Are defined principally because their illness is of the brain as opposed to other parts of the bodies i want to get that message out there but i know that another policy but as you point out is either a going to sit on the shelf if anyone is lucky enough to have it sold. I wanted to be a compelling narrative and there has to be certain appeal for everyone to dig through the book and read the whole book so i didnt want it just to be a policy book. I knew that the real story is the one even i didnt want to tell which is even though i was the champion of mental parody, i was also a consumer of Mental Health services that i didnt want anyone to know about because i was worried that it would ruin my credibility as the champion of Mental Health. So come even while im trying to get Mental Health coverage and intense but either way we had in the federal Employee Health benefits plan, i was trying to keep quiet the fact that i had to give into these go into the settings for my own treatment of addiction and Mental Illness. So it was apparent to me that i had to kind of tell my story and you cant make up the fact that our lives work out the way they do. Out of our control. And what ended up happening is it tracked very well my own struggles to pass the bill and the irony my late father ended up taking over for Paul Wellstone added to this incredible aspect because i had fatherson relationships into these were not real medical issues hes often as moral failings for the most part yet here i was a member of congress negotiating with him and Pete Domenici to get a better feel and of course the house bill was much better than the senate bill because its more inclusive of all to reflect the spirit of parity so i thought what an interesting narrative to educate people about the fact there is a law of the land, the two it in the context of the struggle all of us have been good about the fact we are consumers because no one wants anyone to know they have a Mental Illness or addiction. Host more about the struggle about not wanting anyone to know. Tell me about that. Guest i write in the book about how my mother had really debilitating alcoholism. Everybody knew it. It was written about everywhere. For her age she was wellknown as being well known as being an alcoholic. It was john kennedy who had written about it and yet we kept it under wraps as if it were some big secret in our house so people would come and visit. My mom would walk through the house absolutely debilitated from our call as them and no one would look at her or talk to her. It was like the people we all walk by in washington, d. C. And we dont look at and it was the same thing except it is my mother. So i got that message. You dont want anyone to talk about these issues. I was like everyone else whos been in place wait until my mom goes in her, shut the door so theres no more embarrassment. Thats how we all felt a group of shame. We are outsiders looking at her and thinking. She had a Mental Illness and we felt ashamed around that. It was real. I had that same fear that the same fear that my mom would be exposed even though everybody knew that she was suffering as an alcoholic. Host did you think that you were invisible of having problems when you were in the Congress Backs you are not admitting it to anybody. But did you think that folks didnt see it lacks guest thats the big issue as you know in these illnesses you dont have the insight and its called denial. So i thought i was managing what with the public knew about my own struggles in the way that i conducted myself. I thought i was keeping it secret. The big moment for all of us that have these illnesses is that we are the last ones to know in other words everyone around us knows that those in say anything so that was true for me. I was convinced no one could pick up on the fact. I was perspiring, i was, you know, moving around in an agitated way. I totally thought no one knew and host you started seeing child psychiatrists when you were fairly young and people understood that he had some problem. And you think there could have been an intervention at that point that could have freed you to be yourself . Guest waiting for my son and daughter that i want Something Different for them in the medical system when they grow up because they will have the genetic risk that we ought to account for that when we do a checkup to their physicals need to include a Mental Health screening which in part will say what is your Family History x. Window with modeling runs in your family, but it gallops and your family. We are going to make sure we put you on this track. I know enough to know we could be experts and find out what are the kind of resiliency building strategies, the coping mechanisms, the social and Emotional Learning of skills that we can give to your kids and help them navigate around these issues of anxiety that adolescents all have but if you have that predisposition, you are much more prone to go deeper into that space and so the key is to try to keep people from falling off. Everyone knew i was drinking too much, was a mess, but they thought he was just being a teenager. And i dont think we should just assume that teenagers are going to be a mess. We should try to keep them from ending up going down that road. Host you saw different kinds of therapists that have different theories of what was going on. Some would treat you this way or that way. How did that work out in your mind . He went to one person and one and one said this in another setback. How did you work that out in your own head . Guest i wrote this because theres a very convoluted system out there. Theres the standards of care, theres no consistency in metrics to determine whether you are well or not based upon the baseline. You pointed out as a patient i got all kinds of advice and therapies and i had no clue is testing me any good or is that doing me any good. This medication without medication. I hope just like i talked about with my son and my daughter in the future we are going to have a really standardized and other is a science and art to what you do that there but there ought to be some expectation that the states work for these populations of people just like we did with cancer. We say this therapy is probably better for you depending on your background of genetically. We ought to do the same for Mental Health and addiction. Obviously i didnt get that but it makes me an expert on the Current System and what needs to happen. Host did it take the incident where your car hits the barrier to do it or were you turning a corner and recognizing tell me about how you turned the corner. Theres a lot of people watching this who have probably had some of the same problems youve had and they are sitting there saying how did he get out of the rut that he was in because he kept getting out despite everybody strategic attempts. Guest i talk about and about in the book how i had been to treatment five months before it got into the car accident driving under the influence. The problem is i went during christmas break because i figured ive got at least two and a half weeks no one is good to ask where i am, none of the constituents are going to think where is he at this time on making . Its the holidays. So i checked myself in at the mayo clinic in rochester minnesota and i told the administrators im a congressman. I cant afford for you to send me down the hall. They said thats where you need to go. I said thats going to be too disruptive if anyone finds out im done so i want you to detox me here in the main campus from my opiate addiction from my dependence on oxycontin. They said okay so of course they detoxed me. It takes several, a good week and a half and i kind of went over during the day to the mentalhealth wing to get counseling but i wasnt really in it. Wouldnt you know i get some treatment we know it works and recovery. Its a the medical, social, the spiritual. I got the medical but not the social and spiritual aspects of recovery. So even though on my bodys site i was clean, my head was and where it needs to be in five months later i was back in the jackpot so i would say recognizing the fact i hadnt before treatment because of course after, i went back to me and i got i went to the mentalhealth section finally. Host it sounds like you are in control of your treatment. Should the doctors have been in controlling said no, you are going to the mentalhealth unit lacks guest didnt have the insight that i needed and that is a big issue today because i think a lot of us who are in the fruits of our illness do not have that insight and that is one of the big challenges getting people treatment who dont recognize the need to treatment. Host the stigma is what you are dealing with if it comes out anybody finds out, im done. Did you ever know anybody when it happened . Guest its the fear. I had the specter of scandal always looming over me because thats what they wanted to get. They wanted to write that story so it was always trying to be careful not to get into a situation would create a scandal. Host i was wondering did you ever hear the book of thomas i was back at George Mcgovern and all of a sudden he threw up a Vice President ial candidate on the basis of having had electroshock treatment and i was angry at that point where it seems like its what the stigma does to you so its not surprising. Did anybody else realize youve made the term at that point . Did you tell anybody or did you just say put me in the Mental Illness section a Mental Illness section and im ready . I had to surrender after the car accident and every one knew i was in trouble. Everyone was calling on me to resign. I have started to hit bottom at some level politically and big egg was up. Everybody knew it was and i couldnt hide it anymore. Host sometimes they say in alcoholic treatment that you have to hit the bottom is when you understand. Guest i dont think thats the case i think we can raise the bottom for a lot of people. I hit bottom and of course i changed the floor and hit new lows and thats what we do. Host defined normal. Guest the abnormal becomes normal. Host the concept of comorbidity is thrown around. Describe for me what you mean when you say i comorbidity with comorbidity is about. You have the distinction that you either have an addiction or Mental Illness. Often if you have an addiction or Mental Illness you also have a Mood Disorder because you are not regulating your thoughts and emotions in a healthy way. So you need Mental Health which is a component of treatment for addiction and alcoholism but the funding streams as you have Mental Health over here. It will allow a lot of people to fall through the cracks because they are not mental, they do not want to be labeled as a Mental Illness patient or someone recovering from addiction so it works against the people who need to care for both to have the systems of care. Host in your case do you feel one was more problematic was with that you have mental problems that you were medicating with alcohol and guest the bottom line is who cares if it is the chicken or the egg. If it is the quality of my life was disrupted. And it didnt matter whether it was because of the psychiatric issue or that ive selfmedicating or the fact i might have through my abuse of medications i should say my interactions with medications i ended up having a bigger problem thats how we should focus is getting people into some stability. Host when did you decide what led to the decision. Im going to make my cause in Congress Getting mentalhealth 30s so people can get the treatment that whatever you needed but that isnt true for most people so you took on a real issue so when did you decide to do that and what got you started. Guest i couldnt have imagined i would be the sponsor of a bill that president kennedy spoke about when he signed the original Mental Health act of 1963 and that i would in some way be connected to this amazing legacy that i was born with because of the sins of my last name. As i said i grew up thinking i dont want anything to do with this mentalhealth stuff because i was ashamed to have it all in my family and i knew we were supposed to keep quiet so the notion that i was an outspoken leader about this is contrary about how it was programmed so i dont know how it happened. Its a miracle for me. I had a chance to do this because it does mean a lot to be part of this. People that are like me have entered a struggle and the struggle and its satisfying to connect with other people who feel like theyve been marginalized. Host when did you pick put the first bill in congress . Guest why does the cosponsor. He and rhode island. I was aware of it. Was the primary sponsor. Furthermore i have a the chapter president in rhode island who talked to me about it. So, i was already a cosponsor and when i go to washington, i went to basically signon tool for those i have signed onto as a state rep because its like basically taking your agenda to the national level, but i couldnt leave that i ended up having the distinction of being the first name on the bill. I assumed because the bill required equal coverage for Mental Illness and addiction that there would be tons of people that the police in line and maybe i would be lucky to make the top 100 because theres 435 members of congress. So honestly, i cant begin to describe what it was that allows me to be the sponsor. Host did you know on the committee . Guest i was on the Armed Services committee. And then i was on the appropriations committee. I served on the nih subcommittee and the hhs subcommittee and a fair i learned a lot and have dedicated a lot of. In a very direct way for more appropriations like alcoholism. So, that i was very proactive. In fact, whenever we had a mentalhealth addiction hearing, he would let me have the chair to conduct the hearing because, Jesse Jackson junior does this, roosevelt or a business does the same Patrick Kennedy does mentalhealth. So, again, jim i dont know how that happened to just kind of happened. Host do you think they saw that you are on a mission that you didnt know about . [laughter] guest like co. Like i said i didnt have the insight. A lot of people knew things about me that i didnt even know about myself. Thats either so much business for your folks. Host why do you think that your mental problems and emotional illness and Mental Illness, whatever, how does it affect your ability to operate in the congress . Guest if they make the we make the distinction between Mental Health and Mental Illness. I think a lot of people get this confused. If you are in a place where you are brain health is in a severity index where its debilitating you, you have an illness that needs to be treated by the medical system. And so, of course thats where parity comes into place and covers you. Primary care, secondary care and let me just say this because its important for people to know whether you are impatient or outpatient. They need pharmacy or er benefits if they provide a cancer patient or the cardiovascular. Most people dont thats the law of the land. Then theres the other side just mentalhealth. We all need better Mental Health. And we need to do better Mental Health so less people fall into the mental on this. So, suffice it to say, i kind of believe in and out of it being more disabling and sometimes less disabling so there isnt a clear narrative but i was impaired all the time and i think i probably had as we talked about a level of denial about how i was impaired or not. Host people all around you could see that you were at the level guest well, i was blessed because i had the staff. A lot of people applied to work for me. I have terrific chiefs of staff and a longest running staff as we know the high staff turnover. I was blessed by a group that stuck with me. My very first hired executive assistant. Brilliant, organized. I have so many good people and i needed them to vent and they really helped me function. Host they help you by not saying anything or covering up the things you were doing . Guest they definitely i think made up like i was killing it is an appropriate or on the committee during a debate between the early. David obie, i was announcing appropriations everywhere in my district and people measure effectiveness from a member of congress to what are they bringing on the internet scorched i was basing it and everybody knew it. I also had fantastic constituent service. This woman is inside and out of everything in rhode island and so the reputation was whenever you think a candidate gets it done so even though they were like wow i wonder how patrick is doing today they are at this event with me speaking at the chamber of commerce rolling their eyes were forever, they all wanted to come to my office because they knew i could deliver. So i would say theres a lot of people who are just like be in the Business World who are functioning and do not know they have a problem or they do have a problem and are not fully aware that it may be affecting them in ways they dont need to have it affect them like host as long as they can get by without having to confront the public situation than they can keep going and thats basically the running under the surface in a way. I was when people read what they say here is a guy with four and a half years of it guest february 22. Host i sat next to a guy on the ways and Means Committee that had to dwis and he wound up going into god we acted reelected. A lot of people will look at you and say i havent got the family and resources and i dont have access. So they dismiss that they could do what youve done. What do you say to them . Guest the honest assessment is that we dont