And at the same time let me give you a heads up for full disclosure and also for purposes of a lively discussion that im going to challenge you a little bit on the points that you make in the book as practicing psychiatrist and head of the largest, one of the largest psychiatry departments in the world i know something about the budget matter, but please do know that i do this in the best of intentions and in the interest of clarity and accuracy and the believe that we are both soldiers in this very important historically neglected mission. Im going to orient my questions along three themes, first your background, second, substantive issues that you address in the book and then third, what are the steps Going Forward that we can sort of advocate or aim for in order to provide some corrective measures and what youll be doing Going Forward in that regard. So to begin, let me just ask, youre train as a journalist and comes from the best schools in the country, you could have picked anything as your area of interest, why did you get into Mental Health care . Well, it started when i was a journalist for an alternative weekly called city link run by the south florida and im Investigative Reporter and future writer so it wasnt my only area of interest and what happened in my case is i had three separate awakenings about what the scope of the problems were and it started in early 2000s when i was working for city link and because of it, the reporting thats described, i was honored as 2001 Florida National alliance of Mental Illness journalist of the year. Criminalization of people with Mental Illness in south florida which were among the worst in the country which is a problem across the country and, my interest started a raft of shootings of people with Mental Illness in both the say of miami and Miamidade County. And this is still by the police . By the police, right, by the police. So there was that not trained to be First Responders to mental patients. Right. And later on i began exploring the Crisis Intervention Team training did the Memphis Police department and i have a section of my chapter, one of the chapters in the book describing that but i had three separate arenas and so the issue for me as a journalist to cover other abusive arenas of misconduct, this instruct me as something calling out for the tools of Investigative Journalism and future writing, so first were the shootings, then there were the tragedies of people who had completely inept care or no care at all of a rare minority of them but some people with untreated schizophrenia were in fact, killing loved ones and i opened my initial story where the person that was let out of a facility over the objection of the psychiatrist but the facility wanted to save money and then he had a dream that he wanted to send his father to heaven by killing him with a baseball bat and i profiled this example of the untreated, then then i learned in the same time frame and then i learned through good offenses of one of the countrys great reformers judge steven lifeman who has really changed yeah, i know him well. Right, so judge lifeman gave me a tool of a modernday hell which is the ninth floor of the Miamidade County jail. It is my original article had the photos but the photos and narrative feature writing simply does not do justice to the horror that you saw. So its my view, its not even 19th century Mental Health care, the 1700s, so there were mostly minorities, mostly untreated and refusing their medication or not treated properly who are naked, surrounded by blue cloth that they couldnt use to rip or kill themselves and they were spouting gibberish or locked behind these dungeonlike cells and only place to sleep in metal beds and judge told me at the time, it makes you wonder who is crazier, are we crazy or is the system crazy that this is existing and he then developed over the years a Reform Program that led literally, like 15 years later to the closing of the facility and gettering diverting people away from the Mental Health system. About at the same time so this is threepart answer to explain why im covering these issues in this book. The second was my great interest in wondering, well, what works, thats when i got interested in the work of robert drake and others. In the early 2000s there was a program rolled out by Substance Abuse, Mental HealthServices Administration to find out programs to work for the seriously mentally ill. I wrote a paper on it as a fellow with a Progressive Policy Institute and that was let me just interrupt you. What year was your experience in south florida and with samsa. My as a me as a journalist was in 94 to 2004, so i broke my stories in south florida, but then i wanted to understand what works and how could we do better thats where i got interested in things like in terms of the police, crisis intervention training, i learned about family psycho education from mcfarland, all the great valuable programs that particularly in these psycho social programs that are still unused by in large across america for the most seriously mentalill people and thats one of my big talking points and stresses in my book. So that was that, and at that point, i hadnt yet become fully aware of the role of dangerous overmedication and offlabel medication and that awareness came about because of some other reporting that i found that i really dug into which had to do 2009, 2010 concerns that veterans were being heavily overmedicated for ptsd with antipsychotics and tranquilizers and chemicals as oppose to actually providing thoughtful Compassionate Care let alone evidencebased cognitive treatments. Those are three arenas that have stood with me since then and then i began researching my book, this is a longwinded answer but i wanted to explain the context of why im covering all of that and then theres the fourth element the abusive troubled teen facilities which exist for parents who dont know how to deal with kids who are misbehaving or drug users and i expose what amounts to teen torture facilities across the country but focus telling the story primarily of program in alabama. So these that these abusive facilities and inept residential communities flourish because Community Care is so awful and families and people struggling with Mental Illness and families just struggling with kids who are misbehaving and experimenting with drugs which probably doesnt require them to be sent to some inhouse facility, theyre all being victimized by a system that a president ial commission years ago rightly called is in a shamble. Thats obviously a lot of areas to cover and unpack, that is is the range of issues that im think to go cover in this book. All i can say god bless you by curiosity, you stumbled into an area which is essential to what ive been doing my whole profession and you hit the nail or several nails in terms of what are the sort of glaring and egregious problems that exist and the fact that they can continue, you know, uncorrected, unattended, it is a social justice issue. There are terms that are used in Public Health care. Public health such as unmet clinical needs when you dont have treatments for something like, lets say memory improvement or Health Care Disparities when certain sectors of the population dont get because of discrimination, children, pediatric pharmacology, racial or ethnic, but Mental Health care, the lack of it is all of those but its much worse like you say. Its a social i consider to be a civil rights violation, why theres the legal action is another matter but this is just basically to concur with what you have been saying and, you know, i think you struck can i make one point, there is one area of legal action, thats the Justice Department suing the jail system particularly like los angeles that are notorious and 22 people have been sent to prison for brutalizing but you have to be careful, art, society has to manage somehow in a humanitarian or brutal way its constituents and the fact that we havent embraced the sure, i agree with your points. This area is basically largely untouched and it is a National Disgrace and national scandal. Im going to help you in the course of this interview thereafter if you like to really sharpen the fine points and to establish scholarly evidence to support these points. So just to continue, excuse me for making comparisons, youll correct me if they seem inappropriate. Seems like the territory that youre covering here with Mental Health remains on one hand what fuller has done in his writings particularly in american psychosis. Right. Would you would you agree . No, agree with that. Im a centrist who goes with the facts are and i dont let ideology. Essentially what i found is dr. Or tory played ramp id overmedication and he favors a wider use of involuntary outpatient commitment and in many cases, whittaker doesnt pay as much attention on his side to the and hes one of the endorsers of my book, but he doesnt pay as much attention as as tory does to do side effects of mismanaged and poorly treated Mental Illness in terms of the homelessness, jailings and police encounters. Of course, they view as opposite but i see the wisdom in each of their point of views and thats what im trying to address as a reporter and i dont have an ideological agenda. Im not that religious but i have to say god bless you again. I think you have taken a studious but enlightened sort of approach in this allimportant topic, so just diving into the substance of the book, whats the implication of your title by Mental Health, maybe it was your publishers title conotes yeah. Like eisenhowers military industrial complex. Well, it was inspired by a book coauthored by the great investigative journalist called america, inc. He was the guy that broke and famous Investigative Reporter and seems to me that the corporatization and dollaroriented orientation of companies has corrupted both for profit and even nonprofit Mental Health care in this country. Thats in particular the pharmaceutical industry. The subtitle may look corruption, lacks oversight and failed reforms endanger our most vulnerable citizens and so i am trying to paint what some have called the shock doctrinetype approach to the arena of Mental Health care and im trying to use as many vivid examples as i can of how things have gone off the rails and thats what most of the book is about and i look at the ive used the resources of the Justice Department and many lawsuits to explore the difference schemes used by Drug Companies to help promote offlabel and improper uses of medications, looked at corrupting ebbing effect on the fda and pushing out for really risky uses that dont meet a real cost benefit analysis, these medications and they extend to an arena that doesnt get much attention but i think its very central and has to do with the department of health and Human Services and the program that the agency that runs medicare and medicaid, they pay for dangerous offlabel use and thats the center for medicare and medicaid services. So regardless of the Justice Department getting over the years, in the last 25 years, 35 billion in penalties and payments from Drug Companies for illegal marketing, they it doesnt affect what hhs, this agency does, they continue to pay for fraudulent uses that the Justice Department spends years building cases over the illegal marketing. Thats one side. And even less known is the fact that these company signed what are called corporate integrity agreements with the Inspector Generals Office with the department of health of Human Services and what happens is as a result of that is they violate one agreement, they pay, lets say half a Million Dollars in the settlement, they agree to never, you know, go forth and do no wrong anymore and then according to subsequent lawsuits, allegations, they continue to violate those agreements. Art, can i art, can i interject here because i would like to make a corrective statement, if i could. Sure. So you are like an explore who is trying to map my world and, you know, you hit on so many of the thirdrail issues that really constrain and prevent Mental Health care providers that think they know what the right thing to do is and want to do it but cant and you are trying to bring these to light to precipitate action in our country and, you know, what youre doing is important and so on track but i have to tell you, the pharmaceutical industry, cozy relationship with the fda, cms, thats a redhairing. Those are redhairing, those are not good, they are in many cases prosecutable but thats no the biggest problem and we are going to get to that in the few minutes in the course of the way i layed out the questions i wanted to ask you. I want to interject and we will get you a Pulitzer Prize one of these days for proposing the whole thing but i just want to say that from the standpoint of pharma, marketing schemes, cozingy up to researchers, not having restrictions, its the deepthroat follow the money or follow the whatever the term was. Im a reporter and i go where the facts go and im openminded to learn new things so im glad to hear what you have to tell me. Good. So just getting back to the more substantive issues, you break down the Mental Health system into kind of three coexisting systems, Public Sector which is state and municipal, finance care, academic, for profit and everything nongovernment and va system and shadow of Mental Health system which you identify which is your Nursing Homes, prisons and your homeless shelters. Am i characterizing what youre describing correctly . I think that is in a general way a reasonable way to look at a very complicated system, however, i think under cover art, let me interject. Let me reframe the question to give you the best opportunity to answer. So most countries think that they have responsibilities towards their citizens and whether we consider health care a commodity or right, presumably providing health care in some reasonable way and we do it in terms, you know, general medical health care, expensively and efficiently but you can get it and its good in most cases. When it comes to Mental Health care, its terrible. Right. And we have these as i just enumerated the different systems of care, you know, the standard and then the shadow, so youre trying to sort of understand how this works and whats not going right in it and my question to you is, my conceptualization of what i understood from your book accurate or consistent or if not i think its i think its accurate up to a point but it misses this other i wouldnt call it shadow, you know, lets say the va or however youre defining or Nursing Homes. I dont call those shadows. The reality whats truly in the shadows is completely out of control multibillion dollar troubled youth industry and along with it a lot of the extremely poor quality ris dential treatment programs and in general treatment programs for people with drug addiction and Mental Health combined but in drug addiction by itself. Thats one of the important points we are facing the Biggest Health crisis since the aids epidemic. Opioid epidemic, some legal and many illegal and we have a Health Care System where first its acknowledged that theres no access but when you actually look at the quality and i highlight the work of dr. Mark mcgovern of stanford university, when he actually used the assessment tools to look at dual diagnosis patients. Half of people with serious Mental Health illness have a Substance Abuse and half some serious Mental Illness. He went in hes invited in by clinics that are advertising and are proud of dual diagnosis. He goes in Mental Health clinics and finds out that 90 of them are not minimally component and he goes to drug treatments and 80 are not minimally component. It could be handled in a half day by independent evaluator and essentially abandoned by most states and supported by samsa up to 2012. What im getting at we are facing a major addiction crisis and our central system is essentially incentivizing to keep relapsing and care. Also what im hearing is less than up and up scrupulous providers or organizations take advantage of this by trying to make profits from providing care thats not going to be effective. Im going to give you an analogy which may or may not be appropriate. Extensively why are we in afghanistan fighting . Im going to answer my own question. Presumably is because they dont want to provide safe havens for bad guys to con fire and create conspire and create terrorist and the things that you describe, for profit organizations, the Nursing Homes that load up on mentally ill individuals and use chemical stray jackets, these things are allowed to flourished because the real culprit in this in my opinion, the government has not provided a framework for health care to be provided including Mental Health care and financed and then it allows for these things for pharma to misbehave, for providers that provide lousy care to make a lot of money and stay in business. This is what creates it. But i think, you know, you sort of sort this out in a way thats unique and very insightful because most Mental Health advocates havent appreciated it fully. You state this in your book. I want to read a quote from your book that i find to be insightful. Its on page 22 and youre talking about the usual analysis of Mental Health problems in the country and youre citing an article that was in the boston globe, i think, is that we dont fund health care, Mental Health care enough. Theres not enough support for the va, for states, for thirdpayer reimbursements and you say none of these expolitications have probed deeply into the quality of care itself after people get access to the treatment and outside of noting problems arising from the shortage of Trained Health care providers. Mental health care offered by providers is aloid good and more people need to receive more treatment regardless of the actual quality. The debate of repealing obamacare, such a fiasco that even having insurance doesnt mean good health care. Funding has to be sufficient to provide services to people but has to be goodquality care which most of it now is not. Per right, theres been this is you as well as anybody would know there have been discussions over the decades, very panels, how do we have meaningful quality measure meants and they keep offering knew methods, but its not really implemented and theres no culture of enforcement and what i have argued is that what we are arguing is epidemic of malpractice even if it isnt acknowledged as such within the legal system and that is in part because the reality of malpractice attorneys is they dont take a case unless someone has died. And then i feel and im glad that you pointed out because im generally a progressive but i am arguing that access alone is not the answer and i do point to some ways to try to implement an approach to Mental Health care that is based on the hippocratic oath, first do no harm and the second point of my point, do what works, and those issues like the social programs like support employment or what i discussed in the latter part of the book, im glad that you noticed that point, do i think thats a missing part of the debate. Currently around very legitimate fears that both medicaid could be undermined by the Trump Administration and also, of course, obamacare and Affordable Care act. Various waivers, subsidy cuts and so on and obviously as many as 3 Million People or more with addiction and Mental Health issues were added to Health Care Coverage as a result of these reforms and expanded medicaid that came in and theyre all still vulnerable and the waivers that are now being promoted by the current hhs secretary could further gut and weaken medicaid benefits and programs to those who are already on medicaid before this program added, unfortunately, these dangers obscure the fact that getting access isnt going to solve the problem by itself. Exactly. And, of course, many of the vast majority of the people who have what are called severe persistent Mental Illness, schizophrenia, bipolar disorder, status leads them to be on medicaid and if they dont have medicaid, they have no insurance. Right. But theres also you could add to your litany you just described, the fact that the Mental Health parity bill passed in 2008, the final legislation, you know, not finalized and approved and signed until 2013, that this is not enforced either. Insurance companies sure. They are not complying, the big private insurers have not complied with the parity bill and requires some organization u the American Psychiatric to go out and sue them to do this and theyve got such deep pockets that they just drain resources of these organizations, so thats another area of noncompliance. Yeah. Yeah. Theres a great report that the reality is theres a shortage of providers, short of innetwork and outofnetwork providers and theres no real party if the out of pocket costs are still extraordinary and they feel free to continue in these practices that make it harder for lets say a wellmeaning, a patient unable to see a doctor of your skill set would be very difficult for most Peoples Insurance to find and over half of the countrys psychiatrist at this point are just not taking any insurance programs. Its like pay private pay which is leaving them wander the fields of mediocre medicaid that they will have trouble getting on anyway. Youre absolutely right and thats something unfortunately that i feel badly about that my profession, the leading one is not taking insurance and, you know, you can say its because the benefits are too low, but on the other hand, we ref a responsibility to provide care. I will just add to this that fact that its very constraining, prior to the second half of the 20th century there was little or nothing that medicine, health care could provide to people with serious Mental Illness because we didnt know much about it scientifically and we didnt have treatments. The latter part of 20th century and 21st century, they are now array of various psychosocial, al albeit not perfect but are effective but throughout history during 20th century if you had severe Mental Illness there was nothing for you, you couldnt get any treatment. Now we have treatments and people cant get it because of lack of access, lack of payment or unavailability of lack of care and its all part of what youre describing here. Listen, im trying to use our time efficiently and theres so much i would like to talk about. Let me just move onto say that the book is organized in a fashion along the lines of vulnerable or abused patient populations. You have a chapter where it talks about the children and how theyre now being drugged or treated with medication, the elderly, who are in Nursing Homes are managed also with excessive medication. The military, prisoners who are in incarcerated, you seem particularly concerned about the mistreatment of the military, understandably and you devote six chapters to it. And well, first let me ask you, you seem that this was something that really was right for further discussion and exposure, is that accurate . Yes, yes. I feel my feeling about department of va is handling medication issue is one of the great mishandling in terms of antipsychotics and opioids. Is it just the va or is dod . No, dod also. For instance, dr. Freedman has done very good reporting for the New York Times and hes a fantastic researcher and he has shown that the overuse of stimulants and antipsychotics to active duty troops helped increase by over a thousand fold , the percentage of people who were getting these kind of psychiatric medications and similar medications and the rates of ptsd were skyrocketing and when they came out, when they came out of the active duty, its a problem in both of the active duty military and the va, but its a bigger problem in the va because va has been more heedless and less willing to change than the department of defense. So the department of defense in 2012 approximately said we are no long Internal Revenue going longer going to have combat troops and they put roadblocks to freewilling prescribing for anything on earth, but the va hasnt done that despite research researches including collaborator of yours in yale, one of the countrys great psychiatric showing, but they studied rispira, its not effective. Now what to me is the real harm is theres no real effort to keep accurate count of the degree to which the massive overmedication with psychiatric meds and recently opioids is contributing to needless overdoes deaths, only sparing academic coverage and theres a very striking report that just came out by researchers in south texas va hospital. Its not in my book but in a fourth coming newsweek piece that shows 400 increase of accidental overdoes likelihood or suicides based on poly pharmacy, five or more Central Nervous system medication drugs and i look and not known, in wisconsin you had a drug oriented chief of staff who helped kill 30 or more patients by giving opioids freely to them and people were dying in the and the va covered it up and they are still continuing to cover it up. Its a major problem thats not addressed. Its nauseating to see this. I want to stick with this for a minute because i think its useful to one illustrate question i had like your book and also a question to you that was not addressed in the book. So your writer, im a scientist clinician and i dont know how to communicate the book frankly is very well done. Thank you, i appreciate the plug. You introduce a topic there, an area and you provide Background Information to support or illustrate it including many, many case examples, horrible mistreatment and abuse that goes on on in vulnerable population that we have been saying, the va and the military, dod post discharge has been prime area of this kind of inadequate care, but the real questions beyond why is this bad care, overdrugging and medicaid medicating and heedless consequences going on, why isnt there an effort, if the military is such an important component of society, why havent been able to figure out whats going on, is causing so many active duty or vets to need treatment. We know that pts existed, since civil war, shell shocked, it wasnt legitimized with vietnam war with ptsd, why are there so many cases now. Richard freeman excellent article which showed that you can sensitized somebody to be vulnerable with ptsd with unnecessary use of psycho stimulant medication. The wounds of war that have occurred in the middle eastern wars exceeds anything that it would imageable, why is this happening . Well, i think in part it is there are several factors. One it is more actively diagnosed now than it used to be. For instance, the actual diagnostic category didnt exist during vietnam war. Its something that as my understanding is its something that arose in the 1980s as opposed to even though people used terms like shell shock and actual clinical category that allowed for this didnt exist and didnt have the actual nature of deployment which is these repeat deployments where people who sign up and particularly lowerincome people who are in the military sign up and its a way to keep getting access to benefits and future in the military or future in going into careers or college and keep going back and theres redeployment where they they go back and then you have then you have it is allowed to continue to unwind and develop because there is still loads of stigma about getting help and getting help again so one of my chapters i do look at alternative approach by a very talented psychologist who doesnt need medication at all but really compassionate psychology and a lot of stressreduction exercise for helping people get off these overwhelming amounts of medication who do have ptsd and she helps them look at it in a different way. This is a radical approach. It doesnt have loads of controlled studies but its certainly worth exploring. So if you combine all of these missteps, it is a toxicfuel, sort of create ptsd, if you were designing a system to lets overmedicaid people, lets send them over and over again back into the ward situation, lets not have inappropriate clinicians to deal with in a responsible matter. All of these issues are something that is going to create what we have now which is a lot of people with these issues. About 30 , if you look at the major recent wars, about 30 people of people who have been in active duty have some form of these issues. Of course, the percentages vary. The statistics are staggering. At one point it was more soldiers dying by suicide than by enemy combatants, but the point that i was getting at with this question is, if the health of our Service Persons is so important, why havent we figured out ptsd, you talk about a treatment. Ptsd is a known condition and model it in animals, when aids epidemic came about in my training in late 70s, in five years after it first emerged, two scientists identified the hiv virus because of the huge amount of funding that was put into the best laboratories to the research. So why dont we know what the path of physiology of ptsd, ways to innaculate soldiers, go to harms way routinely, why dont we have support mechanisms whether they are pharmaceutical pharmaceuticalogic and this could happen. It simply requires an effort like a Manhattan Project for military, psychological health. Well, i agree with you on all of these points excepts theres no culture of accountability in the va or in many and in some respect the va, the va and dod report to congress and the president , you know, they should be holding them accountable. Well, they should and they dont. When president kennedy said, lets put a man on the moon, you know, we did it. We did it. When the aids epidemic go ahead. I agree. I just think its significantly more complex but what your former collaborateor gave me picture points not being critical of the va also doing work, he said that theres a general culture of allowing doctors to essentially do how they feel fit no, no. The va culture is clearly abysmal. Theres no doubt about it. General mattis, if they we wanted to take this on if this was ebola or some type of Infectious Disease and allout assault, combat, im the scientist here. Im telling you, this is not like Global Warming and possible to figure out. No, i agree with you, but here is let me make two points on that. If there are solution that is could be implemented now and they are not and this applies for a range of Mental Health issues and ptsd is handling by the va. Retaliation against whistle blowers, failure to take responsibility action in the face of major Health Scandals that has not yet been involved, so whatever good intentions might exist and part of my expose is whatever is on paper about guideline has no meaning at all in the real daytoday practice. Youre absolutely right and thats something that you say is actionable and just takes somebody with authority to do the right thing. I think it could happen, he refer today psychiatrist, and he also said i know bob better than you do. Of course you do. Hes a great productive researcher and also an idealog and the pharma can have a way with doctors. Lets not spend time here. I want to get on sure. A couple of things that are important and potentially little controversial that will put you on the spot. Okay. Okay, here we go. Part of the books that sound antimedical, antimedical, antiscientific, kind of a favoring of none pharmaceutical treatments over pharmaceutical means of treatment. Do you really believe that drugs are more harmful than helpful. I believe sort of in this radical of this kind, i believe that its very dangerous that off label irresponsible use of psycho antipsychotics for communities that dont some veterans of ptsd, Young Children and the use of chemical in Nursing Homes that according to fda estimates kill 15,000 Senior Citizens needlessly a year who shouldnt get it. On the other hand, sensitive compassionate prescribing like i described and i highlight a wonderful psychiatrist for Mental Illness called the village in long beach, hes a very compassionate prescriber and from reading your book compassionate user of medications for your patients. So i am not i make clear despite the fashionalism and im not objecting the view that theres no biological role. I referred to the different genetic understandings, folds in the brain about secrets secrets schizophrenia and im not a critic about medications but im opposed to dangerous use and that to me is a dangerous unsolved unaddressed issue. No question about it. Adhd and reflected by who is getting stimulus. Right. Let me just say you have and i dont have the quote marked but you have a wonder quote from the paper from one of my colleagues olson who has done analyses of trends and treatment prescribing and in it you and he basically say that theres too many people getting antidepressants for conditions that dont warrant them but that are even more people with conditions that would warrant them who are not receiving treatments. Yeah, i think both ideas that speaks volumes. Yeah, i agree with him. I was surprised to learn that most of the people who are getting antidepressants dont actually have the clinical sign that is would justify their use and those who do have them justify their use based on real clinical assessment are not getting that. Now, with antipsychotics its a different issue because if people with schizophrenia are only 1. 45 of the population and olson and others have shown that adults get up to 75 of the adults get antipsychotics for conditions that arent just justified and over 90 of kids are getting it, then things are clearly out of control and then it causes more harm because they are not getting really tailored personalized they therapies, so just willy nilly pushing out psychotics to paying attention what the individual needs. Thats one argument. Youre absolutely right. It goes to the cardinal victim for positions, first do no harm. Im going to get to im going to get to the last part of your book, first i want to say where you go a little bit overboard. On page 29, another sort of scientific fraud. This is Robert Whittakers term, pharmaceutical solutions for Mental Illness that rely on balance series of claims. This causes by insufficient seratonin and dopamine. Whittaker i dont view as credible for reasons you previously suggested as well. I think thats just wrong. Its like saying that the hypothesis for alzheimers disease is a roost for Drug Companies to develop vaccines. Well, all i can say about this, first of all, its an area of great controversy within medicine and with dr. Marsha angel wrote her pieces, you should shake her head, shes a respected person she was head, i know. What im saying its an area of dispute that i am and one of the things that i did so thats one thing, i spoke to dr. Rosenhak about the issue. I literally called him up and asked him, could this possibly be true because i myself didnt really believe that this chemical imbalance theory was as fragile as arguing and he agreed with her. Well, first of all, bob who like i say is a close and colleague is an idealog. Thats just plain wrong. You cannot discredit you cannot i think that a fairway to put it first of all i do cite in my 60 pages of end votes and the kindle version allows you, i do link to the sourcing for this questioning but i also point out that the dopamine hypothesis in particular is getting a very strong rethinking by very Good Research thats coming forward. It is but it isnt discrediting it. Its not like vaccines and autism. This is like my feeling im im getting a wrap sign. Okay. We dont have time. I apologize. I just got so into it with you and youre a fascinating speaker as well as writer. The last two chapters talk about what we can do and you cite bob drake and another colleague of mine and bill similarly and i think the point that i take away from this is, the Mental Illness like schizophrenia, severe bipolar, its disease management and you have multiple sources of treatment. The term is called collaborative and multispecial care. Okay. Thats exactly what we need but that gets to the heart of quality argument that we need to have it available for people. The last thing i want to say, what are you working on next . Well, next project im working on is im doing first of all i have a newsweek piece coming out soon which is looking at additional parts of the v. A. Particularly im building on my book and looking at the way theres been an overreaction with chronic pain patients and very abruptly taking them off opioids when they have been functional and not dangerous to themselves or others and not engaging addictions. Ive added that piece in fourth newsweek piece. This is a topic that interest you, go to our website at booktv. Org in the search bar type in Mental Health book with a archive of materials all of these prals are available to watch online. Cspan where history unfolds daily. In 1979 cspan was create as a Public Service by americas Cable Television companies. And is brought to you today by your cable or satellite provider. [applause] the importance of discussing Artificial Intelligence may very