We asked Senator Cory Booker 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?
Going back to my time on the Newark City Council in the 1990s, I have seen how untreated mental illness and addiction problems can devastate families and entire communities. I have seen how we send people struggling with mental illness or addiction to jails or hospitals, instead of connecting them with support professionals or drug treatment centers. As president, I commit to being relentless in combating this epidemic with the power of our entire federal government. People struggling with addiction and mental illness, as well as their families, deserve nothing less.
I will also implement a plan a set of proposals around gun access and storage that are shown to significantly lower the rate of suicide. My plan will implement a federal licensing program to make it more difficult for those at risk of suicide to purchase a firearm — if you need a license to drive a car, you should need a license to own a gun. My plan will also incentivize extreme risk laws which empower law enforcement and family members to petition a court to temporarily remove firearms from individuals at risk of hurting themselves or others; require the safe storage of firearms; and expand education and training for health professionals on suicide prevention. And finally, to ensure we are working effectively across the government to combat this epidemic, I will appoint a federal coordinator with the single goal of reducing our suicide rate.
I am also a co-sponsor of Medicare for All, which would ensure that everyone who needs mental health care is able to get it, with universal access to mental health professionals. I will also ensure that school systems and universities around the country have the resources they need to implement effective suicide prevention plans and practices.
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?
I live across the street from a drug treatment facility in Newark — I approach this problem as someone who sees my neighbors struggling with addiction every day. Opioid use and addiction is a public health crisis devastating communities across the country, from inner-cities like mine to rural communities, factory towns, and suburbs. We need to combat this crisis by treating addiction like the disease that it is, and providing resources for individuals and communities to heal. That’s why I am a co-sponsor of the Comprehensive Addiction Resources (CARE) Act, which would authorize $100 billion over 10 years to combat drug addiction and funnel money to cities, counties, and states — particularly those hit the hardest by drug overdoses — to boost spending on addiction treatment, harm reduction services, and prevention programs.
We also need to hold the pharmaceutical industry accountable. In the Senate, I called for bringing pharmaceutical CEOs to Capitol Hill to testify about their role in the opioid crisis. I wrote key provisions of the bipartisan SUPPORT for Patients and Communities
Act, which enhances patient access to non-opioid treatment options and requires a study to help us better understand safe and effective alternatives to prescribing opioids.
I will also work with Congress to pass the Humane Correctional Health Care Act, a bill I recently introduced in the Senate, which will help ensure that incarcerated individuals receive the health care they need, including treatment for substance use disorder.
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?
We must eliminate the stigma around mental health. I will ask my Department of Health and Human Services to launch a campaign focused on combating the mental health stigma. One in five Americans will experience a mental illness in any given year, and when we stigmatize people struggling with a mental illness — when we isolate people with mental illness — we only make it less likely that they will seek the treatment they need.
We also need to provide more mental-health services in our schools. I’ve called on my Senate colleagues to fund at the highest possible level the Student Support and Academic Enrichment grants — a program that only receives $400 million of the $1.6 billion it is authorized– which schools can use to provide school-based health and mental health services and counseling.
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?
We have a responsibility to ensure that all Americans have access to the care they need near the communities in which they live. I support providing additional institutional grants to universities to address the severe worker shortage of mental health professionals and peer support specialists. I would also work with Congress to fund and expand loan repayment programs, like the National Health Service Corps, to take on the shortage of mental health providers, particularly in rural and other underserved areas. Additionally, I will expand the Conrad 30 waiver program, which encourages immigrant doctors and health professionals to practice in underserved communities.
And, I support increasing investments in telehealth, expanding Medicare reimbursements, and encouraging states to increase Medicaid reimbursements for underserved hospitals and health providers to ensure every community has access to life-saving medical care.
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?
We overly incarcerate our most vulnerable citizens — the mentally ill, the poor, and those with addiction problems. We need to treat those struggling with mental illnesses or addiction with treatment and support services, not prison and jail. In the Senate, I was instrumental in helping pass The First Step Act, the biggest overhaul of the criminal justice system in a decade. The First Step Act added educational and vocational training and mental health treatment for those in federal prisons. It also reauthorized the Second Chance Act, which provides people leaving prison with post-release support services, including mental health and addiction treatment. My Next Step Act would also create a community reinvestment fund to reinvest in underserved communities hit hardest by the war on drugs — this fund would emphasize health education programs, among other things. And, to reduce recidivism and break the cycle of addiction, I have introduced the Humane Correctional Health Care Act, which will help ensure that incarcerated individuals receive the health care they need, including treatment for substance use disorder.
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?
I am a co-sponsor of the Behavioral Health Coverage Transparency Act, which is meant to hold insurers accountable and enforce the federal parity law by requiring insurance providers to report the rates and reasons for mental health and substance use disorder claims denials versus general medical care denials. The Behavioral Health Coverage Transparency Act would also direct the Department of Health and Human Services, the Department of Labor, and the Treasury Department to conduct at least 12 random audits of health plans per year to discourage noncompliance with the Federal Parity Law.
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?
Nobody in America should be forced into an institution to receive the care they need. I am a co-sponsor of the Disability Integration Act, which would ensure people with disabilities who are eligible for institutional care would have the right to those same services in their own homes.
I have also released a proposal dedicated entirely to long-term care, which guarantees access to affordable long-term services and support to every American that needs it. My plan removes the institutional bias in Medicaid by ensuring that Home and Community
Based Services be available to everyone without waitlists. It also expands eligibility for long-term care through Medicaid by increasing the asset threshold from $2,000 to $200,000 and increasing the income limit from $36,000 to $49,000 for a family of two. My long-term care plan would also acknowledge the work of family caregivers with tax credit worth up to $4,000.
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?
Poverty takes a mental and physical toll on the health of children and families. I am the only U.S. Senator to live in a low-income Black and brown community and I see firsthand the challenges children and families living in poverty face. Housing is a basic need and a basic right, and Americans shouldn’t have to face insurmountable financial challenges to put a roof over their heads. That’s why I have proposed a housing plan that would cap rental costs at 30 percent of income and totally eliminate homelessness by expanding the right to counsel in eviction and increasing funding for homelessness-prevention programs. I will also fight for Medicare for All to ensure that all Americans have access to affordable, quality health care, including mental health care.
I have also proposed several policies to empower workers, including a $15 minimum wage and the Rise Credit, a massive expansion and reimagining of the Earned Income Tax Credit, which would put an extra $8,000 in the pockets of working families.
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?
I am a co-sponsor of the Comprehensive Addiction Resources (CARE) Act, which would authorize $100 billion over 10 years to combat drug addiction and funnel money to cities, counties, and states — particularly those hit the hardest by drug overdoses — to boost spending on addiction treatment, harm reduction services, and prevention programs. I will also fight for Medicare for All, which would guarantee that every American has access to psychologists and psychiatrists. And, I would end the War on Drugs and encourage states and localities to push those struggling with mental illness and drug addiction toward treatment, not jail or prison. I have proposed legislation that would create a community investment fund to reinvest in underserved communities hit hardest by the war on drugs — this fund would emphasize health education programs, among other things. I would also work to increase funding for the Student Support and Academic Enrichment grants, which allow schools to invest more in school-based health and mental health services and counseling.
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?
In the Senate, I wrote the law that helps hospitals and emergency departments develop innovative alternatives to opioids for pain management. This is actually a law building upon a program pioneered by a New Jersey hospital. As President, I will continue the hard work of tackling the opioid crisis head-on — meeting with people, including those struggling with addiction and their families, and learning best practices from health care providers and experts. We need to be working on the front-end to prevent the overuse and abuse of opioids–that starts with researching, implementing, and scaling best practices for evidence-based opioid treatment and intervention and giving Americans struggling with addiction access to treatment and care.
11. Is there anything else you’d like to share with the mental health and addiction community?
Going back to my time on the Newark City Council in the 1990s, I have seen how untreated mental illness and addiction problems can devastate families and entire communities. I have seen how we send people struggling with mental illness or addiction to jails or hospitals, instead of connecting them with support professionals or drug treatment centers. As president, I commit to being relentless in combating this epidemic with the power of our entire federal government. People struggling with addiction and mental illness, as well as their families, deserve nothing less.
That also means guaranteeing that all people have access to paid family and medical leave to ensure that they or a loved one can seek the physical or mental health care they need, with up to full wage replacement for the lowest-income workers. I also support providing workers with paid sick leave to ensure that no worker is forced to choose between getting the care they need and receiving their next paycheck.