As the current candidates for president discuss hot-button issues with each news cycle, and the 10 Democrats debate on Thursday, one issue that isn’t getting the attention it deserves is the mental health crisis that is claiming more than 150,000 lives a year through suicides and overdoses and creating a vast ripple effect of suffering among their survivors.

This crisis is fueled by a health care system that is ill-equipped to handle mental health and substance use disorders, and magnified by leaders who lack the political will to turn words into action.

Rates of depression and anxiety, especially among young people, are higher than at any other point in history. Stigma certainly plays a role in people not getting the help they need, but access to care is often the deciding factor in whether someone has a shot at recovery. Many people can’t afford treatment due to inadequate insurance coverage and others — especially those in rural areas — often have to wait months to see a provider, if there’s even one available. How many red flags do we need to finally prioritize mental health and addiction prevention and treatment in this country?

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That’s why Mental Health for US, a nonpartisan coalition of more than 50 members that we co-chair, asked leading presidential candidates to share their thoughts on critical topics around mental health and addiction in the U.S. The survey, sent in July 2019 to candidates averaging at or above 1% in national polls tracked by RealClearPolitics, asked 11 unbiased questions focused on suicide and drug overdose, criminal justice reform, access to mental health care, and more.

Of the 13 presidential candidates invited to complete the survey, seven have responded so far: Sen. Cory Booker, Mayor Pete Buttigieg, Sen. Kamala Harris, Sen. Amy Klobuchar, former Rep. Beto O’Rourke, Sen. Bernie Sanders, and Sen. Elizabeth Warren. All provided thoughtful, solution-oriented approaches to addressing our mental health crisis and suggested policies and actions to improve access to mental health care.

It’s no surprise that plans and focus areas varied. Booker’s responses were geared toward issues such as gun reform, criminal justice reform, and expanding access to care, while Klobuchar’s responses focused more on prevention and intervention strategies that address mental health and addiction as illnesses of the brain instead of as moral failings. Warren’s responses focused on improving and expanding existing programs to address the whole continuum of care, and Harris’ responses were interested in removing barriers through telehealth to provide access to care in settings that work for Americans.

Although multiple respondents mentioned “Medicare for All” options as solutions to increasing access to care in rural and underserved populations, Sanders used it as the primary avenue to expand treatment services. And while Buttigieg echoed the sentiments of other respondents, his responses were grounded in the importance of community and the need to overcome stigma as a barrier to care. O’Rourke’s responses particularly focused on the rising suicide rates and kept veterans and the Veterans Health Administration top of mind when addressing deaths of despair.

Each respondent expressed support for expanding and protecting mental health care services for youths, veterans, racial and ethnic minorities, and other underserved populations. Some actions were proposed by all of the respondents, such as holding pharmaceutical companies responsible for the opioid epidemic, expanding resources for teens and youth, and decriminalizing (to varying degrees) mental health and addiction.

You can read each candidate’s complete response here.

As former legislators and as Americans with firsthand experience of the toll that mental health and addiction can take on individuals, families, and communities, we are pleased that seven presidential candidates took the time to respond and get their plans in front of voters. But the conversation can’t end here. We encourage all policymakers and candidates to view the Mental Health for US policy platform and see what Americans agree are solutions to confronting head on our mental health crisis.

While the president alone cannot solve this public health crisis, he or she can lead and shape policy conversations with the power to change our current trajectory. We need real, concrete solutions from candidates and elected officials, not lip service. The 57.8 million Americans living with mental health and substance-use disorders, as well as their friends, families, neighbors, educators, and employers, need action.

Candidates and policymakers can and should proactively propose their own plans; campaign on these issues using accurate, nonstigmatizing, and productive language; and most importantly, listen to the millions of Americans either directly or indirectly affected by mental illness and addiction, all of whom deserve to be heard.

Patrick J. Kennedy, the former Democratic U.S. representative from Rhode Island, is the founder of The Kennedy Forum and DontDenyMe.org; co-founder of One Mind; and author of the New York Times bestseller “A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction” (Blue Rider Press, 2016). Gordon H. Smith, a former Republican U.S. senator from Oregon, is president and CEO of the National Association of Broadcasters. He is the author of “Remembering Garrett: One Family’s Battle with a Child’s Depression” (Basic Books, 2007). Kennedy and Smith are co-chairs of the Mental Health for US coalition.

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  • The current state of addiction treatment is a horrible scam on the public. Its about reimbursement/cost instead of good care. This area of “medicine” needs an overhaul with certifiable/verifiable standards of care.

  • As the parent of a mentally ill adult child and a woman who lives in chronic pain reading this article just made me angrier! My son has severe bi-polar, Borderline Personality Disorder, Asperger’s Syndrome and ODD. He just turned 30 this past week. He and I were estranged for over 3 years because he went unmedicated at the suggestion of his now ex-wife. I couldn’t stop him then because she had so much control over him. He publicly accused me of hurting him sexually when he was young. He said he saw these images and assumed it was me, but it came from power of suggestion from his ex-wife. Yes, she’s mentally ill as well but refuses to acknowledge it. She’s a master manipulator and hated me because my granddaughter loved me so much she only wanted to be with me and jealousy took over for my ex-DIL. She allowed him to publicly humiliate me and then made sure I wouldn’t see my grandchildren for 3 years. Early summer 2018 my son’s mental status had diminished so severely he became a monster. He was so far gone that any suggestion of medication threw him into a rage. Any noise threw him into a rage. She told him she wanted a divorce. That sent him into a downward spiral into psychosis. He was kicked out of his home and he went to live with a friend but would constantly threaten suicide. He’d go back to their house and began doing the unthinkable. They’d call the police who would put him in Emergency until a bed became available at a facility. He’d spend 5-8 days. They gave him medicine, but when they released him there was no prescription and he was out on the street again. He did this seven times in 4 months last summer. He was released each time from a different facility within one week. He became homeless. His last attempt was his most dangerous. He was at gunpoint with 12 cops for 45 minutes until he finally gave up. They put him in the State Psychiatric Hospital. After 2 months they sent him to jail on a domestic abuse and weapons charge. They wouldn’t allow bail. He threatened suicide again. They put him in Solitary with no clothes in the winter. They did this twice. They let a murderer out on $50K bond within 24 hours, but they wouldn’t let him out on Bond; they wouldn’t even give him a bond trial. His friend convinced him to see me and talk to me. I kept him alive for that month he was in jail. He’d call me for a minimum of 2.5 hours everyday. I was so heartbroken for what he was going through. I had to hire two lawyers for him. One criminal and one divorce. Trying to find these lawyers wasn’t an easy task. I contacted NAMI (National Association for the Mentally Ill). They couldn’t help me at all. They didn’t work with mentally ill people who had criminal cases. They poorly medicated him in jail and then sent him home without a prescription because they lost it. He went through withdrawal. He was a monster again, but in my home this time. He broke me again and I had to leave on several occasions. Because I hired an outstanding lawyer, he got him out on home arrest with an ankle monitor. We had to find him an outpatient counseling facility as part of his home arrest agreement. The only facility that would take him isn’t the greatest, but they have him on a good med regiment that he is finally stable. The agreement for his counseling wasn’t individual but group three times a week. Who was in the group…Drug Addicts. Not a single mentally ill patient but him. He was always worse when he got home. I had to go to the psychiatrist with him to tell her that he wasn’t getting better and she finally got him medicated correctly. The psychiatric/addiction facilities are overcrowded or non-existent in my state. We have all suffered because of it. As for holding pharmaceutical companies “responsible for fueling the Opioid Crisis” is absolutely ridiculous! I wish the politicians would stop trying to put the blame where it doesn’t belong. The crooked greedy doctors and Pill Mills made it easy access for Addicts to get opioids. Those who went to the crooked doctors were already Addicts and had the cash for more fuel to add to their fire. They want to curb the opioids on the streets…Go to the streets and leave our medications and doctors alone. If they listened to chronic pain patients they’d see we do not become Addicts! These medications are usually stolen out of medicine cabinets and dispersed on the streets. When overdoses occur they seem to forget to document that alcohol and other drugs are also in that person’s system. Politicians are reading the wrong statistics. No one has asked the chronic pain patient of what they think of all this blame. They don’t ask doctors to show the records of the patients to whom he has prescribed opioids, but instead raid, arrest and ask no questions. The government has ruined thousands of innocent lives because they are looking at the wrong entities of this crisis! So, like the mentally ill in this country, chronic pain patients are also overlooked and now the suicide rate is up to 10% of just chronic pain patients whose meds were tapered so low or completely restricted that death seems like a better alternative. I have had days like that myself from drastic tapering but somehow I keep hanging on and hoping that the Government would “Wake UP and SMELL the Coffee.” The pharmaceutical companies produced the medication. I wasn’t taking pain medications in the 1990s so I cannot say what the labels read, but the labels did not continually go into the addicts mouth, the pills did and the doctors who continued to prescribe them and asked no questions. Doctors and pharmacists are very largely to blame how pills got into the wrong hands. Pill Mills are still around but a lot less than before. If you drastically reduce the production of opioids, shortages will continue in hospitals and more people will die. With all these lawsuits more people will die! The companies will go bankrupt. So guess what? Not only will chronic patients not have access to medications, but anyone with any type of chronic illness that requires medications to stay alive will also die due to unattainable access. The one statement that is now a continuance controversy is “Substance Use Disorder.” DSM now integrates medication dependence as a Substance Use Disorder of which is completely inappropriate. Dependence is not addiction. Dependence on opioid medication regiments is just as necessary to the chronic pain patient as Insulin is to the diabetic. We both need these medications to have quality of life.

  • What are they doing to help people with chronic pain and their friends and familys. Why do addicts have more rights than ederly people with chronic pain. Why cant we get adequate care anymore. Why isn ‘t anyone asking that?

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