church located on nicollet mall in beautiful downtown minneapolis and moderator of the forum tonight's guest speaker patrick kennedy will be introduced by his good friend and by our esteemed former u s congressman jim ramstad who represented minnesota's third district from one nine hundred ninety one to two thousand and nine mr ramstad we're honored to have you here with us tonight you thank you for that warm welcome our speaker for this evening has been called the nation's leading advocate for mental health and addiction policy and research the new york times called him the public face of addiction in america were president kennedy patrick songful alive today and were he to write a sequel to is celebrated award winning book profiles in courage there's no doubt in my mind that is nephew patrick kennedy would occupy a full chapter in that book patrick story is also about hope and recovery as you'll hear momentarily when our beloved colleague and dear friend paul wellstone perished in that horrendous plane crash paul had started the movement for legislation providing parity for mental illness and addiction and when paul perished i was proud to join senator kennedy and patrick kennedy as i did senator wellstone in sponsoring a landmark mental health an addiction parity legislation which finally finally was signed into law by president george w bush in two thousand and eight what to me the speaker for this evening is more than just a former colleague he's a little bit little brother i never had played i'm very pleased to introduce to the westminster town hall forum a true profile in courage cars from patrick kennedy you are blessed to have him as your congressman and this nation's been blessed to have his leadership on this issue of coverage for addiction because keep in mind the bill that jim mentioned is called the mental health parity and addiction equity act and paul well stone believed in them both being in the final bell but it was jim's effort in the house to really make that a reality and he was out there so in the fields for this bill before i was but of course it's all about who gets the credit and so when it came to me getting as much of the credit that was properly do jim i took every advantage of that opportunity him well barely mention his name in passing whenever i have a chance that the truth is that i would never have been able to to to work on this bill had it not been for his leadership we worked on it within the house conference but it took the democratic majority for us ultimately get the bill passed and a jim mentioned this was signed into law by a republican president and just so anyone doesn't get any apprehensions about any political speech it took democrats and republicans to pass this bill because guess what mental illness and addiction affects both democrats and republicans equally so i couldn't believe when they said there would be a big audience at the westminster town hall how big it was going to big but i have to say i haven't seen this many people in one room since i last house usually i get introduced and they talk about how i was elected to the state house in rhode island at the age of twenty one and then how went on and was elected as the youngest member of the congress to age twenty seven and then how i was selected by my colleagues at the age of thirty one to be the fourth highest ranking democrat in the house and then i and then traduced and airman thinks that's a great thing except i have to come up and put the cabby out in there and i said i'm sure it had nothing to do with my last name being kennedy whatsoever so i am honored to be in this place particularly for me knowing that i spent a good deal of my time in congress working for minnesotans if you can believe it i i lived right next door to paul well stuff we both lived in this condominium called complex called justice court i mean how much better does it get paul well stone in justice court it's perfect and i and i and he and i would walk to work or walk back at night and then i got to work with jim ramstad at and then when it am so we'll we'll do jump into questions i think that will be the most interactive and allow all of our time to go fast but i'll just start by saying i left congress  two thousand and eleven and i didn't know what i was going to do with myself so i figured that no one was returning my calls because jim knows this when you're a former member of congress you fall off the face of president kennedy's new frontier was fast approaching as i was leaving congress and so i thought well maybe i can repurpose some of john f kennedy's fiftieth and you know keep this political life that i had to live so i figured i'd call my cousin caroline i said caroline i've got a great idea to celebrate your father's fiftieth anniversary because i looked in the history books and you know they called your father's administration the new frontier and i said i was just in a meeting with some top neuroscientists and they told me that the brain is the last medical front here and so caroline i think we ought to have a no that and repurpose your father's mantle about the next frontier which is praying scientists and caroline said patrick i love your enthusiasm for the brain i just so excited you're so passionate about the brain she said but we've already got the president coming in the speaker in both houses and they're going to honor daddy and his legacy and i figured as a try and caroline said don't worry you can have may twenty fifth i'll give you daddy's library  and at that point i didn't want to ask her what may twenty fifth was so i had to google it and found may twenty fifth was when president kennedy said that we would go to the moon in this institutes for childhood human development studies early developmental disabilities national institute on neurological disorders national institutes on alcoholism national institutes on mental how national institutes on aging i mean i could keep going you got the point all of them study the same orbit so i had the bright idea maybe i could get the middle work together so i brought them all and and i ran the tape of john f and i so i saw them all the room i said you know what i am in a room full of modern day astronauts because you see my ogle took us to outer space but the big challenge for our generation is to start a new race a race to enter space and you all are the astronauts that are going to take us there and all of a sudden tim you don't have to ask people to put their phones down they they put them down after i said that they were all astronauts they put their i pads down they actually looked up and they smiled and i said furthermore we've got to put an american flag on all of you because what you're doing is fundamental to our national security as a nation because there's nothing that's going to make more of a difference to every aspect of our society than the work that you're doing to unlock the mysteries of the mind to understand how this precious organ which makes this country so great because of the creativity in the personality ingenuity of our people all wrapped up in there the fact they've got brains that are always creating the new in the best in the world that that is our courageous natural resources and you're helping to figure out how to maintain it and unlock its mysteries and i will tell you i have to give myself a little credit here i was mocked by these neuroscientists afterwards and tom in seoul came running over to me said patrick i've never been called an astronaut before but i love it i love it and so then steve hyman a former and i managed rector came over he was proposed at harvard head of the mit brode center you don't have to know what that means except that it's a really big deal and he said patrick i want to do the ten year race to enter space for you and i'll call all my former and i colleagues and get them to participate and i said you're on and we went on from there and we created what was called one mind one mind for brain research so instead of us researching all the separate diagnoses we research all the mechanisms from the to the metabo loam to the proteome to the connect dom to the pheno believe it or not there are that many layers of science that need to be done and then they all have to be integrated so i said how do we do this and i asked my friend dan goldin who ran nasa and he said you know what the race to enter space is just like the race to outer space we need supercomputing capability and we need to integrate all the levels of science in what's called systems analysis and i said i don't know what that means so you don't have to worry about it just means that all the science has to talk to all the rest of the science i said ok i got you know we need to put a nasa for the race yes that's what we have to do so so we got that going we hired a four star general who ran operations in iraq to be our c e o why because there's so many turf battles in research that no one wants to share the science even though that science can help unlock the mysteries of another diagnosis and if you were surprised to hear if i were to ask you where was most of the foundational research on all the time are discovered in the national institute on aging the national institute on neurological disorders or the national institute on children you'd be right if you if you guessed children and the national institutes on children is named the eunice kennedy shriver national institute on childhood and human development because she got her brother to start that why because of my aunt rosemary why because my aunt rosemary and my aunt eunice wanted to understand the developmental disability that she suffered and to help prevent it and it was that understood understood that the symptoms of down's syndrome was dementia because people with down's syndrome have much higher dementia than most any other population how could my aunt eunice have known when she got that it's two it started fifty years ago that her late husband my uncle sarge shriver died of alzheimer's then all five of my shriver cousins are now worried about having all simers but that we're closer to unlocking the mysteries of all timers why because fifty years ago we started researching dementia for people with down's syndrome before anyone even knew what all  good should give you chills that eunice started it to help understand developmental disabilities and the research that came from that is helping to unlock the door to the disease that all of her five children are worried about succumbing to that illustrates my point that all of this science house to be seen in a holistic way so i figured this really works so what's the next fift anniversary is coming up i can take advantage of so now that we've war and we've brought all this fragmented neuroscience together how we're going to bring the fragmented mental health field together so when you know that the last bill that john f kennedy signed into law was called the community mental health act signed into law shortly before he was assassinated and at the signing ceremony he said the mentally one sentence what the challenge before this nation is in tackling all issues related to mental illness and addiction they could use that quote and have it capture the whole essence of the challenge that this country faces and all its areas here and again the mentally ill need no longer be in to our affection now isn't it the truth that in all things mental illness all things that addiction the people suffering from those illnesses are airlie in to our affections as a society that's why we're in such desperate shape as a country in terms of dealing with these epidemics epidemic and no one wants to deal with it because the people suffering from the zeal illnesses are airily into our affections but president kennedy didn't say or beyond the help of our psychiatric hospitals he didn't say beyond the help of our psychologists or our psychiatry this he said beyond the help of our communit and that my friends is the answer for this country if we want to understand how we're going to address this challenge because this is no longer that someone else's business it's no longer the business  mental health system it's no longer the business of the health care system or the criminal justice system or you name it it's all of our challenge and when john f kennedy said beyond the help of our communities he was illustrating what the answer to this is and that is that it's going take all of us to be part of the solution so we had kicked off a nother organization i named the kennedy forum and the whole mission of the kennedy forum is to advocate for the civil rights of people with these illnesses because though for he signed this into law he gave another famous speech that was perhaps one of the most famous speeches of his whole administration and when he talked about the moral challenge of his time which was civil rights and he said how amongst us would be willing to trade the color of their skin and be content with those who counsel patience and delay and if you hear anything about where we are with those suffering from mental illness or addiction today everyone saying well let's wait oh maybe we can get to this next year oh that's a yes i know it's an injustice so many people are homeless oh i know our emergency rooms are clogged with people without getting proper care because their mental illnesses aren't treated oh i know that there's an epidemic of addiction oh i know there's an epidemic of suicide oh i know that our veterans are returning home and dying at record rates at their own hands but oh so we'll wait to later to get to that problem in fact it won't even come up in any one of the president's state of the union addresses we'll deal with that later on and then understand what it was like in one nine hundred sixty three when all of president kennedy's advisors were telling him to vote post civil rights now we'll get to civil rights do president to go on national television and speak about this as a moral issue in the way that he so powerfully did who amongst us would be willing to trade the color of their skin and be content with those who counsel patience and delay because it may not be you but try walking in the shoes of someone who's treated as a second class citizen simply because of the color of their skin and then say to yourself oh it must be ok to wait a little longer for them to get the justice that they are guaranteed under the constitution but denied by current law and i think my friend that is the challenge for those who was suffering from mental illness and addiction today because they're discriminated against simply because their illness is in their brain as opposed to another organ of their body it's that basic it's that simple they get second standard care they don't get the reimbursement and if it weren't for the legislation that jim and i worked on together they'd still be paying higher co pays higher deductibles higher premiums and have lower lifetime caps on their coverage but then next to the law that we passed all of those are prohibited and then you think back in one nine hundred sixty four because civil rights was passed and we all know it was just the beginning you needed the voting rights act the fair housing and the fair employment all to come along and what i am saying to all of you is in this fight for equality for those suffering from these illnesses we have to take those next steps just as they did in the civil rights movement so as you can tell i haven't said a word about everything you've come here to talk to me about tonight i've subjected you to all this policy stuff without giving you the guts and glory of my story of addiction it's like being a candidate come on that's really what it's all of that just just come on give me the people people that magazine version i mean you know and but i i understood that it would sell lot of books that that my average garden variety alcoholism and addiction story where i was two million had it on a constant basis and yet kept doing things that put me in that same spot over and over and over again i'm a garden variety dollars an addict but i knew that if i told my story about how i you know got oxy cotton i was already on it but i got some more on air force one because i put my hand in the napkin dispenser because i was so in the brig when i pulled my hand took the top of my finger off and i got it all addressed on air force one they broke out the surgical tables and they stitched me up and i had the pres the united states bill clinton looking over my gun the left go to google that's go stories you know that people will be interested in reading this stuff so i put a little bit of that in there and then of course i told the worst secrets around and that was that both of my sis parents suffered from alcoholism and mental illness and there is been a brouhaha about is if like i made some great reveal when you basically go to any bookstore in america our library and find legions of books  on those subjects in more graphic detail than i could ever tell so why was it so hard for me to to do this book it was so hard for me because it just is hard for every author american to tell the story about their family who has alcoholism and addiction and mental illness and it because we don't talk about these things and that is the common struggle because all of us have different d s m diagnoses and you know that's not the common struggle as all of us can say oh why not like that are you know i'm an alcoholic not an addict or i'm mentally ill i'm not an outdoor and i'm an addict i'm certainly not you know mentally ill i mean it's literally how we talk as consumers the way just think you know it's not me that person's not that bad when we're all in this sitting boat and that is our brains are working very well and just like every other organ the body guess what works your intervention and everyone's like wondering what are we going to do in this country had so much tragedy in the mill mental health doesn't work and you know that i just my the story i know my frame of reference says that they never get better of course they never get better by the time you get them into treatment there and stage for a day in there in stage four mental illness you care of the average stage four cancer patient or diabetic or whatever the same starting line as you would give everybody with addiction and mental illness when they go into treatment and i care into we might even pull out ahead in terms of success rates but isn't it a fact that even to this day we begin treating people with mental illness and addiction till their illness has progressed to such a point that it is hard to unravel how your brain has already become pathology because of the in attended shit by our medical system and the inattention by our society towards dealing with this issue in a way that we would in every other instance of medical care so what is turn it over to  question so what is it that jim's and my bill does and by the way the bill named for paul wellstone that was a battle in itself if you read the book you'll read about how we only wanted to name it after paul if it was comprehensive because we knew paul when want his name on anything but something that was real and and we are all blessed or outpatient out of network or you need emergency room care or pharmacy benefits if you provide it to the stroke victim if you provide it for the cancer patient if you provide it for the diabetic or the asthmatic byelaws you need to provide it for the person suffering from a brain onus and it needs to be equal and or and now  guest care meaning you've got to provide the same primary secondary and tertiary levels of care that you would provide those other patients for the other medical challenges can you hear me united  so by the way united is just they're all in the same bunch you know because anthem blue cross you saw that sixty minutes denied story last year about them you've got every want to say carriers have already serious violations or being leveled against them on parity and now in washington they're all trying to merge you've got an buying signal and you've got at now by humana both of those deals are in the fifty billion dollar range and do you think anyone is knocking on the department of justice's door and saying before you approve that merger maybe they ought to follow a federal law that guarantees equal coverage for people of mental illness and addiction given the the incidence and the epidemic of those illnesses and the track record of all of these insurers i'm sorry to say you know once knocking on their door to do that because what jim and i found is that the advocacy in this space is next to nothing god bless nami and they do a fantastic and mental health america we never would have done our parity hearings without them woefully underfunded in terms of advocacy compared to every other major issue in washington d c which has these big buildings thing gleaming glass and great lobbyists that are are always walking on the hill knocking on you know administration and members of congress we don't have that and why don't we have it because the millions of people suffering from these illnesses either cannot advocate for themselves or they're all anonymous and what happens is guess what politicians take a look around they don't see any votes doesn't get their attention and you know that's just a simple political reality at a time where we've got those dying of addiction far surpassing those dying of motor vehicle accidents and you know how much we do in this country dark try to make sure your is safe and we've got suicide claiming in the order forty two thousand a year and we know it's an undercount and veterans are dying at their own hands at record rates twenty two twenty three a day but now we can't bother to put those same political pressure on the insurance industry and on government that parents are advocates would put on them because if this were being done to cancer we wouldn't be able to get it get even close to the capitol people would be out there making more rallies every day you know making the biggest rally look like child's play but because these are illnesses a shame we can't get the needed political advocacy to really drive this bill main and paul's memory drive at home so that's what i hope comes from tonight in the question answer i'm happy to give you some scintillating to tales of my addiction and how it played out in america's one of america's most famous political storied families but i hope after all that said and done if you get the book you'll see i've got a whole road for public policy on how we're going to call it insurance companies measure non quantitative treatment limits if you don't know what that is it's ok just know that's how they did your son or daughter or mother father sister or brother care to another level of mental health care addiction treatment it's called ization management medical necessity terminations and that is otherwise known as non quantitative treatment limits and you can know why they get away with it because that seems when in fact that's the difference between your loved one getting the care they need or getting tonight and kicked out a detox that's the difference so we should be sharp on these things and i put in a real g in the back of the book again once you're done reading the very soon a really interesting story of my addiction as a member of congress  o tim i know i've talked over way over but you are supposed to come and get me thank you patrick kennedy you're listening to the westminster town hall forum broadcast from westminster presbyterian church on nicollet mall in downtown minneapolis i'm tim hart anderson senior minister at westminster presbyterian church and moderator of the forum on our speaker tonight is patrick kennedy who served in the u s house of representatives for sixteen years where he co sponsored the mental health parity and addiction equity act of two thousand and eight he is the author of the new book a common struggle while the ushers collect questions from the end house audience let me extend a special thank you to the co sponsors of this forum the westminster counseling center and the online news source men post for information about these organizations visit their websites at westminster counseling dot org and men post dot org i'd like to invite the radio audience to join us at westminster church for our next forum on thursday october twenty ninth at noon when jennifer lawless will speak on the topic running from office why young americans are turned off to politics and now mr kennedy if you return to the pulpit i will present the question from our audience i remember when i was young and we used to use the phrase the c word in reference to cancer because there was such stigma and shame a tense attached to cancer somehow we got over that as a nation and look what's happened in terms of treatment for cancer how do we get over that stigma and how if you personally done that in your own line with mental illness and addiction so the most recent analog to this is a hiv aids many people with hiv did not want to self identify and just like with mental illness addiction their illness would progress because they wouldn't get the medical care they needed because they didn't want anyone to know and more of them died a result of the shame then anything else and i think that's also true for these illnesses shame is the biggest killer so that's why the common struggle is the silence around these subjects so i am the sponsor of parity but i need treatment so what do i do i check myself into maddow at christmas time because i figure no one will know because it's during christmas time they'll think i'm out skiing with my family they're down in the beach somewhere in florida they won't know that i'm out in rochester minnesota so cold that you cannot believe it in the middle of december what is he thinking so i would go and i when i went in there i said to the doctors i said now you got to detox me from opiates here and they said no no congressman the normal course  treatment is you gotta go down to the general's debility and i said that where the crazy people i mean come on i mean this is like the and the mentally ill they're down there right the a dead addicks they're down there i can't go down there don't you know who am you know i'm the sponsor of parody they'll ruin my credibility if they know that i'm like that hair club for men guy like not own way and my the sponsor of the law but i'm also a thinking that many people who are in recovery who remember which took them a long way down the road before they were ever able to turn the corner so that was true for me so five months after that i got into a car accident question was part of the problem because you know i was so fraid of what people would think that i never had the time to actually get the treatment that i needed and that's one of the big problems today we have a parity law on the books i grant you it's not in full effect because it's not being paid for in the system is not there but the idea is it will change if we demand this treatment but we have to first ask for it and the big impediment to that is the shame around these illnesses we have lots of questions from audience here at the westminster tal form of about guns and gun violence and mental illness would you care to talk about that so my family is a victim of gun violence this and i've seen how it affects not just the person who's killed of course of the death of my uncles but the profound effect that it had on all of their children and on my dad my mom my whole family  you know blown apart by that and it was a murder they were murders violent murders so i my heart goes out to all those families who are going through this who are going to live with this for the rest of their lives it will cross our headlines you know will go on to the next tragedy but every single one of those families and every single one of the families who who lose a loved one tonight and many places in america due to gun violence they're going to live with this the rest of their lives that the impact is well beyond the total numerical number of deaths due to guns every year it is magnified because of every single family member and loved one that those people who died affected so all i would say is we definitely need to address guns i i wrote the seven day waiting period in rhode island and we added a background check for police chiefs that was not subject to the p c i check in order to for it to be a p c i check you have to have a felony most police officers know which homes they're there to send in cars out to on a regular basis and many times those are late nights and domestic violence none of which gets all which gets pleaded down so it never ends up as a felony and so my point is is that we need a much thorough background check than what we have we did it in rhode island i know it can be done because we did it and we need a much better mental health system the these things are not mutually exclusive so there should be something that passes because even if you can't get support for my position on safer gun laws at least we should be able to get better mental health system in place and that should not be held hostage for the perfect because the perfect should never be the enemy of the good and i think it would be a good thing if congress passed a mental health bill if it were able to also include you know more gun safety minimizing the large clip ammunition all of the clampdown on the gun show loophole and all that stuff yeah but i'm not going to make that a litmus test on whether i support a mental health bill passing and i hope the congress doesn't is it either we have a lot of questions from our town hall forum audience about children helping children with addictions but who don't acknowledge it what advice you give to parents with children might be suffering from mental illness or addiction well first of all we need a check up from the neck up in every single physician's visit that you have whether it's a pediatrician who certainly ought to be doing this to time given the early onset of these illnesses pediatricians need to be trained and they need to have the wraparound services to help the families all of that needs to be we need out our a game but we also need check up for the neck up for you know obstetricians and we need to check up on the neck out for our geriatricians because addiction is also skywriting skyrocketing amongst our elderly the point is if we make mental health an addiction care normal normal part of health care then it won't seem like such a big deal because you want to go in there well what's my limpid level i mean do i need to be on a cholesterol drug or not or how's i how my doing on this i mean when it be great if we were kind of having this conversation because we all wanted better mental health care i mean can you imagine like where we actually wanted to be healthier mentally i mean perish the thought you know that that as a nation that badly something that we would desire as  consumers so we have to change the thing we have to be all about producing healthier mentally healthier children and that means giving them coping skills helping them deal with stress toxic stress all of those things like that conversation should have been before all of that the minnesota national guard has this highest suicide rate in the country for veterans returning to the communities that sent them to war what effect does the involvement of the whole community have on the health and recovery of veterans well when you could spend the next week talking about this but i would just emphasize my previous point about making sure we  insurance companies and and united ought to start with the name united you know what no one realizes seventy two percent of all returning veterans will never darken the hall of the v a in their lifetime in any realize that don't you think that all these veterans just went to the v a not true because you know what most veterans are guard and reservists you realize that our guard reservists are over half the force we send to our wars in iraq and afghanistan which means when they return they return to their employer and my point is if their employer does not  employer sponsored health care that cobbers mental health and addiction guess what's going to happen to those veterans they're not going to get their signature wound of war treated by our medical system because insurance companies are denying mental health and addiction coverage at a higher rate than they would the rest of physical medicine so my thing would be our fortune five hundred companies ought to be aware because if they think the v a scandal was bad about veterans not being able to go see a physician imagine what i want to when you know j p morgan or wal mart or fedex or one of these companies i'm a good enough to hire all these veterans actually stumbles upon the fact that their employer sponsored health care has a phantom network of mental health providers so when those veterans in their course of employment need these services because they serve all of us and can't get them it's because we haven't properly enforced the mental health parity and addiction equity act so we needed to parity for our patriots that would be my answer because we could all feel awful about the terrible plight of our veterans but if we're not prepared to do something about that then not a lot of hot air and talk and we should be all over the hot air and talk talking about insurance companies a lot of questions about how to deal with them insurance companies claim would be too expensive to cover mental health to the degree that it needs to be your premiums would be too high and you would not purchase that kind of policy how can all this be overcome how do we make a that's expensive no i don't want to plan that i'm not going to sit here when think of it but the real answer that should be the answer is that you should do this because of the cost savings i know it be great if we saved all these americans from dying about overdose and from suicide but you know what works in washington works in the private sector is just give me the dollars and cents please tell me that if this saves dollars it's answered frankly all the health  you the savings aren't if you spend a lot more which is what we need to do in mental health and addiction care not a lot more we've got to build out a system that's nonexistent if we do that it's going to cost a lot of money but you know where the return is lower co morbidity costs in the rest of medicine and health care and that's a that's a fact four times the rate i have to quote jim ramstad all the time four times the rate if you have an untreated mental illness or addiction the rest of their health care costs so this is an easy calculation it'll say and of course insurance is squeezed everything now they've got to find where is the secret sauce that's going to allow me to hold premiums lower you know what addressing all those things like irritable bowel and you know sore shins that you get because you're falling down the stairs in the last aeration to get because you stumble through this and that and none of it is written up as a symptom of alcoholism and addiction none of that so you really want to know the true cost you know i ask i b m to partner with these insurance companies and really goal all of the true costs of untreated mental illness and addiction and they're going to find our health care system is rife with cost of entry to mental illness and addiction and no one calls it for what it really is and that's what we need to start doing i think that's all we have time for thank you