Commencement 2019: Kennedy asks grads to make U.S. safer, more supportive, and more loving for people with mental illness, addiction

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Kennedy at the Podium
URI photo by Michael Salerno

President Dooley, thank you for the honor and opportunity to be here today.

Thank you also for the honorary degree because that makes me one more member of the amazing class of 2019.

So, to the class of 2019, my fellow classmates, congratulations.

And to my fellow Rhode Islanders, it is great to be back home.

I’ve reflected a long time on what kind of message I wanted to offer this special group of students before me.

You know, I’ve given a lot of addresses over the years.

But as they say in the movies… this time, it’s personal.

In an apartment not far from here I began the journey toward discovering the best version of myself, a journey which has lasted, and will continue to last, a lifetime.

A wise person once said the definition of hell is when, on the last day of your life, you meet the best version of yourself… and you discover that there is a huge gap between who you are and who you could have been.

Ouch.

That is not a good situation my friends. So, we all need to work every day to close that gap.

For me, part of this journey has also meant wrestling with the darkest version of myself. My “shadow self” as some call it.

And learning to understand, and embrace, and have compassion for that part of me.

Sometimes we treat ourselves much worse than we would ever treat a friend. We say things to ourselves we would never say to a loved one. That’s been an important reflection for me.

I struggled through high school with what I now understand to be mental illness and addiction.

I have bipolar disorder, and to cope with that I have used both alcohol and prescription painkillers to self-medicate.

And for me this has been the central challenge of my life – amidst a great many blessings.

I am now 51. I recently celebrated with my family a profound and humbling victory: my eighth year of continuous sobriety.

So, this should give you an idea of how protracted this struggle can be.

Growing up, my problems were referred to, if at all, in whispers. And too much of the advice I got was judgmental rather than medically sound and supportive.

I’m very proud that my late father, Senator Edward Kennedy, was one of the nation’s most important champions for healthcare. But he didn’t really understand that what was going on with me was part of healthcare, too.

When it came to my asthma, or my brother’s bone cancer, he was

all-supportive
all-loving
and
all-in

to fight the illness.

But when it came to my mental health challenges, and the vicious cycle of addiction that followed, he tended to lay that one on me – rather than viewing what I was experiencing through the prism of an illness.

This was a blind spot that a lot of people had in his generation. And too many people still have it in your generation.

More often than not, my father’s diagnosis was that “Patrick just needs a good swift kick in the ass.”

We now understand genetic predisposition to addiction and mental health much better. We have tools and therapies to intervene in, and prevent, devastating symptoms and behaviors.

And let me just say that if anyone within the sound of my voice is struggling with these issues, and this is statistically likely, I want you to know from my own experience that this is the most hopeful time in human history for a person to overcome mental health and addiction issues. There is a toolkit that a trained professional can give you to work on these issues. And with the right support, it works.

It’s not easy and it’s not magic but it’s worth it – to live a full and free life. So, let this be the day you resolve to get the help you need and deserve.

Honestly, I was probably the biggest skeptic about these issues. I spent many years lost in the fog of shame…

I also believed I was suffering – not from diseases of the mind and body – but simply because of shameful personal failings. And many times in my life I lacked the faith I could prevail.

These days, I see it more clearly. No one wakes in the morning and chooses to alienate all their family friends and risk losing their job and being arrested. Because they think that it will be a great plan for the day.

By the time I got to Rhode Island to attend URI, I had already been to rehab and attempted the first of my many recoveries. I worked hard at it, and committed to seeing a psychiatrist, but I was so embarrassed that I used to park my car blocks away from his office.

But he helped me—and it was the first time I ever realized treatment with therapy and medication could work.

I struggled with these illnesses, just like everyone else. Being a Kennedy certainly has its benefits.

But I can assure you of this: mental illness and addiction are in no way impressed that I come from a famous family.

Untreated or unheeded, these illnesses are equal opportunity destroyers.

Still, through all of this, at the age of 21, I was elected to the RI House of Representatives. The press noted I was the youngest Kennedy to ever hold office. That was a nice factoid to talk about.

But the real achievement in my own eyes was doing a pretty good job in three terms in the State House – while at the same time dealing with my mental health challenges.

Fighting asthma was tough and it nearly killed me a few times. It was an excruciating painful physical challenge just to breathe during those attacks. But for me, at least, it was a walk in the park compared to maintaining sobriety and struggling with my mind.

This was when I started realizing that getting good care and good insight into your illness—even when you aren’t always the best patient and despite some setbacks—can allow you to function and even thrive.

Again, these diseases are treatable. The challenge is that society discriminates against them and the people who have them.

And so does medical insurance, by not covering them properly and equally with other illnesses. So mental illness and addiction end up being the only diseases for which getting gold-standard treatment is questioned, and even sometimes discouraged.

When I was 27, I was elected to represent Rhode Island in the U.S. Congress. Believe me, I did not go to Washington to become the nation’s voice for mental health and addiction care.

For several years, I tried to add mental health and addiction to my legislative agenda without calling any more attention to my own situation or providing any more personal information.

This was the mental health and addiction equivalent of “don’t ask don’t tell.”

And then I blew it—and almost blew my entire career.

In the Spring of 2006, with my 40th birthday approaching, I was having problems keeping my illnesses under control. I had quietly gone to the Mayo Clinic for care over Christmas, and then when I returned to the House, I tried to balance my duties there with an outpatient day program—which allows you to go to work, but still get intensive therapy and support for recovery.

Then on May 6th, I woke up at 3 am in a panic thinking I was late for a vote. I drove under the influence to the House of Representatives and crashed my car into a security barrier.

On TV the next morning, I was forced to tell the truth.

And THAT is one of the biggest problems when you have a mental illness or struggle with an addiction. It’s the secrecy, the lying, the self-delusion. Ultimately, the shame.

Our secrets are our most formidable adversaries: they are “the enemy within” that blocks our recovery… you become a con artist… only you are your own victim.

I knew this in my heart. So I went for it.

I went from living the big lie… to telling the big truth.

I admitted what had been really going on, in a way I couldn’t take back or hide from. And I announced I was going to get care. This wasn’t about politics. This was about saving my life.

A small side note… when I went back to rehab at the Mayo clinic they conducted a full physical exam. And they actually discovered and removed a couple of precancerous growths on my skin. So, the decision to come clean probably saved my life several times over.

When I got back to work, I felt incredibly fortunate. Not only because I had survived such a dark chapter, but also because had found my highest calling as a public servant: I prepared to devote myself, heart and soul, to making access to treatment for mental illness and addiction a reality for everyone.

During the very next session of Congress, with the support of many like-minded colleagues, I got a bill passed and signed into law called the Mental Health Parity Act.

This basically put mental health and addiction on a par with other chronic illnesses for insurance purposes – as a matter of federal law.

So nowadays, if they treat you for cancer, or diabetes or cardiovascular disease and you also have psychosis or depression or anxiety or addiction, they have to extend treatment to those areas also.

And this holds true whether it’s:

in-patient, in-network
outpatient in-network
in-patient out-of-network
outpatient out-of-network

or whether you’re talking about with pharmacy benefits or emergency room benefits, or both.

That’s a mouthful, but in summary, you’re covered!

But we didn’t stop there.

You know, we said:

“Not only is it wrong to charge higher premiums, higher copays or higher deductibles for mental illness and addiction.

…It’s also against the law to have lower lifetime caps on coverage.”

…And it’s wrong to have more restrictive medical management decisions on whether or not approve care.”

So, they can’t wrap people up in red tape like they used to, with what they call pre-authorization, or concurrent review, or retroactive review to a greater extent than they apply to cancer cases, for example.

We need to make sure medical insurance treats these illnesses equally in relation to other dreaded diseases. And we must eliminate those blind spots in our society.

Too many of us still look upon these illnesses as merely shameful behaviors instead of complex, but highly treatable, conditions.

Taken to the extreme, we see these conditions criminalized in a manner that just throws a mountain of lives in the garbage. We don’t rehabilitate, we incarcerate. And if you follow the money, you understand why.

And some of what the current administration has done in this area has been helpful. I only wish there were more areas of bipartisan, common ground in Washington today.

Let me leave you with my perspective on this. My big picture thinking.

America spent trillions on cancer. My brother had bone cancer, my sister had lung cancer, my mother had breast cancer. Dad had brain cancer. They each benefited from this research and from these lifesaving dollars, as did millions of other Americans.

We now need to ensure we focus on this generation… your generation. I was looking at some of the most recent and most disturbing statistics about the changing causes of death for people your age.

You are the very first generation to be more at risk to die of suicide or overdose – or some other cause connected to mental illness or addiction – than any other cause of death.

Let me repeat that:

You are the very first generation to be more at risk to die of suicide or overdose – or some other cause connected to mental illness or addiction – than any other cause of death.

But you’re also the first generation to grow up under the protections of the Mental Health Parity Act, which we passed to prevent this from happening.

Still, we have a lot of work to do to enforce these laws, and these days that is one of the major areas of advocacy I’m involved in today… to finish the job.

Consider that the height of the HIV Aids crisis we were spending 24 billion dollars a year to combat it because it was killing 53,000 Americans a year. Thankfully, just like many forms of cancer, this has gone from a fatal illness to a mostly manageable chronic disease. This is wonderful news and our hearts soar to hear of these miraculous developments.

But against that backdrop, we had 72,000 fatal overdoses last year. We had 47,000 suicides. Why aren’t 120,000 American lives lost last year to mental health and addiction…. worth the same bold commitment our country is famous for making, to combat other health care challenges?

Why are we spending only 1/5 of the money on something that is killing twice as many people? The staggering rates of suicide and the overwhelming rates of overdoses among young people are literally lowering our life expectancy as a nation.

To make matters even worse, the opioid and methamphetamine epidemics have ripped a hole in our social fabric that across the entire country. No one is exempt from this. But somehow, we still don’t have the sense of urgency required to reverse this appalling scourge.

At this very moment, several presidential candidates are floating the idea of what they describe as a major investment in the nation’s mental health infrastructure.

But I have to be straight with you. They aren’t talking cancer dollars. It’s more or less a drop in the bucket. They’d be pushing more boldly for funding if they really thought a suicide or addiction death was on par with a cancer death.

We need to look out for young people in this society, and you need to exercise your vote.

Maybe we need to take a harder look at giving you the vote a bit earlier because not enough people are looking out for you in Washington.

At the very least, I want that 24-year-old who overdoses or that thirty-year-old who contemplates suicide to be valued at least as much as a person like my Dad, who died in his 70’s from brain cancer.

This is also an investment to counter income inequality. Consider that instead of making a few people at the top of the economic ladder richer, this money can allow all Americans to live a richer, healthier life.

Again, we benefit as a society when we treat mental illnesses and addiction as health issues instead of as criminal justice issues. There are proven, scalable programs that succeed at a community level. The Kennedy Forum is committed to promoting these solutions. We want to implement what works, over and over again.

This is the public health challenge of our time, and solving it will help reconnect our fractured nation.

Because, regardless of your age, your gender, your ethnicity, your politics or your socioeconomic class, we all have one thing in common – our brains are what allow us to function and be ourselves.

And if our brain diseases are not properly treated… we lose ourselves… and America loses what we could contribute.

It’s a time of particular uncertainty for young people. I urge you to consider meeting that uncertainty with action. To dedicating some of your valuable time and youthful energy to a cause greater than yourself.

Today this generation faces multiple existential crises…

You have shown the courage to tackle climate change where past generations have failed.

You are witnessing challenges to the fragile balance of power in our democracy that previous generations took for granted.

And today, I have talked to you about the devastating mental health and addiction statistics threatening your own generation with epidemics that no other generation has endured.

We have a lot of overwhelming concerns in the world now. But please, don’t let this issue get lost. That is my request to you as the future of this country and as voters who will shape the national dialogue for many decades.
As you go out into the world today, I ask you to do whatever it takes to make this country a safer, more supportive, and more loving place for people with mental illness and addiction. Do it for yourself. And do it for all the Rhode Island kids coming up behind you.