Speeches & Floor Statements

Opening Statement: Alexander: Early Intervention in Mental Health is Critical

Posted on December 13, 2017

Sean Lester is, by all accounts, a typical, busy, Nashville young adult with a full-time job who also attends college.

In June 2014, two days before his 25th birthday, he experienced his first schizophrenic experience. Since then, Sean has been admitted to the Vanderbilt Psychiatric Hospital five times, spending ten weeks receiving psychiatric treatment.

Sean wrote me, saying, “This may seem slightly depressing, but my story does not end there. The doctors and staff I encountered at the hospital and at the Centerstone clinic taught me to live productively again in society. I have been free of the hospital for a whole year now. During that time, I have taken medication, returned to work, and even paid off a car! I am currently enrolled at Tennessee State University as a Junior pursuing a degree in Psychology.”

Sean is one person out of nearly 10 million in the United States with a serious mental health condition.

Without this treatment, his story could have had a very different outcome.

In Tennessee, about one in five adults have a mental illness, according to the Tennessee Department of Mental Health and Substance Abuse. That is more than a million Tennesseans, and over 230,000 of them have what is considered a serious mental illness.

Over the past few years, this Committee has worked in a bipartisan way to update parts of the federal mental health system – including programs at the Substance Abuse and Mental Health Services Administration (SAMHSA) – for the first time in over a decade.

As I said at the beginning, this effort was championed by Senators Cassidy and Murphy, as well as Senator Collins and other members of this committee.

The reforms were part of the Mental Health Reform Act, which passed this Committee on March 16, 2016, and were included in the 21st Century Cures Act, which Majority Leader McConnell called “the most important legislation” Congress passed last year.

Today marks the third hearing on the implementation of Cures.

We hope the updates in this law will help more Americans access quality, evidence-based mental health care.

As I said when we began hearings on the Every Student Succeeds Act, a law is not worth the paper it’s printed on if it is not implemented properly, and I intend to ensure that the 21st Century Cures Act is fully and properly implemented as well.

Our focus today is to hear how SAMHSA is implementing the mental health provisions in Cures.

About 10 million Americans have a serious mental illness, which includes severe schizophrenia, bipolar disorder, and major depression, yet millions go without treatment as families struggle to find care for loved ones.

Most of the services and treatments for people with mental illness are provided by the private sector, like Vanderbilt, or through programs run by the states.

The largest role the federal government plays is the amount of money spent through Medicaid, in partnership with the states.

The federal government also plays a role through SAMHSA, which, while relatively small compared to Medicaid and the responsibility States have, is critically important to improving the availability and quality of prevention screenings, early intervention and treatment programs, and recovery services.

Tennessee received over $80 million in SAMHSA grants last year.

Prior to our work on Cures, federal mental health programs had not been updated in over a decade and the coordination between federal agencies was not as effective as it could have been.

I hope today we will learn how implementation of these provisions is going:

How has coordination improved between federal agencies on the best ways to assist those with mental illness?

For example, we hoped that promising research into early intervention programs at the National Institutes of Health would translate into clinical applications for patients.

We also included updates to the SAMSHA block grants to states, to ensure the funding is best meeting the needs of those suffering from mental illness.

In addition, to improve the care patients receive, we encouraged the adoption of proven, scientific approaches to treatment, and so I would also like to hear how the agency has started to incorporate more evidence-based approaches for treating mental health.

We also hoped the reforms would help increase integration between primary care and mental health care, ensure that insurance coverage for mental health disorders is comparable to insurance coverage for other medical conditions, and strengthen suicide prevention efforts.

Dr. McCance-Katz, our witness today, serves as the first Assistant Secretary for Mental Health and Substance Use – a position we created in the 21st Century Cures Act. She has new authorities through Cures to work with states and federal agencies and to help more Americans receive the treatment they need.

I look forward to hearing about the progress being made to ensure more people can receive the help they need and have positive outcomes like Sean.