Patrick Kennedy Talks The “Turmoil” Of Protecting Mental Health Care In The Trump Age

After his father, Ted Kennedy, passed away, former U.S. Congressman Patrick Kennedy chose not to run for re-election in the House of Representatives so he could devote more energy to the issue that he cares most deeply about: changing the way we talk about and treat millions of Americans who suffer from mental health disorders.

Kennedy’s goal is to remove the stigma around mental illness and addiction. He chronicled how how these diseases run in his own family in his memoir, A Common Struggle. And now, alongside Newt Gingrich and social justice activist Van Jones, he has founded an organization called Advocates for Opioid Recovery. The group’s goal is to provide millions of people with the medications they need to fight opioid addiction.

A month into life under the Trump administration, I spoke to Kennedy about this new project and more.

Fast Company: Tell us a bit more about your efforts to bring us closer to mental health parity, which requires mental health benefits to be reimbursed on par with medical and surgical benefits.

Patrick Kennedy: Parity was passed in 2008, but it really went into effect within the Affordable Care Act. It was treated as an essential health benefit. I like to say that the ACA was really a mental health bill, but most people don’t think of it as such. It represented the biggest step forward we have had in covering people who were previously denied or couldn’t get affordable coverage.

So why aren’t we all getting the same access to mental health as we would any other kind of health care service?

We are still in the formative stages. We didn’t really have a chance to enforce parity within the ACA plans. We saw staggering inequities in how mental health parity was applied by the various insurers. Unfortunately, the insurance companies have a real stranglehold on the Hill so we have had trouble since we passed the law just getting it implemented.

We even got resistance from the Obama administration because they had to juggle how to get the ACA implemented with the support of insurance plans, which were some of the biggest supporters in getting it passed initially. They were loathe to push anything that as perceived as onerous regulatory requirements on these insurers.

How would you take steps to enforce the law?

I have tried but you can’t enforce it unless you have disclosure of [insurance companies’] medication management practices. On the whole, the insurers haven’t complied and the government hasn’t enforced it. Until we see the data, we can’t really audit it to see if the insurers are compliant.

What’s the future of mental health in America with the ACA on the chopping block?

Everything has been thrown into turmoil with all the talk of ACA repeal. In my opinion, if you take it away, you take the rug out from underneath this whole movement to treat mental health disorders like any other illness. This past January, I hosted an event around how we anticipate the repeal going into effect. I think our strategy should be to prepare for the worst if the ACA gets undone.

We can really take a page from the Civil Rights struggle. What got the legislation implemented was the process of going to the individual states and locales and organizations and companies to establish case law—and you know, to fight for implementation and seek redress where there were wrongs and identify patterns of discrimination. We could use this new energy that you see on the television every night with people protesting all around the country. You can mobilize this whole movement coming together. I also have strong relations with the labor union leadership, as my family has worked with them a long time.

We could make a case to the elected attorneys general and say, “You have an obligation to make sure that your consumers aren’t discriminated against when it comes to the insurance they purchased. You need to investigate the insurance practices if it’s clear there’s some smoke.” I think we can take this on.

There’s still so much stigma attached to mental health. Will that prevent any of your mobilizing efforts? Will people come forward and speak out?

This has been the most difficult part of the whole advocacy movement. Part of it is that so many people can’t admit to their own family that they’re living with the disease. The medical system is living in denial, and patients are living in denial. To address this, I started ParityTrack for anyone to register a complaint about rights being violated.

Can you speak about your efforts to engage with Republicans, namely Newt Gingrich, your Advocates for Opioids cofounder?

I maintain a close relationship with the former Speaker [Gingrich]. He has enormous influence in health care policymaking in general, and is regarded as a real expert. He’s relied upon by the Trump Administration for a lot of advice right now around these issues. Between him and [Senator] Rob Portman in Ohio, this issue is getting some attention in the administration. Ohio has been highly impacted by the addiction crisis, which is killing thousands.

I would also remind the administration that the new president was elected in states with the highest rate of suicide and overdose in the country. His voter base is drastically affected by this. And studies have found that life expectancy of middle-aged white men is going down.

Do you have a sense that the Trump administration will move this issue forward? Is mental health a priority?

Right now, it seems like there’s been a bit of a chaotic attitude toward everything. I’m hopeful that when and if President Trump settles down and gets his legs underneath him, that he’ll be proactive about this as opposed to kicking the bar door down. In the past year, we’ve seen three major mental health bills pass—Addiction and Recovery Act, 21st Century Cures Act, and the final implementation of the Mental Health Parity and Addiction Equity Act—and I’m concerned about the freezing or suspending of progress of this legislation. These bills were bipartisan and included a lot of support across the aisle for mental health. But there’s still some hope that the administration could take a different tack on these issues when they announce the new Assistant Secretary for Mental Health.

You’re advising a mental health startup called Quartet. Can you tell us more about why you’re working with this company?

I think there’s a real story in the fact that with all the bad news coming down the pike on mental health, there’s an enterprise solution like Quartet. The company is doing more mental health identification and screening. The model really focuses on showing the hard value proposition for stakeholders providing access to mental health treatment, and demonstrates real results on patient outcomes. Quartet wants to show that improving access to mental health treatment isn’t a cost, but it’s a savings.