Transcripts For CSPAN2 Hearing On Mental Health Substance U

Good morning. The Senate Health education labor and Pensions Committee will please come to order. Todayerer holding a hearing on our nations growing Mental Health and Substance Use disorder crisis. I will have an Opening Statement following by senator murkowski. Then we will introduce our witnesses. I believe Ranking Member will join us a little later as well. After the witnesses give their testimony, senators will each is have five minute farce for a round of questions. While we werent able to have it open to the public, live video is available on our Committee Website and if you are in need of accommodations, you can reach out to the committee or office of congressional accessibility services. We continue to see a high number of new covid cases, so we are having this hearing in a larger hearing room where we can be socially distanced limiting the number of people who are in the hearing room, experience depression, anxiety and other Mental Health disorders. Drug overdoses were on the rise, and our Health Workforce was stretched far too thin. Mental Health Issues were responsible for 56 million Doctor Office visits and 5 emergency room visits. In 2019, suicide was the second leading cause of death among adolescents. From 1999 to 2019, the rate of Overdose Deaths more than tripled and then covid19 hit and made things worse. Our nation lost over 100,000 people to it drug overdoses in a single year. Overdose deaths, especially deaths involving fentanyl, skyrocketed in my home state during the pandemic. Nationwide, we are also seeing a concerning rise in methamphetamine and cocaine use as well. Across the country, people are stressed and this pandemic has been especially traumatic for children. Our schools, teachers and education leaders are seeing this every day. Our educators are on the front lines trying to help so many students experiencing Mental Health challenges often without the support of trained Mental Health professionals. We have seen sharp increases in kids visits to the emergency room for Mental Health crises, thoughts of suicide and suicide attempts, especially among girls. As of last december, over 167,000 children have had their world shattered after losing a parent or caregiver to covid19, some have even lost both parents. We know marginalized students are facing the worst of these challenges deepening inequities they already face. We know educators and caregivers are facing their own Mental Health challenges from the strain of this pandemic as well. We need to continue helping our students and educators and ensuring schools have the support, training and resources they need. But right now, our Mental Health workforce is stretched too thin to meet the needs. If we just keep stretching without taking action, something is going to break. For example, nearly half of psychologists reported feeling burnt out last year. We arent even close to providing Mental Health care to everyone who needs it. 130 million americans live in areas with less than one Mental Health care provider per thousand people. In my home state of washington, our Mental Health Care Workforce is only able to meet 17 of our states needs. Meanwhile, nationwide, less than in 1 in 10 people who need treatment for Substance Abuse actually get it. These hardships are not felt equally. The highest increase in opioid deaths has been among black more thanes. Rates of suicide are highest among american indian. And pop with Developmental Disabilities already almost five tombs more likely to have Mental Health needs have had their lives up ended. While some communities may face greater Behavioral Health challenges, this crisis affects all of us. Even if we arent personally struggling with Mental Health or sub stoons use, we have friends and family who is are, whether we realize it or not. We all rely on First Responders, Health Care Providers, teachers and other front line professionals who are facing burnt out and trauma. We all have a stake in making sure people can get the help they need. Thats why democrats passed the American Rescue plan to provide resources for schools to hire counsellors and psychologists, communitybased Behavioral Health providers, programs to treat Mental Health, suicide, burnt out and Substance Use and more. But we are not done. Healing the scars of this pandemic wont be quick or easy. This will take years. And we must act accordingly. Its time to build on this committees bipartisan history of expanding access to Mental Health services and responding to drug Overdose Deaths like we did in 2016 and 2018. In my state, i have seen how communities can benefit from some of the critical programs this committee has worked on, inen colluding programs that the Substance Abuse is and Mental Health Services Administration. For example, in clark county, which saw fentanyl deaths trip until 2020, lifeline connections is using a grant to better prepare teachers and school personnel, Law Enforcement, First Responders and caregivers to respond to Mental Health crises and refer those in need to appropriate treatment. Meanwhile, in king county, federal support allowed to provide Mental Health services for over 150 adults experiencing homelessness. And the tribes and bands of the nation are using Grant Funding to fight the high rate of suicide in their community by update daiting their Health Records and Mental Health procedures, hiring more therapists and expanding tell health services, which has been critical to reach people during the pandemic. If were going to respond to the behavioral Health Issues this pandemic has made worse, its clear we have to build on these efforts. That will take legislative action. So i look forward to hearing from our witnesses about how we can do that and working with senator burr and everyone on this committee on a bipartisan effort to reauthorize, improve, and expand critical federal programs that address Mental Health and Substance Use challenges. I hope every member of this committee and the senate can Work Together to bring their priorities forward to us to include. My goal is to work with Ranking Member burr to fold these priorities together into a larger package that makes progress on many of the issues that were going to hear about today. Like suicide screening and prevention, youth Mental Health, the Opioid Crisis and breaking down barriers in access to hen tall health. Finally, i want to acknowledge that disorders do not exist in a vacuum. In addition to the pandemic, there are a lot of issues people are worried about right now from gun violence to Climate Change to systemic racism to just making ends meet. As we work to do more to help people struggling with depression, anxiety and stress, we also need to look for ways to solve the problems that are making things so hard for so many people in the first place. I hope to continue to work with my colleagues on these root causes as well. Id like to introduce two letters for the record. One from the American Academy of pediatric, the American Academy of child and adolescent psychiatry and the association with recommendations for addressing the National Emergency and childhood adolescent Mental Health and others for the American Federation of state employees highlighting the importance of supporting the behavioral Health Workforce. So ordered. With that, i will turn it over to senator murkowski for her opening remarks. Madame chairman, thank you for convening the hearing. I appreciate that. I want to thank senator burr for asking me to substitute in as Ranking Member today on this incredibly, incredibly important and certainly timely conversation as we talk about Mental Health and Substance Abuse disorders. You have outlined well i think the statistics, the challenges that were seeing. We knew, we have known for years now that Mental Health and Substance Abuse disorders have really been at crisis levels in many parts of the country. Certainly in my state of alaska, and we have seen those challenges and those issues only further compounded by this pandemic. Access across the country, access to Mental Health and Substance Use care remains severely limited. Exacerbating suicide and Substance Abuse rates. You have mentioned the statistics in your state, madame chairman, with regards to Mental Health providers and facilities in alaska more than 80 of our communities do not have sufficient Mental Health providers. Again, we are seeing this crisis only continue to elevate, and unfortunately, it knows no barrier on this spectrum. We are seeing more and more young kids. It used to be when we were talking about suicide statistics, we would look at that 25, 45 year age bracket. Now the alarm that were seeing is in 10, 11, 12yearolds, who are suffering. We have an obligation to hear and to respond. Alaska ranks second in the country for suicide deaths. We have seen a sharp increase in drug Overdose Deaths, just as we have seen across the country this year. Alaska has one of the highest rates of binge drinking. Suicide rates amongst members of our Armed Services have doubled. We have seen some very, very Disturbing Trends of late, and as we have seen, our native people face shockingly disproportionate rates of Behavioral Health and Substance Use disorders and suicides. These are statistics that keep you up at night not just because they are numbers, but these are real people. These are our constituents. These are people in our neighborhoods, in our communities. They are people who are in pain. And as we will hear from the young woman who will be introduced in just a momt, a youth advocate from anchorage, alaska, she reminds us that these people that are not statistics, but these real people are looking to us 3 they are watching the leaders waiting for us to do something, and i think the message of hope needs to be that we are paying attention, that we are listening and we are working together to try to address some of the root causes of what we have seen. Just within this committee, we have seen some strong collaboration on efforts. I have been working with senator hosten on the mainstreaming Addiction Treatment act, which allows Health Care Providers to prescribe a drug that can truly save lives with the medicationassisted treatment. In addition to lifesaving treatment, we know that we have to invest in wrap around Recovery Services. I have visited programs in alaska that focus not just on preventing the Overdose Deaths, but also really building a community for alaskans in recovery because that has to be the follow on. We have worked on efforts to reduce fetal alcohol syndrome disorders to address the Mental Health needs of senator smith and i are leading the Workforce Shortage loan repayment act to bolster our supply of providers, but also the tel Mental Health improvement a act to ensure that insurance covers these critical services. Senator king and senator kelly and i are working on the effective suicide screening and assess the in the Emergency Department act to provide resources for emergency room personnel to identify, assess, and treat individuals at risk of suicide. I think unfortunately, we know thats where far too many who are seeking help end up sitting in an emergency room where you dont necessarily have those that are trained to identify and assess. Later this week, im going to be introducing the guarding our Mental Health act to prevent cost guard members who seek help from being automatically processed for discharge. Again, we know we have to make headway on the stigma issues associated with Mental Health. And then with senator rosen, were going to be introducing the youth Mental Health and Suicide Prevention act to ensure that the grant can provide additional Mental Health programming to students. Madame chairman, we know around this senate here theres plenty that can divide us. I would like to think that Mental Health, Substance Use, these are areas we can find true bipartisan consensus and hopefully we can build a package that addresses these issues head on, and i commend the work that you have made along with rank ing member burr to do just that. Again, im looking forward to being able to troo the committee to a bright Young Alaskan and when it is appropriate i will do that. But thank you, i look forward to the testimony from all witnesses today. Thank you. We will now introduce todays witnesses. Senator burr has joined us, so i will turn it over to him to introduce our first witness. Madame chairwoman, thank you very much for holding this hearing and for the opportunity to introduce the witnesses to the committee. This doctor is the american psychology chief science a officer. He also serves as the john van setters distinguished professor of psychology and neuroscience at the university of North Carolina chapel hill. He began his academic career as an assistant professor and later director of Clinical Psychology at Yale University department of psychology. His research is focused on interpersonal relationships primarily amongsted a let isnts ask published more than 150 scientific articles and 9 books over the course of his career. He earned his masters degree from the university of miami, bachelors from emery. I thank you for being here today and for all your work on behalf of families across the nation ask in our great state of North Carolina. Thank you. Thank you, senator burr. Next we have dr. Durham. Shes the clinical professor of industry and pediatrics at Boston University school of medicine and Boston Medical Center. Shes a Board Certified physician with a background in pediatrics psychiatry and addiction medicine. Her roles have always been in marginalized community and a dedicated advocate for effect wit witable Mental Health treatment. Shes the director of training for Boston Medical Center transforming and expanding access to Mental Health in urban pediatrics or the team up initiative. So glad you could join us today. I look frd to your testimony. Our next witness is sara goldsby. She was confirmed by the senate in february of 2018 after serving as acting director. She has led the response to the Opioid Crisis and serves as ko chair of the emergency team. Meaning shes been on the front lines of the crisis we are talking a about today. Shes helped expand access