I have seen serious mental illness and its impact on lives and families firsthand. And I’ve worked directly in this field with many of you for the past two decades. I bring great personal passion—as well as empathy—to this discussion.
As Prepared for Delivery
Good afternoon, everyone.
I’m so glad to be here in attendance at this historic meeting.
I believe no administration has ever held a White House meeting that puts such a clear, intentional focus on one of the most neglected aspects of our healthcare system: how we care for Americans with serious mental illness.
So I’d like to begin by thanking all of you for being here today, whether you’re an advocate, a policymaker, a public health professional, a healthcare provider, a law enforcement officer, or involved in this issue in some other way.
Most of all, I want to thank everyone present who is here because someone in your lives has struggled with serious mental illness.
I have seen serious mental illness and its impact on lives and families firsthand. And I’ve worked directly in this field with many of you for the past two decades. I bring great personal passion—as well as empathy—to this discussion.
So thank you for being here, thank you for being advocates, and thank you for the work you do every day for the people you love.
President Trump has a clear vision for our healthcare system: a healthcare system that’s affordable, personalized, puts you in control, and treats you like a person, not a number.
He has promised a system that protects vulnerable patients, and provides you with the affordability you need, the options and control you want, and the quality you deserve.
Too often, our healthcare system doesn’t look like that—and no one knows it better than Americans experiencing serious mental illness, their families, and their friends.
To get us where we need to go on healthcare, the President has promised to protect what works and fix what’s broken.
There is no question, sadly, that the way we support and treat Americans with serious mental illness is broken.
According to SAMHSA data, more than 11 million Americans had a serious mental illness in 2018. A third of them received no treatment in the past year. One third.
Just imagine if one third of Americans with cancer, or heart disease, or diabetes, received no treatment for those illnesses in a given year. We would recognize it as a national failure, which is precisely what we have had for too long on serious mental illness.
Americans with serious mental illness die somewhere between 15 and 20 years younger than other Americans.
One in 25 of these individuals will die by suicide.
About ten times more Americans with serious mental illness, about 400,000 at any given time, are in jail or prison than are in inpatient psychiatric facilities.
These are major challenges to overcome, which is why I am glad to work for a President and an administration that are more focused on serious mental illness than any previous administration.
That is true all across HHS, and especially at the Substance Abuse and Mental Health Services Administration.
From Day One, Assistant Secretary McCance-Katz has made it clear that SAMHSA should focus on promoting scientifically sound, truly evidence-based treatment for serious mental illness.
That’s shone through in how we’ve improved and expanded SAMHSA’s training programs, which we have increasingly focused on promoting effective approaches and providing communities with expertise on the ground.
We’re also supporting treatment through our payment policies.
Last November, I announced a historic new opportunity for states to support inpatient treatment through the Medicaid program, by applying for waivers around the IMD exclusion.
We’ve now approved two such demonstration projects, for D.C. and Vermont.
In addition, today, we announced awardees for a Medicaid innovation model called Integrated Care for Kids, or InCK.
We know that providing the right services and treatment when kids begin to show signs of mental health challenges is essential to preventing those problems from getting worse.
The InCK model will support care coordination for kids so that, when mental health challenges arise, there is a full set of crisis services available to address their needs, support their families, and tackle the problems early on.
On top of that, we issued an advisory this year to help states understand how Medicaid reimbursement can support school-based mental health services.
We’re also looking at how we can clarify and reform privacy regulations, so that families have the information they need to help loved ones dealing with serious mental illness.
Today, in conjunction with the Department of Education, HHS’s Office for Civil Rights rolled out an updated resource for school administrators and healthcare providers that provides clear explanations and examples of when students’ health information can be shared under HIPAA and FERPA, the federal student privacy statute.
As part of a broader regulatory reform effort, HHS is currently examining how HIPAA can be modified to improve coordination of care for all patients, including those with serious mental illness.
HHS’s Center for Faith and Opportunity Initiatives is working with partners, including many of you here today, to engage more with faith leaders, in partnership with clinical providers, on providing community support for those with mental illness and their families.
These are just some ways we’re getting started, and I’m excited about where we’re headed.
The appropriations legislation moving through Congress this week makes substantial investments in the priorities I’ve just discussed.
That includes a $31 million boost in funding for SAMHSA’s Project AWARE.
Project AWARE supports infrastructure and training for school staff around mental health awareness and ways they can assist children who may need services. It also supports direct services, for addressing mental health challenges and promoting positive environments within schools.
Further, the appropriations legislation increases SAMHSA’s funding for Assisted Outpatient Treatment, or AOT, a highly effective method of court-ordered treatment.
I want to underscore why we believe interventions like AOT are so important.
There is nothing compassionate about letting individuals with serious mental illness suffer from lack of food or housing because their illness prevents them from making rational decisions.
There is nothing compassionate about letting individuals suffer from symptoms that can cause them to be arrested, and often incarcerated, where they will not get the care and services they really need.
When Americans with serious mental illness are in crisis, we need to ensure they are connected to psychiatric care and community supports.
In some cases, that requires legal interventions and assertive forms of treatment.
President Trump has rightly recognized that, in the name of autonomy, we have gone too far in gutting the ability of families and communities to help individuals in crisis.
We have the tools we need to help individuals with serious mental illness live healthy, fulfilling lives. We need to use those tools.
Stripping communities of the ability to provide treatment when needed has had devastating consequences, so tragically visible on our streets and in our prisons. We must do better, and we will.
Finally, I’ll underscore that we’re supporting research on new tools for treating mental illness.
We’ve made it a priority to support research on effective interventions around serious mental illness and suicide at NIH.
And in March, FDA approved the first new drug for major depression in decades, which received Fast Track and Breakthrough designations.
All of these are encouraging data points—and the occasion of this summit is just one more encouraging data point on top of all that.
As I said to start, our country faces huge challenges around mental illness.
But together with all of you—working with families, with state and local governments, with healthcare providers, with educators, with faith leaders, and with law enforcement—we can build a better system, a system that provides all Americans living with serious mental illness with the kind of evidence-based treatment that we would expect for any other health condition.
When we provide that kind of treatment, Americans with serious mental illness can enjoy lives just as rich, long, and fulfilling as anyone else—and that will be a tribute to the work of all of you in this room.
So thank you again for being here today, and I look forward to some further discussion.
