some gentleman my name is pat laurent and welcome to my show i am a mental health advocate i am trying to change the minds of a lot of people out there as far as the mentally ill are  concerned i am trying to get you to realize that there is a huge population of people that are homeless letters that are wandering the streets that don't have the right medication and they need your help and they need my help and they need the help of my guest and i have a wonderful guest today and his name is david matty auto and he is the executive director of the massachusetts this well it's it's kind of a long road but what started me into health care was back in the early one nine hundred eighty s i was studying at boston university for a master's in public health and finishing that up took an interview at the state house for the health of public health committee in one thousand nine hundred four as i was getting of finishing my master i also got offered that position a position with the research staff on the public health committee well that grew into my boss was a representative named richard valcke who became chairman a ways and means hundred five to one nine hundred ninety i went with him and worked on the whole state budget his budget director but also public health mental health medicaid and other areas of state government and i enjoyed it immensely five years ways and means and then in one nine hundred ninety a group of psychiatric hospitals was forming an association in which i'm still employed by it was a beginning of it's lasted all those years wow yeah sterling's lawyer yeah twenty four years and i feel very fortunate because as i said i think it's a good match for my skills and interest i'm very involved still down at the state house  actually a lobby as to registered lobbyist for mental health i don't look at it is a dirty term or anything like that i believe in what i'm doing and that's been part of the reason why it's lasted so long i believe in the work we're doing  the mental health area absolutely i've i've been to the state house and i've been a lot i'm not a registered lobbyist but you know i love to do that i love to lobby for something that's it's necessary and real thousand two thousand may second two thousand at two thirty in the afternoon governor postle luci yes he was very good for mental health yes and that was the beginning of starting to see some situations yeah and people willing to try to change minds try to really educate right and that's what i was trying to do i used to be there a lot and  i think it was for borderline personality disorder i saw so many people vulnerable people blind people hearing impaired people  lobbying for the benefits for themselves because they were being taken away and it was heartbreaking yes and i do learned when they did that that was like applause and so that was the only thing i learned in sign but i felt so bad for those people and then i'm thinking about mental health stigma why  people here lobbying for mental health and that's what we really want to get into and yes there has been a change  what do you think has changed made it change well i think to me one of the real important things has been people like yourself coming down to the state house in talking about issues but i also think some of the celebrities you know some of the top politicians senator ted kennedy was a huge advocate his son patrick is a tremendous advocate now for mental health vice president gore's wife was a big advocate for mental health and so we started to see a little bit of more of a recognition that this  leaders in the state house now are far more interested in mental health we have a committee no which we didn't have time years ago the mental health and substance abuse committee that right there tells you that it's getting more prominent right i what i did notice there was one doctor i worked for for twenty three years his son had schizophrenia there was one doctor that i worked for for say five years his nephew who was going to be a surgeon had schizophrenia and is now walking the streets there was another doctor who was the greatest i surgeon in this part of the country his daughter has schizophrenia and and you know it it's not only it's not only the little guy it affects it affects sic they said it was a virus and it had started as a virus well nobody really knows and and then from then the problem why don't they know well it's really something that needs more research mclean hospital still in great deal of research in fact they have a new research center in the last you know ten years and they're hoping to find a cure for some of these illnesses you know they're probably years off but on we need a lot of research to figure out exactly what's going on you know and  it's it's complicated it's you know when these are often long term illnesses and the you know the general public i'm talking generally might not even realize a lot of these situations until it happens to someone in their family or someone they know and that's what we're trying to get at we're trying to make and this is why i like going down the state house we're trying to make it is known as possible that mental health is just as important as physical health and that's why we wanted parity to say if you get treatment for cancer you should get treatment for mental health and substance abuse so another whole area that's been stigmatized these are only says we say their own this is we have to support them we have to give the state needs to fund them insurance needs to recognize it and i understand that a lot of insurances are kind of not giving like they should well that's that's a huge problem that's a huge problem in terms of getting the proper amount of coverage we see people turned away because insurance won't approve length of stay they won't even approve sometimes people who are coming into the hospital it's very hard especially for substance abuse we have situations where people have to wait for beds while they get approved by the insurance companies it's something we're working on i mean they've gotten better over the years but it's still a long way to go in the average person again wouldn't realize this till date till they go through it and it's especially hard for people who aren't savvy in terms of how to deal with an insurance company right now and we were talking the two of the show and you were telling me about how many beds the department of mental health used to have and how many they have now they had years ago going way back they had thousands you know i think over ten thousand back in the fifty's and sixty's and there were some decisions made to put you know a lot of the mentally ill to live or in the community the problem was we all know this now thirty forty years later they didn't fund the community properly right so that's why you started seeing people on the streets and you know unfortunately in jails and we're still we're still struggling with that the d m h now has six hundred twenty six beds which is not even a fraction and that even a fraction of what that you have and so what you have this and you've spent some time i understand working in the prisons you have a lot of mentally ill in pr you have a lot of substance abuse people suffering from substance abuse in prisons you have a lot of homeless are we really saving money are we really saving and what kind of quality of life is a us i right right and the mentally ill let's say a mentally ill person is homeless and mentally ill person might urinate in the park and so that is a misdemeanor and say does it again and again well it sets working its way up and eventually he's indecent exposure he sent to prison and he's mentally ill i mean he's so used to the voices in his head control and i'm now all of a sudden he's has all of these guards controlling him and when i used to teach the prison guards massachusetts had the highest rate of suicide in the prison of the mentally ill and and that's tough you know for a mentally ill person to be controlled by everything and  they used to say that sometimes the the people who were incarcerated used to actually help you know they would put things off your hands on the way so that they couldn't get to the person who was trying to commit suicide so they'd be dead you know it's just not fair there are just too many unfair things going on and you know it's up to people like you over the state house and lobby and we will have a t v show to to just educate people right right we have probably people in prisons and probably should be in the department of mental health system getting care in one of their hospitals how many hospitals have there are not many left now and in fact we have a brand new beautiful hospital and one sister that was just built two years ago just open and it's beautiful and it's got two empty units because they said they don't have the funding for it so we're trying to change that we're trying to get that open the full you make full utilization of that hospital you know there's that issue in the d m h that's the public system in the private system the system i represent we run into problems all the time with communities people say they want mental health treatment but try citing them in a facade and a community it's very hard there's something called nimby not in my backyard and we see that it's still in mental health and we need to get around that we  really do because you know you notice very well the biologically based parity the reason why that passed is because the legislature in massachusetts took the lead with the governor and said these are illnesses like other illnesses and should be treated as such right absolutely yeah and that's what we need to to do that that's why you know if i'm if if one of my hospitals wants to expand somewhere or to put beds in a different community we would hope the community would understand that absolutely and support it right it's hard but you know as i said we will working on the stigma issues it's in one  and had t shirts made and her sister or a teacher that said bipolar and glenn wore a t shirt saying my sister has bipolar right and they did that what all types of mental illness my sister has schizophrenia and her sister had schizophrenia and her teacher and they walked through i think what is the grand central station right with the hundreds of people walking with these t shirts just to show other people that these people are are ok right you know there was medication with medication you could do wonders if you have the right medication while young i mean yeah you know look it  it was a good depiction of what families are going through we want to help and in my system the private system one of the problems we run into is the want the status of her short and we need we need i don't know if the average length of stay is about for a mentally ill person is about eight nine days it takes six weeks to two minutes the medications going to right right you need follow up care they need you know they need to go to the doctor after they get out of the hospital in a lot of doctors are so busy now that that can be an issue in the community is stressed the whole mental health system needs more and more resources were were really pushing this year in the state house for for mental health and there's a great deal of interest it's the climate is improving and we're cautiously optimistic  the senate a lot of people may not know this but this senate formed a special committee because of all the substance abuse issues they're looking at substance abuse the house right now is we've been meeting with someone a key leaders about the mental we're going to put more pressure on the insurance companies that if they don't have the beds and people are lingering in him in emergency rooms they should have to have more responsibility they have to either fund some more beds or find places alternatives for people absolutely one of the things that they they don't really concentrate on too much as a family on the families on a mentally ill person iraq so traumatized number one because they've kind of lost their child totally become somebody else and number two because they can't get the benefits that they need they don't know how to get the benefits that they need  and this goes on and on and on and on for years and years and and it's hard for the families photogs or them to understand what happened to their kid without teaching the families and  near me is a good research resource for for for teaching families they have the family to family right and they get together and they teach the families you know what exactly has happened  mental illness is a physical illness etc it's not their fault there's no such thing is a schizophrenia genic mother and i mean that was way in the past and it should never have been brought up that that the mother could be so you know part and integral part of their kid that it would be their fault right it's not their fault it's either in the genes or it's just something that affects the child when they get to a certain age and it's usually schizophrenia is usually sixteen to twenty five sometimes a little later but my daughter it was eighteen and and thank god for one medication that she's been taking for i think tank in years now and but that medication is very strong and people have got to realize that there's got to be more research on medication right because i mean just like with chemo chemo can do so much damage and and so can medication for mental health and  research has got to be in there the funding is going to be in there and but god bless that medication it's still working on my kid right right yeah yeah we we've really been able to let people function very well in the community a lot of times because the medication but you're right there needs to be more research and you know for the families in for our discharge patients one of the recommendations we put together for the state house for the legislature actually zero two one was that there should be an arm's blood semen for all the insurance companies so that when you when when a family member calls what what can i do to get treatment for my child or her son or daughter  or spouse whatever you would have a resource at the insurance company or at the state you know if it's mass health or medicare there should be an eye on bud's minority someone to reach out and the other thing we recommending is patients who are discharged from hospitals or who are struggling with it should have a coach call something like a coach someone work with them follow on are you going to your appointments need to support we really do right i mean it's not saying when and down the road i don't know how long it's going to take but we're we're now moving to new reimbursement systems in health care call global payments and they want to give one payment to take to one of two the providers to take care of all patients which would be good because we find that the mentally ill have a lot of physical illness ailment absolutely and all of this should be addressed right in a comprehensive manner don't separate just treat the mental health and not the physical all got to be dealt with that's called global payments in it's going to take a few years to really take hold but that could help in the long run don't you think absolutely i mean sometimes a mentally ill they may have diabetes right a lot of may have diabetes i think smoking the smoking is now less than it was before thank god and so pretty prominent and also pretty prominent and in order for them to get outside at all that have to go and smoke prick and they get like two of those a when they were in the hospital for them to even understand their physical health and take care of those issues right so you're absolutely right about having someone to guide them take care of them and right you know and i really think pat you probably  probably one of most prominent advocates i never in massachusetts and you probably learned and i would say to the listeners it's kind of unfortunate but it's true you have to advocate for yourself yes every your family and in or your friends or loved ones whatever that's the best advice i could give anybody really you have to advocate hard because there's all these barriers put up to treatment absolutely and you know you strategies for overall improvements but the bottom line is many times you do have to push yourself you know you look you know that right i absolutely know that and i'm afraid we've run out of t let it be let mental illness be a thing of the past let you know you you want cancer to be a thing of the past but mental illness affects i huge population and  so i'll be going back and we'll be talking a lot more about mental illness thank you for listening but by ok