he is a doctor by trade. formal training at northwestern, harvard and ucla health systems. -- douggieard -- comparison is very apt. [applause] to everyoneo much for coming out. we of three distinguished panelists with us today to talk about mental health care. it is a tremendous issue that is still misunderstood, poorly addressed, can this part of everyone's lives. still stigmatized and talk about a lot of different issues. right dr. barbara van halen.

she was 100 influential people last year. she is the founder of a non- profit mental health care network. i have dr. roger ray, chief medical officer of the carolina health care systems. he provides strategic direction related to import for breach of performance quality and patient safety for the system. it generates knowledge needed to understand, prevent, and treat mental disorders -- mental disorders. 30 percent roughly, possibly even more this ability --

disability in this country is related to mental health rather and a physical health issue how we are addressing that. >> happy to jump in. thank you for moderating this. we are delighted to be here. from the standpoint of people who are in the trenches, anything about this all the time, we thought it might be useful to begin with numbers to provide a context of where the issue is from a public health perspective. and mental health versus physical health. i have a sense you can only begin to bend occur if you pay

attention to mental health issues. of the same time you pay attention to mental health issues there will be critical issues about overall health. the numbers are pretty striking. the mental health association measures disability talking about a number of light years. the number of years lost to , is pretty clear, especially in the data that was just released two months ago, that the past decade has seen a transition from infectious diseases to chronic, non- political diseases being the largest source of disability. when you look within that

group, practically within the ages of 15-49 years, which is lastay woh breaks up the -- breaks up the life span, it is neurological disorders that drive the story. it is for that age range, over 40 percent of all disability. that is more than virtually all other chronic diseases. so this is the number-one source of disability. and yet we tend not to think of it that way. if anything we minimize the impact. it is not just morbidity. it is also mortality. these people killed -- these things kill people at a very high rate. suicide has become a major source of mortality. there are 37,000 suicides each

year in the united states. one every 15 minutes. , that isat in context more than twice the number of homicides in the united states. more than number of deaths from hiv. amazingly more than the number of traffic fatalities which is about 34,000. 37,000 suicides is not something you hear about very often. it tends not to be in the morning news for a lot of reasons. it is a huge public health issue. it is shameful. at the same time that the number of homicides and the number of

traffic fatalities and a number of deaths from aids has really dropped. the number of suicides essentially has not changed in three-four decades. it continues to be creeping up very gradually. that requires a lot more attention from all of us. in terms of framing the issue in terms of public health issues, morbidity and mark -- mortality, talking about a very large part of the challenge for american health care. seen this, you have increase the man working as a medical officer in the north carolina health system, which is the best health-care system. how have you been working to address this need and working in terms of the population? andhank you for being here thanks to the atlantic for putting this on.

people say why are you in the conversation? for those of you that do not know carolinas' health care system, 60,000 team members across largely to states. and we sell 11 million patients last year all across the continuing. we have about 40 hospitals that are part of the system. like most we're focused on where do rico from here? how do we transform care within the communities we serve in the area we are responsible for. if you chase any of the information are around where is the real consumption in health care today? ofre is there high, possibly portable utilization, you will come to this realization very

quickly that we are going nowhere on the overall health care's been if we do not deal with behavioral health. one in four of us have a diagnosable behavioral health condition at some point in our life. if i have a noticeable condition i take medication for and i have substantial behavioral health issue as well, the chance i will take my medicine right for diabetes that by 7 percent -- 70%. if you look at what are the factors in play that ad substantially to overconsumption come over utilization, and therefore, a reflection that we've done a badly, behavioral health as part of the conversation. this is not an overall health care transformation. fact the same journey. we are, as a system, doubling down on that notion.

building a new be brought health facility outside of charlotte. any time it is economically challenging to do so, it will ever break even from a pure economics point of view, but it is the right thing to do for our communities and we believe intensely about our mission to provide that part of the care. through the carolinas i would say not enough. not enough care coordination. not enough community resources challenging. to be moreources committed of behavioral health

and that is why we are participating in this conversation. not just ineficial terms of overall patient health .ut beneficial to the system addressing the whole patient rather than just behavioral or ignoring the of your help. >> absolutely. any of us today have to go to the emergency room it would be one of the bigger things that would happen to was this month, if not this year. a few of the patients that when 20 times or more to emergency room, up of 90% chance that is a substantial unmet need from of behavioral health expected -- perspective. if we're going to get at that overall utilization, we have to

focus better meeting that need. speaking of community resources you have been working with veterans and their families and active service which is address ptsd, still a lot of unmet needs. how is the organization been at mobilizing, not just doctors but all sorts of mental health professionals to bring a team effort approach. the notion was to ask the mental health community to step up and give an hour of the week of their time to provide free services to returning troops, families, and what happens very

quickly, which is a wonderful part of this conversation. so as i began to build and give an hour, and i'm a clinical psychologist and my father was a veteran of world war ii, and i grew up during the vietnam era and we did such a horrible job of taking care of those men when they came home. none of us knew how long the wars were going to go on. i for started with people like me who i assumed but likely. i get some of my time and i assumed others would. boy, was i right. the mental-health association, psychologists, social workers, pastoral can't -- pastoral counselors were looking for ways to help.

affecting physical health. service members have a chronic physical issue that leads to chronic anxiety which leads to substance abuse to deal with the anxiety in the physical. then when you add in post- traumatic stress, which is a very understandable human reaction to what they are dealing with. we're trying to get in front of that. so what we have done very early on in the process was to look at we have all these mental health

professional stepping up to give, how can we knit the community together and reach out to primary-care physicians. teachers in the primary schools and colleges. how can we reach out to business owners? as you will hear from us, there is a drumbeat. mental health is an issue that cuts across all aspects of life, all sectors, and a goal is to how we put those pieces together to make sure there is an integrated system of care that helps on the mental health side and also on the physical health side and everything in between in terms of our lives. that is our work right now. speaking of the integration, we have been hearing so much in he news after sandy hoook and the boston bombings, talk of identifying people who might benefit from earlier access to

care. feel like as a country we need a policy to address these sorts of issues? good way told be a approach getting more resources in the community? to it.e are two pieces the president has announced the way to do that and something called project aware, which will create services within schools, communities. rober. the school system and mental health care system that provides a better safety net. one of the things many of you may not realize is relative to the rest of health care what makes mental health different in many ways is it is mostly about

youth. 50 percent of mental illness begins by age 14. 75 percent by age 25. that is very different of cancer and heart disease. we're really talking about young people. about projects like that that will be creative in the unfortunate aftermath of sandy hook. this will hope to provide -- help to provide an increased national awareness about the needs. the second piece, and the one that is more difficult to grapple with us to do with where i come in. that is realizing that as with other medical problems, we just did not know enough often. the state of the knowledge here is pretty poor. we have some services we can what we canwe do

currently, but we are also aware that we need to know about the risk, who needs what kind of care, about who will do fine by themselves eventually because a lot of kids run into trouble and come out of it without much of a star. we do not want to label them and push people into treatment who do not need it. there is a whole range of things that tell me and tell the people i work with that there is enormous need for better services. we have got to get on the bandwagon of where we have been for cancer and heart disease, which is getting a scientific agenda together to allow us to identify the problems much earlier and know what the right intervention would be so you can preempt psychosis and preempt the worst outcomes, which is

often what we see in the tragedies you read about in the paper. things as you were talking hours thinking is different in the mental health arena, we have seen it and other health-care issues, but not the way we see it with mental health, and that is a term i do not really like but something everyone is aware of, the notion of stigma. stigma as per -- anything that prevents people from getting the care. refers to what you would think if you find out i am struggling with depression or bipolar disorder or my husband came back with post-traumatic stress. sometimes stigma as what i believe about myself. and even if the entire room would stand up and applaud if i want to get help for my substance abuse issue, i am not willing to do that. wonderfuling a

conversations with the administration about fitting these pieces together and the notion of awareness. as i think about that, it is awareness, but awareness in a different way. o awareness of an individual level, whether it is teacher, employer, a mental-health professional not only aware of what they are treating out here, but also, who they are as human beings and recognizing where they can intervene. we are really, i think, in a great place for the first time in our history. almost because of the tragedies and the last 10 years of war. people have a much better understanding of post-traumatic stress now than they did 10 years ago because it is in the news so often. shootings, boston bombings, these were shooting shoved in our face.

our hoping we do not lose attention span and we are more willing to tackle what is really a difficult issue. everyone to say to here, and you did not have to do this, raise your hand if you or anyone in your family is struggling with a mental health issue, people turn white. they are afraid i am going to do that. beforeng way to go people are comfortable saying my mom was schizophrenic. that occurred to me as the notion of awareness. a different kind. a few years ago she did a public-service announcement to try to increase awareness. it is a remarkable moment. she sits on a completely bare stage. everything is dark.

by saying i am glad close and have a mental illness and my family. says i wantps and to know what went through your mind in the two seconds between the words illness and in my family. and if you felt different about me between the possibility that i was the one that was ill or that i was caring for someone that was ill. it does make you stop and think that we have a lot of work to do to make this an acceptable in the same way we have come to except aids, cancer. when i was a medical school there were words to could not say. you could not say cancer. it is a topic no one would talk about. we are still struggling with that here. until we can get to a point where we are able to discuss it and be open about it, it will be hard to help people get care.

this illness is often you feel so depressed and do not feel you deserve care. you just want to die. if you are psychotic and paranoid, you are too fearful to go out and get help and do not think you need it anyway because it is everyone else against duke, and you know that. there is a real problem in these disorders that often pre-empts their own treatment. like barbara, i do not like the term treatment because it signifier it -- if stigmatizes the problem. there is discrimination, a little more of an action word that is implicit in this field. we have a lot of work to do to turn that around from of social policy perspective. >> speaking of labeling, discrimination, later this month we have the new addition of the

statistical manual of the psychiatric association. it is the official book that makes labels for all of these illnesses and conditions. changese a few notable but there is a sense about what the changes are, whether it is right or whether thing should be labeled and that certain ways and what is good and bad about that piece. do you see positive changes coming from this? do things differently? fewer labels, more labels, more names? >> i am not a fan of this at all. that is the wrong person if you are looking for positive answer. >> the good thing i can say about this process, the diagnostic process is it does case maybook, in this

be even electronic. as long as you think of the book as a dictionary, it is useful. so it is made up of a set of categories and defines them. it allows clinicians to have a combination. i was old enough to remember before we had that. it was really a tower of babel. the bad news is when it is used to be something more than that. people call this the bible of psychotherapy or the bible of psychiatry. that is a real problem. these are what one of my colleagues calls fictional categories. they are contrived. these are names we put on things that clinicians have agreed to cluster together. we used to do that in the rest of medicine. then it something happened, which we figured out how to look at the biology underneath the

symptoms. we were then to -- we were able then to come up with a little more precision. we did not just talk about chest pain, we understood it could represent a heart problem, a long problem, an emotional problem, and we developed a set of tests to pull those apart. those various tests gave us precision that allow us to know which person should be treated for heart disease in which a person has pneumonia, even though they may have very similar chest pain. aboutchiatry, it is just the chest pain, just about the symptoms and how the cluster together. that is useful to know, but not by any means where we need to go. it is 30 years behind. what we really need it now is to do what every other area of medicine has done, which is to build not just reliability, the

ability to have the same language, but the validity, something that will give us the understanding of the biology and help us to tease apart the clusters so you can begin to realize depression which has nine systems and have kept five of those to meet criteria, which means to people with the same label, one out of nine, and that is not precise from my perspective. figuring out a way to construct this so that you can understand what are the different ways of getting to that set of symptoms that we now labeled as depression and what would be the best treatment that is really the agenda for the research field that i lead. we have created our own effort called the research the main criteria, which is an attempt to may be filed the field for dsm 6

or 7 or something that will be much more valid, as well as reliable. taken no small task. >> primary-care physicians that are not psychiatrist, it can seem like a murky area. they're really not comfortable addressing. do not know what to do with behavioral health issues. you have mentioned only about 5% of the patients in the health system are seen in the hospital. you are investing a lot in the addressing primary-care physicians for mental-health first aid, training them better to address these issues, recognizing the signs they need to integrate these. is a great question. there is a lot we can do inside the integrated system. there is a whole nother book of

work that has to do with others in the community to bring attributes or skills or capabilities that we would not. on the primary care side, primary care physicians recognized intuitively and seeing any data that behavioral -- the contribution beeper help care can make. if any of you and directed with a hospital or emergency room or health care system in the past year i would bet dollars to doughnuts that we ask you one-75 * if you are allergic to anything. any question that might highlight for us of behavioral health need to dive deeper into? not so much, not always, certainly not reliably in every situation. that is the kind of

transformation on our side that we have to make. to surface something and have the primary care physician paralyzed with anything for them to do would not be fair to them. so we support them with care coordination, treatment algorithms provided. immediate consultation if we're looking at some sort of crisis circumstance. so it comes with support. but i believe that we certainly can and must get to a place by amystifying by creating language by objective conversation about what is to begin talking about the behavioral health side as part of every single health care and counter. add to that then the issues that are either societal or multi disciplinary within a community where the whole community can help. is all ofst stigma

our jobs. it is not necessarily easy to do. arm, i would on my be concerned about it, but i do not know i would be overly concerned. the same lump that impairs the ability to communicate, all of a sudden that is unsettling. when behaviors' and communications is affected, even in a very medical way, it is unsettling. -- when behavior's in communication is affected, even in a very medical way, it is unsettling. i am encouraged by progress being made as it relates to neurologic and their ally could predict neurologic psychic basis. i encouraged by the new relationships we have available to us from multiple places in

the community, because this is a moment where it is not just that we can, we really must. of the things that you my wholeout the dsm and career watching it change and , and iersion are we on agree we need a structure because we use language and have to be able to communicate with each other, but one of the ofgers of those kinds manuals, especially people, and often it is the young professionals because they want to grab on to something. they want to be grounded. we want to be very careful for those that have the opportunity to mentor and teacher. we other danger is something have become very free to come to see very powerfully dealing with the military issues.

even the best-based practices currently today and mental health care will treat these symptoms and a certain percentage of patients exactly -- a certain amount of a percentage of patients. but there will be a percentage that does not respond to that. they may respond to other things. sometimes the other things are really surprising things, which is why again in the veteran space we are really learning that for some who are struggling, and i would say this goes well beyond the veterans, for some that are struggling with issues of posttraumatic stress, depression, anxiety, one thing that is very powerful for them is being able to continue to do something productive. you get into the cycle where someone who is depressed or anxious, especially the veterans who used to have this mission

that meant so much. they come home and no longer have the mission. this contributes to depression. it cycles and there you go. whatever is in front of us that we are trying to help on their journey, that we are aware of maybe a lot of different things that will ultimately lead that person -- meaning there is not when best, not always won rights and have to be open to looking at the different partners and components. husbands we drive my

who is also in this space. we forget to look at health issues. we did not stop to ask the person. sometimes we forget, we have to get a good health history. depression neighbor -- may be related to health issue that we not ask about. very complex, but i am optimistic, very hopeful and excited about where we're heading. >> we have came full circle in terms of behavioral health issues affecting treatment for physical health issues. following up on the veterans, and also in terms of labels, we recently came across a story whose husband had returned from service, having symptoms of ptsd, a violent outburst. by the time he finally became willing to seek

treatment, he did not feel like he could because he could not get anonymous care through tri- care. his colleagues in supervisor would have found within the service he was getting that. at the same time could not afford to see a civilian psychiatrist either. that know about us. >> convincing him to seek care was a battle in and of itself. what is the way that we can get a confidential anonymous care to the veterans, especially with ptsd? >> that is what we do. there are nearly 7000 mental health professionals. we are constantly talking to the department of defense about this issue. it is critical, because again, stigma for some is the way to not get treatment because they are uncomfortable getting

treatment, but also a real issue for the military families. it is not just the service member who cannot say he needs help, if the wife is struggling, she is afraid or kids are struggling. so we're working. i am very proud of the relationship within the dod, because there is a lot more openness. we just saw hold of the world of huge impact on mental health, military sexual trauma. most of the women were seen for posttraumatic stress. it is not for combat exposure but military sexual trauma. that is a complete opening up above very ugly issue in a very open and let's go in here and figure out what we need to do. things are changing, but there will not be a change within the system soon enough to meet the need, which is why organizations

like us that offer free confidential -- here's an example of how things have changed. when i first part of the message was thank you very much for the desire to help military, but we have it covered. other people would take me aside and said you build this, we are going to need it. now within dod and the highest levels of the pentagon, high-security individuals, they are delighted we exist because it has come around and out to where the chairman of the joint chiefs, the current chairman, former chairman, recognize number one access to care for these men and women. and making sure it is credible and good care, but access. give ane insurer or hour. the goal is to get that. i read that article and was so

sad because that service member and his family did not know about us. one thing we're doing is constantly trying to get the information out because it is a critical need. it is really good to hear you say about the change in dod. i work really closely with the vice chief and chief of staff. we have the largest project that is a collaboration with the department of defense, and especially with the secretary of the army, to come up with a way to bend at the curb on suicide, which has become an enormous problem. since 2009 we have had more deaths from suicide than combat in the army. that number is still going up, even though, that is coming way down. we're still seeing this problem. we do not understand it. what dod asked for back in 2008 was to get an outside group in to help them figure out what are

the drivers? almost everything we assumed was a driver in the beginning has proven not to be. was due to the stress of combat, multiple deployment, more waivers and more people coming into the army that would not have been admitted previously. virtually every one of those factors has turned out to be a non-factor when we really looked at the data. it is really shocking. what has been extraordinary is to see the way the leadership has taken this issue on. if you wanted to test that, the perfect a state is if you wanted to go to the vice chief of staff in the army and say how many suicides have you had so far in 2013? or even if you were to say, how many in april of 2013? he could not only tell you the number he would pull out from

his breast pocket the list and talk about every family he had spoken to of a social -- of a soldier who had committed suicide. they live with this and are living with 300 or more per year. if you go to your governor, mayor, a congressional representative, try it. ask them how many suicides have we had in our community? how many suicides have we had in our state? they have no idea. how many families have you talked to who have had this experience, and they will look at you with a completely blank stare. they did not even know there is an issue. though the military nba are getting beaten up relentlessly for this problem, they have taken it on in a way that does not happen. - though the military and va

are getting beaten up recently for this problem, they have taken it on and a way that does not happen. they may have paved the road for the rest of us in any to make this a priority and helping us to address mental health issues as something we do talk about and focus on and commit to bending the curve in the same way that 50 years ago they began to integrate long before the rest of society did and in many ways paved the way for racial integration through world war ii and the years thereafter. we may see that again. i do not think the rest of us have caught on to that yet. there really needs to be in a way showing how this is implemented in the military and finding a way to disseminate that much more broadly. rather you call it reducing stigma or reducing access. it has been really remarkable to

see. while we tend to think that is the problem, in a really interesting way they can really be pointing to a solution. >> dr. ray you were telling the about the emergency room care services. you are able to provide evaluation that some of the videoals remotely with technology where someone is speaking with a psychiatrist right away. video conferencing and consultation. how does that factor into addressing the needs an urgent care for civilians? >> the stories are incredibly important. individuals and as society based on our human reaction to human experience. everyone probably in the room

knows you cannot talk very long about behavioral health crisis and emergency rooms without hearing stories that are horrifying and horrible. been focusedusly on it for awhile. is no one is planned that a suicidal patient comes into an emergency room as their last place for help and they stayed there for days just looking for access to any treatment. our first step with that understanding emergency care psychiatrists are a scarce resource. that we need to try to affectively spread and leverage as best we can, create virtual linkages between behavioral and one that we're building that is linked to every

emergency room and the system around the metro areas so psychiatrists can interact with patients, specifically of the emergency room settings. interact with emergency room physicians or care givers. help me think through this, what should i do? an interview is better than none. a consultation is lighter than none. -- better than none. it is not a substitute for actually having enough capacity. that is why we are focused on that as well. we have found useful the technology that allows us to take expertise and a scare resources and distribute it more widely than what you can do in person. we will do the same thing with care coordination, a community resource navigation. we will do the same thing with crisis intervention. this extension. --re doing it with i see you

icu and lots of parts of the health-care continuing, but particularly in the crisis, emergency-room related. we found this a useful tool. hundreds of patients per month being seen that way. such aust seems like daunting task. so much to tackle. all whole system that needs overhaul. you are managing it day today. at the same time trying to change and things. so implementing that on the day today at the same time while things are going, while things are still functioning. how do you implement change and operate a functional system at the same time? of discussions that we have every day. we did not have the luxury of

calling a timeout. does notalt, delete work. the analogy is the plane is flying, how you read the side while the plane is flying? redesign while the plane is flying? we see thousands of patients per day while trying to change the course in some of the ways we're talking about, and at the same time 8000 more people became 65, and the complexity of their health polyps over time will continue to grow. we have that is one more dynamic to throw into the mix. but i thinkficult, you have just heard even in this discussion, some things that are daunting but quite achievable. some of the things we're talking about we have already done.

they have done a tremendous things. that gives us a lot of optimism. looking forward, the science that changes the way we think about this disorders will transform the treatment as well. are brainhat these disorders, that we can, through the power of genetics, nerves science and modern cognitive science really begin to understand at a much deeper level than what we have in the past. i think the opportunities to develop much better treatments it's not that far away. we will understand these at the level of circuitry and molecular basis. has transformed

cancer care. we know how it has transformed the care of diabetes and many other areas. we will be there, and we have the tools. now does have to apply them and get answers. exciting, there is those developments, research, cience, and he mentioned, -- you mention cancer. how we transform patient care in addition to treating the illness. how we take care of treating the human being has transformed dramatically. that has to do with community resources and the way we think about the holistic human being. we're just talking about suicide in the military. fort bliss currently has the lowest suicide rate in the army. when i started visiting fort bliss, it was a very interesting story because the commander

general got into heat because of comments he made about suicide. i did not know him at the time and i was called to an interview to say what i thought about what he said. i said it looks like he was really angry about all of these suicides and could not stop it. when he got wind of how he risk -- of how i responded, i did not he heard, and when about it, he invited me to come visit. what i meant was an amazing man, compassionate, intensely caring and wanted it to stop, the suicides from happening to these men. what they have done is almost this amazing community-based response.

everything they can in terms of tools they know will work. they have raised awareness and education. you see these young men, often young men, who have been in 22 -- that there 22 years old and are so proud of what they've learned from the commanding officers program. they learned if someone is talking about running their car into a tree, you should take it seriously. are yould say, what talking about? what they have talked these afraid ando not be step up and respond and then get people help before it is too late. they have the lowest suicide rate. the focus on research, understanding the issues from a biological, genetic, as well as an understanding as it does take

an entire community. we all need to step up in ways we can, and that is happening now. we're doing it. we're seeing the positive impact. even though this is a huge and daunting task, i feel like there is a window open now and we have the opportunity and skills. questions right now. sorry. we could keep talking for a long time. hopefully an opportunity for someone to ask something of one of us. to go before we turn to the audience, we have a question from one of our guests watching on line. how will obama's new brain mapping initiative affect the meet -- future of mental health care? >> i think i might be the one to answer that. there wasond of april a brain initiatives announced. it stands for brain research for accelerating innovative narrow technology. so it is an acronym that

includes the word brain have. the acronym is brain. had a lot of success in the past decade. to mapogy will help us the brain. whether it is through narrow euro imaging or other ways. we have the power to do this as the resolution we could not have even imagines a decade ago. what we do not have is the ability to map brain activity and real time. it is all very dynamic. do ise want to be able to map the brain to see what is going on and where it is activated at a level not only that has the temporal resolution but also the spatial resolution

to understand which connections really matter for changes in mood or memory or any of the things that are important for human behavior and human cognition. the brain initiative, the nate -- next great american project, genomes the lastn k great american project, he wants this to include the defense agency for research project -- defense advanced research project agency and the national science foundation. the first meeting will be held this weekend to bring people together to map this out and talk about what this will look like. a lot of this will be focused on developing the tools. it will not immediately lead to cures or diagnostics but over time the hope is if these are

havingrain disorders, the tools to look inside the brain and understand how it is working will give us what we need to be able to do a better precisehe more diagnostic and potentially developing new therapeutics as well. i think it will have an impact, not immediately. the for several years will be about the development of that technology. >> need for more science. back here. ray.rst, a comment to dr. i really enjoyed what you are doing in carolina. in europe where i work for a decade we implemented a social psychiatry program that got people out of the emergency room. we realize it also cut the evolving -- revolving door emergency room visits to the medical side and that can make a

lot of fiscal difference. hopefully you will see that in your system. i am from mount sinai medical school. can you say a word about the pharmaceutical industry's -- you know where i am going. go a little further. i am curious what is behind the question. >> i would like you to comment on the ability or lack of ability to develop new treatments and the role of the pharmaceutical industry in doing that. >> a short question with the long answer. the pharmaceutical industry, which has certainly been demonized a lot in the press, and sometimes rightfully so, but many times unfairly, is still the place where new treatments will be developed. if the treatments are medications or vaccines and even

devices. that is not happening in the academic sector and government does not do a very good job of this. we need a sector like this devoted to developing novel of the intervention. unfortunately for the most part this sector has left dodge. they have decided that there is no compelling science to drive them to a new treatment. they see it in cancer, immunology, and they see it to some extent in areas like rheumatoid arthritis and certainly in some areas of infectious diseases, but they do not see it in neurological or psychological disorders. ,lzheimer's, autism, depression schizophrenia. we're trying to figure out ways to get them back into the game,

because the science is generating new, great opportunities. we think we have inside the presence that will work in four hours instead of four weeks. we of new treatments for autism, which we think will really make a difference. we're really focused on trying to provide cognitive tools for people with schizophrenia so people can go back to work or finish school. i think there really are great opportunities. the way we're trying to do this now is through a public/private effort. bringing in industry that helps to understand where the opportunities are and to work with the fda, to work with the academic sector, bring government into this as well so what happens in a way that is really being done for the public good, and everyone realizes if we're going to bend at that curb and decrease mortality, morbidity, we have to come up with something better than what

we have now. we will provide the scientific leads if they provide the commitment to follow the lead. maybe they will be devices. maybe they will be video games. there's a whole range of things we can think about. amazingly a group of scientists from a person -- pharmaceutical company published a paper on the idea you could develop devices that would help to change brain behavior or brain activity in a way that would be so targeted it could be a tree before depression or ptsd or something like that. it is a challenge. we have to realize if it takes a decade to create new treatments, they need this territory completely. 2023 we will feel it. there will not be anything better than what we of now. what we have now is just not good enough. continue top would

see more innovation. thank you very much. thank you to the panelists. that is all for us. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2012] >> on c-span today, "washington journal" is next. wilson centerdrow will host the u.s. special operations command there. live coverage of the pentagon briefing with defense secretary britishgel and the defense secretary. in 45 minutes, a talk with the former national intelligence director, john negroponte. that a look at the president obama is upcoming trip to

mexico. a discussion about propose internet sales tax ♪ host: one of the issues to be discussed today when president obama meets with the new mexican president, enrique peña nieto, will be the war on drugs. that is what we want to talk to you about this morning on the "washington journal" as we go through the newspapers and the websites. if you support the war on drugs, (202) 585-3880 is the number for you to call. if you are opposed to it, you can also make a, and dash a comment on our facebook page. you can send it they tweet @cspanwj, of