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"Americans Must Make Commitment to Mental Health Care"

President George W. Bush

University of New Mexico, Albuquerque, New Mexico
April 29, 2002

Millions of Americans, millions, are impaired at work, at school, or at home by episodes of mental illness. Many are disabled by severe and persistent mental problems. These illnesses affect individuals, they affect their families, and they affect our country.

As many Americans know, it is incredibly painful to watch someone you love struggle with an illness that affects their mind and their feelings and their relationships with others. We heard stories today in a roundtable discussion about that -- what the struggle means for family.

Remarkable treatments exist, and that's good. Yet many people -- too many people -- remain untreated. Some end up addicted to drugs or alcohol. Some end up on the streets, homeless. Others end up in our jails, our prisons, our juvenile detention facilities.

Our country must make a commitment: Americans with mental illness deserve our understanding, and they deserve excellent care. They deserve a health care system that treats their illness with the same urgency as a physical illness.

To meet this goal, we've got to overcome obstacles, and I want to talk about three such obstacles this morning. The first obstacle is the stigma, the stigma that often surrounds mental illness -- a stigma caused by a history of misunderstanding, fear, and embarrassment.

Stigma leads to isolation, and discourages people from seeking the treatment they need. Political leaders, health care professionals, and all Americans must understand and send this message: mental disability is not a scandal-- it is an illness. And like physical illness, it is treatable, especially when the treatment comes early.

Today, new drugs and therapies have vastly improved the outlook for millions of Americans with the most serious mental illnesses, and for millions more with less severe illnesses. The treatment success rates for schizophrenia and clinical depression are comparable to those for heart disease. That's good news in America, and we must encourage more and more Americans to understand, and to seek more treatment.

The second obstacle to quality mental health care is our fragmented mental health service delivery system. Mental health centers and hospitals, homeless shelters, the justice system, and our schools all have contact with individuals suffering from mental disorders. Yet many of these disorders are difficult to diagnose. This makes it even harder to provide the mentally ill with the care they need.

Many Americans fall through the cracks of the current system. Many years and lives are lost before help, if it is given at all, is given. Consider this example -- and for the experts in the field, they will confirm this is a story which is often times too true: a 14-year-old boy who started experimenting with drugs to ease his severe depression. That happens.

This former honor student became a drug addict. He dropped out of school, was incarcerated six times in 16 years. Only two years ago, when he was 30 years old, did the doctors finally diagnose his condition as bipolar disorder, and he began a successful program, a successful long-term treatment program.

And to make sure that the cracks are closed, I am honored to announce what we call the new Freedom Commission on Mental Health. It is charged to study the problems and gaps in our current system of treatment, and to make concrete recommendations for immediate improvements that will be implemented -- and these will be improvements that can be implemented, and must be implemented, by the federal government, the state government, local agencies, as well as public and private health care providers.

To chair the commission, I've selected Michael Hogan….Dr. Hogan has served as the Director of the Ohio Department of Mental Health for more than ten years, and is recognized as a leader in this profession. He has been focused, as a state official, on how our mental health system works, and how it doesn't work.

I look forward to the Commission's findings. I look forward to their proposals. I look forward to making progress and fixing the system, so that Americans do not fall through the cracks.

The third major obstacle to effective mental health care is the often unfair treatment limitations placed on mental health in insurance coverage. Many private health insurance plans have developed effective programs to identify patients with mental illnesses, and they help them get the treatment they need to regain their health.

But insurance plans too often place greater restrictions on the treatment of mental illness than on the treatment of other medical illnesses. As a result, some Americans are unable to get effective medical treatments that would allow them to function well in their daily lives.

Our health insurance system must treat serious mental illness like any other disease. And that was Senator Domenici's message to me at the Oval Office. And it was Nancy's message when we had them up for dinner. And I want to appreciate the fact that they have worked tirelessly on this problem.

I have a record on this issue. As the Governor of Texas, I signed a bill to ensure that patients who critically need mental health are treated fairly. Senator Domenici and I share this commitment: health plans should not be allowed to apply unfair treatment limitations or financial requirements on mental health benefits.

It is critical that we provide full -- as we provide full mental health parity, that we do not significantly run up the cost of health care. I'll work with the Senator. I will work with the Speaker. I will work with their House and Senate colleagues to reach an agreement on mental health parity….

We must work for a welcoming and compassionate society, a society where no American is dismissed, and no American is forgotten. This is the great and hopeful story of our country, and we can write another chapter. We must give all Americans who suffer from mental illness the treatment, and the respect, they deserve.

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