So here i am, 27, looking at a bill that says the brain is part of the body and Insurance Companies cannot discriminate in the reimbursement of illnesses to the brain any more so than they would any other illness of the body. I have no business being the primary sponsor of that bill. It tells you a lot about stigma. That the longest member the youngest member, lois died on the totem pole, got to put it in so my point is stigma still ranks big in all of this and as a result we have not made the progress we need as a nation, still. When hivaids, we were losing 53 million americans a year. Within one or two years of the aids activists coming all over the country and demanding change, congress was appropriating 24 million a year to tackle this illness. Addiction, opioid overdose and other overdoses, account for 112,000. You add the 300 50,000 people who die of alcoholism, which of course no one really acknowledges as a Major Public Health issue. Then you add the 50,000 who successfully take their lives via suicide. The total amount of money we all get combined to deal with this crisis is one quarter of what we got with hiv aids. We have done more now for Mental Health addiction than any other time, president biden, to Certified Health centers, 11 billion. Congress passed a 1 trillion infrastructure bill. Great. We need infrastructure in our Health Care System to deal with Mental Health and addiction because it affects not just those suffering with a primary diagnosis, it impacts people throughout the medical system and they are ignorant for the most part and they do not treat Mental Health and addiction, they say it is for psychologists psychiatrists to treat. So we think, you have read the headlines, you see more money being spent, we must be addressing this. But if we were truly mobilized and not just taking what we were given, we would be demanding much more and getting much more for this illness. I hate to make it a per capita spent but if you look at what we spend on cancer and hiv and cardiovascular, diabetes versus what we spend on bipolar, depression, schizophrenia, alcoholism, we are still far away from even parity, which is give us the same as what we would get if we had another illness. Peter i want to clarify, 53,000 we lost. What is your diagnosis . Patrick bipolar ii, which is often referred to as manic depression. It is a Mood Disorder. I also have addiction. I am addicted to anything and everything. A lot of people think, you are an opioid addict. And i was, but i was also addicted to stimulants like adderall. I was addicted to anything that would change my mood. That is the nature of addiction. We often get that is confused. Oh, it is the opioids, it is the methamphetamines. 90 of the people i know who have addiction have other addictions because the disease of addiction, in alcoholism you could easily have it in chemicals and now as we are learning from gambling addiction, we are learning from other forms of addiction, that it can be ubiquitous. There is a great stanford psychiatrist talking about dopamine nation, which means thanks to social media and everything there is all types of addiction so we have to have a much better understanding of literacy about it. I get help from a psychiatrist who is trained in addiction. A lot of the Mental Health treatment, providers do not know how to treat addiction. So i have a certified doctor and also go to 12 Step Recovery and thank god for that, i took medication assisted treatment, which means i was taking medication to deal with opioid addiction when i was in congress. Since i have Left Congress i have been able to spend more time getting my own recovery on a solid plane which has allowed me to taper off of the medication but that is an important mechanism to help people as well and there are other forms of medication for other types of illnesses. The point i make in the book is that there are evidencebased forms of intervention that we are not deploying. Thats the bottom line with the previous statistic is that there is a lot we know what to do about that we dont do it. We dont pay for it and we do not insist that the provision Mental Health be consistent with evidencebased models of care. So behavioral therapy, which is changing the way you act, is a way of changing the way you think, is that standard of care for every type of addiction and Mental Illness. There are different types of it. That is still not trained. In 60 of Mental Health providers in the country, they do not know how to treat eating disorders, Mood Disorders, particular addiction with that particular type of evidencebased intervention. We have so much to do and it just is about political urgency. I was lucky, i was able to get to the other side and be in recovery. A lot of people are not that lucky because they do not have the resources i had. That is why i fought so hard for the equity and parity act and why i spent a dozen years in congress trying to enforce that Mental Health equity and parity addiction act because it is not just writing the bill, it is getting it enforced and the Insurance Industry has a very Strong Political lobby unfortunately and it has been very difficult getting that law fully implemented and as you know, most people still have so many barriers in getting care paid for. Preauthorization, current review, retroactive review, all different types of care, primary, secondary, tertiary, and network a network come out of network, outofnetwork, inpatient, outpatient, pharmacy. They would never imagine doing this if it was cancer. Even cms, they would bless any new expensive drug for any other illness but Mental Health, you have to fail first on these five generics before you get help. They will not even pay they will say you have to go in intoxicated before you get any care or you have to wait one week before you can get care. We need care on demand. My own experience, if you do not intervene when people are ready for prude ready for treatment, you have missed a golden opportunity and the problem with these illnesses is that people often not do not have insight. When you have one, you dont know you have one. For me, i did a book on my own struggles years after leaving congress and i was amazed when i went around, interviewed a lot of folks i worked with, they told me, patrick, you are in real trouble. But the irony is no one told me that at the time. And of course as is the case with most people of these illnesses, you are the last person to know you have them. That is not true just with addiction, but also people with schizophrenia and bipolar. So when you get an opportunity to treat someone, you have to take that opportunity and when Insurance Companies place to many barriers between you asking for help in getting help, finding a doctor, inadequate networks, phantom networks, thank you chairman widen for your leadership on the finance committee, we need to raise these issues up because it is pressure that will bring change. If you do not bring the Current System up and come up with a new model, we will be stuck in that same merrygoround where people really are not getting the care they need. Peter tell us about february 22, 2011. Patrick that is my sobriety day. The big problem we have politically in the country as there are over 30 million americans and longterm recovery. All of them are insurance based anonymous. I do not say what twelvestep program i work, i just say i am in twelveStep Recovery. It is ok to say you are in recovery. I say i am a person and longterm recovery who has not used anything since fairbury 22nd, two thousand 11. If we can mobilize those people have these illnesses and they know how devastating they are, we could change. We should not change anonymity but that does not mean people have to consign political activism and being a potential advocate to the corner. Bill wilson, founder of aa, testified in front of congress. We need to build a political constituency. When i was in congress, i knew i could get whatever number of bricklayers that day after tomorrow or laborers or sheet Metal Workers were teamsters. They turn out. They have less, members they have lists, members, donate, participate. In Mental Health and addiction, there is no listserv, no environmental list where you know everyone in this district, state reps or congressional, cares about this. And that is where we should start. Then we should get all the advocate groups and get their list and add it so that Anyone Running for office immediately knows they have a better part of their constituency cares about these issues. If we do that, we will get that money we need, the change in regulation we need, we will get the infrastructure for Information Technology and data sharing to help us manage these illnesses so we really know if we are Getting Better or not. We will get the social sport social support. We will get the proper sober housing facilities which we know work beautifully but which are not paid for. We will get all of that. We will get people through democratic participation but if we are all silent we will not get what we need because politicians will not see us and so we need to build a modernday political movement. We need an aflcio of Mental Health addiction. Psychiatrists, clinical marriage family counselors, everyone together and we need to get people with depression, bipolar, schizophrenia, addiction, alcoholism, get them altogether. We have 99 the same agenda but we operate in our individual silos so need to organize. Peter Mental Health in erica statistics reported in your book, 84 million americans have one or more disorders. 44 million have one or more Substance Use dorders. 31 million, just press a disorder. 20 million americans, anxiety disorder. 18 million, alcohol use disorder. 11 million, mental and Substance Use disorder. 7. 7 billion, cannabis use disorder. 3. 7 million, schizophrenia. 61 of those listed above have received Mental Health treatment. Only 12 have received substance treatment. Patrick yes. The statistics are jarring. They show we would never imagine cancer, 12 of people with cancer get treatment . We have a program, i helped start and advocacy and there is a qr code at the back of the book, alignment for progress, we want 90 screens, 90 given intervention, 90 achieving and being supported in recovery by 2033. We screened that for cancer, hiv , aids, cardiovascular disease. Why cant we do it for Mental Health . 90 getting treatment. We do it in other illnesses, why not Mental Health . 90 recovery, we know social support accounts for so much of the total impact of good care. We are not paying for those things. So we have a very specific agenda. We have a qr code in the book for the strategy for progress and that is a cure ration by committee of all of the issues that committee can do in Congress Though if is a chamber of commerce or aflcio or environment, the advocates have delineated by every committee in congress what you can do in that Community Committee to help advance the cause. I was on Armed Services committee. My labor friends came in. I said sorry, i am army, navy, air force, marines, i cant help you. They said we can help you you can help us a lot. We have prevailing wage issues with the department of defense. Environment came in. I said what does Army Navy Air force marines has to do with it . The department of defense has a bigger environmental budget than the epa. I had no idea. In Mental Health and addiction, we need every committee in congress to be doing something. I guarantee you many of my colleagues on the Housing Committee did not recognize they are perhaps on the most Important Committee in congress to address the Mental Health and addiction crisis because if you do not have stable housing, none of the rest of it works. But how many Mental Health and addiction advocacy groups have focused on hud . On the Labor Committee . What does labor have to do with it . That is where we get support of employment so we can reorganize the way we have the workplace set up so people in recovery can be supported at work. We are not organized to meet the huge Public Health crisis we have as a nation. We do not have our issues mapped out, i tried to do this, i put a 1. 0 together but i am working on filling it in. We do not have our vision. That is what i am trying to do with the 909090 by 2033. I stole that from hiv aids. If we had someone with cancer, broken arm, we would expect to get 90 screened, 90 evidencebased intervention. It is unfathomable that we would not expect that. Yet we just accept that people will not get care for these illnesses. That is a hangover from generations of stigma and shame. The 12 people in the new book i just wrote with my coauthor really break the mold and say these are treatable illnesses, they are complex, they involve getting coworkers, family, friends involved, they also necessitate both the medication, Mental Health treatment, and social support. It is threepronged. Just because it is complex does not mean we cannot wrap our arms around. When he data. Debt we need data. We subsidize medical records for every other medical condition except Mental Health and addiction. So 90 of behavioral Health Providers in this country are not on electric health records. Peter what about hippo . Hiop hippa. Patrick that is being changed. Whatever your issue is physically, it is all on your medical. But you are telling me my medical record will not show i am on been the draw and if i was unconscious and had a car accident and the real me into a local emergency room, they could kill me if they didnt know it and it wasnt in my medical record. We need to change the system. In the book, at the end all of them did this because they want to advance better policy and we have links to all that Public Policy in the back of the book. Peter you use the term Substance Use disorder rather than substance abuse. Is that purposeful . Patrick yes. We are changing nomenclature all the time. A lot of Mental Illnesses today are called neurodivergent permit brain illnesses. People are still behavioral health, Mental Health, there are all kinds of connotations. Certainly the words abuse can note that it is willful, bad moral character. No one chooses to get out for the day and alienate their friends, potentially risk losing their job if they have one, risk going to jail because when you have these illnesses you do all kinds of things that jeopardize not only your life but that of others. The fact of the matter is if you actually think it is up to someone to choose these things, you are absolutely wrong. No one would ever choose to be alienated by their friends, to be pitied and ridiculed, to lose your economic wherewithal, to be separated from your family. Choice for me is not giving up. I have 13 years of continuous sobriety but i have to make sure i do not pick up that first substance. That is my moral responsibility. No one gets a get out of jail free card in terms of their responsibilities but we have to understand when people are hostage to their illnesses promote people are living on the streets not far from where we are taping this, the schneider homeless shelter, they are prisoners of their brain illness. We ought to be going in and setting them free. The notion that we leave people to languish and die on our streets around the country is shocking to me. And we have this libertarian position, we do not want to interfere with their civil liberties, they choose to live that way. No. No one chooses to live that way. Governor newsom has started in California Care reports, where we aggressively go after people who are on the streets, dying on the streets, saving them from lves. In my own case with my mother, brother and sister and i had to get guardianshi my mother. We saved her life so she could be around for our kids. They never met my father, obviously, who died before they were born, but they got to meet my mom and it is because my brother and sister and i went to court to get guardianship over our mother to keep her from killing herself. She was so happy, at the time she wasnt happy, but she ended up being so grateful that she was able to make it to the other side because we intervened. In this system today, we do not allow families to get involved in helping their loved ones, we do not make it a very simple process so that people can get the care they need, and there can be all kinds of safeguards for peoples rights. We are not dealing in a situation of 50 years ago where people were just consigned to asylums without having any rights. We could have the best of medical assessments, Mental Health courts today know how to do this, it is just shocking that we as a nation continue to let this languish. Peter in your book you write about the impact on families. I have been through it myself ri many of those years, teens, 20s,hemy dad would say to my broth