Q: Do you follow local politics in Brigantine and the slew of controversies, from the budget deficit to the golf course?
A: No, right. I look forward to getting into the hometown politics as we move forward. Harper (my stepdaughter) will be starting pre-K, and we really appreciate Brigantine's got a pre-K. We also are looking forward to having both Harper and then Owen in the school system in Brigantine, and now our new little one coming up. ... We've been by the local school on many occasions, and we go to the Community Center for storybook hour.
Q: You seem to be a local figure around town. For instance, my tax preparer sees you out running every now and then.
A: Yesterday, I was running and saw (Mayor) Phil Guenther on the north point of the island. I didn't know where exactly he lived, but now I do. That's just being part of a community. You start to get involved, get to know your surroundings and people get to know you. It's a nice, small community.
Q: Your house has been under construction for a while. Are you moving in soon?
A: We hope to move in in plenty of time for the baby. We are anticipating some time by end of October.
Q: I hear congratulations are in order.
A: Yes, (due) this Thanksgiving. It's a girl.
Q: So there may be another Democrat in Brigantine?
A: There you go. That got a lot of laughs, but keep in mind I think it was an omen. As you know, once (my son) Owen was born and he came over to Brigantine, the town flipped and went Democratic in that next election cycle. I don't think it's an accident.
Q: How did you and your neighbors fare in Hurricane Sandy?
A: We'd just torn down the house that had been there originally. It had been 100 years old. We'd attempted to refurbish it ... and the carpenters, who were also friends of my wife, said, "We can't do this job ... it needs to be torn down."
The irony was we took it down within a month of Sandy hitting, and we took it down before Sandy, if you can get where I'm going here. Everybody was bemoaning, "We wished we had insurance cover our house getting destroyed." We were like: "No, we wish Sandy had worked its magic on our house because we had to take it down anyway."
We'd already just started to lay the foundation for the new house, so even at that point we couldn't restart. So, we're hoping the previous zoning regs and height requirements were sufficient to stand us in good stead for the next hurricane. I thought our new house was way high. Now, I'm starting to realize, it could've been put up even higher.
Q: Most of your time is taken up with advocacy for mental health issues. What is mental health parity, and how does that compare with what we have in place now?
A: I got to be the primary sponsor of the legislation known as the Mental Health Parity and Addiction Equity Act that was passed in 2008. When I first got to Congress, I was the youngest member at 27. It's not ordinary that you have really freshman members of Congress - when they're lowest men on the totem pole - get to be the sponsors of major pieces of legislation. That's indicative of (what the) stigma was and still is. No one wanted "mental health" and "addiction" in the same sentence as their name.
I only say that as an illustration that the biggest challenge we have is implementing health care that includes coverage for mental health and addiction services. There's a general unease and reluctance to treat everything that has to do with the brain like everything else with physical health care. My legislation was simple. We ought to treat the brain like every other organ in the body. So if insurance covers in-network, out-of-network ... pharmacy benefits and emergency room services (for physical ailments), then you need to cover all of those services for schizophrenia, for bipolar disorder, for addiction.
We know this is a physical illness. We know who is at highest risk. But our whole country and our medical system does nothing to treat these illnesses like we would any other physical health issue. The consequences are we have people who not only get sick because there's no prevention, but get sicker because there's no treatment.
I have asthma, (and) I get treated for my asthma. I have medications. I have inhalers. I know not to be around animals that may provoke an asthma attack. Stress can induce an asthma attack. But I also have another chronic illness, and that's addiction. But I get no supportive care for that illness even though that illness is just as physical, is just as chronic and, frankly, is just as if not more deadly. Thirty-six thousand people commit suicide every year, and that's an undercount. That's not to add all the others who die and there's no known cause.
Q: And also the illnesses that are secondary, that are related to addiction, such as Hepatitis C.
A: And HIV. Exactly. When you're not healthy mentally, your cardiovascular disease gets worse. You'll probably get lung cancer because you're addicted to a cigarette because you used nicotine to help self-medicate for the underlying mental illness. The ripple effect of being untreated for your mental illness spills over.
And diabetes. I mean, come on. Do you think we're going to treat diabetes when someone's still an active alcoholic? And yet our medical system will reimburse for the diabetes but it won't reimburse for the alcoholism. We're in the year 2013, and it's still this way.
It's shocking to me, especially when you consider our returning veterans, our heroes from Iraq and Afghanistan, they suffered what's known as the, quote, invisible wounds of war. ... Because we have no mental health and addiction services that are part of routine care, many of our veterans are now ending up dead because of suicide, at record numbers. Eighteen veterans take their own lives a day. Or they're incarcerated, like many others who are untreated for their mental illness, because the only way we know how to treat these illnesses in our society today is to lock people up. That's a tragic state of affairs.
Q: Your legislation passed in 2008. What's happened since then?
A: We're five years after the passage of the (parity legislation) and we still don't have the implementing rule that will define how insurance companies must comply with the law that the Congress passed and President George (W.) Bush signed into law. We're still in a state of flux.
Here we have the anniversary of President (John F.) Kennedy signing the original big mental health bill, the Mental Health Community Services Act. That was enacted 50 years ago this October. Guess what my hunch is? My hunch is the White House is going to release the rule sometime in October. How ironic (that) 50 years after my uncle signs the most sweeping mental health bill of that time, we're going to mark the 50th anniversary at a time when we'll be marking the most sweeping mental health reform of our time. ... Even though President Kennedy had the right vision, we never implemented his vision. So a lot of people fell through the cracks. So I'm going to host the anniversary of this signing he had (with the Kennedy Forum on Oct. 23) and say let's not repeat the mistakes of 50 years ago.
Now is our chance.
Q: You're optimistic that the rules will be in place this fall, but historically it has been a very difficult road to travel. You've seen it yourself. What needs to happen to make mental health parity not only a priority, but a reality?
A: We need advocacy. This is where my old hat as a politician comes in. We can have all the best intentions and we can have what we know needs to be done, but that doesn't mean it will happen. In mental health, the problem is we're so shamed by our illness that we're not often apt to go out and hold up signs saying, "I have a mental illness and I demand justice." Who do you know who's going to put their hands up? Look at the AIDS movement. AIDS was deadly ... and finally people stood up and said we're not going to tolerate this. "Silence equals death." The AIDS movement did it; we've changed the whole treatment trajectory for AIDS thanks to the people who stood up and were advocates. In mental health, we need the same thing.
Q: How do you change attitudes when, for instance, a big aspect of treatment is anonymity?
A: Well, it's changing. I am also in a 12-step group but it's all right for me to say I'm in 12-step recovery so long as I maintain the anonymity of what 12-step recovery I'm in. It's also important that I'm a citizen. Part of my recovery requires me to help those who, like myself, suffer from this disease. So what do I do? Not only do I try to be of help within my 12-step recovery, but I also need to make sure my elected officials and representatives spend the same resources on this that they do on cancer. All this is about is equality.
What do I think will be the catalyst to change all this? Our veterans. Our country cannot sit on its hands and wait while our veterans die because of the invisible wounds of war.
Q: Do you think veterans will be more likely to persuade lawmakers because they're better organized or that no congressman wants to be seen going against them?
A: I think those are all factors, but let's be frank. People who have mental illness or addiction are not the most celebrated lot. They're not the most popular group in our society. It's easy to say no to them and dismiss them because they don't manifest their illness in a very sympathetic way.
Our veterans, everyone knows about. Even though they're affected in the same way as everyone else - they are self-medicating, they're getting involved in self-destructive behavior. ... Not only are the veterans more of a popular, sympathetic group, but their experience helps people overcome their prejudice in general toward these issues.
Q: What work is being done by One Mind for Research, which you co-founded in 2011?
A: We're in the midst of launching major initiatives as we speak with the (National Football League), with the National Institutes for Neurological Disorders (and Stroke), with the Wounded Warrior foundation. Our aim is to unite everybody who's interested in the same organ, the brain, in a way that unifies their efforts.
We don't have enough money, unfortunately, to do this brain research. But maybe if we share a little of what I know about Parkinson's, a little bit you know in Alzheimer's, and you know in brain disorders, we all come out winners.
Q: What was your first exposure to mental health issues?
A: It was part of my life from a lot of different perspectives. First of all, we have this giant in my family, my aunt Eunice (Kennedy Shriver), who started Special Olympics. We all went to Special Olympics events. And my dad and my aunt Rosemary came and visited us all the time, so I was very sensitized to that. I was also sensitized to the fact that my mother at the time was suffering from profound depression and she self-medicated and was an acknowledged alcoholic back in the '70s. Talk about stigma; it was even worse back then. In my family, even though we like to think of ourselves as enlightened and progressive, the fact of the matter was we didn't talk about it. Here was my mother suffering in our midst and no one said a word.
My dad was suffering. He had seen his brothers violently murdered. He had enormous trauma he suffered from and no one talked about it. No one bothered to help him. And he thought it was something wrong with him as opposed to ... something that needed to be addressed. Because the stigma was so great, he thought it would mean people would think less of him if he sought treatment. It was shocking, but we lived in the cone of silence.
Then those genetic and environmental risk factors passed on to me. I was determined not to have, quote, these problems. I kept fighting to keep them at bay because that's how I relate to these issues, to treat them as some marginal issue I can keep controlled. But here I am, a member of Congress, supporting mental health parity while also active in my own addiction. And not wanting to get treatment because I worried what people would think if I went to treatment. You can't make this stuff up.
I went to treatment on a number of different occasions, but after the most notable incident where I was arrested for driving under the influence (in 2006), I went to treatment. When I came back, a lot of my colleagues shared with me their own stories. (In the next election) I felt for sure I'd be thrown out of office. I was re-elected, with my biggest numbers ever, and it was the following legislative session ... that we passed (the parity legislation).
I could never have thought in my worst days that this would follow in any grander design. ... I just try to ... let myself do the next right thing, because it's personal. It's my family, but it's also my political legacy in Congress (that's) wrapped up in this mental health work.
Q: Do you think you would've become one of the lead mental health advocates had it not been for that experience?
A: Well, I already was. The reason I got the support of my constituents after my self-destructive, humiliating experience getting arrested was because I was already known to be a champion for this. I'd already been talking about (it) for years. There's a lot of politicians who all of a sudden come to an issue after it's big news for them and they kind of remake themselves.
Q: How would insurance companies benefit from parity?
A: The actuaries tell us if we provide mental health and addiction services, it's going to save us from that person being back in AtlantiCare a dozen times this month because they've been tripping and falling down stairs, they've been in fights and traffic accidents. The litany goes on and on. I'd like to see the day where instead of us having to make our own case, the numbers speak for themselves. Better well-being means we don't have to use as many medical services.
Q: Beyond the insurance companies and the politics, what other practical roadblocks exist to mental health parity?
A: Because we feel so stigmatized, we require higher privacy standards in information technology so that if I go to treatment, that's a fact that the rest of my (medical) chart cannot reveal. ... If people find out I was in a mental health ward, I may lose my job. I may lose the respect and esteem of my friends and colleagues. So we've erected all these privacy barriers.
Here's the problem: In protecting ourselves .... we end up jeopardizing ourselves. Let's say I'm a recovering addict, which I am. I have a high tolerance to opioids because I was really addicted to Oxycontin. Let's say I get wheeled in to AtlantiCare in another couple months and no one knows that I am someone who's a recovering addict. If they put me under and the anesthesiologist doesn't know the way my brain works, I'm a dead man walking. That could totally cost me my life.
That's going to be our biggest challenge in the mental health community. We need to get over our own alienating stigma.
A: We see this stigma here in Atlantic City. There's a push to move social services out of the Tourism District. What are your thoughts about that?
The notion that by moving John Brooks (Recovery Center) and the Rescue Mission out of the community you're somehow going to eliminate the problem - that's folly.
On paper, it means there won't be a line of people waiting around the corner for their medication. There won't be a bunch of folks congregating in a particular place for any social services that will be an eyesore to the economic interests of Atlantic City. Well, it's not as if they're going to go away. Now you have to worry about where they're going to go if you don't provide the services and what the consequences will be.
If it's not in Atlantic City's interest to have a bunch of people panhandling in front the casinos, I get it, but come up with a plan that's realistic. Thinking they're going to take a bus from Atlantic City to Egg Harbor Township is, on its face, ludicrous.
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Patrick Kennedy, 46
Lives in: Brigantine
Born: Brighton, Mass.
Family: Wife Amy, stepdaughter Harper, son Owen
Education: Providence College, bachelor's degree in social science
Professional background: U.S. representative, Rhode Island's 1st District, 1995-2011; senior adviser, American Psychiatric Association and Marwood Group; co-founder, One Mind for Research