Joseph Woodrow Hatchett United States Courthouse And Federal Building--
Madam President, before I get to my topic today, I would like to say that when Senator Sullivan first came to the Senate, I hadn't been here very long, either, and this was my presiding time every week. I loved the Alaskan of the Week. I…
Madam President, before I get to my topic today, I would like to say that when Senator Sullivan first came to the Senate, I hadn't been here very long, either, and this was my presiding time every week. I loved the Alaskan of the Week. I don't think they are ever going to run out of Alaskans of the Week as long as Senator Sullivan is here. So I was right back in that chair, where you are, thinking of the many times I heard Senator Sullivan do the presentation on the Alaskan of the Week and how much I enjoyed it.
Yes. I think the point you are making here, too, are that these are--we now have 5 years of evidence in several States, multiple years in other States. So this isn't just assuming what will happen but looking at what we have carefully tried to keep track of, of what does happen. And as you pointed out, that de facto mental health system, mental health delivery system of the emergency rooms and police--nobody was well-served by that. Certainly, the police weren't well-served. The emergency rooms weren't well-served. And people had many mental health challenges that weren't served by that as well. And seeing those numbers go down dramatically of people having to go to the emergency room for mental health services or being kept in jail overnight or longer than overnight for mental health services, nobody benefits from that system.
And so we are seeing real numbers where the people who work at the emergency room, the people who are in the police department are among the biggest supporters of this system when it gets in place. Also, the whole idea of crisis intervention, there are opportunities in this law for that to happen.
In any of the new structures, whether that is drug court or veterans court or other places you would go to try to be sure somebody is getting the help they need when they need it, there also would be due process involved in anything added; that we use this bill to add to the system due process where people have a right.
If there is an emergency moment, obviously, you have to deal with that as an emergency moment. But people then have a right to have their day in court as well, if they are not part of that crisis intervention moment of seeing that happen. And so that is important.
But in Missouri, 150,000 people are now part of this excellence in mental health effort. That is about a 40-percent increase on what some of the same facilities were doing before, but now, they do it with more certainty that they are going to get their cost reimbursed. They do it with the right kind of staff, and 365 days a year, 24 hours a day, 7 days a week, they have to be available. And the new States that enter the program will go through that same type of competition to be among the 10 States every 2 years that could enter the program and get us to all 50 States in that program and have the kind of staff they need, the kind of accessibility they need.
I think, originally in our bill, which was 8 years ago now--2014--24 States applied to be one of the first 8 States in the pilot program; 19 of them went through the whole process, and 8 States were selected. But in the other States, there are now 30 States that have big units that were able to qualify as individual demonstration grant units to show what they could do. And we really, I think, both believe that those units in those States will become both the models and the incentive to bring the whole State into that program now that that is possible and seeing what we are seeing with results and also results on the nonmental health side.
One of the unique things I think that this pilot did was--part of the pilot was to see what happens with the other healthcare issues that people have who have mental health concerns. And what has happened is that they have seen those costs go dramatically down. If you have a behavioral health problem that is being dealt with, you are much more likely to show up to your doctor's appointment. You are much more likely to show up to dialysis. You are much more likely to take the medicine that has been prescribed, whether it was for your mental health situation--and occasionally, that is the best way to deal with mental health--or your other health situations. And so those costs go down.
And even in the immediate healthcare space, we are seeing that States believe they are saving money in the immediate space of healthcare. There has never been any question that in the long run you would save money if you treat mental health like you treat all other health. There has never been any question, whether it is the prison system or law enforcement or your personal income capacity, that all those were good things to do.
I think what we have shown in these early States is that even in the immediate healthcare space, you save as much money or virtually as much money or even more money on the other health costs for the one in five adult Americans--and now big numbers among the younger Americans who have a mental health problem--you save as much space for their other health problems, and one in five adult Americans are going to have a lot of other health problems. It is a pretty big segment of our society.
And I think, Senator Stabenow, seeing what happened there has also been persuasive to States as they are beginning to think about making this part of their permanent program when these pilot projects are over.
Just one final thought, we want to be sure that we are encouraging people to get the healthcare they need. You know, if this system works like it should work, you really never know what you are doing in terms of how you have changed people's lives in the future or the lives of people they might impact.
We don't want to create any stigma here that a resilient, broad-based mental health system that is part of this bill means that you should be hesitant to seek mental health help. You know, if you have a mental health problem, you are more likely to be the victim of a crime than you are the perpetrator of a crime.
But if those problems get out of control--often suicidal thoughts first before you have homicidal thoughts--but if this system works the way it should, who knows what good you have done by just letting people go through their normal lives as contributing citizens with treating their mental health and talking about their mental health.
As Senator Stabenow said, being able to talk about somebody in your family that has a mental health challenge as readily as you talk about somebody in your family that has a cancer challenge or a dialysis trip that they have to make multiple times a week to go somewhere or medicine that they take for something else and talking about this in the context of the good it does in making our society safer should, in no way, be interpreted to mean that people with a mental health concern are unsafe.
But if you don't deal with that problem in the right way at the right time, it has the potential to be unsafe. Most of these shootings we have seen, the shooter goes into that shooting clearly anticipating that they will not come out of that shooting alive either. So it is suicide; it is homicide; it is things that if you dealt with that problem a decade earlier--and maybe in some cases, the specific problem even a week earlier--but if you dealt with it a decade earlier, as people began to see that, you know, We need to get you some help.
Just like if your hearing is going bad or your eyesight is going bad, people say, ``Let's get an appointment and go see what we need to do,'' and anybody can be seen at these certified community behavioral health centers. Anybody can be seen if you are covered by--it is very much based on the federally qualified health center model. If you have insurance that covers this, you can go there. If you have a government program that covers it, you can go there. If you need to pay cash, you can go there on a very affordable sliding scale. But people are seen, and nobody--in our State, at least, and I think this would be the case in all nine of the pilot States--nobody who needs to be seen that day is not seen that day. Nobody who needs to be seen that day is not seen that day.
And nobody who needs to be seen isn't seen pretty quickly as you have time to schedule that appointment. It changes people's lives; it changes communities; it changes the way we talk about mental health.
As Senator Stabenow said on the floor, the last 50 years after President Kennedy signed his last bill into law--now, here we are, almost 60 years after that bill was signed into law taking what would be, so far, the biggest step toward accomplishing what that Community Mental Health Act envisioned.
And Senator Stabenow, I will turn to her for any final comments.