Mental Health Professionals Workforce Shortage Loan Repayment Act of 2019

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks and include extraneous material on the subject of my Special Order.

Mr. Speaker, I bring to the floor a topic very near and dear to my heart, and I rise today to recognize the entire month of May as Mental Health Awareness Month.

I cochair the Congressional Mental Health Caucus along with my Republican colleague, Mr. John Katko from New York, and we work to educate Members of Congress and their staff on the work still needed to expand mental health access and protections, and also to reduce the ever-present stigma.

The topic of mental health in Congress has and is building momentum, and it is spurring action to increase delivery of mental health services, something I have worked to do for over 2 decades.

This year alone, our House Mental Health Caucus has grown from 47 Members of Congress to 92. However, mental health still affects millions of Americans of all ages, genders, races, and remains woefully underfunded and misunderstood.

Suicide currently plagues our veteran community. Roughly 20 veterans per day take their own lives, according to the VA.

A 2005 to 2016 Department of Veterans Affairs' Suicide Data Report found that the veteran suicide rate is 1.5 times greater than the nonveteran population, with over 6,000 veterans dying by suicide each year.

In the Hispanic community, my own community, approximately one in ten individuals with mental illness use

mental health services from a general health provider, while only one in 20 receive such services from a mental health specialist.

Machismo and other cultural tendencies are preventing our loved ones from being open and honest about what might be troubling them. The stigma ranks high.

We must continue to let our loved ones know that there is absolutely zero, I reiterate, zero shame in asking for help and that seeking support is a sign of strength.

We also have seen that one in four Latina adolescent children, I say children because they are still children, report contemplating suicide, a rate higher than any other demographic.

The increasing diversity of our country underlines both the need and the importance of assessing culturally and linguistically appropriate services.

The 2018 election focused on healthcare and the future of the Affordable Care Act, ACA.

One of ACA's most critical successes was increasing mental health service and delivery. Insurance companies for decades denied coverage for patients needing mental health services.

We inserted provisions to end this appalling practice and made mental health an essential part of basic coverage, including screenings and other preventive services.

Together, we made sure that no American is discriminated against when seeking mental health care, and that mental health and substance abuse, these disorders, are covered equal to physical illnesses like diabetes, asthma, high blood pressure, and other illnesses.

As we head into 2019, these reforms and the ACA must be strengthened so more Americans seek the lifesaving care they need.

We must also continue to look at what is being done locally to support access to mental health services.

In 2001, Pacific Clinics, a nonprofit, and I started a school-based mental health program with $500,000 seed money from SAMSHA, Substance Abuse and Mental Health Services Administration.

The program began in three middle schools and one high school. The schools were very reluctant at first, because of the stigma connected to it and the fear of being labeled ``crazy schools.''

We kept pushing forward, and the program has now grown to 35 schools, with a waiting list.

The program serves as a model for H.R. 1109, the Mental Health Services for Students Act, which would provide $200 million for 100 school-based mental health programs nationwide.

Senator Tina Smith of Minnesota has also introduced a Senate companion, S. 1122, and we are very grateful for her support.

We knew that if we started early with children, we could help them succeed and save lives. But stigma remains a big barrier preventing many parents from getting their children the care they need.

We all need to continue sharing the message that it is always okay to seek help. If we address issues early, we can help students and their families succeed in and out of the classroom.

The Los Angeles County Board of Supervisors and the County Department of Mental Health have been instrumental in the success of this program. The Department of Mental Health for Los Angeles County took on funding the program when SAMHSA funding ended in 2009.

Seeing the success of this program, Supervisors Barger and Hahn, in January 2019, directed the Department of Mental Health to identify funding and to develop a countywide plan to provide school-based mental health services. Countywide means to 14 million people.

In April 2019, the board of supervisors formally adopted a plan to funding for pilot sites, to hire additional mental health professionals, and to develop a Mental Health First Aid pilot program that would educate students.

Beyond stigma reduction and educating loved ones of warning signs and symptoms, we need to ensure that we have a reliable workforce to be able to deliver lifesaving services to all in need, regardless of their ZIP Code. There is a national shortage of trained mental health professionals, and the California Future Health Workforce Commission has stated that, without dramatic policy changes, California will have 41 percent fewer psychiatrists and 11 percent fewer psychologists, marriage and family therapists, clinical counselors, and social workers than needed by 2030.

Recognizing this, I, along with my colleague, Mr. Katko, reintroduced H.R. 2431, the Mental Health Professionals Workforce Shortage Loan Repayment Act of 2019.

My Mental Health Caucus co-chair is wonderful in this sense, and I thank him for that.

This bill would expand the mental health workforce by providing loan reimbursement to mental health professionals who commit to working in underserved areas.

Our work continues, but it can't be limited to this Congress or any other Congress. I encourage all to get involved, educate yourselves, and share resources with friends and family. If you see somebody who has fallen on hard times, reach out, help them out, and, if needed, refer them to a mental health services provider. Together, we can continue to build a movement and eventually live in a world where there is no stigma, or it is very much reduced.

Mr. Speaker, I yield to the gentleman from New York (Mr. Katko), my friend.

Mr. Speaker, it is wonderful to hear all the work that Mr. Katko has done on mental health. He has been exceptional in this field, and I thank him for all his support. Working together is a pleasure.

What is mental health? If somebody says you belong in a crazy house, not so. It could be a child in school, a middle school, suffering the effects of bullying, or somebody who has had trauma, a shooting or something that affects them, and it won't go away and it festers when they grow older.

Forty percent of the incarcerated need mental health services. Foster children, who are unaware of what their next step will be after they are emancipated, need mental health support.

That can just go on and on. It is something that is needed. Somehow, we are not doing our job.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I rise today in recognition of Mental Health Awareness Month.

At the outset, I want to thank my colleague, Mrs. Napolitano, for being a partner in this and a leader in this issue for a long time. I am honored to speak with her on this issue. Many of my comments today are going to echo the sentiments that she just spoke here in Congress, but it bears repeating, in my own words.

Throughout May, my colleagues and I will bring attention to the impact of mental illness on American society, as well as Congress' role in addressing mental healthcare issues facing the country. It is an honor to collaborate with my colleagues in the Congressional Mental Health Caucus, including Mrs. Napolitano, to raise awareness for mental illness, reduce the stigma surrounding mental illness, and create legislation that improves mental health outcomes for all Americans.

Mental illnesses have a devastating effect on those struggling to live with them. This includes changes in mood, social interactions, sleep patterns, and eating habits. Sadly, the most extreme consequences that occur all too often for mental illness are when individuals inflict self-injury or take their life.

Here are some statistics that should stun everybody.

Suicide is the 10th leading cause of death, and it is the 2nd leading cause of death among Americans aged 24 and younger. Let me repeat that. The 10th leading cause of death for all Americans is suicide, and for Americans aged 24 and younger, it is the 2nd leading cause of death. That is stunning.

Approximately 1.4 million Americans attempt suicide each year, and over 47,000 Americans lose their life to suicide each and every year.

The United States has 3,700 suicide attempts daily and 129 suicide deaths per day. This equates to one suicide every 12 minutes. By the time I finish this speech, statistics will have it that another person will have taken their life. That should wake people up in this country.

Not only does suicide have severe emotional costs on families and communities, it also has a huge cost to our economy. It is estimated that suicide and self-injury reduce the economic output of the United States by nearly $70 billion a year.

The suicide epidemic is responsible for nearly the same amount of deaths in the United States as another major crisis, one that gets far more attention, and rightfully so, that being the opioid epidemic. It is estimated that opioids were the cause of 47,600 deaths in America last year, only a few hundred more than suicide.

While solving the opioid crisis has received ample funding and attention, and rightfully so, reducing suicide and improving mental health treatment deserves the same recognition. We fall far short of that now, far short of that.

To give you an example, the Zika virus came about in this country, and, of course, it was a terrible virus with terrible consequences. Congress

promptly enacted $1.6 billion to address it. A total of one person died from the Zika virus. Of course, there were many other health problems that were attributed to it.

Again, the $1.6 billion that was appropriated was rightfully so. Nowhere near that much is appropriated for mental health and suicide research on a yearly basis. The National Institutes of Health needs the money.

Congress has a responsibility to assist individuals experiencing mental health challenges through effective legislation and research subsidies. Congress should advance policies that increase America's access to mental healthcare treatment as a mechanism for preventing self-harm incidents and suicide attempts.

Just one-third of Americans with mental illness receive treatment-- just one-third. Our country is in desperate need of additional trained therapists, psychologists, and counselors. This lack of access can be partly attributed to a shortage of mental healthcare professionals in certain communities.

In order to establish a more reliable supply of mental healthcare professionals, Congresswoman Grace Napolitano and I recently introduced the Mental Health Professionals Workforce Shortage Loan Repayment Act of 2019.

Our bill delivers professionals to areas that require mental healthcare experts the most by forgiving their secondary education student loans. It invests in bolstering our mental health workforce, while expanding treatment for Americans with mental illness.

I am proud to stand by my colleague across the aisle, Grace Napolitano, in pushing this most important bill.

Americans across the country, regardless of age, social status, or background, are affected by mental illness. Mental Health Awareness Month serves as an opportunity for any of my congressional colleagues, Republican or Democrat, to join the conversation.

I can't think of a more bipartisan action than what we are talking about today. Together--together--we can improve mental health outcomes for Americans across the country by engaging in thoughtful discussion and crafting efficient policies.

Finally, it is an honor, once again, to co-chair the Congressional Mental Health Caucus with Congresswoman Napolitano. I am grateful for her continued leadership, her commitment to this issue, her stewardship, and her mentorship to me on it, as well.