← Tony Mantor: Why Not Me ?
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- [00:07]
A
Welcome to why Not Me Embracing Autism and Mental Health Worldwide, hosted by Tony Mantour, 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, 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, unwavering 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. Hi, I'm Tony Mantour. Welcome to why Not Me Embracing Autism and Mental Health Worldwide. Welcome to our special event crafting 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 U.S. 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 Forum to advance integrated care models, what specific policies can Congress prioritize to better coordinate mental health services with primary care, especially for underserved communities?
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We need to have the strategy. Sounds pretty obvious, but we don't have a strategy. We don't have a blueprint. You're going to build a house, you got to have the blueprint. Then you got to 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 use, how much money could that save you on law enforcement? All the costs that are incurred from over hospitalization and over incarceration? 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 coordinated away. We know the costs are going to be these costs. Because if we're not creating that three legged 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.
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So what do we do? What's the answer?
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Here is 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 cost 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 micromanage 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 and 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 housing 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, I'm 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 in 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.
- [05:37]
A
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?
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So I think that clearly the current system re stigmatizes people because if you Go to go down the hall, the proverbial hall, to get your mental health as opposed to having it part of your overall health care. You start to think, well, what's wrong with getting health care 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, 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. Oh, I don't want to, 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.
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A
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?
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B
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 goes upstream. Prevention and preemption of illnesses is the model for all the rest of the physical health system. So why shouldn't it be true with brain illnesses? 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 homeschooling 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 amygdalas are on fire and they're traumatized and they come from families that have these problems distracting them. 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 numeracy 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 this 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 cognitive behavioral therapy works if it's targeted for the types of diagnoses that each cognitive behavioral therapy has been shown to be effective on. So that needs to be delivered and telehealth can do that.
- [09:59]
A
What have been the issues in getting this going stronger?
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Problem is obviously it's all about where 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, or 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 a site of service for the health care 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, cognitive behavioral therapy for that kid, Whether they're from Massachusetts or California, who cares? We need to know at 9am, at 10.30am 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 surface of the need out there. So if we're fighting over who gets to take care of a population that is 100 times bigger than what we could ever take care of, that just
- [12:02]
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makes so much sense. What do we do?
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The insanity of the current system is breathtaking. 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 in 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 I said, in the schools where the kids are. But we have to change the kind of the 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 a number of 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 90, 90, 90 by 2033.
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A
Okay, so in closing, we've touched on several subjects here, and it's just the 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?
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Well, I think that again, the basic thing is we're faced with lack of human connection. It's a phenomena that stret the whole Age span. We are isolated, you know, by technology and 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 and this small cohort of people to, you know, not engaged in a community the way society used 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 connection. 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, sud, is that we can get a lot of lot more specific to address your particular set of challenges, which is there's a heterogeneity to all of these illnesses, there's overlapping characteristics. And so you can't just pigeonhole people into these bigger buckets when we're all on a spectrum.
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Yes, I totally agree, you need personalized approaches.
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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, you know, 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, 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 interest 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 in the political system, but just in our lives and be part of a community. And we all impact in our own spheres of influence, 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 got to solve all the world's problems, 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.
- [18:44]
A
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.
- [19:07]
B
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 umpteen years of medical school and so forth, you know, if AI can, you know, basically supplant any financial analyst 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 a third of our population unemployed and not have something that builds productivity and helps solve the challenges that now AI can't 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 in 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 rot as a result of AI.
- [21:27]
A
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.
- [21:51]
B
Whatever we do, we need to focus on our ability to manage in an ever more stressful and toxic world, not just politically, but, you know, disparities in 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 amygdala, as opposed to being able to operate in our prefrontal cortex. So 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 going forward.
- [23:08]
A
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.
- [23:29]
B
Listen, Tony, thank you for giving me the opportunity. You know, as a former politician, I need some platform. You're giving me the platform. Thank you so much, Tony.
- [23:38]
A
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 WhyNotMe World. One last thing, spread the word about why not me. Our conversations are inspiring guests that show you are not alone in this world.