Patrick Kennedy: Part 2 : A Real Mental Health Strategy

Welcome to Why Not Me?
Embracing Autism and Mental Health Worldwide? Hosted by Tony Mantor,
broadcasting from the heart of Music City, USA, Nashville, Tennessee.
Join us as our guests share their raw, powerful stories.
Some will spark laughter, others will move you to tears.
These real life journeys inspire, connect and remind you that
you're never alone. We're igniting a global movement to empower
everyone to make a lasting difference by fostering deep awareness
on wavering acceptance, and profound understanding of autism and mental health.
Tune in, be inspired, and join us in transforming the world, one.
Story at a time.
Time. Hi, I'm Tony Mantor. Welcome to Why Not Me?
Embracing Autism and Mental Health Worldwide. Welcome to our special event,
crafting justice Empowering autism and mental health through legislation. Yesterday's
conversation was so engaging and packed with so many topics
that we just did not have time to cover them all.
He's graciously given us his time to come back today.
Joining us today is Patrick Kennedy, former US Congressman and
passionate advocate for mental health reform with a legacy of
groundbreaking legislation, including the Mental Health Parity and Addiction Equity Act.
He has reshaped how we address mental health and addiction
in America. He joins US as he shares his personal journey,
the challenges of pushing for systemic change, and why mental
health advocacy is more critical now than ever. It's great
to have you here for the second straight day. I
really appreciate you taking the time. So let's jump into this.
Given your work with the Kennedy Form to advance integrated
care models, what specific policies can Congress prioritize, do better
coordinate mental health services with primary care, especially for underserved communities.
We need to have the strategy. Sounds obvious, but we
don't have a strategy. We don't have a blueprint. You're
gonna build a hash you gonna have the blueprint. Then
you gotta know what your materials are. We're just buying
materials haphazardly. How many housing units do we need? I
don't know how many housing units? Well what's your challenge? Well,
we don't know. And by the way, if you did
have enough housing us, how much money could that save
you on law enforcement and all the costs that are
encouraged from over hospitalization and overincarceration.
Well I don't know.
Well how many medical clinicians, Well I don't know. My
point is is that we don't have the strategy. We
haven't said, okay, we have this challenge. Because we have
this challenge, people are going to need these things. If
they don't get these things in a coordinated way, we
know the costs are going to be. These costs because
if we're not creating that three leged stool, and we're
only buying two legs of the stool and it keeps
falling over, we're going to be wasting a lot of
money without getting the effect of the combined three legs
of the stool. And so if you don't have the strategy,
you're never going to be able to implement effectively a
way to address the challenge that people are having in
America where they're living. So many are living on the
streets and locked up in jail, are isolated and miserable
and suffering in their own homes and their families.
So what do we do. What's the answer.
Here's the problem, here's the cost to that problem. If
we took that cost and we appropriated what we're spending
already to better approach this problem. What could we get
We could dramatically address this problem if we knew we
were spending things in the way that would mitigate costs
by actually spending on things that would benefit the people
and in turn reduce the costs. Again, it all comes
back to aligning the financial incentives of the system. In
that way, you wouldn't have to micro manage all of
the proposals in Congress saying oh, you need.
To do this, and you need to do this, and
you need to do this. No.
No, the system will do all the things that it
needs to do if it's in its own self interest
to do it. And so we need to do is
create the financial models for it to be in its
own self interest to do the things that it needs
to do. And the way we do that is not
silo budgets, because that way, the housing person couldn't care
less for the fact that if they don't have enough
supportive housing, all those people who could benefit from supportive
out how and not end up in jail because they
had it and the right kind of clinical supports around it,
they would have eyes on that they would know, oh line,
part of the strategy what does HUD need to do
to comply with the presidential strategy to reduce the number
of Americans living in the streets, in jail and hospital ers.
And so forth. We know what to do, We know
what to do.
We just have not tasked each of the federal agencies
to do what they need to do to take their
mission and appropriate that mission to addressing the national mission.
Okay, you wrote a book.
It emphasizes reducing stigma around mental health and addiction. How
can future legislation build on this to promote mental health
literacy and early intervention, especially in schools and workplaces.
So I think that clearly the current system restigmatizes people
because if you go to go down the hall, the
proverbial hall, to get your mental health as opposed to
having a part of your overall health care, you start
to think, well, what's wrong with getting healthcare for your brain?
Like why is that so underpaid, why is it so difficult,
and why is it part of the rest of my
medical chart?
And it's not.
So you can do all of the trying to change
social attitudes, but the best way to change social attitudes
is to change the norms so that people don't think twice.
You know, they're not just checked for their scoliosis. They're
checked for their hearing and their eyesight. When they go
to school, they're checked for learning challenges. They're checked for
kind of emotional and mental health challenges. You know, just
the facts, you know, not making any judgment on people.
We're all going to have a very continuum of various challenges.
Let's start with that supposition. And then we're not going
to be all self conscious. So I don't want you know,
I've got some differentiated diagnosis that makes me look like
I'm different. That's where we change things. You can't just
change attitudes but not change the structure of the system
that creates the attitudes that we're trying to change.
Right now, the latest thing is telehealth and digital mental
health platforms. What legislative measures do you believe are necessary
to ensure these tools are accessible and effectively integrated into
existing mental health care systems.
Well, we clearly need to address the youth mental health
problem that's going upstream. We can't just treat our way
out of the challenges we have on a public health level.
The number of people with severe mental illness, with severe
suicide ideation, with severe addiction, if we don't go upstream
and mitigate and minimize the enormity of the size of
the increase in all of these and so it all
is grows upstreams. Prevention and pre emption of illnesses is
the model for all the rest of the physical health system,
So why shouldn't it be true with brain illnesses?
And the fact of the matter is we could go upstream.
And in the area of telehealth, we know that you
go where the kids are, where the kids' schools, that's
where you reach everybody. Of course, there's home schooling you
have to deal with, but you could deal.
With that too.
The issue is how do we change the makeup of
what we understand to be education, because no one can
learn if you know kind of their migdalists are fire
and they're traumatized, and they come from families that have
these problems distracting. Then you need to start the very
earliest stages to educate on brain literacy, how people can
learn how to mediate their thoughts, their feelings and hence
their actions, and so that they can get the tools,
the coping mechanisms, tools, the problem solving tools, you know,
as I said, in a graduated way, with greater skill
sets as people move on, just like they would throughout
their numerous journey from addition to you know, multiplication to
geometry to you know, with English, with language, with history,
you know, you just it's.
The same with this.
We need to just graduate people up so that they're
very have a lot of agency, because what's the point
of education to create the opportunity for people to take
those skills and deploy them in a world which they
will be able to succeed and navigating. They can't do
that today if they're missing the set of skills. So
we first have to embed this in terms of our education.
And two, while people are struggling, we have to bring
them the therapy that works, and kind of behavioral therapy
works if it's targeted for the types of diagnoses that
each kind of behavioral therapy has been shown to be
effective on. So that needs to be delivered and telehealth
can do that.
What have been the issue in getting this going stronger?
Problem is obviously it's all about word to pay for it. Again,
we need to recognize that an ounce of prevention is
worth a pound of cure. If we took all the
dollars that we're going to spend in the future because
we haven't addressed kids challenges now where it can be
a lot more effective through preemption and prevention, we're going to.
End up spending down the line.
We got to make again make sense of that mathematical
paradigm so as it would justify that intervention earlier on.
And frankly, we could in the meantime fight to make
sure that all payers reimburse for this in schools. But
right now, schools in most states are not designated as
side of service for the healthcare delivery system.
But the schools are where the kids are.
You don't want to have to wait for their parents
after they pick them up to drive them across town
to some clinic. Why not change what we define as
the school nurse's office. Have therapists, by the way, who
are not having to be just from that state because
that's where the clinical licensure is. We ought to have
much broader licensure so that if it's telehealth, whether the
therapist who's perfect for that patient's particular diagnosis and delivers
the best care cog of behavioral therapy before that, whether
they're from Massachusetts or California, who cares? We need to
know at nine am at ten thirty am on Tuesdays
can they deliver this in this school and there's a need.
For a child to get that care?
You know, why should we forego that based on some
bureaucratic state licensure barrier when in fact, all the clinicians
out there have more than enough work to have to
be battling over whether someone from out of state gets
to take their job.
Guess what, we're barely scratching the service of the need
out there.
So if we're fighting over who gets to take care
of a population that is one hundred times bigger than
we could ever take.
Care of, that just makes so much sense. What do
we do?
The insanity of the current system is breath taking. We
need to change a lot of things to facilitate the
delivery in an effective and universal way in telehealth to
the country. Breaking down these very obtuse, antiquated licensure barriers
was one thing in the payment that goes with them,
in terms of making sure that therapists can get reimbursed
for the therapy that they're delivering in a way that
attracts the number of therapists we need and that they
deliver that therapy and the evidence form a manner that
is matched with the diagnosis that a child or anyone
else has, and that that venue doesn't necessarily need to
be in the.
Current clinical model.
It could probably be, as they said, in the schools
where the kids are, but we have to change the
kind of regulatory, financial reimbursement infrastructure to facilitate that to happen.
That's why the Alignment for Progress through the Kennedy Forum
has mapped out, you know, a very comprehensive but lengthy
strategy to solve this global problem. You've got to tackle
it from another different perspectives, as they say, you know,
how do you eat an elephant, and it's one bite
at a time. You've got to tackle different pieces of
this and you can do it all concurrently. But everyone
needs to know their role and they all need to
know that there's a global goal and vision that goes
back to our ninety ninety ninety by twenty thirty three.
Okay, So in closing, we've touched on several subjects here
and it's just a tip of the iceberg. What do
you think that the listeners need to hear that is
very important that we might not have touched upon today.
Well, I think that again, the basic thing is we're
faced with lack of human connection. It's a phenomenon that
stretches the whole age span. We are isolated, you know,
by technology. Then of course we're isolated by all hosts
of other kind of embedded kind of bureaucratic approaches in
our communities. And of course we've gradually retracted from the
institutions that used to connect us to one another in
the past, and so now makes it so easy to
just shop online to you know, do this in this
small cohort of people, to you know, not engaged in
a community the way society is to be built around,
you know, organized religion or you know these social clubs,
these fraternal groups, these community organizations and workplace where people
are now remote as well. In other words, we have
just basically undermined one of the principal kind of foundation
blocks for our all collective mental health, which is the
social connection. So we have to come up with a
way to build that social connection in an environment which
no longer supports social connections.
So what does that agenda look like we need to
do that.
We need to also understand that AI, Well, it's going
to be a huge value, as I said, to delivering
personalized medicine to each person, especially in the field of
idd SMI s U D is that we can get
a lot more specific to dress your particular set of challenges,
which is there's a heterogen at eight to all of
these illnesses. There's overlapping characteristics, and so you can't just
pigeon old people into these bigger buckets when we're all
in a spectrum.
Yes, I totally agree.
You need personalized approaches.
It's not a one size fits all, and AI will
give us that personalized approach.
But here are the things to be cautious about.
And that is in the wrong way, AI could really
divert us from doing things that are in our own
personal and collective self interest. Obviously, we're influenced by all
of the environment, and of course if we're spending all
of our time on technology and all these other devices
embedded with AI, it's not going to be long before
the continued kind of isolation and potential fragmentation is going
to be made even worse than it is today and
we'll be prey to kind of this technological ecosystem which
is going to be calling the shots on how we
think and how we act and what we do, and
if we have seed our autonomy to that, you know,
our agency, because we think we're in charge, but we're not.
We're really being influenced by these outside factors that are
driven by some other interests. That is principally only worried
about us consuming more bad food, consuming more addictive technology,
consuming and buying more of things that are making us
more empty inside. There's just an existential I think challenge
writ large for the world that we're going into right
now with AI, where frankly, we're also going to displace
a big portion of the economy which will no longer
be needed in a world where AI can supplant a
lot of current jobs out there from even the most
educated of our workforce. So that's going to create an
economic destabilization which I think is clearly going to contribute
to a mental health destabilization. So there's a lot that
we have to look forward to, a lot that we
have to be concerned about, cautious about.
What we need to do is be in.
It to try to manage this rather than to sit
back and think it's going to be managed for us.
This requires our involvement and what I mean by that
is not just an the political system, but just in
our lives and be part of the community, and we
all impact in our own spheres of influence, you know,
the way the world shakes out, and we all have
to take responsibility for doing our part.
We don't have to worry that we've got to solve
all the world's poms.
Just try to do our part and be content knowing
that that's all we can do.
And if all of us do.
What we can do, then the world will be so
much better than if we just check out, which I
think is a worry that I have because it's so
overwhelming in terms of the world's challenges that the default
is to hide and that's going to only kind of
exacerbate the current isolation that we all live with.
You know, you brought up a great point there, and
I'm curious to know what your thoughts might be on this.
You brought up the employment situation with many throughout the
country working remotely while only a few are working together.
How do you think this will affect them mentally? The
workplace is a very important part of our mental well
being in this country.
Well, you know, the bottom line is if AI can
totally replace legal advice, if AI can totally replace medical
advice from a doctor, if an AI can make a
better diagnosis than someone who's been through unpteen years of
medical school and so forth.
You know, if.
AI can you know, basically supplan any financial analysts out
there because it can make better decisions on how to
manage your investments.
I mean, there's no end to it.
Like what I'm saying is even people who are software
engineers are going to be put out of business by
AI that they're creating.
So think of that a.
World where literally an enormous section of our current employment
base is going to be rendered obsolete because of AI.
And think about the mental health toll that that will
have on a country, on any human being who has
now lost their sense of purpose, which for many is
tied to their ability to provide for themselves and their
family and have a contributing role to make in society.
So we're going to have to evolve what are the
jobs of.
The future, what do we expect, and then we have
to train for those jobs so people don't get displaced,
And then we have you know, a third of our
population unemployed and not have you know, something that builds
productivity and helps solve the challenges that now AI can solve.
So that's a lot of change, and change involves stress
and the level of change.
Hence the level of stress.
Is going to be enormous, and that's going to put
enormous tests on everybody's ability to manage and cope with
that change and stress. So it's not too much to
say that a big mental health challenge is going to
be directly related to the economic challenges that are going
to come as a result of the technological changes that
are going to be wrought as a result of AI.
Yes, I see AI taking over and becoming very big.
Just in what I do here in the music field
in Nashville. It's kind of a sad situation, even though
there are good parts to it. But on the flip side,
in the music field and I'm sure other things as well,
it takes a tremendous amount of creativity out of the
building process of a song.
Whatever we do, we need to focus on our ability
to manage in an ever more stress full and toxic world,
which is politically but you know, disparities and wealth and income.
There's just going to be so many structural.
Challenges, and we're going to need to build resilience in
our people to manage, survive, and thrive. And we're not
going to have the wherewithal to use our brains to
think creatively and imagine possibilities for new ways of coexisting
and living and surviving if we're locked in our a
makedala as opposed to being able to operate in our
prefrontal cortex.
So it, at the end of the.
Day, a lot of our national security challenges, technological challenges,
creative challenges all rest on our ability to mediate those
challenges by having healthy brains that can cope and manage stress. So,
at the end of the day, mental health is going
to be a key aspect in any solution for going forward.
Absolutely, I truly believe that we are on the same
page on that subject. Well, this has been great, incredible conversation,
insightful information. It's been a true pleasure. Thanks so much
for joining us for these two fantastic episodes. Your time
and perspective have truly made this a very special episode.
Listen, Tony, thank you for giving me the opportunity and
now as a former politician, I need some platform. You're
giving me the platform Thank you so much, Tony, It's.
Been my pleasure.
Thanks again, thanks for taking time out of your busy
schedule to listen to our show today. We hope you
enjoyed it as much as we enjoyed bringing it to you.
If you know someone who has a story to share,
tell them to contact us at why notmt World.
One last thing, spread the word about why
Not me, our conversations, our inspiring guests that show you
are not alone in this world.