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Today, Hillary Clinton announced hercomprehensive plan to support Americans living with mental health problems and illnessesby integrating our healthcare systems and finally putting the treatment of mental health on par with that of physical health. Nearly a fifth of all adults in the United States, more than 40 million people, are coping with a mental health problem.[1]Close to 14 million people live with a serious mental illness such as schizophrenia or bipolar disorder.[2]Moreover, many of these individuals have additional complicating life circumstances, such as drug or alcohol addiction, homelessness, or involvement with the criminal justice system.[3]Veterans are in acute need of mental health care, with close to 20% of those returning from the Iraq and Afghanistan wars experiencing post-traumatic stress or depression.[4]And the problem is not limited to adults: an estimated 17 million children in the United States experience mental health problems,[5]as do one in four college students.[6]

Americans with mental health conditions and their families need our support. The economic impact of mental illness is enormous at nearly $200 billion per year nationwide in lost earnings[7]and the human cost is worse. Too many Americans are being left to face mental health problems on their own, and too many individuals are dying prematurely from associated health conditions. We must do better. To date in this campaign, Hillary set out policies that will direct support to individuals with mental health problems and their familiesincluding a detailed agenda to support military service members and veterans, an initiative to end Americas epidemic of drug and alcohol addiction, and a robust caregivers agenda. Today, she is building on those proposals with a comprehensive agenda on mental health. Hillarys plan will:

As a down-payment on this agenda, Hillary will convene a White House Conference on Mental Health during her first year as President. Her goal is that within her time in office, Americans will no longer separate mental health from physical health when it comes to access to care or quality of treatment.The next generation must grow up knowing that mental health is a key component of overall health and there is no shame, stigma, or barriers to seeking out care.

Early Diagnosis and Intervention

Most mental health conditions have their origins in childhood and adolescence. But today, two-thirds of children with mental health problems receive no treatment at all,[8]and children in high-risk groups such as those in juvenile justice settings, in the child-welfare system, or whose mothers experienced depression during or after pregnancy are particularly underserved. The consequences of delayed and inadequate treatment for children and young adults with mental health problems play out over decades. For instance, adolescents with serious mental illness are about three times more likely to drop out of school and twice as likely to face a premature death as are their cohorts who do not face such problems. Hillary is committed to expanding early diagnosis and treatment of mental health conditions, and preventing them when possible. As president, she will:

Federal Support for Suicide Prevention

Suicides, which are usually fueled by mental illness, are rising among numerous population groups, from adolescents and college students[11]to veterans[12]and older adults.[13]The overall rate of suicide increased by 24 percent between 1999 and 2014, and is now at its highest level in 30 years.[14]Over 40,000 Americans die of suicide every year, making it the tenth-leading cause of death nationally.[15]As the former director of NIMH, Dr. Tom Insel, often notes, suicides have 11 victims: the person who dies, and at least 10 people close to them who will never be the same. Hillary believes that suicide is a critical issue that she will prioritize as president. She will:

Integrate our Healthcare Systems and Expand Community-Based Treatment

Demand for mental health services far outpaces supply, and our health care system lacks the treatment infrastructure and behavioral health workforce necessary to provide adequate care. Of adults experiencing any mental illness today, nearly 60% are untreated. Of those with a serious condition, 40% are untreated.[16]We need to close the treatment gap, and ensure that there is no wrong door to access care. Hillarys plan will:

Improve Outcomes in the Criminal Justice System

Today, our criminal justice system is increasingly becoming the front line of engagement with individuals with mental health problems. Law enforcement officers routinely have to intervene or respond to unfolding situations that involve individuals with mental illness. As many as 1 in every 10 police encounters may be with individuals with some type of mental health problem.[21]And our county jails today house more individuals with mental illness than our state and local psychiatric hospitals.[22]Hillary believes that while greater investments in prevention and community-based treatment for behavioral healthcare will minimize these encounters with the criminal justice system, there are also specific steps we should take to improve outcomes for those individuals who do end up interfacing with law enforcement. She will:

Enforcing Mental Health Parity

The Mental Health Parity and Addiction Equity Act of 2008, which Hillary proudly co-sponsored, requires that mental health benefits under group health plans be equal to benefits for other medical conditions. The Affordable Care Act built on this important law by requiring that insurance plans offered in the individual and small group markets offer mental health coverage as an essential health benefit. But while the right laws are on the books, they are too often ignored or not enforced. Millions of Americans still get turned away when seeking treatment for mental illness, even when the interventions are well-established and evidence-based. A recent report published by the National Alliance on Mental Illness suggested that a patient seeking mental health services is twice as likely to be denied coverage by a private insurer as a patient seeking general medical care.[24]As part of her commitment to fully enforcing the mental health parity law, Hillary will:

Housing and Job Opportunities

Hillary supports a full range of housing and employment support for individuals with mental health problems, to help them lead independent and productive lives. As president, Hillary will:

Brain and Behavioral Science Research

We are still in the early stages of unraveling the mysteries of human brain development and behavior. Hillary believes we need a pioneering, multi-sector effort to transform our knowledge of this fieldfrom mapping the human brain to generating new insights into what drives our behavior to investing in clinical and services research to understand the interventions that work best and how to deliver them to patients. Combining neurobiological research with behavioral, clinical, and services research will help us develop new therapies to help patients today while laying the foundation for future breakthroughs. Through it all, Hillary believes we must ensure that the resulting data and insights are widely available to researchers. As president, Hillary will:

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Hillary is committed to delivering on the above agenda and to ensuring that mental health is treated like the national priority it already is. As a down-payment on her agenda, Hillary will convene aWhite House Conference on Mental Healthwithin her first year in office, to highlight the issue, identify successful interventions, and discuss barriers that must be removed to improve todays system.

Hillary has also laid out policies that offer additional support to individuals with mental health problems and their families, beyond todays announcement. Earlier this year, she released a robustCaregivers Agenda,to support family members and workers who care for individuals with health conditions, including mental illness. She also set out a $10 billionInitiative toCombat Americas Deadly Epidemic of Drug and Alcohol Addiction,which provides incentives to every state to dramatically expand its prevention and treatment programs for substance use disorders. And she has released a detailedVeteransAgendathat outlines a robust plan for tackling the issues facing veterans, our service members, and their families, including expanding access to mental health care and treatment, ending the epidemic of veteran suicide, and reducing homelessness.

Hillary Clintons Record

The comprehensive mental health agenda Hillary released today builds on her record of fighting for better services for Americans with mental illnesses. In the U.S. Senate, she co-sponsored the Campus Care and Counseling Act, which established critical mental health support and early suicide prevention for college students across the country. She supported a $500 million increase in mental health care for veterans, co-sponsored the Joshua Omvig Veterans Suicide Prevention Act, and worked across the aisle to make sure their mental health needs would not be forgotten in policy recommendations to the Department of Veterans Affairs. And she strongly supported the enactment of mental health parity laws, which have helped ensure that millions of Americans with mental illness do not lose access to the services that they need because of financial restrictions or arbitrary treatment limits. This record reflects Hillarys strong belief that mental illness must be treated no differently from other medical conditions and her commitment to the needs of Americans and their families coping with mental illness.

[1]Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health, September 2015,http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf).

[2]Center for Behavioral Health Statistics and Quality,Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health(2015). The range of conditions includes depression, which the CDC estimates will soon become the second leading cause of disability in the world, PTSD, which affects nearly 8 million Americans, anxiety, and bipolar disease and schizophrenia.

[3]Nearly half of the people in treatment for drug or alcohol addiction also have a co-occurring mental health problem, as do more than half of incarcerated individuals. See SAMSHA, National Survey of Substance Abuse Treatment Services, at 3 (2013),http://www.samhsa.gov/data/substance-abuse-facilities-data-nssats/reports; NIH,http://www.nimh.nih.gov/health/statistics/prevalence/inmate-mental-health.shtml(using DOJ reports) A quarter of those who are homeless have a mental health problem. HUD, The Annual Homeless Assessment Report to Congress, at 18 (2010),https://www.hudexchange.info/resources/documents/2010HomelessAssessmentReport.pdf.

[4]SAMSHA,http://www.samhsa.gov/veterans-military-families.

[5]Child Mind Institute (2015),Childrens Mental Health Report,

http://www.speakupforkids.org/ChildrensMentalHealthReport_052015.pdf

[6]NAMI, Mental Health on Campus (http://www.bestcolleges.com/resources/top-5-mental-health-problems-facing-college-students/)

[7]Insel, T.R (2008) Assessing the Economic costs of Serious Mental Illness. American Journal of Psychiatry. 165(6), 663-665.

[8]Child Mind Institute (2015),supra.

[9]Pam Belluck, New Findings on Timing and Range of Maternal Mental Illness,New York Times15 Jun. 2014.

[10]Efforts to identify the most promising programs are ongoing. See Nathaniel Counts and Paul Gionfriddo, New Initiative Explores the Intersection of Education and Mental Health,Health Affairs Blog, 23 Aug. 2016http://healthaffairs.org/blog/2016/08/23/new-initiative-explores-the-intersection-of-education-and-mental-health/.

[11]Suicide is the second leading cause of death for people aged 15-34.SeeCDC (2015), http://www.cdc.gov/violenceprevention/pdf/suicide-datasheet-a.pdf.

[12]Veterans commit suicide at rates 50% higher than the general population. Seehttp://www.annalsofepidemiology.org/article/S1047-2797(14)00525-0/. Veterans can be in a state of heightened suicide risk even 30 years after their active service ends.

[13]See, e.g.,The high suicide rate among elderly white men, Wash. Post (Dec. 8, 2014).

[14]Sabrina Tavernise, U.S. Suicide Rate Surges to a 30-Year High,New York Times22 Apr. 2016.

[15]American Suicide Foundation, http://afsp.org/about-suicide/suicide-statistics/.

[16]APA By the Numbers, 7-27-2015.

[18]American Psychiatric Association Report: S. P. Melek, D. T. Norris, and J. Paulus,Economic Impact of Integrated Medical-Behavioral Healthcare: Implications for Psychiatry (Denver, Colo.: Milliman Inc., April 2014.)

[19]AMA/AACAP resources.

[20]The Obama Administration took similar actions to expand the pipeline of mental health providers in the wake of the tragedy at Sandy Hook Elementary. In 2013, the Department of Health and Human Services announced $30 million in grants to training programs at hospitals and universities across the country, in order to train 4,000 new mental health and substance abuse health professionals.Seehttp://www.hhs.gov/about/news/2014/09/22/hhs-announces-99-million-in-new-grants-to-improve-mental-health-services-for-young-people.html. Hillary will evaluate the success of those investments in making future awards.

[21]Arun Rath, When Cop Calls Involve the Mentally Ill, Training is Key,NPR14 Jun. 2014, http://www.npr.org/2014/06/14/322008371/when-cop-calls-involve-the-mentally-ill-training-is-key

[22]APA By the Numbers, 7-27-2015.

[23]Re-engineering Training on Police Use of Force,Police Executive Research Forum, Aug. 2015,http://www.policeforum.org/assets/reengineeringtraining1.pdf

[24]Michael Olive, Despite Laws, Mental Health Still Getting Short Shrift, 7 May 2015, http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/5/07/despite-laws-mental-health-still-getting-short-shrift

[25]NAMI, Road to Recovery: Employment and Mental Illness, at 3-4 (2014), https://www.nami.org/About-NAMI/Publications-Reports/Public-Policy-Reports/RoadtoRecovery.pdf

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Hillary Clintons Comprehensive Agenda on Mental Health