with all of their money invested in these

companies that have left america. host: tom in detroit. caller: i can sympathize with the last caller. working in the school lunch program, senator harkin recently said there were not enough food and vegetables to give everyone 5 servings a day. how are we going to get to the point, let alone in these food deserts', how are we going to look at this systemic problem, maybe give extra credit for food stamps? i have to be available. host: you are a physician in

your helping your local school? how did you do that? caller: a physician was in the newspaper said he had the guts to call himself capt. breakfast coming getting kids to eat. i congratulated him and he asked for my help. i have been donating some of my time, here in michigan. i cannot really say much more than that. host: 1 not? w --hy not? -- why not? caller: just because of the school district, because of other pr matters. host: talk about what you did for the school system and how you went about changing it. caller: one of the biggest

problems was there was money being offered to the schools for a limited choice of food, much of which was high in fat or sodium. many of these things that they are trying to reduce articulate incentivized through the porfood program. it would be more expensive to get the healthier options. we need a better, wide array of choices, rather than the sodiumd-ense products that we -- sodium-dense items that we already have. guest: i think what he is

referring to is how the federal government giving public schools a certain amount of cash and commodities. i think what he was saying, the commodity, the food, is not as healthy as it should be. that is absolutely true. there is a lot of great work done by school leaders, many of whom are super heroes, whether or not they are wearing the outfit, whom are due in a lot to improve the school program. the process covers is going through will also be better forces institute -- it will alswill also be better. it will force the school system

to provide better food. caller: this has taken a long time to call. as a libertarian person, it is hard for me to buy into the long run facilitation process, but clearly, the subsidy money is offering very unhealthy food to kid. that is something i would love to see michelle obama tackle. guest: food deserts is the phrase for areas where there are no grocery stores, no significant grocery stores within reasonable distance, said there is no convenient source of food. there is a lot of attention being paid to try to get grocery

stores and into those areas. the obama administration has proposed a government loan and grant program to get some of these stores and in these areas. low-income families, in particular, who are more likely to be in food deserts and do not have the transportation to drive through a grocery store, and up paying more. so good and good fruit and vegetables into low income neighborhoods is something important that we have to do. host: next phone call on the republican line. eric. caller: so far, i have heard of a lot of feel-good stuff, and i

remember watching on c-span a speaker from either the brookings institute or harrison foundation, and he made the point that there was very little proof -- it is a popular position -- one thing he said is this food insecurity that you are talking about, which is an emotional argument that you are making, and that one in 50 kids will only missed one meal in one month. our real problem is obesity. how you respond to that? we have to pay a lot of tax dollars for something that is not really a problem. could we take some of that money and use it for real science? guest: you must mean the

heritage institute. i have to agree with the -- disagree with some of your numbers. you are correct, we do not seem millions in this country facing the type of starvation that kids in developing countries do. the reason we do not is twofold. we are a much more affluent country, so even the low income people in this country are in a better situation than the lower middle income people in other countries that are far poorer. also, the programs that we do have in place, like the school summer program, it keeps kids from being hungry.%% when we say, for example, that there are 17 million kids in the country who live in households where somebody is skipping a

meal, parents are more likely to skip their meal, although they are affected by the stress. the fact that we only have 1 million, as opposed to 17 million is a testament to the summer school program and a reason not to cut back. host: one viewer writes this -- guest: a lot of schools are starting a garden. that is good for the food that comes from it, but also to teach kids where food comes from. it will not be enough to supply the schools with what they need

host: -- what they need. host: republican line. scott. go ahead. caller: i was listening, and seems like when the government is in charge of the land of money for people to spend on food, the government will be in a control, and you are going to have some horrible results as opposed to leaving it up to the free market. the free-market will give people jobs. the government only takes from the economy. we need to never forget that. also, the fda and other unconstitutionally-created agencies help that information

-- helped to suppress certain information. >> that may ask you something. -- host: let me ask you something. there was money in the stimulus in the short term, for example, for every dollar you put into the economy, you get back $1.41. do you see an argument for providing money, providing a program like this to boost the economy? caller: the government is the reason that we are in this problem. the government on monday the way to get the usout ous out of depn

here. host: what about the comparison there? some say that for every dollar, you get $1.41 in the economy. is there an incentive to creating these programs? guest: absolutely. this money is quickly spend because people need them so badly. there are other studies showing most stimulative programs involve food stamps because families are so desperate for the food, they spend that money quickly. these programs are very stimulative to the economy and it is hard to argue that all public programs are illegitimate.

the constitution provides for congress to make laws for the welfare of the country. these programs are among their many strengths, our countercyclical, in the sense that they keep the economy afloat when the private sector fails, when we have these cyclical depressions. it is government support that helpedd+ to stabilize the econo. host: brooklyn. independent line. caller: good morning. i think the really big solution to a lot of this is education. i have worked with kids for many years, all different circumstances. in certain places, there is only one store for the neighborhood and it only sells junk.

then you might have one supermarket that is overpriced. you did not always have those whole foods-kind of options. by talking to kids, the faster you can get the information out, that is the best way. it will not even be expensive. it is just a matter of knowing what to look for, knowing the additive to stay away from, looking for the better quality food. we have so many cultures in this country, and eat differently, and you can share all that knowledge, too. guest: nutrition education and general education are both incredibly important. there is a lot of advertising to

kids that sometimes gets in the wake of good nutrition and education, but i agree. it is fundamentally important, but also families, schools need resources to provide food for people. host: next phone call on the republican line. george, go ahead. caller: there is something surreal about this then. i hope that there are lots of people out there who are in shock from what he is aying about the government supporting the people. it is sickening. i hope there are a lot of other people who feel the way i do. i do not know what to say. that is my comment for this morning.

guest: let me approach this another way. we have tens of millions of children in school every day during the school year. millions of children in day care. over the summer, in summer programs, not as many as there should be. one thing the federal government does it is it helps pay for food for kids in those programs. that is basically what we're talking about with these programs. the choice is to say everybody always has to bring food from home, in order to feed the kids. then some will eat, some will not, some will do worse, some will do better, just based on whether or not they are eating. or providers can feed the kids

at the program, and the government stepped in after world war ii when it was discovered that so many recruits were coming in the undernourished. the government stepped in and said it was a matter of national security to feed kids healthy food in these programs. so you have to make a choice about how you make a kid to eat. host: conn. peggy, independent line. caller: i am not against the food stamps for those truly in need, but my gut feeling is that

these programs are really meant for subsidizing the big conglomerates. they should only allow fresh fruits, fresh vegetables, staples and like rice, flour, beans, -- but it seems like they are buying so much junk food. you are really subsidizing the big u.s. food manufacturers. i wonder what your guest has to say about that? guest: studies have shown that the food that individuals purchase from food stamp is about as good as others. they are making the same choices, and restricting the through they can buy create problems for the stores and beneficiaries. the other thing i would say is,

when people talk about food stamp recipients, they talk about them as the day are a different population from the rest of us. the concept is people are on the program for a long time, but the fact of the matter is, tens of millions of people in this country cycle on and off of food stamps. recipients today are seniors, unemployed people who have been on the program for six months, will be off in another three months, others that have been on for a longer time, some with disabilities, half of them are kids. it is a portrait of america. have all the chiidren will be on food stamps at some point before the age of 18. half all adults will be on food stamps at some point between the

ages of 18 and 60. so we should not look at food stamp recipients haas a separate population that needs to be controlled. just as we all want to be treated with dignity and respect, food stamp recipients tran also be treated with the -- should also be treated with dignity and respect. host: next phone call. caller: my aunt lives in south carolina. her husband was about to die and i found up she was only getting $10 a week for food stamps. i thought it was a mistake. with her permission, i called

local authorities, and that was right, $10 a month. i do not know if it is still there, i sure hope not. guest: the amount of food stamps you get depends on your income. everyone is low income but the poorest people get more money compared to those with the highest income. the minimum benefit was $10 per inevitable, and you are right, it is -- individual, and you are right, that is too small. it has been improved a bit since then. host: next phone call.

republican line, lori. caller: i am a cafeteria food stuff worker and i appreciate everything that happens in the food-service industry. the i am first and foremost seeing what is being promoted to the children. the summer program is an excellent program. i do not work in the summer, but i know the government provides a lot of nutritional food. in our county, they provide a good, healthy, nutritional meal. we provide five different choices of vegetables and fruits, the sides and their meat choice. they are getting a choice of nutrition here.

the school summer program is there for anyone who is in need, who signed up for it. also, it is more of a food supplement for someone who may not get food during the day. i believe it is important for that child to have a meal in the summer. guest: that is a a greatnote to end on. across the country and in congress there is a lot of support for these times of the efforts. bipartisan support >> at the white house today,

president obama is meeting with the israeli prime minister, benjamin netanyahu. both are offering comments and briefings to the press. we are recording those remarks and will have them as soon as they become available here on the c-span networks. also today, queen elizabeth ii is visiting new york. she is scheduled to give an address at the united nations. that is happening live on c-span at 3:00 p.m.. later, she plans to tour ground zero. >> we will have more british programming coming up tomorrow on the c-span networks with " prime minister's questions." david cameron takes questions from his party and the opposition with live coverage

starting at 7:00 eastern on c- span2. >> c-span, our public affairs content is available on television, radio and on line. you can conneet with us on twitter, facebook and youtubb. you can sign up for e-mail that c-span.org -- e-mail at c- span.org. >> will spill efforts continue on the gulf of mexico. here is a look at grand isle, state park. >>