Senator Bernie Sanders (D-VT)

We asked Senator Bernie Sanders to get on the record about mental health and addiction. Here’s what he had to say:

1. Suicide is the 10th leading cause of death in the US and the second leading cause of death for American youth. Every day, 20 Veterans die by suicide. What steps will you take to prevent suicide?

We are experiencing a crisis in mental health treatment in this country. Bernie’s Medicare for All plan would address this crisis by providing comprehensive coverage for mental health and substance abuse treatment services as well as prescription drugs. Mental healthcare, under Medicare for All, will be free at the time of service, with no co-payments that can be a barrier to treatment.

Bernie’s Medicare for All plan requires an evaluation of health disparities, including racial and geographic disparities, and a plan for addressing the disparities found in the evaluation. A central part of the plan requires increasing access to mental health care, including how to train the workforce we need to address these disparities.

He will dramatically expand access to community health centers which provide primary medical, dental, and mental health care, as well as low-cost prescription drugs, to more than 28 million Americans.

And he will significantly expand the National Health Service Corps and Teaching Health Centers to recruit and train mental health providers to deliver culturally competent care in underserved communities.

As a nation, we have a moral obligation to provide the best quality care to those who have put their lives on the line to defend us. Bernie will:

  • Fully fund and expand the VA so that every veteran gets the care that they have earned and deserve.
  • Get veterans compensated faster by improving how compensation claims are processed.
  • Expand the VA’s Caregivers Program.
  • Expand mental health services for veterans.

 

2. Every hour, eight people in America die of drug overdose, from opioids and increasingly from other drugs as well. What would your administration do to turn the tide on the addiction crisis? 

The opioid epidemic is killing thousands of Americans every year. No one is unaffected. This epidemic, caused by the greed of pharmaceutical companies, is ravaging communities across America.

We know that pharmaceutical companies lied about the addictive impacts of opioids, and knew how dangerous these products were, but refused to tell doctors and patients. Yet, while some of these companies have made billions each year in profits, not one of them has been held fully accountable for their role in this epidemic.

Bernie will address this crisis with the urgency it requires and hold these pharmaceutical companies responsible for the destruction they caused and continue to exacerbate.

He will focus on treatment and prevention. We cannot continue to treat the people struggling with the disease of addiction as criminals. As President, Bernie will give people struggling with opioid addiction the health care they need by guaranteeing health care, which includes substance abuse and mental health services, to all people as a right, not a privilege, through Medicare-for-all.

Make significant investments in funding for treatment, recovery, prevention, and research. He will provide communities across the country struggling with this epidemic the money and resources they need to address this issue.

Hold pharmaceutical companies accountable and prohibit their harmful direct-consumer marketing for opioids by passing the Opioid Crisis Accountability Act. This bill will also:

  • Prevent illegal distribution of opioids and large unreasonable number of opioids from flooding rural communities and states.
  • Hold CEOs of drug companies criminally liable for illegal advertising, marketing, or distribution of opioids
  • Penalize drug manufacturers who do not comply with the new regulations by eliminating patent exclusivity and require federal funds received by the company to be reimbursed to the government.
  • Create and enforce fines on drug manufacturers found liable for worsening the opioid crisis. 

 

3. Rates of anxiety, depression and suicidal behavior are all rising among our teens and young adults, but the time from first symptoms (usually around age fourteen) to treatment continues to be almost a decade for many people. What would you do to make sure that more individuals get the help they need when they first need it?

Cost, availability of services, and stigma all act as barriers to care for too many young people. Despite the progress we’ve made, many young people avoid seeking the treatment they need because of the stigma associated with mental health issues.

Health care is not a commodity. It is a human right. The goal of a health care system should be to keep people well, not to make stockholders rich. That is why we need Medicare for All. Medicare for All would provide comprehensive health coverage to all with no premiums, deductibles, copayments, or surprise bills.

By enacting Medicare for All, we will provide comprehensive coverage for mental health treatment services. For too many families with teens and young adults, cost is a barrier to getting the mental health care they need. Mental health care will be free at the time of service, with no co-payments.

In addition, he will transform our public schools into more than just places where children learn – they will be community centers that build the health and well-being of students. He will transform our education system into a high-quality public good that connects education, health, and social-services to young people. A strong investment in sustainable community school programs can help us achieve that. President Trump has proposed eliminating funding for community school programs.

Instead of cuts, Bernie will:

  • Provide $5 billion in annual funding for sustainable community schools to provide a holistic, full-service approach to learning and the wellbeing of our young people.
  • Our schools are a public good. By transforming them into community schools, we can provide:
  • Health and support services including dental care, mental health care, and substance abuse prevention.
    • Community and youth organizing.
    • Community goods and services such as job training classes, art spaces, GED, and ESL classes.

 

4. Our nation is experiencing a shortage of mental health and addiction care providers—including both traditional mental health professionals and paraprofessionals like certified peer support specialists and recovery coaches—and other barriers to treatment, especially in rural and underserved areas. What is your position on improving access to mental health and addiction care for these communities?

34 million Americans are uninsured, even more are underinsured as the price of healthcare continues to soar.

When Bernie is in the White House, he will guarantee health care as a human right to every person in America, rebuild America’s health care infrastructure, and bring more providers to our underserved and rural communities.

As part of this effort, Bernie will bring increase the number of health care facilities and providers to provide mental care in underserved communities.

  • Increase federal funding and expanding community health centers, which currently serves over 28 million people in underserved communities. In 2017, community health centers served one in five people living in rural areas and almost one million agricultural workers.
  • Significantly expand the National Health Service Corps and Teaching Health Centers to recruit and train mental health providers to deliver culturally competent care in underserved communities.
  • Cancel all student debt to free up providers to work in communities that need care the most.

Second, Bernie’s plan sets up regional offices to help administer Medicare for All, and one of their responsibilities is to recommend changes in provider payment rates to help meet the needs of the area.

Medicare for All removes the bureaucratic nightmare from providers’ daily practice. No more spending a significant part of your day filling out forms and arguing with insurance companies. No more having to navigate getting reimbursed by many different insurance companies. This is especially important for mental health providers, the vast majority of whom are self-employed. Under Medicare for All, the doctor-patient relationship, not insurance company profits, comes first.

By eliminating the predatory, wasteful, and restrictive private insurance system, and replacing it with a universal, comprehensive, Medicare for All program, Bernie will empower every American to seek the care they need, regardless of their income. 

 

5. For many people, the initial point of care for their mental health condition or substance use disorder begins with the criminal justice system. What is your plan to advance crisis intervention services in the community while also providing treatment and alternatives to incarceration for those already involved in the criminal justice system?

According to the Department of Justice, one in five inmates in prisons are people with a cognitive disability, while another one in five inmates have a serious mental illness. Instead of incarceration, we should be providing people with disabilities with the services and supports they need to stay in the community, including mental health care and home and community-based services. It is our moral responsibility to make it happen.

Bernie believes our nation’s criminal justice system must be reformed and focus on rehabilitation of our citizens, which includes at the federal level, we will establish a new model police training program that reorients the way we do law enforcement in this country. He will require and fund police officer training on implicit bias, cultural competency, de-escalation, crisis intervention, adolescent development, and how to interact with people with mental and physical disabilities.

Instead of spending $80 billion a year on jails and incarceration, we are going to invest in health care, jobs, and education for our young people. It is an international embarrassment that individuals with mental health conditions do not have access to adequate health care outside and also in the criminal justice system. As President, Bernie will make sure all people have guaranteed health care and he will reform our broken criminal justice system to end the overwhelming criminalization of poor people, people of color, and people with mental health conditions. 

 

6. The Mental Health Parity and Addiction Equity Act (Federal Parity Law) was enacted in 2008, yet some insurers continue to illegally deny coverage of care for mental health and addiction treatment services. How will you ensure enforcement of the Federal Parity Law?

Bernie strongly supported the Mental Health Parity and Addiction Equity Act and through negotiations, successfully fought for protections in the bill for Vermont’s already robust parity laws. As President, Bernie would expand those parity regulations nationally through federal regulation.

He will also pass Medicare for All to guarantee every person in this country mental health treatment.

 

7. How will you fulfill the intent of the Community Mental Health Act of 1963, a law that meant to ensure that people have access to mental health and developmental disability care within their communities rather than in institutions?

Every person with a disability deserves the right to live in the community and have access to the services and supports they need to pursue the American dream. It is our moral responsibility to make it happen. No one should have to choose between being taken out of their homes and communities or being denied the support they need to survive and thrive.

As President, Bernie will end the institutional bias that forces people with disabilities out of their communities by passing the Disability Integration Act, of which Bernie is a proud cosponsor, and enacting Medicare for All, community-based mental health care and home and community-based supports as services, without asset or income restrictions to all. And under Bernie’s administration, the Olmstead decision will be vigorously enforced through the Department of Justice Civil Rights Division, reversing the Trump Administration’s disgraceful rollback of disability rights enforcement.

 

8. Poverty is associated with very poor outcomes for people with mental health or substance use disorders, primarily due to lack of secure housing and employment opportunities. What will you do to ensure that income is not a barrier to recovery?

Bernie believes we must recognize that in the 21st century, in the wealthiest country in the history of the world, economic rights are human rights.

We must guarantee everyone in our country basic economic rights – the right to quality health care, the right to as much education as one needs to succeed in our society, the right to a good job that pays a living wage, the right to affordable housing, the right to a secure retirement, and the right to live in a clean environment.

To guarantee housing a human right, he will ensure that every person has affordable, accessible housing. He will build the 7.4 million affordable units to fully close the affordable housing gap. He will fully fund Section 8 rental assistance and guarantee vouchers to everyone eligible for the program without waitlists. He will end homelessness in America by building permanent supportive housing and connecting homeless people to available services.

He will raise the minimum wage to a living wage of $15 an hour and enact a federal jobs guarantee to ensure everyone is guaranteed a job that pays a living wage.

Bernie’s Medicare for All program will guarantee comprehensive health care, which includes substance abuse and mental health services, as a human right to all people, regardless of income.

When he is President, he will increase educational opportunities for all including an expansion in career and technical education opportunities to prepare students for good-paying community employment. He will cancel all student debt and guarantee tuition and debt free public colleges, universities, trade schools and apprenticeship programs and end equity gaps in higher education attainment by ensuring all our students get the help they need so they are ready for college and receive the support they need when they are in college. 

 

9. People of color, immigrants, Veterans, people living in poverty, people who identify as LGBTQ+, and others have unique needs and challenges as it relates to mental health and addiction. What will you do to ensure that these and other underserved groups have access to the mental health and addiction resources and supports that they need?

Bernie’s Medicare for All program will guarantee comprehensive health care, which includes substance abuse and mental health services, as a human right to all people, regardless of income, race, sexual orientation, gender identity, or immigration status.

He understands that one policy alone will not solve this crisis. Both his plans and his record show that he will address this issue with the urgency it deserves.

Specifically, his plan requires the Department of Health to conduct an evaluation of health disparities, including racial and geographic disparities, and to submit a plan to Congress for addressing the disparities found in the evaluation. It also creates an Office of Primary Health to increase access to care including mental health care. It also includes training the workforce we need to address these disparities. His Medicare for All plan includes explicit language that bans providers from discriminating against patients, including discrimination based on race, color, gender, and pregnancy, and allows courts to award damages to patients if this is violated.

He will dramatically expand access to community health centers which provide primary medical, dental, and mental health care, as well as low-cost prescription drugs, to more than 28 million Americans.

And he will significantly expand the National Health Service Corps and Teaching Health Centers to recruit and train mental health providers to deliver culturally competent care in underserved communities. 

 

10. Given that overdoses and suicides are decreasing US life expectancy, evidence-based treatment options are critical, but treatment options are still limited. What role do you see research playing in improving mental health and addiction treatments?

Bernie believes we need to make significant investments in health research, including robust mental health and addiction research funding. Bernie strongly supports additional funding for the NIH. He also believes that a comprehensive health research agenda should include not just the necessary financial support for disease-specific research, but must also consider our long-term investments in science education and how we can broadly support the next generation of scientists tackling some of the greatest medical challenges of our time.

Medicare for All removes the bureaucratic nightmare from providers’ daily practice and lets providers do what they were trained to do: provide care. For providers: that means no more spending a significant part of your day filling out forms and arguing with insurance companies. No more having to navigate getting reimbursed by many different insurance companies. This is especially important for mental health providers, the vast majority of whom are self-employed. By eliminating the predatory, wasteful, and restrictive private insurance system, and replacing it with a universal, comprehensive, Medicare for All program, Bernie will empower every American to seek the care they need, regardless of their income.

The amount of medical research and quality improvement that could be done with data from a national, public single payer system will be transformative. With a renewed focus on research and quality improvement, the US can finally focus on improving population health, and stop lagging behind other countries on health outcomes.

 

11. Is there anything else you’d like to share with the mental health and addiction community?

Bernie is running for President so that, when we are in the White House, the movement we build together can achieve economic, racial, social and environmental justice for all. He believes that in the richest country in the history of the world, everyone should be afforded the right to health care, an education, a good job, affordable housing, a clean environment, and a secure retirement. The time is long overdue for the United States to join every other major country on Earth and guarantee health care to all people as a right, not a privilege, through a Medicare for All program. Health care is not a commodity. It is a human right. Bernie’s Medicare for All program would provide comprehensive health coverage to all with no premiums, deductibles, copayments, or surprise bills. And he will address the disparities in our healthcare system. He will rebuild America’s health care infrastructure and bring more providers to our underserved communities.

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