1 00:00:06,760 --> 00:00:12,000 Speaker 1: Welcome to Why Not Me? Embracing Autism and Mental Health Worldwide? 2 00:00:12,680 --> 00:00:20,200 Speaker 1: Hosted by Tony Mantor, broadcasting from the heart of Music City, USA, Nashville, Tennessee. 3 00:00:21,239 --> 00:00:25,360 Speaker 1: Join us as our guests share their raw, powerful stories. 4 00:00:25,880 --> 00:00:29,880 Speaker 1: Some will spark laughter, others will move you to tears. 5 00:00:30,880 --> 00:00:36,440 Speaker 1: These real life journeys inspire, connect and remind you that 6 00:00:36,520 --> 00:00:41,400 Speaker 1: you're never alone. We're igniting a global movement to empower 7 00:00:41,600 --> 00:00:46,640 Speaker 1: everyone to make a lasting difference by fostering deep awareness 8 00:00:47,120 --> 00:00:53,280 Speaker 1: on wavering acceptance, and profound understanding of autism and mental health. 9 00:00:53,680 --> 00:00:58,160 Speaker 1: Tune in, be inspired, and join us in transforming the world, 10 00:00:58,520 --> 00:01:04,440 Speaker 1: one story at a time. Time. Hi, I'm Tony Mantor. 11 00:01:04,760 --> 00:01:09,320 Speaker 1: Welcome to Why Not Me? Embracing Autism and Mental Health Worldwide. 12 00:01:09,440 --> 00:01:14,080 Speaker 1: Welcome to our special event, Crafting justice, empowering autism and 13 00:01:14,160 --> 00:01:18,680 Speaker 1: mental health through legislation. Joining us today is Patrick Kennedy, 14 00:01:19,000 --> 00:01:23,720 Speaker 1: former US Congressman and passionate advocate for mental health reform. 15 00:01:24,200 --> 00:01:28,520 Speaker 1: With a legacy of groundbreaking legislation, including the Mental Health 16 00:01:28,560 --> 00:01:32,280 Speaker 1: Parity and Addiction Equity Act, he has reshaped how we 17 00:01:32,319 --> 00:01:36,280 Speaker 1: address mental health and addiction in America. He joins us 18 00:01:36,280 --> 00:01:39,400 Speaker 1: as he shares his personal journey, the challenges of pushing 19 00:01:39,440 --> 00:01:43,520 Speaker 1: for systemic change, and why mental health advocacy is more 20 00:01:43,520 --> 00:01:46,920 Speaker 1: critical now than ever. Thanks for joining us today. 21 00:01:47,080 --> 00:01:49,080 Speaker 2: Thank you. I appreciate you having me on. 22 00:01:49,240 --> 00:01:51,960 Speaker 1: Oh it's my pleasure. So let's start off with this. 23 00:01:52,360 --> 00:01:55,240 Speaker 1: As the lead sponsor of the Mental Health Parity and 24 00:01:55,280 --> 00:01:57,880 Speaker 1: Addiction Equity Act of two thousand and eight, what do 25 00:01:57,960 --> 00:02:02,160 Speaker 1: you see as the most significant barriers to its full implementation? 26 00:02:02,600 --> 00:02:06,480 Speaker 2: Well, first, you know, there's two different approaches to dressing 27 00:02:06,520 --> 00:02:10,240 Speaker 2: the problem. You know, one is punitive. You create a 28 00:02:10,280 --> 00:02:15,200 Speaker 2: liability that forces payers to react and try to cover 29 00:02:15,320 --> 00:02:19,120 Speaker 2: their liability by doing you know, what is required by law. 30 00:02:19,520 --> 00:02:25,400 Speaker 2: The other is to incentivize the actors IE insurance which 31 00:02:25,440 --> 00:02:29,200 Speaker 2: includes the federal government or CMS is the biggest insurer 32 00:02:29,240 --> 00:02:31,800 Speaker 2: of all, to do the right thing, not through a 33 00:02:31,840 --> 00:02:35,680 Speaker 2: stick approach, but because it's in their self interest from 34 00:02:35,760 --> 00:02:40,280 Speaker 2: the dvantage point of paying for itself. It's financially, it's 35 00:02:40,360 --> 00:02:43,280 Speaker 2: their foot share. Responsibility would be to do this because 36 00:02:43,720 --> 00:02:46,720 Speaker 2: it's been demonstrated to be more cost effective par The 37 00:02:46,800 --> 00:02:51,720 Speaker 2: reason why we need to do the kind of stick approach, 38 00:02:51,840 --> 00:03:00,480 Speaker 2: the punitive federal lawmaking and regulating approach to make players 39 00:03:00,639 --> 00:03:04,680 Speaker 2: do something that is not in their financial interest is 40 00:03:04,760 --> 00:03:07,640 Speaker 2: because we have set up a paradigm where it's not 41 00:03:07,760 --> 00:03:11,320 Speaker 2: in their financial interest, i e. If they make their 42 00:03:11,360 --> 00:03:14,960 Speaker 2: profits on a year in, year out basis, it's never 43 00:03:15,040 --> 00:03:18,320 Speaker 2: gonna be an investment that they get a return on. 44 00:03:18,560 --> 00:03:24,400 Speaker 2: But if the payment and insurance system was able to 45 00:03:24,720 --> 00:03:29,760 Speaker 2: capture the value of paying for the right mental health 46 00:03:29,960 --> 00:03:33,480 Speaker 2: interventions at the right time for the right person, then 47 00:03:33,560 --> 00:03:37,280 Speaker 2: they would be doing it all day long, every day 48 00:03:37,440 --> 00:03:40,560 Speaker 2: of the week, and twice on Sunday. They wouldn't need 49 00:03:40,760 --> 00:03:43,560 Speaker 2: the Federal Mental Health Parity and Addiction Equity Act to 50 00:03:43,680 --> 00:03:46,839 Speaker 2: tell them to do it, because they're all about their 51 00:03:46,880 --> 00:03:50,040 Speaker 2: own fiduciary. And if their own fiduciary says you gotta 52 00:03:50,160 --> 00:03:53,400 Speaker 2: do it because it's less expensive, there's a bigger return 53 00:03:53,440 --> 00:03:55,400 Speaker 2: on the investment, they would do it. So part of 54 00:03:55,440 --> 00:03:57,640 Speaker 2: the thing is I feel like we're pushing the bowler 55 00:03:57,720 --> 00:04:01,119 Speaker 2: up the hill. Because the insurance industry is enormously powerful. 56 00:04:01,120 --> 00:04:04,960 Speaker 2: They've got a lot of you know, obviously lobbing power 57 00:04:05,000 --> 00:04:07,760 Speaker 2: in DC and influence across the country. 58 00:04:07,880 --> 00:04:11,320 Speaker 1: That seems like a huge bridge to cross. So what's 59 00:04:11,360 --> 00:04:12,440 Speaker 1: the next step. 60 00:04:12,360 --> 00:04:16,760 Speaker 2: Kind of try to do battle with them when you're 61 00:04:16,760 --> 00:04:22,400 Speaker 2: representing consumers you know, across the board, whether it's the 62 00:04:22,480 --> 00:04:26,600 Speaker 2: IDD community, the SUD community, the SMI community, who by 63 00:04:26,680 --> 00:04:32,040 Speaker 2: their very definition are overwhelmed, you know, both by their illness, 64 00:04:32,040 --> 00:04:36,680 Speaker 2: which compromises their advocacy as self advocates and their families 65 00:04:36,960 --> 00:04:39,640 Speaker 2: advocacy because they're so busy trying to take care of 66 00:04:39,640 --> 00:04:41,760 Speaker 2: their loved ones. The notion that they're going to be 67 00:04:41,839 --> 00:04:45,600 Speaker 2: engaged in a legal process to enforce you know, the 68 00:04:45,720 --> 00:04:48,599 Speaker 2: law that was written to protect them, and as you know, 69 00:04:49,360 --> 00:04:53,440 Speaker 2: that's the where the rub is. It's you need enforcement 70 00:04:53,720 --> 00:04:57,960 Speaker 2: because otherwise the law is meaningless unless it's got teeth, 71 00:04:58,080 --> 00:05:00,800 Speaker 2: unless it's got enforcement. So it's a of a challenge 72 00:05:00,800 --> 00:05:03,760 Speaker 2: to pass the law because the insurance industry will create 73 00:05:03,880 --> 00:05:07,320 Speaker 2: you know, levers to mitigate the impact of the law 74 00:05:07,360 --> 00:05:10,360 Speaker 2: itself in terms of its definition. But then there'll be 75 00:05:10,400 --> 00:05:13,680 Speaker 2: another layer that will mitigate the law's impact on them, 76 00:05:13,720 --> 00:05:17,560 Speaker 2: and that's the regulatory bird. And then of course, and 77 00:05:17,600 --> 00:05:21,679 Speaker 2: then there's the legal appeals process. So like on all three, 78 00:05:22,200 --> 00:05:26,039 Speaker 2: you're fighting the most powerful industry in the country, which 79 00:05:26,200 --> 00:05:29,040 Speaker 2: you're going to lose, lose, lose. 80 00:05:29,400 --> 00:05:32,520 Speaker 1: So what steps do we need to take so that 81 00:05:32,680 --> 00:05:35,440 Speaker 1: this becomes a winnable situation. 82 00:05:35,920 --> 00:05:38,680 Speaker 2: So the idea that we're going to be able to 83 00:05:39,040 --> 00:05:43,560 Speaker 2: win in that environment is going to be determined by 84 00:05:43,640 --> 00:05:48,000 Speaker 2: how effectively we can advocate. Now, I'm not saying that, 85 00:05:48,240 --> 00:05:51,839 Speaker 2: you know, we can't speak truth to power and fight 86 00:05:52,000 --> 00:05:54,960 Speaker 2: power with political process that's been done from the beginning 87 00:05:55,000 --> 00:05:57,800 Speaker 2: of time. I mean, you know, you have the industrial 88 00:05:57,839 --> 00:06:00,479 Speaker 2: Revolution and then you have the labor movement. The labor 89 00:06:00,520 --> 00:06:03,839 Speaker 2: movement was a reaction to the industrial Revolution, which exploited 90 00:06:03,880 --> 00:06:06,880 Speaker 2: people and put them in these factories and had kids 91 00:06:07,040 --> 00:06:10,000 Speaker 2: in these factories and had unsafe working conditions, and the 92 00:06:10,240 --> 00:06:12,960 Speaker 2: American people said, no, you're gonna have to negotiate. We're 93 00:06:12,960 --> 00:06:15,400 Speaker 2: going to create this thing called unions. You're gonna have 94 00:06:15,400 --> 00:06:18,279 Speaker 2: to negotiate with You're it's going to give people power 95 00:06:18,560 --> 00:06:22,039 Speaker 2: to have labor be represented at the bargaining table so 96 00:06:22,080 --> 00:06:24,880 Speaker 2: that you can protect that other aspect. 97 00:06:25,160 --> 00:06:27,920 Speaker 1: So where do you think we stand with everything that 98 00:06:27,960 --> 00:06:31,400 Speaker 1: you're seeing now moving forward with what we're trying to do, 99 00:06:31,839 --> 00:06:33,080 Speaker 1: We're nowhere. 100 00:06:32,720 --> 00:06:37,320 Speaker 2: Near that point of realization where we need to organize 101 00:06:37,360 --> 00:06:42,880 Speaker 2: politically to create the political power like the unions did 102 00:06:43,160 --> 00:06:46,400 Speaker 2: to speak up on behalf of our community because, as 103 00:06:46,440 --> 00:06:48,760 Speaker 2: I said, for a lot of reasons, and on the 104 00:06:48,839 --> 00:06:53,280 Speaker 2: least of which is stigma, shame, the continued stereotypes and 105 00:06:53,360 --> 00:06:58,560 Speaker 2: implicit biases that relegate these illnesses to people's moral judgments 106 00:06:58,600 --> 00:07:01,520 Speaker 2: on a person because of their illness. So we've got 107 00:07:01,520 --> 00:07:04,400 Speaker 2: a lot of challenges to get organized politically, and we 108 00:07:04,480 --> 00:07:08,719 Speaker 2: got a lot of challenges to get organized legislatively, regulatorily, 109 00:07:08,800 --> 00:07:12,560 Speaker 2: and legally. So basically I've shown you that this is 110 00:07:13,400 --> 00:07:15,920 Speaker 2: the rock of Sisyphus. You know, you could just keep 111 00:07:15,920 --> 00:07:17,920 Speaker 2: pushing this up the mountain, it's going to roll back 112 00:07:17,960 --> 00:07:20,360 Speaker 2: down on us because we just don't have the power 113 00:07:20,520 --> 00:07:23,200 Speaker 2: on all of those levels. That's not to say we 114 00:07:23,280 --> 00:07:25,800 Speaker 2: don't need to work on creating that power. If I 115 00:07:25,960 --> 00:07:29,360 Speaker 2: had any number of dollars from the world, well, the 116 00:07:29,400 --> 00:07:32,080 Speaker 2: United States is four hundred and seventy eight billionaires, if 117 00:07:32,080 --> 00:07:34,160 Speaker 2: they which, of course all of us have mental health 118 00:07:34,200 --> 00:07:35,880 Speaker 2: and addiction issues in our families. 119 00:07:36,280 --> 00:07:39,360 Speaker 1: Yeah, so if you could tell them one thing that 120 00:07:39,440 --> 00:07:41,680 Speaker 1: would help all this, what would you tell them? 121 00:07:42,280 --> 00:07:45,960 Speaker 2: If any of them put their money behind this, I 122 00:07:46,000 --> 00:07:47,600 Speaker 2: would tell them, first thing we need to do is 123 00:07:47,640 --> 00:07:49,640 Speaker 2: create the political power, because you're going to have all 124 00:07:49,640 --> 00:07:51,520 Speaker 2: the ideas in the world, but it's not going to 125 00:07:51,600 --> 00:07:55,960 Speaker 2: work if you don't align the political power to you know, 126 00:07:56,040 --> 00:08:00,720 Speaker 2: be institutionalized, meaning anyone running for office has to be 127 00:08:00,800 --> 00:08:03,680 Speaker 2: doing the right thing because they know that a third 128 00:08:03,720 --> 00:08:07,880 Speaker 2: of their constituency, half of their constituency, two thirds of 129 00:08:07,880 --> 00:08:13,880 Speaker 2: their constituency has signed on to these basic principles and 130 00:08:14,200 --> 00:08:18,760 Speaker 2: as such, you know, basically had embedded those principles into 131 00:08:18,840 --> 00:08:23,160 Speaker 2: policy and into law and into regulation. So the bottom 132 00:08:23,200 --> 00:08:26,960 Speaker 2: line is, we just don't have that, but we can 133 00:08:27,120 --> 00:08:30,360 Speaker 2: get it. Like I am convinced, as a former elected 134 00:08:30,400 --> 00:08:33,480 Speaker 2: official who has run plenty of political campaigns, you could 135 00:08:33,480 --> 00:08:37,320 Speaker 2: put a political campaign together that would make this the 136 00:08:37,400 --> 00:08:40,960 Speaker 2: most powerful special interest in the country, no doubt. In 137 00:08:40,960 --> 00:08:43,400 Speaker 2: my mind, this is the most powerful because it's the 138 00:08:43,440 --> 00:08:46,480 Speaker 2: most personal to every single family in America. And when 139 00:08:46,520 --> 00:08:49,280 Speaker 2: it's personal in this regard in a way that frankly 140 00:08:49,600 --> 00:08:53,520 Speaker 2: I think supersedes most other quote special interests in terms 141 00:08:53,559 --> 00:08:58,439 Speaker 2: of the power of this as an existential personal issue 142 00:08:58,480 --> 00:09:02,760 Speaker 2: for the families involved, then we could smash through any 143 00:09:03,520 --> 00:09:07,760 Speaker 2: barrier in our way and get what's best for our families. 144 00:09:08,679 --> 00:09:11,320 Speaker 2: So that's one approach, But as I said, the other 145 00:09:11,400 --> 00:09:15,920 Speaker 2: approach is, which may be easier depends, is to try 146 00:09:16,040 --> 00:09:19,480 Speaker 2: to do the impossible, which is to create a new 147 00:09:19,800 --> 00:09:25,840 Speaker 2: financial system which acknowledges the value, the financial value, not 148 00:09:25,880 --> 00:09:32,240 Speaker 2: the moral, not the human, not the altruistic benefit of 149 00:09:32,800 --> 00:09:37,320 Speaker 2: good mental health interventions, the financial benefit of good mental health. 150 00:09:37,360 --> 00:09:40,880 Speaker 2: And if you did that, and you constructed an insurance 151 00:09:40,960 --> 00:09:46,120 Speaker 2: history that competes over who's got less liability across a 152 00:09:46,280 --> 00:09:49,320 Speaker 2: longer period of time, then they'll say, well, if I 153 00:09:49,440 --> 00:09:53,040 Speaker 2: own these patients and the risk that comes with them, 154 00:09:53,520 --> 00:09:55,920 Speaker 2: I'm going to do whatever I need to do to 155 00:09:56,240 --> 00:10:02,960 Speaker 2: manage that risk, meaning minimize my lif liability, my exposure 156 00:10:03,400 --> 00:10:07,120 Speaker 2: to pay more money for that risk than I need to. 157 00:10:07,520 --> 00:10:10,600 Speaker 1: Well, that said, what does this whole process entail. 158 00:10:11,080 --> 00:10:12,840 Speaker 2: What do I need to do? Well, I need to 159 00:10:12,880 --> 00:10:16,480 Speaker 2: do this early intervention, I need to do preemptive this, 160 00:10:16,920 --> 00:10:19,880 Speaker 2: I need to put in chronic care management that I 161 00:10:19,960 --> 00:10:23,320 Speaker 2: need to do all these other things, which by the way, 162 00:10:23,800 --> 00:10:27,960 Speaker 2: may include paying for things that aren't necessarily clinical and medical, 163 00:10:28,280 --> 00:10:30,920 Speaker 2: because a lot of what we need, which frankly the 164 00:10:30,960 --> 00:10:34,000 Speaker 2: parody law has been helpful to do, is to pay 165 00:10:34,040 --> 00:10:39,359 Speaker 2: for those social services, those human services, those housing services, 166 00:10:39,600 --> 00:10:43,880 Speaker 2: that frankly get us better clinical outcomes than another pill 167 00:10:44,120 --> 00:10:48,239 Speaker 2: and another kind of medical intervention. So what would decide 168 00:10:48,280 --> 00:10:50,920 Speaker 2: that is not me coming to Congress with the law 169 00:10:50,960 --> 00:10:55,320 Speaker 2: and say you must cover, you know, sober housing for 170 00:10:55,360 --> 00:10:58,240 Speaker 2: people with addiction, because we know it's so much more 171 00:10:58,240 --> 00:11:02,160 Speaker 2: effective than paying for a whole life more rehabs in 172 00:11:02,280 --> 00:11:06,760 Speaker 2: terms of the longevity of people's sobriety and the stability 173 00:11:07,040 --> 00:11:10,320 Speaker 2: for them in their lives in tackling a very chronic 174 00:11:10,400 --> 00:11:15,199 Speaker 2: and insidious illness. If you've got stable housing and supportive 175 00:11:15,240 --> 00:11:18,880 Speaker 2: housing and by the way, recovery community organizations, by the way, 176 00:11:19,000 --> 00:11:22,280 Speaker 2: all of which cost a whole lot less than our 177 00:11:22,400 --> 00:11:26,160 Speaker 2: current medical paradigm to address addiction. You know what, I 178 00:11:26,240 --> 00:11:28,920 Speaker 2: wouldn't have to scream at the top of my lungs 179 00:11:28,960 --> 00:11:31,880 Speaker 2: for the payers to do this, because they'd be saying, oh, 180 00:11:32,160 --> 00:11:35,120 Speaker 2: that's cost less than the current model of continuing to 181 00:11:35,160 --> 00:11:38,600 Speaker 2: cycle people in and out of detoxes and emergency rooms. 182 00:11:38,640 --> 00:11:40,240 Speaker 2: And by the way, when you add the cost of 183 00:11:40,240 --> 00:11:43,080 Speaker 2: our criminal justice system to that, this thing is not 184 00:11:43,200 --> 00:11:46,000 Speaker 2: even a close call. So I guess what I'm saying 185 00:11:46,160 --> 00:11:49,520 Speaker 2: in an overarching way is that there are a lot 186 00:11:49,600 --> 00:11:52,120 Speaker 2: of things that we've got to do. All I want 187 00:11:52,160 --> 00:11:54,880 Speaker 2: anyone to know is that we know what they are 188 00:11:55,240 --> 00:11:57,600 Speaker 2: and we do them. It's a matter of political will. 189 00:11:57,679 --> 00:12:00,720 Speaker 1: Can you expand on that political will and how you see. 190 00:12:00,559 --> 00:12:03,760 Speaker 2: It at political will is not just directed to Congress 191 00:12:04,000 --> 00:12:08,200 Speaker 2: and the regulators. That political will can be amongst the payers, 192 00:12:08,640 --> 00:12:12,600 Speaker 2: influence the payers. They can be political will to force 193 00:12:13,080 --> 00:12:18,640 Speaker 2: the employers to use their power as the major payers. 194 00:12:18,760 --> 00:12:21,760 Speaker 2: They are the payers. The insurance industry is really taking 195 00:12:21,880 --> 00:12:24,960 Speaker 2: orders from the people that write their checks, which you know, 196 00:12:25,000 --> 00:12:28,080 Speaker 2: of course, the employers. And if the employers say, god, 197 00:12:28,200 --> 00:12:31,320 Speaker 2: this is crazy the way our premiums are going up 198 00:12:31,360 --> 00:12:34,160 Speaker 2: every year, and all we get is they're managing the 199 00:12:34,240 --> 00:12:37,560 Speaker 2: chairs on the Titanic, and can't these insurance companies come 200 00:12:37,640 --> 00:12:40,079 Speaker 2: up with a better mouse trap here? This is just silly, 201 00:12:40,280 --> 00:12:43,160 Speaker 2: And they might at some point break and say, God, 202 00:12:43,240 --> 00:12:45,679 Speaker 2: I can't be cutting benefits. I'm not going to get 203 00:12:45,679 --> 00:12:48,080 Speaker 2: the employees I want. They're not going to be healthy 204 00:12:48,080 --> 00:12:50,120 Speaker 2: the way I want. Their families are not going to 205 00:12:50,120 --> 00:12:52,160 Speaker 2: be healthy, which means they're not going to be present 206 00:12:52,200 --> 00:12:55,200 Speaker 2: on the job as productive employees if I don't address this. 207 00:12:55,400 --> 00:12:57,319 Speaker 2: And the way to address this is not to ratchet 208 00:12:57,360 --> 00:12:59,680 Speaker 2: down on what's covered. The way to address this is 209 00:12:59,720 --> 00:13:03,679 Speaker 2: to pay for what works and benefit from those interventions. 210 00:13:04,160 --> 00:13:08,520 Speaker 2: That ultimately is another political route. And of course most 211 00:13:08,520 --> 00:13:12,000 Speaker 2: people think politics, they think my member of Congress, my governor, 212 00:13:12,040 --> 00:13:15,720 Speaker 2: m elected. There is another political power, which is, you know, 213 00:13:15,800 --> 00:13:18,559 Speaker 2: the payers. And by that I don't mean just the insurers. 214 00:13:18,679 --> 00:13:20,680 Speaker 2: I mean the people they work for, which is the 215 00:13:20,720 --> 00:13:24,679 Speaker 2: major employers. And it turned the investors investor community. 216 00:13:24,760 --> 00:13:28,480 Speaker 1: So yes, that makes total sense. Your call for a 217 00:13:28,600 --> 00:13:32,920 Speaker 1: ninety ninety ninety goal by twenty thirty three, can you 218 00:13:33,000 --> 00:13:36,560 Speaker 1: explain to our audience what the ninety ninety ninety is 219 00:13:36,960 --> 00:13:40,760 Speaker 1: and what legislative policy or framework do you think that's 220 00:13:40,880 --> 00:13:43,400 Speaker 1: essential to achieving this target. 221 00:13:44,000 --> 00:13:47,440 Speaker 2: So you know, one thing I noticed, after you know, 222 00:13:47,559 --> 00:13:51,480 Speaker 2: thirty years of advocating for mental health and addiction, is 223 00:13:51,520 --> 00:13:55,000 Speaker 2: that we as a community, we'ren organized. Going back to 224 00:13:55,040 --> 00:13:58,480 Speaker 2: my point that we need an afl CIO And if 225 00:13:58,520 --> 00:14:01,000 Speaker 2: you're a Republican, you need a chain Chamber of commerce 226 00:14:01,320 --> 00:14:04,520 Speaker 2: or a league of conservation voters. If you're an environmentalist, 227 00:14:04,559 --> 00:14:08,360 Speaker 2: meaning we need to get our act together because we're 228 00:14:08,400 --> 00:14:10,959 Speaker 2: not organized. And if you're not organized, you don't pack 229 00:14:11,000 --> 00:14:14,360 Speaker 2: a punch you up no power because you're operating on 230 00:14:14,600 --> 00:14:18,400 Speaker 2: fifteen different advocacy points as opposed to one, and you 231 00:14:18,559 --> 00:14:22,560 Speaker 2: diminish our collective power. And so one thing I thought 232 00:14:22,760 --> 00:14:25,480 Speaker 2: we needed to do is in order to coalesce everyone, 233 00:14:25,520 --> 00:14:29,280 Speaker 2: we need to coalesce both the psychiatrists, the psychologists, the 234 00:14:29,400 --> 00:14:32,000 Speaker 2: mental illness community, the addiction committey, which are, by the way, 235 00:14:32,040 --> 00:14:37,400 Speaker 2: is siloed. And you needed to also frame what everybody 236 00:14:37,680 --> 00:14:40,360 Speaker 2: is for so that we can get everybody on the 237 00:14:40,400 --> 00:14:45,200 Speaker 2: same sheet of music. And what I did was just say, hey, 238 00:14:45,440 --> 00:14:49,440 Speaker 2: what has worked in other major public health challenges that 239 00:14:49,600 --> 00:14:53,000 Speaker 2: are stigmatized, And I look back the most notable as 240 00:14:53,160 --> 00:14:57,120 Speaker 2: HIV eights And when they were beginning their fight, they said, 241 00:14:57,240 --> 00:15:00,280 Speaker 2: you know what, within ten years, we want ninety cent 242 00:15:00,320 --> 00:15:04,800 Speaker 2: of American screen for HIV. We want the best interventions 243 00:15:04,800 --> 00:15:10,479 Speaker 2: that are evidence based to be uniformally and universally prescribed 244 00:15:11,000 --> 00:15:14,200 Speaker 2: as protocols that are common, not patchwork wilt. We want 245 00:15:14,240 --> 00:15:17,880 Speaker 2: everybody that's evidence based, and we want ninety percent to 246 00:15:17,920 --> 00:15:21,240 Speaker 2: be able to live with this condition, even if it's 247 00:15:21,240 --> 00:15:23,360 Speaker 2: a chronic condition, for the rest of their lives, with 248 00:15:23,480 --> 00:15:28,120 Speaker 2: stability and health, you know, absence of disability. That was 249 00:15:28,280 --> 00:15:33,600 Speaker 2: HIV eights and guess what, we can use that same model. 250 00:15:34,080 --> 00:15:38,680 Speaker 2: We want ninety percent of American screen for mental illnesses, 251 00:15:38,800 --> 00:15:43,560 Speaker 2: for addiction, for intellectual developmental disabilities. Why is that so 252 00:15:43,880 --> 00:15:47,080 Speaker 2: outrageous to say we do it for cancer, We do 253 00:15:47,120 --> 00:15:52,840 Speaker 2: it for cardiovascer disease, we do it for is sight, hearing, scoliosis, everything, 254 00:15:53,040 --> 00:15:56,240 Speaker 2: but we don't do it for the brain. It makes 255 00:15:56,280 --> 00:15:57,240 Speaker 2: no sense whatsoever. 256 00:15:58,080 --> 00:16:00,600 Speaker 1: Yes, if you look at HIV AIDS, that was what 257 00:16:01,000 --> 00:16:04,600 Speaker 1: forty years ago. So with all the technology and all 258 00:16:04,640 --> 00:16:07,680 Speaker 1: the information that we've got now, there is no reason 259 00:16:08,120 --> 00:16:11,600 Speaker 1: why we shouldn't be doing a lot more for those 260 00:16:11,640 --> 00:16:13,120 Speaker 1: with serious mental illness. 261 00:16:13,400 --> 00:16:16,360 Speaker 2: We can do it today because you know, the old 262 00:16:16,480 --> 00:16:20,240 Speaker 2: tools of having twenty five pieces of paper fill out 263 00:16:20,480 --> 00:16:24,960 Speaker 2: fifteen hundred different questions in order to screen someone. Those 264 00:16:25,080 --> 00:16:28,160 Speaker 2: days are gone. We're now in the world of AI 265 00:16:28,200 --> 00:16:31,760 Speaker 2: and technology. There's so many ways that we can now 266 00:16:31,960 --> 00:16:37,280 Speaker 2: triage and identify who has what they need in a 267 00:16:37,360 --> 00:16:41,680 Speaker 2: way that automatically not only can help us screen more 268 00:16:41,720 --> 00:16:44,720 Speaker 2: effectively for who's got what and how to best treat them, 269 00:16:44,880 --> 00:16:50,840 Speaker 2: but that diagnostic tool algorithm is going to frankly also 270 00:16:50,960 --> 00:16:53,480 Speaker 2: give us what's the algorithm that's going to produce the 271 00:16:53,520 --> 00:16:57,720 Speaker 2: best results for that person with that level of disability, 272 00:16:58,040 --> 00:17:02,760 Speaker 2: that risk profile, that diagnosis, what's going to produce the 273 00:17:02,760 --> 00:17:06,600 Speaker 2: best outcomes for them? In other words, bringing kind of 274 00:17:06,960 --> 00:17:10,359 Speaker 2: evidence space evidence being what works and shown to work 275 00:17:10,400 --> 00:17:12,760 Speaker 2: in terms of producing the best outcomes that can be 276 00:17:12,840 --> 00:17:15,399 Speaker 2: done in no time. And then the final thing is 277 00:17:15,920 --> 00:17:19,000 Speaker 2: you know, supported in recovery. That's going to take a 278 00:17:19,160 --> 00:17:23,919 Speaker 2: revamping again as I said on the payment paradigm of 279 00:17:24,040 --> 00:17:27,760 Speaker 2: paying for longer term outcomes. That's going to result in 280 00:17:28,080 --> 00:17:30,920 Speaker 2: how do we build which we don't have a recovery 281 00:17:31,200 --> 00:17:34,399 Speaker 2: kind of model of care in this country where we 282 00:17:34,480 --> 00:17:39,159 Speaker 2: pay for the support of housing, the support of community organizations, 283 00:17:39,359 --> 00:17:43,119 Speaker 2: the you know, the peer supports all of those things, 284 00:17:43,119 --> 00:17:46,560 Speaker 2: which whether you have an IDD, whether you have you know, 285 00:17:46,680 --> 00:17:50,680 Speaker 2: addiction or an SMI, you we all need the same things. 286 00:17:50,920 --> 00:17:54,200 Speaker 2: And frankly, this is an opportunity for us to circle 287 00:17:54,240 --> 00:17:57,680 Speaker 2: the wagons so that we're all not fighting our own battles. 288 00:17:57,720 --> 00:18:01,639 Speaker 2: But frankly, whether you have parking sins or down syndrome 289 00:18:01,720 --> 00:18:07,520 Speaker 2: or autism where you have schizophrenic alcoholism, other forms of 290 00:18:07,880 --> 00:18:11,080 Speaker 2: you know what, we all need support of housing to 291 00:18:11,200 --> 00:18:15,760 Speaker 2: varying degrees. We all need recovery, community organizations to varying degrees. 292 00:18:15,800 --> 00:18:19,880 Speaker 2: We all need each other. And if that was the frame, 293 00:18:20,000 --> 00:18:22,640 Speaker 2: then we would be going to the hill and we'd 294 00:18:22,680 --> 00:18:26,040 Speaker 2: be going to other places of power to influence together 295 00:18:26,480 --> 00:18:29,480 Speaker 2: rather than separately. And if we went together, we'd be 296 00:18:29,520 --> 00:18:30,480 Speaker 2: a lot more effective. 297 00:18:31,280 --> 00:18:34,520 Speaker 1: That is so true. How many times have we heard 298 00:18:34,800 --> 00:18:38,159 Speaker 1: that there's strength in numbers. Now, let's go back in 299 00:18:38,240 --> 00:18:41,280 Speaker 1: time a little. It's always said that we can learn 300 00:18:41,400 --> 00:18:45,280 Speaker 1: by our history, learn by our mistakes, then use that 301 00:18:45,520 --> 00:18:49,680 Speaker 1: to change things so that we can grow. So let's 302 00:18:49,680 --> 00:18:53,440 Speaker 1: reflect on the Community Mental Health Act of nineteen sixty three, 303 00:18:53,880 --> 00:18:57,600 Speaker 1: signed by your uncle, John F. Kennedy. What lessons do 304 00:18:57,640 --> 00:19:00,960 Speaker 1: you think we can learn from its partial implaumnation to 305 00:19:01,119 --> 00:19:05,480 Speaker 1: better fund and sustain community based mental health care today. 306 00:19:06,280 --> 00:19:11,720 Speaker 2: Well, he had the paradigm back in nineteen sixty three 307 00:19:11,800 --> 00:19:14,360 Speaker 2: when he signed that bill, which was the last bill 308 00:19:14,400 --> 00:19:16,879 Speaker 2: he signed. And part of the reason it ever was 309 00:19:17,040 --> 00:19:19,879 Speaker 2: realized is that it was the last Billy signed, and 310 00:19:19,880 --> 00:19:23,240 Speaker 2: then he was assassinated. And then when the Congress took 311 00:19:23,320 --> 00:19:26,480 Speaker 2: up the creation of Medicare, and we built the Medicare 312 00:19:26,520 --> 00:19:30,640 Speaker 2: and Medicaid system into law in nineteen sixty five, there 313 00:19:30,840 --> 00:19:37,520 Speaker 2: was a decision to separate people with intellectual disabilities from 314 00:19:37,560 --> 00:19:42,560 Speaker 2: people with effective disorders, so again the dividing of our community. 315 00:19:42,800 --> 00:19:45,719 Speaker 2: And so what ended up happening is we did create 316 00:19:46,040 --> 00:19:51,879 Speaker 2: this whole group home, community based support of infrastructure for 317 00:19:51,960 --> 00:19:55,840 Speaker 2: people with you know, IDD, as imperfect as it was, 318 00:19:56,200 --> 00:20:01,040 Speaker 2: it was created in kind of consistent with A. Kennedy's vision. 319 00:20:01,240 --> 00:20:04,760 Speaker 2: But what wasn't done is that was not replicated with 320 00:20:04,840 --> 00:20:09,119 Speaker 2: people with schizophrenia and bipolar and frankly in a like 321 00:20:09,240 --> 00:20:11,919 Speaker 2: minded way, but probably in a differentiated way, but in 322 00:20:11,960 --> 00:20:16,359 Speaker 2: the same manner people with SUD substance ute disorders. So 323 00:20:17,119 --> 00:20:23,680 Speaker 2: all three separated groups, all, as I just mention, need 324 00:20:23,720 --> 00:20:29,080 Speaker 2: the same things. They need independent living, which involves both 325 00:20:29,480 --> 00:20:32,800 Speaker 2: not only the clinical, but the social and the spiritual, 326 00:20:32,840 --> 00:20:37,040 Speaker 2: which is, you know, the human connection and the vitality 327 00:20:37,080 --> 00:20:39,359 Speaker 2: and the purpose, all of which comes from support of 328 00:20:39,480 --> 00:20:45,199 Speaker 2: employment and community engagement. So that and that matters for 329 00:20:45,280 --> 00:20:47,440 Speaker 2: someone in recovery from addiction, just like it matters for 330 00:20:47,520 --> 00:20:51,160 Speaker 2: someone in recovery from schizophrenia, like it matters for someone 331 00:20:52,200 --> 00:20:56,520 Speaker 2: who has a developmental disability and has been barred from 332 00:20:57,240 --> 00:21:01,159 Speaker 2: participating in our economic system and our society. 333 00:21:01,240 --> 00:21:03,840 Speaker 1: A lot of things that you just brought up are very, 334 00:21:03,960 --> 00:21:08,119 Speaker 1: very valid. I'm willing to bet that a lot of 335 00:21:08,200 --> 00:21:11,840 Speaker 1: people do not realize that some of the issues that 336 00:21:11,920 --> 00:21:14,280 Speaker 1: you just brought up are things that people have to 337 00:21:14,320 --> 00:21:17,280 Speaker 1: live with on a day to day basis. With that said, 338 00:21:17,720 --> 00:21:19,760 Speaker 1: what are some of the things that we can do 339 00:21:20,200 --> 00:21:23,200 Speaker 1: to make this a better situation for our communities? 340 00:21:23,480 --> 00:21:30,000 Speaker 2: So integration and connectedness is the key for all of 341 00:21:30,040 --> 00:21:33,520 Speaker 2: those communities. So John F. Kennedy got it when he 342 00:21:33,600 --> 00:21:38,880 Speaker 2: said people with intellectual envelopmental disabilities and I think in 343 00:21:38,960 --> 00:21:43,240 Speaker 2: turn people with severe mental illness and SGUD. If I 344 00:21:43,280 --> 00:21:46,040 Speaker 2: were to add modernized version of what he said, he 345 00:21:46,119 --> 00:21:51,320 Speaker 2: said need no longer be alien to our affections, which 346 00:21:51,359 --> 00:21:54,600 Speaker 2: is so beautifully put, because we're still dealing with the 347 00:21:54,640 --> 00:21:59,439 Speaker 2: alienation and marginalization of all of these communities. Or he 348 00:21:59,640 --> 00:22:03,760 Speaker 2: said beyond the help of our communities. Now that's really 349 00:22:03,840 --> 00:22:06,600 Speaker 2: profound because he did say beyond the help of our 350 00:22:06,640 --> 00:22:10,400 Speaker 2: pharmaceutical companies. Although we need better therapies, beyond the help 351 00:22:10,440 --> 00:22:14,560 Speaker 2: of our psychiatric hospitals. Yeah, we need more beds, you know, 352 00:22:14,600 --> 00:22:18,960 Speaker 2: we need We're beyond the help of our psychiatrists or psychologists. Frankly, 353 00:22:19,000 --> 00:22:24,080 Speaker 2: we need more of those. But he said communities, So 354 00:22:24,160 --> 00:22:28,639 Speaker 2: he wasn't just talking about these different kind of trade groups, 355 00:22:28,960 --> 00:22:31,840 Speaker 2: you know, therapeutic intervention sheets. He was talking about the 356 00:22:31,920 --> 00:22:36,040 Speaker 2: whole nature of community, which means everybody has a stake 357 00:22:36,119 --> 00:22:39,160 Speaker 2: in this. You know, the people who were you care 358 00:22:39,200 --> 00:22:43,359 Speaker 2: about housing of people, care about employment. This is about everything. 359 00:22:43,800 --> 00:22:46,760 Speaker 2: And that was profound and we still haven't gotten that 360 00:22:46,800 --> 00:22:50,359 Speaker 2: message as we're still grappling with the fact that these 361 00:22:50,400 --> 00:22:56,120 Speaker 2: conditions aren't just satisfied by some bureaucratic infrastructure and reimbursement 362 00:22:56,200 --> 00:23:00,760 Speaker 2: model through the medical system. We've over medicalized the solution. 363 00:23:01,400 --> 00:23:06,200 Speaker 2: It involves a much broader comprehension of what is important 364 00:23:06,200 --> 00:23:11,560 Speaker 2: to people, regardless of what their particular challenge is. They're 365 00:23:11,560 --> 00:23:14,439 Speaker 2: all people. We're all people or human beings. We need 366 00:23:15,080 --> 00:23:19,760 Speaker 2: that totality, and if you're denying people, you know, social 367 00:23:19,800 --> 00:23:24,199 Speaker 2: connection and supports whatever the challenge is, you're not going 368 00:23:24,280 --> 00:23:26,320 Speaker 2: to be able to be successful. So that was where 369 00:23:26,400 --> 00:23:30,879 Speaker 2: JFK community mental health fact really was so powerful, and 370 00:23:30,960 --> 00:23:36,399 Speaker 2: unfortunately didn't survive him the way we should. You know, 371 00:23:36,520 --> 00:23:38,639 Speaker 2: looking back on it, we hoped. 372 00:23:38,640 --> 00:23:42,560 Speaker 1: Well, this has been an incredibly engaging and insightful conversation, 373 00:23:42,960 --> 00:23:46,199 Speaker 1: covering so much ground that I've decided to turn it 374 00:23:46,240 --> 00:23:49,119 Speaker 1: into a two part series. I'm going to wrap it 375 00:23:49,200 --> 00:23:52,399 Speaker 1: up here and pick it back up tomorrow. Thank you 376 00:23:52,480 --> 00:23:55,200 Speaker 1: so much for your time in diving deep with us. 377 00:23:55,480 --> 00:23:58,760 Speaker 1: Your input has given us more than enough to create 378 00:23:58,840 --> 00:24:00,760 Speaker 1: to compel episodes. 379 00:24:01,160 --> 00:24:04,399 Speaker 2: I really appreciate here offering me a chance to just 380 00:24:04,880 --> 00:24:07,320 Speaker 2: repeat what I've heard from a lot of really smart 381 00:24:07,359 --> 00:24:12,040 Speaker 2: people and knowledgeable people. And it's the benefit that I've 382 00:24:12,080 --> 00:24:15,639 Speaker 2: been given by dent to my family and experience in 383 00:24:15,680 --> 00:24:18,480 Speaker 2: life that I get to hear all of these different 384 00:24:18,560 --> 00:24:22,080 Speaker 2: perspectives and formulate them. And I think I have an 385 00:24:22,080 --> 00:24:25,960 Speaker 2: opportunity to kind of help formulate and crystallize them and 386 00:24:26,040 --> 00:24:28,760 Speaker 2: give other people the benefit of the insights that have 387 00:24:28,840 --> 00:24:31,160 Speaker 2: been given to me because I've got all these people 388 00:24:31,280 --> 00:24:33,160 Speaker 2: channeling these ideas into my brain. 389 00:24:33,560 --> 00:24:35,760 Speaker 1: I think you're being a little modest there, but I 390 00:24:35,840 --> 00:24:39,240 Speaker 1: really appreciate this and will continue this tomorrow. 391 00:24:39,520 --> 00:24:42,880 Speaker 2: Well, we ought to keep going. Thank you so much, Tony. 392 00:24:42,760 --> 00:24:52,359 Speaker 1: It's been my pleasure. Thanks again, thanks for taking time 393 00:24:52,440 --> 00:24:55,280 Speaker 1: out of your busy schedule to listen to our show today, 394 00:24:56,280 --> 00:24:58,960 Speaker 1: we hope you enjoyed it as much as we enjoyed 395 00:24:59,040 --> 00:25:02,800 Speaker 1: bringing it to you. If you know someone who has 396 00:25:02,840 --> 00:25:06,960 Speaker 1: a story to share, tell them to contact us at 397 00:25:07,000 --> 00:25:12,240 Speaker 1: whynomt World. One last thing, spread the word about why 398 00:25:12,320 --> 00:25:18,639 Speaker 1: not Me, our conversations, our inspiring guests, the show. You 399 00:25:18,800 --> 00:25:20,960 Speaker 1: are not alone in this world.