When the house gavels back in, watch live coverage here on cspan. Back now to the white house summit on Mental Health. What i would like to do for a few minutes. Lets start with you. In terms of the imd exclusion that they express concerns if we live the imd exclusion we open the door to institutionalization of thousands of people. Do you have comments about that . It will not open the Door Community treatment will always be cheaper and government will always will be a cheaper option if it is effective. But then go back to snakepit conditions of the past of one flew over the cuckoos nest but it is the lack of money for hospitals that created substandard conditions allowing them more money that is truly therapeutic. And to have the panelist speak about the continuum of services that are needed to support the seriously mental ill. What do you see as a continuum of care what happens if you dont have those kinds of services . But these fights over scraps so now we are worried about inpatient versus community when we need both so the entire community is altogether that we need all aspects going in the same direction everything from philanthropy to the government, providers Little Things to train every county to say this is great we need officers trained but we need to get officers out of this business in the first place that is where we are looking to go if we see that is all or nothing what we want is a system yes we do need beds because the illness can be severe we want to keep you in the Community Getting the treatment you need without falling apart unnecessarily because thats how we decide care. Involved in licensure to develop new levels of care we simply dont have them on the Mental Health care system i can name them off from the school nurse or the pentagon for the paramedic all the way to the sophisticated we started moving down with the pierce specialist but burdens on the back of the individuals its very expensive you have to spend a week in austin on your own tab 700 for the program and then you have to pay for the test and then is medicaid reimbursable by insurance . Who will hire that individual so we have to work with those organizations as well estate licensing boards so something that fits between the family and that you take care Nurse Practitioners and telemedicine not just putting the puzzle together. What are your thoughts on the focus on serious Mental Illness . Most people can live in the community we dont have enough clubhouse programs for the serious mentally ill that Many Community programs will exclude somebody because a Substance Abuse disorder or a criminal history because they have a behavioral issue or because they are homeless so most of these Community Programs are not serving the seriously ill a lot of that has to do with not being what reimbursed to take care of a difficult patient talking about continuum of care as long as is focused on the seriously ill housing is a big one where its not with this driveby Case Management they need much more support they need congregant living but we are supposed to believe everyone can have a driveby case manager and that will work and it doesnt so continuing care yes been focusing on the seriously ill and i would argue that hepa can help parents deliver the continuum of care if i can know the diagnosis of what medications my loved one is on i can provide transportation and medication and some of those services but without hipper relief i cannot the best way to reduce the need for housing is assisted outpatient treatment to allow people to stay in treatment so parents can keep them at home rather than getting orders of protection. Can you describe about club houses . The house is the leading example the International Clubhouse association that those are peer communities they are looked down on the community this is a physical space people with Mental Illness run it and to go on the front desk they answer the phones and that. It could be educational or how to get housing they actually Read Everything that is in their sometimes they start businesses and the single best model everyone in new york city where i live has seriously mental relative once you get them can you talk about the details that one of the really nice things of the program to allow those individuals of getting care in the system and to be served in the community. So it combines the treatment that the individual is already eligible for and in need of with a court order and then to enforce the persons care but really there to ensure care is provided to the person and to provide oversight to show why treatment is provided. And with this program and a longstanding program and to see significant reductions of the most damaging cost with serious Mental Illness and hospitalizations and arrest and incarcerations and violence those you are most worried about it is a great tool in the toolbox you dont want too many people you want to have as many options as possible because this is a serious illness and too often it can be a fatal illness. And how this works with Mental Health professionals and of Community Support surely would be one can you say anything about that . Bad is the key you have to have a network of faith communities connected to a network of professional providers. And not just training the Faith Community that they have to be connected the other thing we found early on of a referral list and just dont have that system well enough so the social worker what she does is finds out all the information plus faith communities always ask a question that they get uncomfortable with so what will happen if i have a highly religious client and so they trust us for that. So on the provider side they are excited about this and the clientele in the caseload and also the more important part with that referral aspect they know that individual can go back and then provide them some support any provider knows if you have a client than they have no support and then to have a prescription we expect them to get better is not faith communities waiting for them to get better and thats what the providers are excited about now if you can show the providers you put in evidencebased types of care things that they understand that a psychoeducational group. And with that curriculum to put the provider at ease because now they have a referral source and then to get better so we run into very few problems to go out to talk to the provider as opposed to say there are providers over there and we will give them a list. There are children that have serious emotional disturbance we should scream every child if we start screaming every child you will end up with a lot of kids to be medicated and treated for illnesses and half of all Mental Illnesses begin the age of 14 with 70 percent of kids adhd that basically a little bit behind their peers in the class especially those of color who are medicated so they are those with serious emotional disturbance but take the issue of suicide that it is increasings we have to focus on suicide whether 54000 suicide those were adults those in charge of fixing things spent 2 million and like 43 million or something on kids some really spending money where suicide isnt so while i am sympathetic to make that compassionate group the new york city mayor to tell the principals what to do but the consultants wont actually those that have Mental Illness. I want to give a plug to the report by the Inter Agency Coordinating Committee to put out a report to congress to take the ball and run with it. But thats one of the big focuses and there are significant section and the promise seeing options on those agencies and with the issues that is the real opportunity to allow those opportunities to bubble up to take advantage of successful things we already see on the ground and to help shape the federal government definitely recommend you take a look. I would say three things we have seen the same kind of interest from schools and faith communities in virtually any type of emotion thats taken down the kid track so we have to provide more training for teachers on the recognition so the schools that provide these types of trading as well so we know the difference between a child and then we made it like this in the normal range that has a serious disturbance and then to provide that training as well and number two with the additional monies for research of those emotional disturbance i just had a book come out and i was surprised with little thought of what the outcomes may be because we dont have anything else. So increased funding its important to have those but we need more constraints those are the biggest things that i see and also to provide research for those ordinarily. There is some mention for the Mental Health crisis and would to give a little advice how we are connecting those services with the Mental Health resources for what people need. And the question you have the answer. The systems for too long were just piecemeal putting it to gather with duct tape wouldnt have time to figure out a system that technically address the various needs. Opening opportunities in a coordinated manner it is strategic rather than reactionary it is a reflection of what we see around the country desperate to help wanting to get their loved ones care. The risk we always have is that you call and there is no opportunity there. It is huge but i report that came out a few weeks ago that looked at the reality that parity law is just words on paper in most places around the country you are much more likely to have to go out of network and out of pocket to get Psychiatric Care to wait a week for a physical illness or seven months for a Mental Illness is unacceptable. So we just need to have everything coordinated to have a world where your brain is not part of your body that is just ridiculous and unnecessary limitation we need to get away from. And then and those with serious Mental Illness also thank you to the secretary a czar for his support of the those living with a serious Mental Illness in the nation. So what we are doing at the federal level which is a major priority for the agency and with the course of these illnesses and their families appropriate care must include psychiatric medical services for many, tree treatment of disorders and recovery services. And then addressing childrens needs if we can detect early and illness we can mitigate the impact of the serious Mental Illness to give people more opportunities to live full and Productive Lives in our communities. To have a major resource to make better be do this with a program called project aware with infrastructure in schools and states to meet the Mental Health needs of children and trains school staff on Mental Illness recognition and provides direct services to children and their families. And with the Mental Health block grant with the psychosis programs to provide Rich Services to those with the young people serious Mental Illness in families. And then with those included. We have a program called Certified CommunityBehavioral Health clinics which provide integrated care, Mental Health services, physical services for medical issues, Substance Use disorder services, but they are 24 7required to provide Crisis Intervention Services including mobile Crisis Services providing the most appropriate care and relieving Law Enforcement of the burden associated with bringing thing a bringing those in crisis to a a is not someone with we have funded bed registries in 22 states that help people to identify inpatient and residential beds in real time. Thatso funds programs address criminal justice from diversion to Treatment Programs and programs that assist those with serious Mental Health problems who are homeless. Community resources are important to recovery from serious Mental Illness, and we are glad to have had dr. Sanford here to speak on faithbased services, which can be a huge support. We recognize this and we work with our partners to support such services. Resources tort those living with serious mental on this such as educational assistance, employment and peer support. These services are critically important to a persons ability to recover and live satisfying lives. And these services are as important as medical and psychiatric services. For those with the most serious until health, we have a Treatment Program that provides Behavioral Health services. This program was recently. Valuated participants reported significant decreases in psychological distress, use of illegal substances, emergency increases in with housing stability and employment. In and providing services we must consider civil commitment. Requestsg positive that we address civil laws. At the same time we want to the greatest extent possible to address personal autonomy which is why samhsa is working with services on resources as well as with stakeholders were examining civil commitment laws. The American PsychiatricAssociation Working with us on developing an app. For psychiatric advanced directives which we think will be hugely important for people to make their wishes known more easily. Built a samhsa has National Program of Technical Assistance and training which includes the clinical support system for serious Mental Illness. This includes training on best practices and treatment of these conditions, a Psychopharmacology Center of excellence, a center of excellence for the use of the medication of choice for treatment for schizophrenia. Technicalskin assistance on how to set up a system. We have also established a National Center of excellence for protected Health Information which provides training and Technical Assistance on the sharing of information, particularly information and in emergency situations. These national and Regional Centers help to increase access to care by increasing the numbers of providers with n thenng who ca provided to those in need. Our purpose is to get care to those who are most seriously ill. We continue to work on many fronts and look forward to our collaborations with states and local partners. Thank you very much. [applause] [background sounds] [background sounds] we are ready to start the next can we have everybody take their seats . It is not break time. Can everybody please take their seats so that we can continue the program . Program. [background sounds] they all got up. Will going to keep things going here. We have another speaker coming break out. So if everyone can sit down. Ladies and gentlemen please take your seats as the program will take place immediately. Is now my pleasure to introduce our secretary for health and Human Services. Alex bizarre. Sworn in as President Trumps secretary in january of 2018. His current tenure and hss as a second tour of duty at the department. After surfing as general counsel and then deputy secretary 2003 he has its been his career working in Senior Healthcare roles in both the public and private sectors. It is my pleasure to introduce to you, the 24th u. S. Secretary of health and Human Services, alex is our friend. [applause]. Will thank you all, thank you all for being here. I am so glad to be here in attendance at this historic meeting. I believe no administration has ever held a white house meeting that project clear intentional focus on one of the most neglected aspects of our Healthcare System. How we care for americans with serious Mental Illness. So would like to begin by first thanking all of you for being here today. When there is an a policymaker, a Public Health professional, a healthcare provider, a lawenforcement officer, or are involved in this issue and some other way. Most of all i want to thank everyone president who is here because someone in your live has struggled with serious Mental Illness. I have seen serious Mental Illness and its impact on lives and families firsthand. And it worked directly in this field with many of you for the past two decades. I bring great personal tradition as well as empathy to this discussion. So thank you for being here and thank you for being advocates i think you for the work you do every day in the people you love. Risen from has a clear vision for o