Gov. Gina Raimondo and state officials were joined by former Congressman Patrick Kennedy on Saturday for a discussion about the mental health and substance abuse issues facing Rhode Island. Hosted by Portsmouth Sen. Jim Seveney, members of the Governor’s cabinet and substance abuse community program leaders spent an hour and a half in a standing-room-only Portsmouth Town Council chamber hearing from local activists and residents.
A major focus of the discussion was mental health parity, the principle that insurers are legally required to cover mental issues at same level as physical illness. Although passed by Congress almost 10 years ago, implementation has lagged, leading to frustration and gaps in care among many in dire need.
Raimondo, who had signed an executive order on Friday directing state agencies to step up efforts at parity enforcement, blamed a history of hiding mental illness. “I can’t go anywhere without hearing about mental health, mental illness, and addiction,” said Raimondo. “It’s everywhere. We’re here today to talk about it. We’re going to put it out in the open and get rid of the stigma.”
Patrick Kennedy, who sponsored the federal legislation back in 2008, called it a “medical civil rights bill for people suffering from brain illnesses.”
He said, “Stigma is the biggest barrier holding us back. We may not change attitudes about people who suffer from addiction or mental illness, but we can change the practices of insurance companies and payors when it comes to reimbursing for the treatment of those illnesses.”
Kennedy told a reporter that a two-pronged strategy of advocacy and legal action was needed to ensure compliance. He saw hope in an “organized, mature advocacy movement,” coupled with work by organizations like the Kennedy Forum which tracks cases and helps share best practices on “the best way to successfully litigate.”
“This is not going to happen without a few lawsuits to burnish the idea that there’s liability on the side of not doing this,” said Kennedy. “We want people to do it voluntarily because it makes good business sense — good financial and fiscal health sense. But at the end of the day, you need that stick too.”
The panel on hand for the discussion was chaired by the governor’s addiction policy advisor, Tom Coderre, recently returned to the state from an advisory post in the federal Substance Abuse and Mental Health Services Administration. He was joined by Nicole Alexander-Scott, director of the RI Dept. of Health, Rebecca Boss, director of Behavioral Health, Developmental Disabilities and Hospitals (BHDDH), Laurie MacDougal, founder of Resources Education Support Together (REST), Zarchariah Kenyon, Capt. Providence Fire Department, Emily Pearce-Spence, coordinator of East Bay Recovery, Rebecca Elwell, director of the Newport County Prevention Coalition, and Tom Hill, CEO of Journey to Hope.
“Patrick and I both went through very public battles with addiction, so it was pretty easy for us to decide to make our recovery public,” said Coderre, thanking the packed Council chamber for turning out for the session. “It really needs to happen a lot more. The community coming out and talking about issues like this, that’s the best way to break down negative public attitudes.”
But community attitudes alone don’t support the many organizations involved in these efforts, and funding was another significant topic of discussion. One attendee asked, pointedly, about the state’s lack of financial support for its prevention coalitions, which provide critical front-line educational services.
“No other state in the country has 37 integrated local drug coalitions,” said Portsmouth resident Steve Alexander. He praised the work of Portsmouth Prevention Coalition leader Ray Davis and questioned why he, and other coordinators around the state were being shorted on funding. “In 1987, Rhode Island passed a piece of legislation that took a percentage of the traffic violations and civil marijuana penalties and funded the drug coalitions across the state. Unfortunately, those monies were never delivered.”
Alexander thanked Sen. Seveney for introducing a bill, S2025 , which would ensure that the previously earmarked funds were delivered to the prevention coalitions. “It’s coming up this Tuesday at Senate Judiciary,” Seveney told a reporter, “This is the second time that Rep. Edwards and I have pushed to get this legislation out onto the respective floors and voted on.”
Attendees in recovery and those whose families were touched by addiction spoke about the essential nature of the services provided by the state and service organizations. Early intervention, availability of Narcan, foster families, “safe stations” to connect people with recovery services, the role of the faith community, empowering families, expanded options for treatment, student counselors, and the dangers of legalizing marijuana were all advanced as key issues.
The session could not have been more timely, Coderre told a reporter. “On Wednesday, the [Overdose Prevention and Intervention] task force is meeting to look at our strategic plan,” said Coderre. “Conversations like this will help inform that planning process.”
It will be hard for planners not to think of the final story told by a Portsmouth mom named Debbie, a woman in recovery whose oldest son went to West Point, for which she thanked Patrick Kennedy.”But my youngest is the one I’m the most proud of,” she said. “His name is Bradley. He was 25. On May 10, 2017, I lost him in California. It’s a hard week, coming up on his anniversary. I don’t know what you’re supposed to be doing.I’m a mom and a nurse, and I couldn’t save my son. I saw the warning signs that I didn’t know what to do with.”
“Families need a voice,” said Debbie. “Where do you start and where does it end? It’s the power and the resources that the family can provide.”