A picture of Senator Debbie Stabenow
Debbie S.
Democrat MI

About Sen. Debbie
  • Mental Health Care

    by Senator Debbie Stabenow

    Posted on 2015-12-10

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    STABENOW. Mr. President, I rise to talk about an opportunity we have in the midst of all the negotiations going on to do something incredibly meaningful, that has bipartisan support, and literally will address a group of diseases that affect one out of four people every year--one out of four people who work here, one out of four people in our families. A set of diseases right now for which less than 40 percent of those with the disease get the treatment they need, but when they do, it is manageable and they can go on and lead productive lives. What I am talking about is mental illness. One out of four people every year has some kind of mental illness which is treatable and with medications and with treatment--just like any other disease--can allow someone to go on and live their life.

    We have started the process in public policy of doing what we call mental health parity by saying now that insurance can't discriminate whether it is a behavioral disease, mental health, substance abuse or physical health, but we don't yet have the services in the community. So what happens is we pay dearly. Not only do individuals pay with their lives, their livelihoods, their families, and communities pay, but we pay as taxpayers.

    It was interesting to me, speaking at a conference a couple of days ago here in DC with law enforcement and mental health professionals coming together, to hear about the Cook County Jail in Chicago, a huge facility. The sheriff there now has appointed a psychiatrist as the director of the jail. Why? Because one-third of the people housed in the jail have psychiatric problems. They shouldn't be in the jail. They may have committed some minor infraction because they didn't have a job or maybe they were on the street. Maybe they were hearing voices in their head and didn't hear the police officer and didn't respond in a way--or where it was considered belligerent. We now know from papers today in Michigan that studies show that people who are mentally ill are 16 times more likely to be killed in a year by a police officer. I am not suggesting that it is at all on purpose but it is because of the nature of the behavioral problems and what ends up happening in the real world when people aren't getting the treatments they need. We know what happens in terms of violence and people committing crimes, although someone who has a mental health disease is much more likely to be a victim than a perpetrator.

    We have people in the emergency rooms of our hospitals. I have talked to hospital administrators and doctors who say what we need is to make sure we have a 24-hour emergency psychiatric facility, a place where someone can go or family members can call or the police can use if they find someone who needs help, not the hospital emergency room and certainly not the jail.

    [[Page S8567]] The good news is that we have started a bipartisan effort that can fix this. My partner and colleague in this, Senator Blunt, and I, over a year ago, authored a provision that was passed by the House and Senate to begin something called the Excellence in Mental Health Act. We now have in law a definition of quality behavioral health services. We have federally qualified health centers in the community where people without insurance can go and get preventive care and get the physical health services they need, but the health clinics can't get reimbursed for mental health or substance abuse services. So we now have a definition. We have standards for what quality behavioral health care, mental health, and substance abuse care looks like. We have standards. We begin to provide dollars so that communities can provide those services if they meet the standards.

    A couple of years ago when we put together money for the first step by saying we are going to provide money for 8 States to be able to meet those standards--8 out of 50--the good news was that half the States in the country responded and said: We want to be one of those eight States. Twenty-four States across our country now have signed up. They have received planning grants to assess their community mental health services, what they are doing, and how they can meet these new high standards, how they can make sure they include 24-hour psychiatric emergency services in their community so their citizens have the help they need as well as ongoing help for families and individuals. Twenty- four States have said: Sign me up. We are willing to do the work.

    We have funding for eight of those States to actually be able to do it, to change lives; eight of those States to be able to provide services, treatment, hope for individual families, help for the sheriff, and relief for the emergency room. What we are proposing now and what is under consideration is to fund the 24 States. We have 24 States that have stepped forward. Let's provide them the resources. In the context of what we are talking about in the budget, it is a very small amount of money. We could say to the communities across this country and virtually half of the States that we are going to give them the resources to meet higher quality standards, to be able to provide the services desperately needed for one out of four people every year who have some kind of mental illness. The ramifications of doing nothing are severe in so many ways.

    The reality is that we are at a point where we have the opportunity to say that as a country we are going to recognize and treat diseases above the neck the same as diseases below the neck and support communities that step up with higher quality standards and services. In the world in which we live, this would be a huge bipartisan victory.

    I know this is under discussion, and I am hopeful that as the leadership moves forward, they will join us--the bipartisan coalition in the House and the Senate--in saying yes to give the people an opportunity to live their lives, be successful, work, and manage their diseases in the community just like any other disease.

    I wish to say in closing that if you are a diabetic, you check your insulin every day. If you check your sugar and take your insulin, you manage your disease. It is not debilitating. You can go out and live your life. I imagine there are many people who work in the Senate who are managing diabetes. You can do the same thing if you are bipolar. It is a chemical imbalance of the brain. It is just a different organ, a different part of the body. If, in fact, you have the medication to stabilize and you have the support and treatment you need, you can manage that disease, go on with your life, be successful, work, have a family, and be able to live with dignity. That is what we are talking about. We are talking about giving people who have diseases in the brain the same opportunity for treatment and management of those diseases to live healthy, hopeful, successful lives as we do for people who have diseases in any other organ of the body. We have the opportunity to do that. At the end of next week, I deeply hope we will be able to celebrate that we have done something incredibly important for families across America.

    I yield the floor.

    The PRESIDING OFFICER (Mr. Flake). The Senator from Indiana.


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