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Exploring Mental Health and Public Policy

Aired November 07, 2013 - 15:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

JOE PANTOLIANO, ACTOR, "ASYLUM": We all have these moments of despair. And that those moments are just like the common flu. But you've got to teach the kids first before the parents get in and muck it up. The kids have to know that it's OK. The kids need to know that 85 percent of them will be -- have to deal with a mental uneasiness in the course of their lifetime. Mental illness is so permanent, you know, it has this permanent gauze over it. And we need to change the structure of it. We need to stop waiting for the accidents to happen before we talk about it.

BROOKE BALDWIN, CNN ANCHOR: Right, right. We're talking about it today, and you talk about prevention, but you mention these actors.

And we played a clip from "Silver Linings Playbook." I don't know if you have seen the film.

PANTOLIANO: I have seen it. I embraced it, a brilliant understanding, because if you look at the subtext of that movie, these kids had nothing.

They had no goals. They were isolated. Everybody around them was crazier than they were.

BALDWIN: Do you think there should be more of that in Hollywood?

PANTOLIANO: Oh, yes. I mean, Hollywood is embracing this issue. We've got to start now because killing -- kids killing each other is going to be a daily occurrence.

BALDWIN: Let's hope not. Let's hope not.

PANTOLIANO: Twenty-five G.I.s kill themselves every day now, every day. It's been happening for nine years.

And there's so much despair out there that people have just given up. Guys like that want to be remembered.

BALDWIN: Yeah, I know. It's a huge issue, 22 every day, according to the Department of Veterans Affairs.

We're going to talk to a former congressman who is going to discuss how that needs to change.

Joe Pantoliano, thank you so much for sharing your story and talking about how this has to happen early with kids.

Thank you so much, sir. I appreciate it.

PANTOLIANO: Thank you.

And see the documentary, "No Kidding? Me, Too!"

BALDWIN: You've got it.

PANTOLIANO: The answers are in the documentary.

BALDWIN: Thank you.

Coming up next, how does ObamaCare deal with mental illness? There are some new rules you might not know about. That is coming up.

Plus, I'll be speaking with -- as I mentioned -- former Congressman Patrick Kennedy.

He's the son of late senator Ted Kennedy, the nephew of John F. Kennedy. He has fought hard to give mental health treatment equal footing with physical health care.

Do not miss that conversation. We will talk about veterans as well.

We'll be right back.

(COMMERCIAL BREAK)

BALDWIN: Under ObamaCare, people young and old who purchase their own health insurance will now have new access to mental health treatments.

Some experts are hoping -- we have been talking about the stigma attached to this. They're hoping the stigma for those seeking help for mental problems will change.

So senior medical correspondent Elizabeth Cohen is here in studio with me to talk about something that is so, so important, because people just don't understand what's covered, what's not.

So, ObamaCare, what is covered pre- and post-?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: All right, so, pre- ObamaCare, actually as we speak right now, about one-in-five individual policies, so policies that people buy on their own, about one-in-five of them don't cover mental health services. So, they just don't cover it.

And about one-in-three don't cover substance abuse. So if you need those services, you're out of luck. You've got a policy, you're paying a premium, but your policy doesn't cover it.

Under ObamaCare, they do cover mental health services. You can't have a policy that doesn't. By definition, it has to have it.

BALDWIN: I'm hearing from people on Twitter. I've been watching and people are -- I hear the frustration. I see the frustration of the lack of coverage. But with ObamaCare, with more people needing help, seeking help, with the coverage, do you think that that will increase those saying, yes, help me?

COHEN: You know, it very much could. So, in many ways, that's a great thing, right? We want these people to get help.

So, let's say, you know, you have people who have been wanting help and not getting that help. Yes, it will increase it, and those people, they need it, right?

On the other hand, it is interesting to note that in some communities, it is not OK to seek help for mental health problems.

So even though their insurance will now cover it, it's still not OK. It's somehow seen as being weak.

BALDWIN: Thus, the stigma.

COHEN: Right, thus, the stigma. So it might not be as big of a surge as we think it's going to be.

BALDWIN: OK, Elizabeth Cohen, thank you. We'll watch for that in the coming months.

Meantime, a turning point in mental health care came 50 years ago when John F. Kennedy signed the Community Mental Health Act.

The goal was to stop warehousing people, locking them up in these institutions. Send them home. Build mental health centers to treat them.

But the money wasn't there to follow through. People were released. Many went home to places unable to care for them.

President Kennedy's nephew, Congressman Patrick Kennedy, works to build on the basic promise of that 1963 law. He joins me now, live from Capitol Hill.

Congressman, wonderful to have you on. I know --

PATRICK KENNEDY, FORMER U.S. REPRESENTATIVE: Thanks, Brooke. Good to be with you.

BALDWIN: You got it.

What is it like to be a former member of Congress and a member of one of America's most powerful families, yet your life, it's personal for you. It's ruled by this illness to some degree.

KENNEDY: I am one of those people who suffer from a brain illness. I have severe mood swings, really been defined as bipolar, too, but we have a long ways to go in terms of diagnoses.

And the research into the brain is a research area that should be a national priority, because it really encompasses all of us as Americans.

Whether your illness is addiction or your illness is autism or your illness is Alzheimer's or any of the other illnesses of the brain, we're all in this together. We need to do this together.

Now, the same is true with not only research, but providing mental health care, because the things that we all need, whether it's a developmental disability, a substance abuse disorder or a mental illness, we all need the kind of access to primary care and other health care services. We also need the kind of supportive services that keep us healthy.

So we have a historic opportunity with health care reform and with the Mental Health Parity, the Addiction Equity Act, which I was proud to write along with Jim Ramstad, Republican of Minnesota, and my dad wrote with Pete Domenici.

We have to implement this new law because it's going to be good for all other health conditions to treat the brain as a health issue.

BALDWIN: Laws are one thing, Congressman, but you know very well what has been pervasive in this conversation today is the issue of stigma, saying yes, I need help.

You yourself have been quoted as saying these aren't just medical issues. These are civil rights issues.

What needs to happen in our society to stop this ignorance, this discrimination?

KENNEDY: Like you pointed out, this is kind of a civil rights place. We need to get the law in place.

We can outlaw discrimination, but you can't outlaw bigotry in people's hearts. That's going to be a tougher challenge.

I think your earlier conversation with your medical editor clearly identifies even two-thirds with insurance don't avail themselves of it for a mental health condition because of the shame associated with seeking mental health, quote/unquote, care.

I love Joe's earlier comments that it ought to be about the brain, because that's what we're talking about is the brain. It's an organ in the body, and now under law, you have to treat the organ of the brain like every other organ in the body.

Now, let me show you how that comes to play. So I have asthma in addition to being somebody in recovery from addition. They don't wait until I have an asthma attack. They give me prophylactic treatment.

I try to make sure I'm not in situations where I don't exacerbate my asthma, but if I have asthma, it gets treated.

With my mental illness and addiction, that's not the case. That's no longer allowable under the law. The key thing for people to understand, these illnesses, which are also chronic illnesses, they need to be treated like diabetes is treated like a chronic illness.

We don't wait until someone has to have their legs amputated from their diabetic condition. We treat it before it happens, hopefully.

BALDWIN: It's this invisible thing.

KENNEDY: But in mental illness, we wait until it's cataclysmic until we treat it. And that's the real crisis of suicide and the other examples of untreated mental illness.

In cancer, you would not wait until someone had Stage IV cancer until you treat it. But in mental illness, we wait for the equivalent of Stage IV before we treat you.

That's the fundamental problem that has to change in our country.

BALDWIN: It is a crisis. We need to talk solutions.

Congressman Patrick Kennedy, thank you so much. We appreciate you joining me and sharing your personal story.

All hour, we've been talking about the problems, the issues, the crises, the stigmas presented by mental illness.

Coming up next, let's talk solutions. My panel will join me once again. Stay right here.

(COMMERCIAL BREAK)

BALDWIN: Let's bring back our panel of experts, Dr. Drew Pinsky from our sister network, HLN; psychiatrist Gail Saltz; and Jeffrey Lieberman; and Doris Fuller, executive director of the Treatment Advocacy Center.

So, solutions, Dr. Drew, what do we do from here?

DR. DREW PINKSY, HOST, HLN'S "DR. DREW": I wish there was some magic wand, Brooke, we could wave, but one of the things I have an issue with is physicians being able to mandate care for patients that really need it.

I would say we need to have some sort of law to help physicians, maybe two or three opinions or something, when a patient really needs care, that you can make the patient gets the care, even if they don't want it, if it's to their own good and the good of the community.

BALDWIN: Doris, are we over-diagnosing, overprescribing?

DORIS FULLER, EXECUTIVE DIRECTOR, TREATMENT ADVOCACY CENTER: Those are two different questions. Let me come at this through a back door, Brooke.

We're talking about stigma. Everybody is concerned about stigma. Stigma is a terrible burden for people living with mental illness. The fact of the matter is the leading reason for stigma is violence.

How many people with mental illness commit violent acts? Not very many. So we're looking at a fraction of the population with mental illness who commit these acts that make headlines that create the impression that people with mental illness are dangerous.

So what's the solution? Well, part of the solution is we've got to get to the root. What's the root? We've got to get people into treatment. How do we get people into treatment? Well, Drew is right.

I mean, we have a problem that there are -- the people who are most ill, who are living in an alternate reality, who are most likely to do something dangerous, often don't think they're sick, so they're not going to their doctor and saying, sign me up for treatment.

We have laws in this country to make use of mandatory treatment for people who need it the most, but there's a lot of discomfort about using those laws, and they are probably underused.

BALDWIN: Dr. Lieberman, what concerns you the most here?

DR. JEFFREY LIEBERMAN, DIRECTOR, NEW YORK STATE PSYCHIATRIC INSTITUTE: Well, first, Brooke, let me congratulate you and CNN for doing this program. There's far too little programs or coverage in the media in a responsible and thorough way like you have done in this program.

I actually, despite the rash of crimes and the concern, feel quite optimistic. This is a tractable problem. We simply need to mobilize the social and political will.

The first thing is, and now that we have the Affordable Care Act in place, and the prospect of mental health parity enforced and applied, the first thing is we need comprehensive quality care mental health services in place.

This is feasible because we've got the methods, the knowledge to do so. We just have to make them available.

What Joey Pants was saying, and he didn't make it quite clear, is we need a public health approach to mental health, not just public health approach for diabetes screens, for hypertension screenings.

The second thing is we need adequate funding for research, for understanding how the brain underpins behavior and mental function.

Could you imagine what would happen to stigma if we could say categorically accurately that we had a diagnostic test for depression, for bipolar disorder, for schizophrenia?

I can show you on an X-ray. I can show you on a blood test. That would diminish the stigma.

And the third thing is the media. The media is the biggest, most valuable means to educate the public.

And one thing that's happened that could help enormously, Brooke, is that Senator Gordon Smith, a senator from Oregon, whose son tragically died of suicide, has been appointed as president of the National Association of Broadcasters.

And I hope that he will introduce ways to encourage the media to educate the public about mental illness and the availability of mental health care.

BALDWIN: We are trying to do our part today, Doc, by doing this for this entire hour, and I appreciate you pointing that out.

Gail Saltz, let me just end with you here. With this education, with the hopeful awareness, with the changes in the laws, et cetera, do you think this society more and more is beginning to see the signs, see the red flags?

DR. GAIL SALTZ, PSYCHIATRIST AND AUTHOR: I do think that we have been better able to educate people and I think there are more people.

But there are still many people who don't and who still sort of hold older ideas, the stigma ideas, that this is sort of a moral weakness, and you should be able to get yourself out of it, so there's still education to be done, absolutely.

I think that would help, and I also think actually that if we could better equip our first-responders, who are often the people that are first on the scene, to meet somebody who is psychotic and perhaps being disruptive, as for instance in the case of the Naval Yard shooter, the police came and if they were, A, educated about when someone is psychotic and, B, that that is a psychiatric emergency, that is someone that needs to be taken to an emergency room and evaluated immediately, and enter the system, then at least these few people who are seriously ill and potentially violent might be brought into the system because it's really the first responders who sadly might be the ones that first see them.

So I think that is another route.

BALDWIN: A heartfelt thank you to each and every one of you for the discussion, the healthy discussion and the solutions. I appreciate it.

And when we come back, I want to play you something from -

LIEBERMAN: Thank you, Brooke.

BALDWIN: -- thank you -- Rick Warren, who lost his son to mental illness, committed suicide, what he says about this battle in his own words, next.

(COMMERCIAL BREAK)

BALDWIN: Now mega-church pastor rick warren shares his story of losing his own son to mental illness.

(BEGIN VIDEO CLIP)

RICK WARREN, PASTOR: Matthew was not afraid to die. He was afraid of pain.

I remember 10 years ago, when he was 17, he came to me, sobbing, and he said daddy, he said it's really clear I'm not going to get any better.

We've gone to the best doctors, the best hospitals, the best treatments, therapists, everything, prayer, everything you could imagine, good support, and he says it's real clear I'm not going to get any better, so why can't I just die?

I know I'm going to heaven. I know I'm going to heaven, so why can't I -- he was not afraid to die.

PIERS MORGAN, CNN HOST, "PIERS MORGAN TONIGHT": What did you say to him, Rick?

WARREN: Well, in that situation, I said, Matthew, the reason why is there is a purpose even in our pain, and I am not willing to just give up and say that the solution isn't there.

One thing that needs to change legally is to give families more power in dealing with people who are mentally ill in their family, because the pendulum has swung the other way to human rights so much that many parents and family members cannot get a conservatorship. They see a life deteriorating, falling apart --

KAY WARREN, RICK WARREN'S WIFE: Doctors won't even talk to family members, even when the family member has given permission.

MORGAN: Because it breaches a family member's rights.

WARREN: And, see, the mentally ill, this is a quagmire, and I don't even know how to deal with it.

I just know it exists, which is that two of the basic rights that the mentally ill have, the right to autonomy and the right to privacy, actually stand in the way many times of them getting the help that they need.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

BALDWIN: I'm Brooke Baldwin. Great to be with you today.

"THE LEAD" with Jake Tapper starts now.