Even if i learned about some of his strong arm tactics, some things about him that i did not necessarily like very much on a personal level, i actually came away republicking the man more, and ill tell you why because this man was not just groomed for the presidency at all, but he met with fdr, Something Like, i dont know, six or eight times, and these were just inform mall meetings. Fdr shared nothing with truman. He was a running mate because he was a consensus candidate, got ratify at the convention, and they figure, well, trumans popular in the senate, and when i was to ratify the peace treaty to end it, truman does it for me. Guess what, harry, youre on the ticket. That was it. He did not let truman into the tent on anything. You have a man who had to crash learn the most difficult office in the world in two weeks, which he did, and then amid that, hes president at the birth of the cold war at the claches of europe as they grabbed all the Eastern States and took them over to installing puppet governments and all that, and despite the enormous pressure, the man, roughly as old as fdr, put in 18hour days, and when he got home, he cared about what was going on with the white house. He was interest the. He wanted to see the report,mented to pick out the paint color. They painted the state dining room this green, you know, a moss green. They took the paint off. There was a huge, you know, process, with guys running across pennsylvania avenue with paint samples, and i thought, well, what keep of guy has time for that. Truman had time for it, cared without it, and so he might have been ham handed in term the of what we got, but, you know, perhaps somebody from a slightly more i dont want to say cultured background, he was extraordinarily wellread, but, you know, we might have got a more refined house, but i dont know if we would have got a better one, and structurally, i think hes the reason why we have not had to worry about the place since then, and we havent. The us the answers that frequencyrn that we on to the new jersey of other sensors. [ jzorcd . 1 i remember the first conversation i had at the table was not where are you from or what is school like that about ukraine. Politics. Our beliefs, education, religion and after that moment i thought this week would be intense. But it has spent cool to see the evolution of our friendships and bond to talk about politics or our experience is what we have learned and what we have met. This is an experience i will never forget. I always thought i can never go that far with politics is such a caustic environment but slowly throat though we quizzed people we have met chipped away at the opinion did has been so ingrained in my head maybe i do want to make a difference to run for something local because like the president said yesterday he said dont get cynical because the nation doesnt need any more cynical people that will run hopeless relieve the problems we have some things that are brought up is social media were ebert able to express opinions easily in send the tweet about what we think a and i think that starts the conversation and we like to talk a lot didnt we like to get our opinions out there. I think this whole week has been about morning. I come from a small town where it is very politically of a genetic. There is not much chance for people who dont think the same to get their opinions out without being ridiculed the and being here with the other delegates has given me an opportunity to see another few pan viewpoints and without being shunned or for thinking differently. [inaudible conversations] i am a resident saw scholars here at day e i and our discussion is on the role of Mental Health the role of federal government in Mental Health policy. We typically think of that as a state responsibility and to a large extent it is but the federal government can have a very influential role to Shape Services and policies for the mentally ill patients. Unfortunately over the last few decades we have not use that influence effectively. We have a chaotic patchwork of services with huge gaps through which mentally ill patients fall into the street here and end up in jail. It is completely unacceptable and a heartbreaking situation. Today we have representative tim murphy a and our panel will discuss his proposed legislation and called helping families and a Mental Health crisis to address persistent problems in Mental Health care system in the month of the shortage of psychiatric beds. There is a hearing today is the golan that and inadequate at implementation of treatment denis small problem of violence and outdated involuntary commitment laws a. M. To the questionable prior days of the of the Agency Within hhs that is responsible for funding the services for the nations mentally ill. Everyone on the panel who will respond to mr. Murphys comments are deeply dedicated to the patients in and to the families who love them. For several introduce representative murphy you have a full biography at your desk so i will be brief. Then be will begin. Representative murphy is currently in his sixth term in congress representing the 18th district of pennsylvania. A former psychologist actually he is a psychologist. [laughter] he always has his degree. The chairman of the oversight investigation subcommittee and cochair of the Mental Health caucus and Founding Member of the g. O. P. Doctors caucus. He authored seniors access to Mental Health act that in discharging copayments to seniors on medicare in introduced the of Mental Health security act for roerichs families in education which was mr. Mandel to get College Students who were suffering from depression the help they need before tragedy strikes. Next is dr. Lieberman to the chairman of psychiatry at Columbia University college of physicians and surgeons. Director of the New York State Psychiatric Institute and his expertise is in schizophrenia and this year the president of the American Psychiatric association. Next is dr. Kennedy the cofounder of one mind for research serving 16 years in the house and the author and lead sponsor of the Mental Health parity and addiction equity act of 2008. Authored a cosponsored other bills to increase mentalhealth a and treatment to reduce. In final via a professor of psychiatry at the university in Research Psychiatrist specializing in schizophrenia and policy in the Infectious Diseases in schizophrenia which is an interesting syria. Brodeur of the Treatment Advocacy Center and of the stalemate medical Research Institute and has coauthored numerous Institute Papers and that is our distinguished panel. Mr. Murphy. Spee mcfadyen is convenient. I dont know how to get the slides working . What can we do . We will move to 20 for second century technology. Good morning. To have so many distinguished colleagues in the audience today i wish i could say you were getting continuing Education Credits but we will move forward. But i want to talk about is h. R. 3717 the bill we introduced last december for the important reason that i committed to the parents from the Sandy Hook Elementary School that we would have this bill before the anniversary of the tragedy. Our nation has been rocked and although those with Mental Illness are not of the vast majority likely to be violent nonetheless it is an area of grave concern that there has been committed by an treated Mental Illness. And we need to deal with these things. Someone has to figure a how to make it work. I have no idea. It does look the nancy. [laughter] i will just keep talking. I will give you numbers. There are about 68 million americans that some degree of Mental Illness with the mild acute problem of anxiety or sadness to severe Mental Illness. In 3. 6 million are without treatment. Extremely important to a understand what happens when someone is without because they can be more likely to exhibit violent tendencies but there is a 15 fold decrease that they could become involved with the violence. It is also important to know that they have three or four times more likelihood they are victims of violence rape, assault, robbery for someone is imprisoned on the streets or at home, whenever that might be and children to are mentally ill are three times more likely to be victims of sexual abuse that alone should move us toward action but the problem is the action that has been taken very much are graceful, misdirected and not giving the cerebus to the people that we needed. The government already spends 125 billion for Mental Illness most of that is for payments for disability, the medicaid, a very biddle is for research or for early treatment assets. What saves to happen is if you look at the next slide with king in the 50s 1860s where we had 550,000 beds for a population of 150 million. As the beds closed down rigo have 40,000 but where have the patients bone . Sadly we have filled our prisons so while the state budget burst at the seams we pay for growth in the expansion and overpopulation. It is no wonder why it is not the crime that is so vast but we have traded down hospital bet for the prison cell. We have also traded the hospital bet for a mattress and a flophouse in a homeless shelter with blankets over a subway grate. It is inhumane in the immoral and it is of a third world status even when we do take action which is say a typical situation with seriously mentally ill that is threatening the police are called the taken to the Emergency Department and the ill equipped a and ill staffed emergency room that is not designed to deal with mentally ill patients, they tie them by their wrist and their vegas to often leave them in the hallway or in a room surrounded by a sheet if they get at of controlled they sedate them. What could be more if you read them putting someone in jail or leave them on the streets or chemically and physically handcuffing them to a bet to call that treatment . It is wrong in our nation needs to wake up that pitcher whale that the families feel has got to change. In pursuit of over the last year i have held a series of hearings with oversight investigations subcommittee. There is inadequate Treatment Options quite frankly inadequate outpatient also. The patient is far away from helping to get better with independent housing the treatment is out there. A number of Supportive Services commuted the Wraparound Services but unfortunately there is not enough. There is a huge shortage overall particularly those to treat serious Mental Illness. With 7,000 child psychiatrist with 30,000 that is the serious problem. People cannot get help when there is no health care there is no hope and then people feel a stigma of going from place to place from Police Squad Car to car the wonder they have the stigma because it ignores those with Mental Illness. Another problem is the hipaa laws and in and Family Education rights are subject to a great deal of confusion there is supposed to be there to protect confidentiality records. I legree to make sure that the privacy act is there to make sure people are not Getting School records but it is another barrier because as a feeder often do nothing at all many times parents were in a hospital and try to convince someone else i need to tell you about the history of my son or daughter we cannot give you permission for someone who does not know where they are with psychosis and they dont know who they are but yet they tell people we cannot tell you anything. Its is wrong in the misinterpretation of the law. If you are in the auto accident and unconscious or if you have a stroke or incoherent no one says you have to get better. Why is it someone with deep depression or deep bipolar disorder . We need to refine those are you cannot get a history you cannot give the history you can not diagnose or treat it is like telling a surgery what you do diagnosis they have fractures and their phone but we have to stop that. With confidentiality with the other rules quite frankly this has existed with the standard that says if they have to be in imminent danger then without their authority with that patient care against there will. Basically have to be slitting their wrists overdosing and drugs before we believe they need help. Do we do that with any other medical illness . Did somebody say your cancer cannot be treated until stage four or your chest pains until your unconscious or your cardiovascular problems until you have a stroke . No. But somehow we have the things with the psychiatric illness to wait until the person is completely deteriorated because that is the more optimistic and better product one prague prognosis. There are treatments that are out there. Several but it goes more along the of lions of lets just find it and put it away because nobody wants to deal with the problem. Americas big secret so lets just fund the programs nobody asks a question it does not work. In some cases they dont work they spend on silly things that would make your blood boil. Why is it federal dollars paid where the topics are interpreted of dancing . Stopped taking medication getting in touch . If you want to a weekend workshop pay for god of your own pocket the when millions of dollars go to those sayings then tell people we dont have enough people to provide help . That is wrong and we will not put up with that anymore. It goes to the point of federal dollars. First of all, we empower parents and caregivers to make it clear definition to refine the hipaa select providers in Family Members clearly no it does not mean someone that has no relationship for a the Family Member that is disjointed from the patient can come in to get information. No. This is very important. We want them to have access to history when they need it. Also takes the shortage of the impatient to bet. Right now it is a 16 bad rule. How to read not reimburse you if you have 19 . When most states have a critical bet shortage so we have a boost the beds for medicaid payments. Also will alternatives to the institutionalize why is the only jail or homeless or longterm patient facility . No patient treated is the street extremely effective 44 states have been on the books but very few do it. York is an example to do a rights where they have found instead of putting people with the involuntary commitment with the Family Members or the District Attorney to stay on your medication what they found is the cost fell 46 overall but it is quite high quite frankly. Encourages states to adopt a treatment standard. Looking at it before treatment the next item reaches beyond the emergency room. The cms kim up with the ruling they would limit the of medication is available in three had a rather emotional packed hearing where a representative told us they would limit the drugs available. We had them read out loud from the American Psychiatric association that said you cannot have certain psychiatric drugs and with that i said can you tell me what is the ss are right . The responses of was a brief time that if you dont know we were talking about it is pretty clear you will draw conclusions that have nothing to do with reality and a and understanding my concern for the decision and i pointed out if you are not three hospitalized for seven days it is okay to change it. But limiting the type of drugs that would greatly impaired of physicians ability adding to this overage 65 and receive the diagnosis your twice as likely to double your Health Care Cost for lots of Different Reasons of exacerbation or less likely to comply with other treatments. I reminded him when seniors commit suicide 20 to with the day of their doctor visit 40 one week seven within one month so to recognize many of these antidepressant drugs take between to do six weeks that you cannot use this drug . That was the patients life bad risk. A few days later they reversed the decision but we will not be but up to those decision the chair the same day billing issue is important you cannot get to a doctor bills in the same day. A person is more likely to go to a pediatrician to seek assistance when they exhibit at severe Mental Illness in the averages 112 weeks before the person has their first visit to treat Mental Illness . As a mother brings her teenage son to a doctor and he says i am very concerned about the things that your son says into weedy to see a psychiatrist now you were on medicaid can you come back tomorrow . Headed city main. We will say in these cases there days to be allowances for same day billing. Also chosen territory Access Program where they can call a number it is a very effective mechanism and those barriers. With of rain initiative in with their research on the brain the response after the schizophrenic episode is the Effective Program for these problems. We also want to integrate primary health care for the reason i said before the part of this is the bill puts into the bill that was passed yesterday tuned also put in funding the was approved yesterday a and then another 60 million for t