Representative Patrick Kennedy, D-RI

Speech for the National Coalition of Mental Health Professionals and Consumers

June 22, 2001, NYU Medical Center

Webmaster's Note:  This speech was delivered immediately after that of Deborah Peel, MD.  As such it starts out with references to that speech.  They have been hyperlinked for you so, if you so wish, you can go to Dr. Peel's speech to better understand to what Representative Kennedy is referring

Thank you.  Let’s hear it for Deborah!  Let’s hear it for Kathryn!  It’s a great sign that she’s a great parent that her child is already so ahead of the game in understanding what goes on in life.

I’m just thinking to myself, that it is a little more difficult than getting the knowledge out there.  It’s getting rid of the stigma.

And, of course, Dick and I being in politics, we have to be super-sensitive to perception because perception is 9/10’s of reality in our business.  I’m sure it is in most every business.

You can imagine how much fear there was in relationship to mental illness in my own treatment. I can recall – and I still do it, even though I know better – I still park my car four blocks away from my psychiatrist’s office, because I’m worried that someone’s going to see it right out front.

And here I am, having just received the Legislator of the Year from the National Mental Health Association, telling you that as much as I know about stigma, I still am in desperate fear of the stigma that exists.

I was so happy that Tipper Gore gave me the courage to talk about my own suffering from depression and my own treatment for it.  She came up to Northern Rhode Island two years ago and unveiled a project that I’m working on now as a member of the Appropriations Committee, called the Positive Aging Project.  It was for senior citizens who, understandably, have a high rate of depression for a number of reasons, and who have most of it written off as just part of the aging process – “that’s the way seniors are.”

In the midst of it, I could tell, it was like ice out there.  The seniors didn’t like hearing anyone talk about mental health and depression among senior citizens and having been given all the statistics, they were really cringing.  So, I blurted out that I see a psychiatrist and that I think it’s helped me and I’m certainly not as far along as I’d like to be, but I’m certainly a lot farther along than if I hadn’t seen one at all.  I had known – well, I thought I knew -- I was going to talk about it, but I wasn’t sure because I wanted to just wait and see if the spirit moved me.  But with Tipper Gore there, having spoken about it herself, her spirit moved me and I’ll forever be grateful to her and I know what a profound leap forward this country would have made had we had her today as our First Lady.

In June of 1963, my uncle, President Kennedy, gave a national address on television to make the case for Federal Civil Rights legislation.  In it, he said, “If an American, because his skin is dark, cannot enjoy the full and free life which all of us want, then who among us would be content to have the color of his skin changed and stand in his place.  Who among us would be content with the counsels of patience and delay?”  The country, at that moment, reached a turning point because of the courage of thousands of civil rights marchers including some of our own colleagues like John Lewis, who just received the John F. Kennedy Profile in Courage award,  helped awaken the country’s consciousness to the power of the civil rights movement and helped us overcome the prejudice which had institutionalized inequality up until that point.

What I’d like to say to all of you is that you all are in the midst of a similar struggle.  Your work to bring more effective health care to more people is in the finest American tradition of opening up the doors of opportunity to millions of Americans.  It is extending the American dream that today is so difficult to realize for so many Americans because of their mental illness.

Mental illness prevents millions from playing an active role in their communities; it bars the door to the workplace, leaving many without jobs; and it fosters in those it inflicts feelings of shame, uselessness, guilt and despair.  As we develop more effective treatments, learn how to prevent the onset of mental illness and extend the access to both preventative services and treatment, we, like the civil rights activists before our generation, we open doors, we widen the circle of opportunity as it has been extended so many times in our nation’s history to other sets of Americans.

So I want to thank you, each and every one of you in this audience, because you are the ones that care enough to take on this important challenge.  You are the ones who are willing to make a little noise about the injustices you see to your patients, to your friends, to your family members.  You are the ones who are working to make change happen.  If I could have enough time up here to have each and every one of you come up here, I know you could give me stories that would abound with the injustices that currently exist within our current mental health care system.

I shouldn’t be, nor should Dick be, hearing from seniors in our districts about the 50% Medicare co-pay on mental health care.  We shouldn’t be hearing from child psychiatrists about how they lose money every patient they see or about how, for instance, in Bradley Hospital, the premiere psychiatric hospital in the nation, how they have 50% more kids there any given night than they need to have because there aren’t adequate community mental health services to treat those kids in a community setting.  And that is what is going on.

We don’t need to be hearing from parents telling us that they can’t get access to treatment for their kids and instead have to wait until the criminal justice system steps in to get anyone to pay attention to them at all.

Our mental health system, as Deborah has said, is in shambles today.  You all know the scope of the problem and it touches everybody in this country in one way or another.

But as mentioned before, what happens when it comes to diseases like AIDS and cancer?  We think about mortality and that gets all of the attention.  But look at the burden of disease.  Life can be consumed by disease without being shortened in numbers of years.  Diseases can disable as well as kill.

When a disease strikes a young person right as they enter the prime of their life, when it’s a chronic disease that saps their motivation and their self-esteem, when it sabotages their ability to hold a job or maintain a relationship, don’t tell me that’s not a real disease and don’t tell me these diseases aren’t costing people their lives, because they are costing people their lives.  Not only figuratively, but also as we know all too well, literally as well.

We see suicide statistics that should horrify this country.  For every two homicides in this nation, there are three suicides.  I don’t think most people understand that.  I don’t think that people understand that suicide is the eighth leading cause of death nationwide and among kids, it’s second or third, depending on the age group.  Of course, among seniors, it’s an enormous problem.

And even if you’re cold, and only think of it in terms of the financial bottom line, you should care, because as written up in the Wall Street Journal, this is costing business money.  It’s costing business money in lost work productivity, so that most of the businesses that were highlighted in that Wall Street Journal story and others that are looked upon as being on the cutting edge, are offering a full array of preventative and treatment services that will help keep people healthy.

We see in the country as a whole that mental illness is costing far too much.  Dick will speak about it as he has all over the country, about how the real indictment of our country is the fact that we have two million people in our jails in this country.  One-fourth of the whole world’s prison population is incarcerated right here in this, ostensibly the freest country on the face of the earth.  This should shock people into action because it is an indictment of our country.

Instead, I’ve seen the opposite on the Appropriations Committee.  By the way, Dick is the quarterback.  Dick put me on it, and I’m proud that he put me on the committee that oversees the budget for NIMH and all of the health budgets.  I went on there and was shocked to find that only five of every one hundred dollars that our taxpayers spend on researching disease is going into researching mental illness. Only five of every hundred dollars.  And you think of the World Health Organization ranking of this as the number one most burdensome disease, second in the industrialized world only to cardiovascular disease, and you think that more than one in five people in this country and virtually all families are affected, and we have the gall, living the 21st century, to say that only five of every hundred dollars – and I might add it’s really less than five, and it will be even further decreased if we adopt the current budget that’s been proposed – go to mental illness.

So that’s why we need to fight a system where the stigma exists even in the ivory tower.  Stigma exists even within the ivory tower.  I saw Dr. Hyman the other day and he was asked a question.  “You know, I know the NIH’s budget is increasing.  Is your budget increasing?”  I love Dr. Hyman.  He’s trying to be polite because he has to deal with the new Administration.  He said, “Well, ours is going up at the same rate of increase as pretty much everybody else’s.”  Well, that sort of disguises the fact that if you start real low and go up by a percentage of where you start, you’re still very low.

But this administration doesn’t understand that and the best example of that was their tax bill.  It really showed where their priorities were in terms of what it’s going to cost.  Every time now that I go to a hearing and we don’t have enough money to put into community mental health grants, I’m going to think about that tax cut.  I’m going to think that we should have had a Congress that understood what the trade-off was, but we didn’t understand what the trade-off was, because that trade-off wasn’t made apparent to the public in this country.  What it’s going to cost this country in missed investments and opportunities to have had that tax cut is huge, and I can guarantee where that money will come from because we were there when the Balanced Budget Act passed and eviscerated reimbursement payments.

You see our hospitals crumbling now and you see insurance companies getting even tighter and a good percent of that budget surplus, so to speak, came from the health care system as it is.  That’s the reason it’s suffering so much.  But despite the tightening within our health care system, in my state of Rhode Island the largest bonuses to our top paid executives in our non-profit insurers exceeded six figures.  Bonuses.  And United Health Care’s stock split two for one in February, so investors are winning, people who worked as high execs were making plenty of money, but when it comes to making sure the consumers and the providers were getting reimbursed, just forget about it.

You know the anemic reimbursement rate for providers and we’re simply not going to have services.  The best testimony was your new President saying to you, despite her passion, despite her obvious success in this field, that she would no longer do this.  What does that say about what the future holds for others who may be interested in providing therapeutic and psychiatric help to folks, when your new leader says that this is a situation she finds intolerable?

This is something that has to change, and with the work that we’re doing to get back the House and put new leadership in Congress, we’ll be able to put more money in.  And I should say, as is always this case, when the Federal government acts, there is a ripple effect.  If we do something more to help make sure that we have adequate reimbursement for federal employees and really put that into effect, if we put the research dollars in there, believe me, that will spur the private sector as well.

So we have a lot of work to do, with parity, with the community mental health block grant and I’m going to be working very hard to try to get that done and I’m fortunate enough to have the backing of my good friend, and the person I’m going to introduce.

The last two years, I’ve spent traveling the country raising money for the Democratic Party, and the real privilege for me was that I had the opportunity to travel extensively with Dick Gephardt.  I came to Congress and I knew that he was somebody that I wanted to get close to, not only because he had all the power and could put me on a good committee, but also because I like his style, I like his values and I like what he is all about and, as Deborah said, he is a down to earth person, he’s the kind of person that really embodies all that our party in its finest tradition should be all about.

When people attack Dick for fighting too much for working families and for the disenfranchised, I think to myself, thank God.  Thank God there is a Democrat who is willing to take difficult positions that some accuse as being “liberal.”  Of course Richard Nixon was proposing positions that were even to the left of that back in 70’s and had no criticism.  The thought that in today’s party system that Dick Gephardt could be called a liberal should be frightening, even to us as Democrats.

This is a fellow who has worked to forge consensus and a mainstream in this Congress and in this country and this is someone who knows that he has to work in the middle to bring people together.  He does a very good job of spanning the length and breadth of the party and political perspective, but I always am amazed because all I think to myself is something is wrong with the rest of the party and with the rest of this country that there aren’t more people like our leader.  But thankfully, members of my caucus have had good vision enough to elect him to be our leader.  Let me give you now the next Speaker of the House of Representatives, Dick Gephardt.

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