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  • Author of federal mental health law has advice for California

    Author of federal mental health law has advice for California


    Seventh-graders work together on homework in their school library.

    Credit: Allison Shelley / EDUimages

    Mental health has been at the center of former U.S. Rep. Patrick J. Kennedy’s personal journey to recovery from addiction as well as his public career as a policymaker, author and advocate. 

    In 2008, while representing Rhode Island in the U.S. House of Representatives, Kennedy was the lead author of the Mental Health Parity and Addiction Equity Act, a federal law that requires health insurance companies to provide equal coverage for mental health and addiction care and general physical health care, such as diabetes or cancer treatment.

    Forner U.S. Rep, Patrick J. Kennedy, D-R.I.

    Kennedy, who has long been vocal about pursuing treatment for his substance use and bipolar disorder, remains an advocate for greater access to mental health care.  Earlier this year, he published his book “Profiles in Mental Health Courage” — a reference to his late uncle and former President John F. Kennedy’s classic “Profiles in Courage” — detailing how people from diverse backgrounds across the country have taken on mental illness and addiction. In October, he was a keynote speaker at the annual student wellness conference Wellness Together in Anaheim, where he spoke about his advocacy as founder of the mental health policy nonprofit The Kennedy Forum.

    “As we turn the corner on stigma related to suicide and overdose, we need to finally focus a lot more on solutions early on in a person’s life,” Kennedy said in an interview with EdSource. Not only are young people less likely to seek help due to stigma, but are also less likely to be properly insured, incurring high out-of-pocket costs for treatment when they need it.

    For Kennedy, the key to addressing the youth mental health and addiction crisis is increasing and sustaining funding for care on the local, state and federal levels. He emphasized that schools desperately need the bulk of that funding, given that early intervention significantly reduces a child’s chance of developing a serious mental illness in adulthood.

    California has, in recent years, invested heavily in expanding mental health support for children and adolescents. The state’s next challenge, Kennedy said, is sustaining these crucial services. 

    In 2019, the state embarked on a $4.7 billion Children and Youth Behavioral Health Initiative, focused mainly on recruiting and training new mental health providers across the state’s school system. To help sustain these programs, the state Department of Health Care Services plans to make new public school-based mental health services billable to both Medi-Cal and commercial health insurance, making California’s multi-payer fee schedule one of the largest school reimbursement programs in the country. 

    EdSource interviewed Kennedy about expanding mental health care for students and families. His remarks have been edited for length and clarity. 

    How do we address the enduring impact of stigma on our health and education systems?

    We need greater literacy (regarding mental health) across the board. Many don’t know these mental illnesses as brain illnesses, and they don’t understand that they’re treatable. If we knew we could treat them successfully, which we can, especially if we go in early, how can we think about them differently? We don’t let cancer get to stage four to treat it. We screen it, screen it, screen it. It’s embedded in my medical chart. My doctor asks me 15 ways about my risk for stroke and cancer. We need to do that with mental health. 

    We could address so much of this if we just incorporated better mental health services within our community. So many families have their mental health symptoms exacerbated by lack of stable housing, no supportive employment and a lack of community to help. They become isolated, which is the worst thing for those struggling with their mental health.

    Why does the Mental Health Parity and Addiction Equity Act matter for young people today?

    It used to be the case where, if you had a mental illness, you had to pay higher co-pays, premiums and deductibles to get mental health treatment than you would to get diabetes treatment or asthma treatment. Unlike for physical illnesses, insurance companies would cap the total of dollars you could spend as a patient on mental health. The Mental Health Parity and Addiction Equity Act established that insurance companies could not discriminate and treat the brain any differently than any other organ of the body. 

    Ultimately, we can’t treat everyone based upon bake sales. We have to change the metrics of what constitutes value in our mental health system. We have to get this embedded in regular insurance. 

    How can California ensure that new school-based coverage for mental health care is effective in the long term?

    We have to figure out how to reorient the insurance process so that there’s a way of capturing the return on investment from an earlier investment. The state is the one that has the most to say about overall state coverage for mental health early on, in order to reduce future obligations on the state’s part, which means picking up the pieces of a broken population that hasn’t properly been supported by coverage through early intervention services. 

    We need to get organized as voters. There’s not a family out there that doesn’t have these issues affecting a member of their family, who hasn’t lost a loved one to suicide or overdose. There’s a huge need for mental health treatment because we keep waiting till people are in a crisis. Why not make this a public health issue and really embed resources in elementary and secondary schools so students can take care of themselves? 

    What role should the federal government play in addressing youth mental health?

    We need to have Federally Qualified Health Centers in every public school in America. They could open satellites in each of the schools that can help treat kids where they are. A lot of kids, particularly from minority communities, are not going to get mental health care after school. You could bring tele-mental health into a school nurse’s office, so it’s not just where you get an aspirin, but a real clinic in the school where you could be meeting kids’ health needs writ large. You’d also need ongoing intensive care to connect them to the community health center outside. 

    We already fund Federally Qualified Health Centers. It’s supported on a bipartisan basis. It covers the uninsured as well as the insured. These centers and Certified Community Behavioral Health Centers cover a lot of rural areas and health deserts, and they can provide general counseling and support services. They have a board of directors, who are all people in the community who know the resources in the community and can pull together a more wraparound, holistic approach. 

    So many kids come to school from homes where there’s violence, addiction or mental illness. We need to reach the whole family. In many states where Republicans don’t have good benefits for their people, the centers provide a valuable safety valve for their constituents to get health care. We just need to take that model to scale in schools. The easiest thing is to run all of these through existing bureaucracies, so you’re not trying to create a new system from whole cloth.

    How can students help address mental health? 

    I would say to young people that there are two major ways they can really help the system. One, they can learn about how to prevent mental health challenges themselves through learning about their own brain and learning coping skills and problem-solving skills. We can focus on a lot more upstream, or proactive, mechanisms early in a student’s life, when they can start to build different coping skills and learn how to manage their emotions. 

    And second, if they’re interested in going into the mental health space, they can create a much better track to get into the mental health field. We just don’t have enough hands on deck to really meet the enormity of the need for those who desperately need treatment. Not only do we need to build that infrastructure and access, but also build a workforce pipeline for those trying to go into the field in greater numbers. 

    It’s got everything to do with young people. These are illnesses where 50% of them occur before the age of 14, and 75% occur before the age of 25. They’re illnesses of the young; they can take you hostage and take out whole parts of your life, when, ordinarily, you’d be in the most productive period in your life as a young person.





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  • U.S. Navy Cancels Lecture by Author Who Planned to Complain About Book Bans

    U.S. Navy Cancels Lecture by Author Who Planned to Complain About Book Bans


    Under the misguided policies of Trump and Hegseth, censorship and book banning have been widespread, especially by the Defense Department. Hegseth is eager to please Trump and has stripped recognition from anyone of distinction who is female and/or non-white. Even a photograph of the Enola Gay, the plane that dropped the first atomic bomb, was taken down–because of its name. The Navajo Code Talkers were put into storage. The first women to achieve military feats and honors were mothballed. The U.S. Naval Academy removed almost 400 books from its library because of DEI (diversity, equity, inclusion) themes.

    Ryan Holiday was invited to lecture at the Naval Academy a few weeks ago, as he had in the past. Shortly before he was to speak, he was asked not to mention the books that had been removed from the Academy’s library. When he refused, his speech was canceled.

    Question: if the men and women of the U.S. Navy are brave enough to risk their lives, aren’t they brave enough to read a book about race and gender?

    Holiday wrote in The New York Times:

    For the past four years, I have been delivering a series of lectures on the virtues of Stoicism to midshipmen at the U.S. Naval Academy in Annapolis, Md., and I was supposed to continue this on April 14 to the entire sophomore class on the theme of wisdom.

    Roughly an hour before my talk was to begin, I received a call: Would I refrain from any mention in my remarks of the recent removal of 381 supposedly controversial books from the Nimitz library on campus? My slides had been sent up the chain of command at the school, which was now, as it was explained to me, extremely worried about reprisals if my talk appeared to flout Executive Order 14151(“Ending Radical and Wasteful Government D.E.I. Programs and Preferencing”).

    When I declined, my lecture — as well as a planned speech before the Navy football team, with which my books on Stoicism are popular — was canceled. (The academy “made a schedule change that aligns with its mission of preparing midshipmen for careers of service,” a Navy spokesperson told Times Opinion. “The Naval Academy is an apolitical institution.”)

    Had I been allowed to go ahead, this is the story I was going to tell the class:

    In the fall of 1961, a young naval officer named James Stockdale, a graduate of the Naval Academy and future Medal of Honor recipient who went on to be a vice admiral, began a course at Stanford he had eagerly anticipated on Marxist theory. “We read no criticisms of Marxism,” he recounted later, “only primary sources. All year we read the works of Marx and Lenin.”

    It might seem unusual that the Navy would send Stockdale, then a 36-year-old fighter pilot, to get a master’s degree in the social sciences, but he knew why he was there. Writing home to his parents that year, he reminded them of a lesson they had instilled in him, “You really can’t do well competing against something you don’t understand as well as something you can.”

    At the time, Marxism was not just an abstract academic subject, but the ideological foundation of America’s greatest geopolitical enemy. The stakes were high. The Soviets were pushing a vision of global Communism and the conflict in Vietnam was flashing hot, the North Vietnamese fueled by a ruthless mix of dogma and revolutionary zeal. “Marxism” was, like today, also a culture war boogeyman used by politicians and demagogues.

    Just a few short years after completing his studies, in September 1965, Stockdale was shot down over Thanh Hoa in North Vietnam, and as he parachuted into what he knew would be imprisonment and possibly death, his mind turned to the philosophy of Epictetus, which he had been introduced to by a professor at Stanford.

    He would spend the next seven years in various states of solitary confinement and enduring brutal torture. His captors, sensing perhaps his knowledge as a pilot of the “Gulf of Tonkin incident,” a manufactured confrontation with North Vietnamese forces that led to greater U.S. involvement in Vietnam, sought desperately to break him. Stockdale drew on the Stoicism of Epictetus, but he also leveraged his knowledge of the practices and the mind-set of his oppressors.

    “In Hanoi, I understood more about Marxist theory than my interrogator did,” Stockdale explained. “I was able to say to that interrogator, ‘That’s not what Lenin said; you’re a deviationist.’”

    In his writings and speeches after his return from the prison known as the Hanoi Hilton, Stockdale often referred to what he called “extortion environments,” which he used to describe his experience as a captive. He and his fellow P.O.W.s were asked to answer simple questions or perform seemingly innocuous tasks, like appear in videos, and if they declined, there would be consequences.

    No one at the Naval Academy intimated any consequences for me, of course, but it felt extortionary all the same. I had to choose between my message or my continued welcome at an institution it has been one of the honors of my life to speak at.

    As an author, I believe deeply in the power of books. As a bookstore owner in Texas, I have spoken up about book banning many timesalready. More important was the topic of my address: the virtue of wisdom.

    As I explained repeatedly to my hosts, I had no interest in embarrassing anyone or discussing politics directly. I understand the immense pressures they are under, especially the military employees, and I did not want to cause them trouble. I did, however, feel it was essential to make the point that the pursuit of wisdom is impossible without engaging with (and challenging) uncomfortable ideas.

    Seneca, the Stoic philosopher, used a military metaphor to make this very argument. We ought to read, he said, “like a spy in the enemy’s camp.” This is what Stockdale was doing when he studied Marxism on the Navy’s dime. It is what Seneca was doing when he read and liberally quoted from Epicurus, the head of a rival philosophical school.

    The current administration is by no means unique in its desire to suppress ideas it doesn’t like or thinks dangerous. As I intended to explain to the midshipmen, there was considerable political pressure in the 1950s over what books were carried in the libraries of federal installations. Asked if he would ban communist books from American embassies, Eisenhower resisted.

    “Generally speaking,” he told a reporter from The New York Herald Tribune at a news conference shortly after his inauguration, “my idea is that censorship and hiding solves nothing.” He explained that he wished more Americans had read Hitler and Stalin in the previous years, because it might have helped anticipate the oncoming threats. He concluded, “Let’s educate ourselves if we are going to run a free government.”

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    The men and women at the Naval Academy will go on to lead combat missions, to command aircraft carriers, to pilot nuclear-armed submarines and run enormous organizations. We will soon entrust them with incredible responsibilities and power. But we fear they’ll be hoodwinked or brainwashed by certain books?

    Hitler’s “Mein Kampf” was not one of the books removed from the Naval Academy library, and as heinous as that book is, it should be accessible to scholars and students of history. However, this makes the removal of Maya Angelou’s “I Know Why the Caged Bird Sings” inexplicable. Whatever one thinks of D.E.I., we are not talking about the writings of external enemies here, but in many cases, art, serious scholarship and legitimate criticism of America’s past. One of the removed books is about Black soldiers in World War II, another is about how women killed in the Holocaust are portrayed, another is a reimagining of Kafka called “The Last White Man.” No one at any public institution should have to fear losing their job for pushing back on such an obvious overreach, let alone those tasked with defending our freedom. Yet here we are.

    The decision by the academy’s leaders to not protest the original order — which I believe flies in the face of basic academic freedoms and common sense — has put them in the now even stickier position of trying to suppress criticism of that decision. “Compromises pile up when you’re in a pressure situation in the hands of a skilled extortionist,” Stockdale reminds us. I felt I could not, in good conscience, lecture these future leaders and warriors on the virtue of courage and doing the right thing, as I did in 2023 and 2024, and fold when asked not to mention such an egregious and fundamentally anti-wisdom course of action.

    In many moments, many understandable moments, Stockdale had an opportunity to do the expedient thing as a P.O.W. He could have compromised. He could have obeyed. It would have saved him considerable pain, prevented the injuries that deprived him of full use of his leg for the rest of his life and perhaps even returned him home sooner to his family. He chose not to do that. He rejected the extortionary choice and stood on principle.



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