Date: 2009-06-03
Speaker: TIM MURPHY (republican)
Chamber: H
State: Pennsylvania

I thank the gentleman from Nebraska. And. Mr. Speaker. I also want to thank my friend and colleague from California. GRACE NAPOLITANO. who has been a great advocate. And Im pleased to serve with her as leaders on the Mental Health Caucus. Her passion for working to bring awareness to our Nation and more treatment to those with mental illnegs is truly commendable and admirable. . With 57 million people in this country suffering from mental illness. .it is no small problem. With one in five children and adolescents. with somewhere between 17 percent to 24 percent of our returning soldiers affected with mental illness. it is of great concern to us. Unfortunately. the problem that so often comes up with mental illness 4s not that it is not diagnosable. for it is. It is not that it is not treatable. for it is very treatable. The problem is for so many. the chosen treatment and approach to mental illness is denial. What we do is we deny its significance. we deny its existence. and therefore we deny the treatment to so many. In some ways. we have not advanced beyond those -Puritanical days of the Salem witch trials. where prejudice haunts the ability to get help. so people who have need of mental health treatment avoid it. families are not supportive .of it. employers oftentimes will dismiss employees. without understanding what it is. and quite frankly even here in Congress people have an awareness that is. well. dated. to say the least. when we do not understand that the way we need to approach mental illness is to vigorously approach it and treat it. In the workplace. when mental illness is something that is part of someones treatment insurance plan. we find that it actually saves money for employers because those employees get back to work. When we find that employees are denied mental illness treatment. and may I also add Medicare for the longest time also did not cover mental illness treatment. we find people worse. People who have chronic illness have twice the risk of mental illness. People with chronic illness. which is 75 .percent of our health care cost. have twice the risk of mental illness. And yet for many years. Medicaid didnt cover it. and many insurance plans still do not. When you have a chronic illness and you have mental illness combined together. the health care costs double. They double. And it is important that we treat this with all of the tools possible. Unfortunately. many times mental illness is treated only by pharmaceutical approaches. Some 75 percent of mental illness drugs are prescribed -by nonpsychiatrists. That is unfortunate because Im sure that many heart surgeons with their cardiac patients would not be very happy if noncardiologists treated the heart patients. And it goes on. But unfortunately when insurance plans do not pay for it. that is the only recourse. There is one particular group of folks suffering from mental illness that have been mentioned a couple of times here. and that is our returning veterans from Iraq. Initial studies have suggested that some 17 percent of combat veterans may suffer from posttraumatic stress disorder. More recent studies suggest that of those who are coming back who actually experienced combat. those numbers may be as high as 24 to 25 percent. The military has made remarkable advances in dealing with suicide and depression and posttraumatic stress disorder in our returning soldiers. and with good reason. Right now. more soldiers die from suicide than from combat. It is also something that is contributing to those soldiers who have returned who have some mental health problems may actually engage in highly risky behavior. driving fast. more drinking and more drugs. which leads to further problems for families and more undetected mental illness. The Navy. for example. has established programs where they actually send teams of Navy psychologists and sociology workers out to see where they can return with the veterans and work with them while they are onboard ship. helping to identify problems. screen them and get them involved with the help they need. The Army is also advancing in this. as the Marines and the Air Force. and that is good. because over the last couple of centuries in our country. if you look at the pictures. the photographs. the drawings and the paintings of our military. the ships have changed. the uniforms have changed. the guns have changed and the weapons have changed. But the soldiers have remained the same. Over the last century. we referred to such things as "combat fatigue" or "battle fatigue." And for the longest time. soldiers were treated with "three hots and a cot" as a method of treatment. But now we are recognizing that teams of mental health professionals in the theater of combat are very helpful. Recently the combat stress center in Iraq at Camp Liberty came literally under some fire. however. when one person they were treating allegedly walked into this combat.stress facility and opened fire. He had had his weapons taken away. but then on his way back after he was dismissed from there and told to come back later. he took someones gun. came back and opened fire. Two therapists and three people waiting for care were all killed. It is worth noting that one of those people waiting for care stood up and tried to stop him from killing others. and that person was killed in the process. So even in the course of trying to get some help. we have somebody who stood as the hero. I had mentioned early on that denial is a huge problem. and it is important that all of us understand posttraumatic stress disorder and acute anxiety disorders in our returning veterans. Because whether you are a family member. you are a friend or you are a member of the American Legion or the VFW. it is the responsibility of all of us to.look out for these returning citi- zens and help them get the help they need. Watch for these symptoms: Recurrent and intrusive distressing recollections of an event. including images. thoughts and perceptions such as seeing a comrades dead body or experiencing flashbacks of the sounds of explosions and screaming. Recurrent and distressing nightmares of the traumatic event. H6096 CO Intense psychological distress when exposed to cues or reminders of any aspect of the trauma. such as the backfiring of a car or an explosion that could set someone off again. Extreme physical reactivity. such as racing pulse. sweating. and intense fear. when exposed to any -cues or reminders of the trauma. This could even be set off in Vietnam veterans or World War II veterans when they watch a program or a movie on television. Persisteit avoidance of any reminder. not wanting to talk about it. avoiding any thoughts. activities. places or people. of the traumatic event. A general numbing in responsiveness. such as the person feels detached and estranged from others and may have little range in emotion and few strong feelings. Oftentimes this is a concern raised by spouses when their spousereturns home from combat. and they say he or she is just not the same anymore. The emotions are blunted. They have less ability to show the depth of emotions. less interest in the children. They may also have a sense of a foreshortened future. having come close to death. they may see their own death and problem as imminent and may engage in more risky behavior. They may have hypervigilance. They may be constantly scanning the environment for danger. even when there are no problems. They may be driving along the highway. if they were perhaps the driver.of a Hummer in Iraq. they may be constantly scanning the road to see. are there problems ahead? They may have an exaggerated startle response. especially to sudden movement or loud noises. They may have poor concentration. irritability and anger. And anger is an important symptom that we need to pay attention to for depression and anxiety disorders and posttraumatic stress disorder for veterans. And of course they may have -disturbances in ones ability to sleep. Many times the veteran will work towards selfmedicating. alcohol and drugs. and. of course. keep that quiet from others too. They may find themselves not sleeping at night but having a job where they sleep a lot during the day so they can hide this from others. But what is so important. as I said in the outset. is that denial is not appropriate treatment. and that the rest of us do not get engaged in denial too. It is absolutely essential that we support our returning veterans no matter what. Regardless of someones political views. we need to stifle our own comments and understand they were doing what we asked them to do. They were following orders. And. quite frankly. they were doing -it pretty darn well. And they accomplished their. mission. and were happy to see them returning home. But. that being said. the silent battle that our veterans continue to fight. that invisible. silent battle that goes on inside their own heart and in their own mind is something that we need to be reaching out and paying attention to. And as we look at Mental Health Month. as we have just come back from Memorial Day. as we continue to see the yellow ribbons fly from trees and posts in every hometown of America as our soldiers return home. as we continue to send our notes and our emails and our care packages to our veterans. let us remember that we must continue to reach out for the veteran who has borne the battle. for their orphans and for their spouses and for those persons who have come back with that silent problem of the posttraumatic stress disorder and other disorders. We will work with them. We will help them. And God bless our veterans. And again. I thank the sponsor for this bill on Mental Health Month.