This conversation with the Bipartisan Policy Center lasts about 45 minutes. Good morning and thank you for joining us for this live discussion on the state of Mental Health in the u. S. According to the most recent data from the nih or more thn 57 million americans are living with a Mental Illness. Thats just over one and five. Despite its prevalence the can remain out of sight. For too many, stigma, and despite medical advances far too often it is left untreated. This week we saw senator John Fetterman return to work on capitol hill after being hospitalized for depression. His candid remarks about the experience restates praise from his colleagues and the public. Reminded us of the toll Mental Illness can take and the stigma that continues to be attached to it. This is not a political issue. It is not defined by your point of view of where you live. At the Bipartisan Policy Center this is one of the many issues we focus on. We publish detailed reports with policy recommendations on a shortage of Mental Health care professionals, how telehealth can help, and treatment, and the nationwide 988 suicide and crisis line. And when working on a new report on ways to improve Mental Health services, particularly in rural america. To talk about these issues and more today we are very pleased to welcome doctor jerome adams who served as u. S. Surgeon general, and is now executive director of Health Equity initiative at purdue university. Throughout his career he has been a a public voice of mentl health, substance abuse, Suicide Prevention, and access to care. He will be joined by Rhitu Chatterjee who focuses on Mental Health issues for npr. This discussion is just ahead, but first we will have a special message from representative david trone of maryland who serves as a cochair of the bipartisan addiction and Mental Health task force. Hi, everyone. Im congressman david trone for marylands sixth district. Thank you to Bipartisan Policy Center for hosting this event and normalizing conversations around Mental Health. Americas Mental Health crisis only continues to grow. One in five u. S. Adults live with Mental Illness and suicide as the leading cause of death in america, over 50,000. In o congress my number one priority is to get folks fighting Mental Illness or Substance Use disorder, resources and the support they need. Thats why i i found it bipartin Mental Health and Substance Use disorder task force to bring attention to a National Crisis and move the ball forward on finding solutions. You know more than anyone that the onlye way to make Real Progress in this fight is work together. We must be bipartisan. Mental health doesnt care if youre a democrat or republican, liberal or conservative. It touches every family and every community. We need to ensure that we have all the resources needed to respond to folks in crisis and equip those on the front lines to save lives. Im proud to say i have worked with over 130 members every day to take action on this issue. Last year we introduce over 100 bills to combat addiction and Mental Health, all bipartisan, all. 26 became law. We we passed the largest investment in addiction and Mental Health ever, and the annual government funding bill. We are restoring hope in the Mental Wellbeing act as a package of 30 Mental Health and addiction bills, eight of which i lead, all bipartisan. Further, last to relaunch the National Suicide prevention lifeline, or 988, so that folks in crisis can get connected to trained counselors for free, confidential, 24 7 support. We also provide Mental Health care before it gets to that. So wewe passed the bipartisan Safer Communities act, investing 11 billion in student Mental Health programs, including Early Intervention programs, schoolbased Mental Health and Wraparound Services and a proven to school safety. Yet even as we take these major steps, many people still face the stigma surrounding Mental Health. This poses a significant barrier to assessing proper care. I commendto my colleague senator John Fetterman. Senator fetterman, great, great leadership putting himself first and being an inspiration to so many americans. Our message to america must be its okay not to be okay. Mental illness isnt a failure of character. Its a disease. It cant and should be treated just like cancer. Together, federals date levels must continue work across it e aisle, build a nationwide coalition and invest in communitybased services. Thank you for joining me in this mission. We have to win. Takess care. Thank you, congressman trone ssfor those remarks which actuay set up afo conversation with doctor jerome adams really well. I do want to point out we will be taking your questions today if you want to submit questions, you can use the live chat on youtube or you can do it on twitter using the hashtag bpc live. Dr. Adams, thank you so much for being here. I want to start with your personal perspective, like when and how did you start to see and understand Mental Health as a Public Health issue . Well, thats a quick question to start on i want to say thank you to you and thank you to the bpc for having us here for this incredibly important and timely conversation. And as an educator and former Surgeon General i dont want to assume anything so want to just start offff by defining Mental Health. Its important people understand the Mental Health includes our emotional, psychological and social wellbeing, and it is a spectrum. Spectrum. Far too often, when we talk about Mental Health, what people think about or what we are really talking about his Mental Illness. That is just one spectrum. There are many people who have Mental Health issues and or who are paying attention to their Mental Health without having a diagnosed Mental Illness. It is important to understand that until fitness is just as important as physical fitness. We can build up our Mental Health strength just as we can build up our physical health strength. To the question you asked, my story is like many others. It has been very personal. I have experienced Mental Health through my family, through my role as a physician, and also through my role as a Public Policy maker. From a familial point of view, many of your viewers may remember that while i was Surgeon General of the United States, i spoke very publicly of the fact that my brother was in a prison cell about 25 miles away from the district of columbia due to crimes he committed to support his addiction. I speak about his story with his permission. But it is important to understand that substance misuse is part of that spectrum of Mental Health issues and it is something i have seen up close and personal with many members of my family. I also have close family members who dealt with depression and anxiety. You heard congressman trone talk about stigma. I think that has really limited the willingness to talk about these issues, to even acknowledge that these are issues, and to receive treatment for those issues. That is the personal side of things. As a physician, i am in the hospital today working. I have seen far too many patients come in with physical Health Issues that really are manifestations of unrecognized and untreated Mental Health issues. Rhitu can you give us an example . Dr. Adams i can give you an example. I work in a level one trauma center. Far too often, we see domestic islets cases, suicide attempts, drug overdoses, gangrelated shootings that can be traced back to unrecognized and untreated anxiety, unrecognized and untreated depression, bipolar disorder. Issues that, if we had recognized them earlier or prevented them earlier, and prevention is possible in many cases, we would not have had these horrific manifestations of these issues. Finally, i solve these issues as a Public Policy maker as both an Indiana State Health commissioner, where in scott county, indiana, we have the largest hiv outbreak in relation to injected drugs in the United States. A Public Policy issue, many people remember me as the person who legalized Syringe Service programs both in indiana and many other rural and conservative states. But that was necessary because we did not recognize and treat and intervene early enough with the substance misuse issues, that were in many cases untreated upstream Mental Health issues. In many different ways, i have been involved. I think that reflects the reality for many across america. Rhitu you brought up the issue of stigma. So did congressman trone. It is so important. The pandemic did do away with a lot of the stigma just because, as you say, many, many more people were experiencing some sort of psychological distress during the pandemic. We hear about Mental Health a lot more the media now. Do you think we have really done away with it or is there more work still to be done . Dr. Adams that is a great question. You bring up an important point. The pandemic was certainly a once in a century crisis. A crisis often brings with it opportunity. The pandemic brought with it the opportunity to openly deal with many of the Mental Health issues that people across america are facing, in which and which were exacerbated by the isolation of the pandemic, the Financial Difficulties brought on by the pandemic, by a lot of the exposure to substances of misuse that increased during the pandemic, including alcohol. We saw that skyrocket, alcohol misuse skyrocketed. I spend a lot of time now with college students. I was at Indiana University last week talking to students. I was at ball state yesterday talking to students. I think we also have to give credit to the young people out there. What i mean by that is that they are in a very different place than what you and i were when we went to college. They talk very openly about their Mental Health issues and mental fitness, as i mentioned, strengthening Mental Health, strengthening resilience, understanding how to recognize when you are having an issue, also understanding what you need to do as an individual to help yourself get through tough times. Kudos to them. I think that much, if anything, has changed the way we view Mental Health. But to answer your question, we have not even come close to doing away with stigma, particularly in certain communities. We know that certain communities are at higher risk for Mental Health issues. I will name a couple. Military and veterans are at a higher risk for suicidality. Higher risk for Mental Health issues. Lgbtq community is at higher risk for Mental Health issues because of the stress and stigma they are subjected to. People of color and marginalized communities, higher risk for Mental Health issues. A lot of this comes back to stigma, stigma that society places on these individuals, stigma from the cultures that these individuals exist in. We need to aggressively work to lower stigmas. One of the reasons i talk openly about my familys situation is because people hearing that the u. S. Surgeon general is not immune to having to deal with Mental Health issues and Mental Health crises amongst family members, i think it really gives people permission to talk about these things. One of the most heartening things for me when i was Surgeon General was after a speech, when people would come up and say, that is happening to my family to. That is something i have dealt with and never talked about it before. As congressman trone said, we have to realize that it is ok to not be ok. We need to be more like our younger people and openly talk about these issues. We cannot assume that because we have made progress that we have reached the finish line. We have a lot further to go in terms of addressing stigma. Rhitu so, related to this and what you said about young people having far less stigma, being much more open to talking about Mental Health, much more aware of their own Mental Health, we also know from the data that young people, adolescents, young adults have the highest rate of Mental Health symptoms among them. You have more people, as it should be, seeking help. But that help is often hard to access. 988 made huge strides in making it ok for people to seek help. There has been historic levels of investments into 988, not just supporting the line, but also in Many CommunityServices Related to it. We know more people are reaching out in less than a year. I often hear that for these kinds of counselors who are providing this free and valuable service, it comes with connecting people to ongoing care in their community. That is still such a big challenge. Wait times are high. It is hard even in well resourced, urban areas with a high concentration of Mental Health providers. Things in rural areas are far, far worse, we dont have providers for miles and miles and miles. What are your thoughts on how we improve access to care. Access to care at many levels. You talk about just being in the er and treating patients who had been who, if theyve been treated earlier, things would not have escalated. We need to think of the whole continuum of care. I guess that is the term people use. Dr. Adams yes, yes. You bring up several critically important points. Again, i dont want to assume. For our listeners and viewers, i want you to know that 988 is the National Suicide and crisis line launched in july of last year. Prior to 988, there was not one number that people could call if they needed help or if they were in crisis. Far too often, people were first were forced to call 911. I do not to that pejoratively. 911 does great work. It is not a Mental HealthCrisis Response line. In most cases, if you called 911, you ended up in one of two places. The emergency room or the jail cell. We know that neither of those places is an ideal place for people who are helping who are having an Mental Health crisis to be. 988 was a historic move forward. It was something that was initially approved by the Trump Administration and was ultimately funded and brought across the finish line i the biden administration. The bpc does bipartisan work. This is something that had bipartisan support. But as part of the bpc trying to promote 98 eight, we emphasize that we need three things in order to make this optimally effective for the public. We needed better interagency elaboration we know that often the right hand does not know what the left hand is doing. People worked in silos in the Mental Health world. We need better interagency collaboration at a state, local, and federal level. We need to increase to Behavioral Health workforce, as you mentioned, rhitu. What we dont want is someone to call 988 in crisis and knock it with a need. They will lose trust and faith in the system and it wont help anyone. We also need financing. I say this very directly because i know we have policymakers listening into our conversation today. We need to finance Mental Health in the same ways that we finance physical health in our medical systems and health care systems. I want to do a little bit of a deeper dive on the workforce issue that you br