Follow along with the transcript below for episode: Changing the Conversation on Mental Illness with Patrick J. Kennedy
[INTRODUCTION]
[00:00:02] PF: Thank you for joining us for episode 469 of Live Happy Now. May is Mental Health Awareness Month, and today’s guest reminds us that we can’t just be aware of the problem. We need to take action.
I’m your host, Paula Felps. This week, I’m joined by mental health advocate Patrick J. Kennedy, whose new book, Profiles in Mental Health Courage, shares the dramatic stories of people who are living with mental illness. Because of his own challenges with mental illness and addiction, the former congressman is on a mission to change how we view mental illness in this country and, importantly, change the way we treat it. His bold plan for the future of mental health includes bipartisan action to identify, treat, and manage conditions earlier to enrich the lives of all those affected. Let’s have a listen.
[INTERVIEW]
[00:00:54] PF: Patrick, thank you for joining me on Live Happy Now.
[00:00:56] PK: Paula, it’s good to be with you.
[00:00:58] PF: Well, this is Mental Health Awareness Month, a fantastic time to talk to you. I’m so impressed because you have been very open with your own mental health and addiction struggles. So I wondered what led you to initially disclose all that.
[00:01:12] PK: Well, I didn’t really have a choice. Being a Kennedy and in the public eye, I tried to keep my addiction secret as all of us try to do because of the shame and stigma. But I had a roommate in drug rehab who sold his story of being in rehab with me, with a Kennedy, back when I was starting my political career. Of course, I thought my political career would be short-lived after that disclosure. But I was fortunate to represent a district in Rhode Island. My constituency, the only thing they disliked more than drug addicts were people who ratted on drug addicts.
I survived that election, and then I went on to Congress. Because I had been outed, I was able to put my name on mental health bills, whereas my colleagues might have been more reticent because it was already out. I wasn’t afraid like most of my colleagues would have been to be asked, “Well, why is this something you’re signing on to? Does it perhaps maybe – do you have a mental illness or addiction?” Of course, most of my political colleagues don’t want to go down that rabbit hole. But I had already been out it, so it was less of a risk for me, obviously.
[00:02:30] PF: Being part of such a high-profile family, obviously, that was why your roommate from rehab wanted to sell the story because it had a net worth to it. But what was that like then for the extended family? Because most families – I’m not a scientist. I won’t say all, but I would say most families have an issue of mental illness and addiction somewhere in their family. But they work very hard to keep that quiet. For it to come out in such a public family, how did that play out?
[00:03:00] PK: Well, power of the silence and the stigma is so overwhelming. My family was well-known to suffer from addiction. They say addiction, alcoholism runs in families. In my family, it galloped. It was just serious, and everyone knew it but us. There was – if you went through the Kennedy section of the bookstore, two-thirds of the books would have been covering the various “scandals” that my family, my father, my mother had been through because of a direct result of their alcoholism.
Yes, the problem with me coming out is that it kind of added to that narrative. I felt shamed by it because I grew up with a mother who was shamed because of her alcoholism. I would literally try to hide her when my friends’ parents would come over to pick up my friends from our house. I’d be trying to hide my mother because I didn’t want any of them to see her inebriated in the middle of the day. I used to watch Saturday Night Live, and they’d do skits about my dad. I mean, it was really powerfully painful.
I mean, being open about it now is kind of a way I fight against that shame which still exists. I can’t help but cringe when I have to talk about this to some extent. But I find that it’s therapeutic because this is a brain illness. No one wakes up, Paula, and tries to shame themselves, their family. Put their own physical lives at risk, become potentially at risk for being arrested. People don’t choose to live on the streets. They don’t choose to have untreated mental illness and end up in our criminal justice system. I mean, we still have not turned the corner to really understanding that these “behaviors” of people with brain illnesses are symptoms, and they’re not reflections on a person’s moral character.
Now, being in recovery myself, I have a moral responsibility to do everything I can to keep myself from falling back into addiction. I attend 12-step meetings. I have addiction-certified psychiatrist. I worked the program, as they say. I have a moral obligation because if I drink or drug, I put not only my own life at risk. I put others at risk. I had three DWIs, and I’m – by God’s grace, no one was injured. But I can’t take that chance again and none the least of which I just don’t want to go down that path again. I’m so grateful I have the life that I have today.
[00:05:55] PF: Do you think it’s more impactful because you are in a position of being able to – people will listen to you. You’re in a higher-level position. Do you think it makes it more impactful, your story is more impactful, and that it feels more universal to others if you can be open about it?
[00:06:12] PK: Well, when I came back from one of the DWIs and I had to go to rehab, I was asked to come and meet with so many of my congressional colleagues in Congress who I thought wanted to talk to me about legislation. Of course, I’d show up with my staff because the staff do majority of the work in Congress. My colleagues would always say, “Could you and I just talk?” Then they would tell me their own stories.
[00:06:39] PF: Oh, wow.
[00:06:39] PK: It occurred to me that I was the only person they knew in Congress that has a drug addiction and alcoholism. What was amazing to me is because of the anonymity and the shame of these illnesses, they knew no one else that they were working with who also shared their own illness except for me. I met with colleagues who none of them knew each other had these illnesses, and they would walk around in the halls of Congress not knowing they were walking by someone who had similar life experiences they had and were suffering from similar struggles.
I wrote this Profiles in Mental Health Courage because it’s still a big deal for people to share their stories. As I said, I didn’t choose to do this, but these people who are in my new book, they chose to use their real names and their real stories to try to break the stigma. Unlike a lot of these self-disclosures, these people really told it all. Today, you hear a lot of people say, “Oh, I have a diagnosis,” or, “I’m in recovery.” But they don’t really describe what it’s like to live with these illnesses. Yet in this book, these 12 people really tell their full experience. It’s a very diverse group of people who have different illnesses. I hope it’s going to be helpful to people who may think of themselves as being unique and all alone.
In 12-step recovery, we have some big book, and we get to read about others who also like us have had these experiences suffering from alcoholism and addiction. I have found those so comforting reading these stories because then I realized I’m not alone. Yet most Americans don’t often benefit from that experience of being in recovery and having all of those tools easily accessible, especially hearing that they’re not alone and what they’re going through is really quite common. That was kind of the point for me to try to interview these people and have them share their full stories.
[00:08:53] PF: It is so thoughtfully written. One thing that really struck me is how it shows just the universality of mental illness, of addiction. It’s indiscriminate. It can take out anyone from any walk of life, any profession, vocation. How did you identify who to write about? It sounds like it wasn’t very difficult to get them to open up and tell their stories, which was amazing to me because they are so personal.
[00:09:21] PK: They opened up to me because, frankly, I was able to ask them to do it for our country. It’s not me, but I have this great last name. When my uncle challenged the country to ask not what their country could do for them but what they could do for their country, that kind of feeling is alive when I talk to people. They want to be part of something bigger than themselves. I just gave them that opportunity and platform and told them, yes, they were taking a big risk at disclosing their own challenges. But they also felt they had an opportunity to help others.
For those of us in recovery, that is the key to our own recovery is making our own experience worthwhile, so we can try to help someone else. In helping others, we get liberated from our own self-imprisonment and our own self-centered selfish behavior. It’s really the antidote for our illness to speak out and not be shamed and to help others. That’s the way we get freedom from ourselves.
[00:10:35] PF: Do you have an overall goal for the book? I imagine your goals for this book are not measured in sales. I feel like you have such a grand plan for this. What do you hope to see as a result of this book coming?
[00:10:47] PK: Well, thank you, Paula. I started a campaign. It’s not a political campaign for office. It’s a campaign to build a movement for those suffering from mental illness and addiction, which of course, are treated separately in our reimbursement systems. We do not have a system, so to speak, that treats these as biopsychosocial illnesses. Biological because they’re brain-based; psychological because they’re mental health; and social because if people don’t get support of housing, support of employment, they’re just not going to have the same opportunities to succeed in recovery, which of course, we don’t emphasize in the treatment of these illnesses. We only treat them in acute episodic fashion, as opposed to treating them as the chronic illnesses that they are.
I have something called the Alignment for Progress because I believe we have to align financial incentives. We spend tons of money on the criminal justice system, on fire and police, on emergency rooms, on lost days and productivity and disability. I mean, we are spending so much money not taking care of these illnesses that I think if we align the budgets to actually prevent many of these illnesses from pathologizing, i.e. let’s treat these like we do cancer, which is screen for stage one. Not wait till people are at death store and in a stage-four crisis. These are the things that I think we need to build into a national agenda.
When I was in Congress, I could go to any special interest group, and they would tell me. The labor unions would tell me, “This is what is overtime pay. These are health benefits. This is pension and retirement. These are safe working conditions.” They literally have their whole agenda organized. I hate to say it but in mental health and addiction, we do not have a consumer-driven movement like every other patient advocacy movement. We don’t have a common agenda. Everyone is marching up to Capitol Hill with their own diagnosis and bipolar over here and depression over here and anxiety over here and alcoholism over here.
Even alcoholism and opioid use disorder are treated separately in terms of people’s mindset. You could go on and on. The problem is we’re all united on 99% of the same things, and yet we’re not organized like a AFL-CIO or a League of Conservation Voters.
[00:13:21] PF: Why do you think that is? If you look at the sheer volume of people who are suffering from it, you would think that someone else would have thought of this before now and started bringing it together under one umbrella.
[00:13:33] PK: Well, the psychologist can’t convene the psychiatrist and vice versa. The peer support people can’t convene the social workers and marriage counselors. The schizophrenia people want SMI as the priority, which they deserve. Then we need mental wellness, but we don’t really have that covered because that’s not a diagnostic group. That falls into public health category.
My point is no one’s been able to kind of bring them all together. As I said, I was really honored to be the author of the Mental Health Parity and Addiction Equity Act because as I said, I was outed, so I had no choice in the matter. I felt like I could put my name on a bill that had mental and addiction in it because, essentially, I had already been outed. That bill really affects all groups because it calls for reimbursement by insurance companies, including the federal government, for mental illness and addiction in a way that’s no different from other chronic illnesses like asthma and cardiovascular disease and cancer, so forth.
That is a bill that is kind of like a medical version of civil rights. It affects everybody that’s kind of marginalized from these illnesses. Because of that, I have kind of a unique opportunity to kind of pull everyone in together because everyone, whether you’re a psychologist, social worker, peer support specialist psych, you all benefit from this. If you’re an inpatient hospital or an outpatient clinic, they all benefit from ending discrimination in reimbursement and coverage by insurance companies.
I’m the guy that brought that, so I can call these people and basically say to these folks, “This is the new frontier for us. We need to band together and build a voice.” I often say it’s like that Godfather film where they say, “We’re bigger than US steel,” back in the fifties, talking about organized crime. This is the biggest special interest group in this country. If you count all the families affected by overdose, suicide, those living with these illnesses, there’s no doubt everybody’s affected by these illnesses, including the family members who are often left out of the narrative.
If we ever organized, can you imagine the power we would have to transform the system? That’s what I’m after. In the back of the book, I have a QR code which links people to a policy guide. I’m literally trying to get donors to allow us to build literally a movement. Let’s get the number of people that care about this on listserv. If someone’s running for office, they know how many people in their district, whether it’s a state or federal office care about this issue. If we start doing those things, I am telling you we’ll get more than the money we’re getting today, and we’ll get more of the urgency than we’re getting today.
[00:16:47] PF: How are you seeing the attitudes changing? How is that going to affect how it moves forward? Then part three of this question is in what still needs to happen.
[00:16:57] PK: If we normalize this, if we allow people to get screened at every place of their medical system, if they’re a cancer patient, they had better be screened for anxiety and depression and trauma. If they’re having heart disease, they’re four times more likely to die of a heart attack if they have depression. If they are diabetic and they don’t have their alcoholism treated, just forget treating diabetes and so forth and so on.
Our whole medical system ignores mental health and addiction. I think the more people we normalize this and just treat it as part of treatment for every illness, the less kind of bound up and stigma will be. Look at what we’ve done with HIV/AIDS. You look on the TV and you see ads for HIV drugs. Look on the TV and there’s ads for erectile dysfunction and STDs. I mean, there’s no difference in terms of the stigma that those illnesses had to overcome and the stigma we have to overcome. We can do this. We just have to do it as soon as possible because too many people are dying out there.
[00:18:16] PF: Do you see it getting worse or getting better? Are there higher incidents of mental health problems? Or are we just more aware of it? What’s the research and numbers showing?
[00:18:25] PK: Well, the bottom line is we’re playing a lot of catch-up because we’ve never invested in this space. Today, there’s greater demand. Part of that’s reduction in stigma. But part of it is the real trauma that people are living with today and the toxic world that we’re living in and the ubiquitous technology that’s sapping us. I think we’re going to continue to see tragically worse and worse statistics in terms of the number of people dying of suicide and overdose, unless we take a fundamentally different approach.
That means not just treating these illnesses after they occur but doing our best to try to prevent these illnesses from occurring by embedding, if you will, coping mechanisms, stress management, problem-solving skill development for our kids in elementary and secondary education. If kids cannot learn to self-modulate, in other words, understand how to manage their emotions, they can learn all the numeracy and history and literacy and not be successful in life because if you can’t manage your feelings, then you’re just not going to be successful in life.
Then what we need to do is, just as I said, screen early so that for those who have kind of more predisposition for illnesses, severe mental illnesses, schizophrenia, bipolar, we know who’s at risk. We could deploy a lot better early detection and screening. We need to be doing that because if we intervene, for example, with people who have their first psychotic break, we can dramatically reduce the disability that comes from that illness.
We just don’t treat people with schizophrenia, and we don’t get their coordinated care, which is the evidence form of intervention put in place until after they’ve had multiple psychotic breaks, which frankly really pathologizes their illness, which means they have to take higher medications for their illness. If you have to take higher medications, then there’s higher side effects, which means people don’t want to take those medications. Imagine if we treated them early and they didn’t have to take those high doses. They could probably stay compliant and live much more productive meaningful lives.
[00:20:58] PF: Is this a solvable problem? Can we manage it if we start really working together and implementing these solutions that you’re talking about?
[00:21:07] PK: 100%. We can do this. We could literally – if we have this as an objective, we can align all of our federal agencies and departments and coordinate with county and municipal and states to really address this in a comprehensive way. I said there’s so much cost to us not doing this. We just need to organize ourselves with all the resources.
Now, when there’s a tornado or hurricane or fire, the Federal Emergency Management Agency, FEMA, comes in to manage the aftermath. We need a FEMA for our homeless population with mental illness. We need a FEMA for the scourge of addiction in this country, which means we need a comprehensive approach. When FEMA comes in, they support the housing. They support the employment. They give small business loans. They help with food. They will help with clothing. They coordinate with Social Services. We need that type of approach for these illnesses. We need a multipronged systems-based approach to addressing these. If we do that, and we can do that, we will dramatically reduce the number of people dying of these illnesses and people who are suffering.
Keep in mind, even if someone’s not dying, they’re dying inside. They’re not living their full lives, and they’re not living their lives. It’s one thing to live physically. It’s another to live spiritually and socially and emotionally. We don’t look at that in our medical system and understand the value of people living free, of being hostage to their brain illness.
[00:22:58] PF: You’re doing such incredible work. We’re going to let our listeners know how they can find your book. We’ll give them links to the work that you’re doing, connect them with that QR code, and so they can really support this. Because I know it’s something everyone’s concerned about, everyone is affected by. I think a lot of times, we don’t know what to do, and we feel like, yes, there isn’t a joint movement. There isn’t something that I can do that can help affect change. I so appreciate all the work that you’re doing and the fact that you’re going to let our listeners jump in and help you on that mission. Patrick, I wish you the best of success with Profiles in Mental Health Courage and with all the other amazing projects you’re working on.
[00:23:33] PK: I want to thank you for allowing me to come on, and I appreciate the chance to speak to you and your listeners.
[END OF INTERVIEW]
[00:23:44] PF: That was Patrick J. Kennedy, author of Profiles in Mental Health Courage, and an advocate for mental health and addiction education and treatment. If you’d like to learn more about his initiatives, discover his book, or follow him on social media, just visit us at livehappy.com and click on the podcast tab.
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That is all we have time for today. We’ll meet you back here again next week for an all-new episode. Until then, this is Paula Felps, reminding you to make every day a happy one.
