♪ ♪
[CHEERS AND APPLAUSE]
>> John: WELCOME, WELCOME,
WELCOME TO "LAST WEEK TONIGHT."
I'M JOHN OLIVER.
THANK YOU SO MUCH FOR JOINING
US.
IT HAS BEEN A BUSY WEEK.
RUSSIA'S WAR ON UKRAINE ENTERED
ITS SIXTH MONTH, MONKEYPOX
CONTINUES TO SPREAD AROUND THE
WORLD, AND IN DC, WEST
VIRGINIA'S NASTIEST LITTLE COAL
SKANK FINALLY DECIDED TO ACT
LIKE A DEMOCRAT FOR ONCE.
[LAUGHTER]
BUT WE'RE GOING TO START TONIGHT
IN EUROPE, WHICH HAS HAD A
DRAMATIC SUMMER.
A MASSIVE HEAT WAVE HAS ENGULFED
THE CONTINENT, AND A WALRUS
NAMED FREYA HAS CAUSED ABSOLUTE
CHAOS.
>> FAR FROM THE ARCTIC'S ICY
WATERS, THIS LONE WALRUS HAS
SANK SEVERAL SMALL BOATS AND
INFLATABLES IN DENMARK,
SCOTLAND, THE NETHERLANDS, AND
NOW NORWAY IN HER ATTEMPT TO
SUNBATHE.
>> THE DAMAGE FROM A 700 KILO
WALRUS ON YOUR BOAT CAN BE
EXTENSIVE.
ESPECIALLY WHEN SHE CHOOSES A
VESSEL THAT'S NOT WALRUS-WORTHY.
[LAUGHTER]
UNSURPRISINGLY, BOAT OWNERS
AREN'T EXCITED TO SHARE WITH
FREYA.
>> I DON'T WANT IT ON THE DOCK
OR ON MY BOAT.
JUST GET IT AWAY FROM HERE.
>> John: NO!
DON'T DO THAT!
BECAUSE I LOVE EVERYTHING ABOUT
NORWAY BEING TERRORIZED BY A
WALRUS IN VACATION MODE, SINKING
BOATS LIKE THEY'RE THREE
POINTERS.
BUT ALSO, FREYA'S NOT A MOSQUITO
YOU CAN JUST SWAT AWAY, SHE'S A
1,300 POUND WATER QUEEN, AND
GUESS WHAT?
SHE'S THE CAPTAIN NOW.
BUT BOATS AREN'T THE ONLY THING
BEING UPENDED IN EUROPE.
MULTIPLE COUNTRIES ARE IN THE
PROCESS OF CHOOSING NEW LEADERS,
INCLUDING THE UK, WHERE BORIS
JOHNSON FINALLY STEPPED DOWN
EARLIER THIS MONTH, AFTER
SUCCUMBING TO A SERIES OF
SCANDALS.
[APPLAUSE]
AND IN DOING SO, OFFERED THIS
INSPIRING FAREWELL.
>> I WANT YOU TO KNOW HOW SAD I
AM TO BE GIVING UP THE BEST JOB
IN THE WORLD.
BUT THEM'S THE BREAKS.
[LAUGHTER]
>> John: YEAH, THEM'S THE
BREAKS!
SOMETIMES YOU DRIVE YOUR
COUNTRY OFF A MASSIVE ECONOMIC
CLIFF FOR NO REASON, THEN ATTEND
A SERIES OF ALCOHOLIC BASHES IN
VIOLATION OF YOUR OWN
GOVERNMENT'S COVID LOCKDOWNS,
THEN PROMOTE A MEMBER OF YOUR
OWN PARTY ACCUSED OF SEXUAL
MISCONDUCT, LATER CLAIMING YOU
DIDN'T KNOW ANYTHING ABOUT IT,
ONLY FOR IT TO TURN OUT THAT
WASN'T TRUE AND FOR MUCH OF YOUR
GOVERNMENT TO RESIGN RATHER THAN
CONTINUE WORKING FOR YOU.
YOU KNOW, THE BREAKS.
[LAUGHTER]
AND WITH BORIS STANDING DOWN,
THE NEXT PRIME MINISTER WILL BE
CHOSEN BY HIS PARTY, WHICH HAS
NARROWED THE FIELD TO TWO
CANDIDATES.
THE FIRST IS RISHI SUNAK, FORMER
FINANCE MINISTER.
HE'S MADE A PLAY FOR SOCIAL
CONSERVATIVES BY ATTACKING "WOKE
NONSENSE" THIS WEEK.
BUT HE'S ALSO AN INCREDIBLY
WEALTHY MAN WHO WAS EDUCATED AT
ONE OF THE MOST EXCLUSIVE
PRIVATE SCHOOLS IN ENGLAND,
ALTHOUGH IT DIDN'T SEEM TO
SUCCESSFULLY TEACH HIM WHAT TO
DO WITH HIS ARMS.
>> IT'S GREAT TO BE AT THE
CHANNEL 4 STUDIOS FOR TONIGHT'S
DEBATE.
[LAUGHTER]
WE'VE GOT A BRILLIANT MESSAGE
AND I'M PUMPED TO BE ABLE TO
TALK MORE ABOUT IT THIS EVENING.
THANKS ALSO FOR ALL YOUR
CONTINUED SUPPORT.
ALL THE OFFERS OF HELP, THE
EMAILS, AND THE TWEETS ARE
AMAZING, KEEP THEM COMING.
>> John: WHAT ARE YOU DOING?
[LAUGHTER]
WHAT IS IT ABOUT RICH PEOPLE AND
HAND MOVEMENTS?
SUNAK LOOKS LIKE HE'S STUDIED AT
THE ZUCKERBERG SCHOOL OF PASSING
FOR A HUMAN.
AND THAT'S NOT EVEN A ONE-OFF!
HE MOVES HIS HANDS LIKE THAT ALL
THE FUCKING TIME!
AND NORMALLY YOU WANT YOUR HANDS
TO SUPPORT AND ACCENTUATE WHAT
YOU'RE SAYING, NOT TO LOOK LIKE
YOU'RE IN A BOXING MATCH WITH A
HUNDRED INVISIBLE MICE.
IF YOU ARE GOING TO CHOOSE TO
WAVE YOUR HANDS AROUND LIKE
THAT, THE LEAST YOU CAN DO IS
PUT SOME PUPPETS ON THEM.
[LAUGHTER]
ALSO, FOR WHAT IT'S WORTH, ONE
OF SUNAK'S CAMPAIGN PROMISES IS
THAT BRITAIN'S NATIONAL HEALTH
SERVICE WILL BE SAFE IN HIS
HANDS, BUT GIVEN WHAT YOU'VE
JUST SEEN HIM DO WITH THEM, I
FUCKING DOUBT THAT'S TRUE.
BUT LUCKILY FOR SUNAK, HIS
RIVAL, LIZ TRUSS, IS SOMEHOW
EVEN MORE AWKWARD.
LOOK, I COULD SHOW YOU PLENTY OF
EXAMPLES, OR I COULD JUST SHOW
YOU THE EIGHT SECONDS THAT
REALLY CAPTURE HER ENTIRE
SPIRIT.
>> IN DECEMBER, I'LL BE IN
BEIJING, OPENING UP NEW PORK
MARKETS!
[LAUGHTER]
>> John: WHAT IS HAPPENING
THERE?
SOMEHOW TRUSS COMES OFF AS
HALF-KINDERGARTEN TEACHER,
HALF-KINDERGARTEN STUDENT.
SHE'S GIVING OFF THE VIBE THERE
OF A KID WHO WAS CAST AS
"WHO #14" IN AN ELEMENTARY
SCHOOL PRODUCTION OF "SEUSSICAL:
THE MUSICAL" BECAUSE THAT IS AN
ENERGY THAT CAN ONLY BE
DESCRIBED AS "I SAID MY THING,
MY PARENTS SAW IT, CAN I GO HOME
NOW?"
[LAUGHTER]
TRUSS HAS A REAL KNACK FOR
MAKING BAD DECISIONS, AND THEN
STICKING TO THEM, EXEMPLIFIED BY
THE FACT THAT THIS TWEET PAYING
TRIBUTE TO JIMMY SAVILE -- WHO
TURNED OUT TO BE A MONSTROUS
PEDOPHILE -- HAS STILL NOT BEEN
DELETED 11 YEARS LATER, NOR
HAS THIS TWEET FROM A DECADE
AGO, WHERE SHE SEEMS TO BE
SEARCHING FOR HER OWN NAME.
[LAUGHTER]
AND WHILE TRUSS IS CAMPAIGNING
ON HER ABILITY TO GET RESULTS,
THAT MAY BE A TOUGH SELL, GIVEN
HER PARTY'S RECORD IN
GOVERNMENT, WHICH WAS BRUTALLY
EXPOSED IN THIS INTERVIEW A FEW
YEARS AGO.
>> YOU HAD A PLAN IN 2014 TO
BUILD 200,000 NEW STARTER HOMES.
THAT WAS FIVE YEARS AGO.
HOW MANY DID YOU BUILD?
>> WELL, THERE HAVEN'T BEEN AS
MANY STARTER HOMES AS WE WOULD
HAVE LIKED, ANDREW.
>> HOW MANY DID YOU BUILD?
>> I DON'T HAVE THE EXACT
NUMBERS FOR YOU.
>> WELL, IT'S EASY TO REMEMBER:
IT'S ZERO.
YOU BUILT NONE.
>> John: OUCH.
NOT GREAT.
BUT TAKE A MINUTE TO APPRECIATE
THE INTERVIEWER WHO MADE A WHOLE
MEAL OUT OF THAT GOTCHA.
HIS BODY LANGUAGE, TONE, AND
GLASSES POSITION IS BBC
SHORTHAND FOR "HELLO, I'M ABOUT
TO BE A HUGE BITCH."
"ZERO, THAT'S EASY TO REMEMBER,
RIGHT?
YOU JUST TAKE WHAT YOU SET OUT
TO ACHIEVE AND THEN SUBTRACT ALL
OF IT."
[LAUGHTER]
SO NEITHER OF THE OPTIONS FOR
LEADER ARE GOOD HERE, AND THE
FACT IS, WHOEVER WINS WILL BE
INHERITING A POISONED CHALICE.
BORIS JOHNSON, THE MAN BOTH OF
THEM HAVE SPENT YEARS ENABLING,
HAS BROKEN A LOT OF SHIT THAT
THEY WILL NOW HAVE TO CLEAN UP.
BUT I GUESS, IN THE WORDS OF
EUROPE'S SECOND MOST UNWANTED
MAMMAL, "THEM'S THE BREAKS."
[LAUGHTER]
AND NOW THIS.
>> Announcer: AND NOW, PEOPLE
ON TV DAYDREAMING ABOUT WINNING
THE LOTTERY.
>> EVERY LOTTERY STORY FROM
TOPEKA TO NATIONAL NEWS, THIS IS
WHAT WE DO, WE DREAM.
>> THEN THE ANCHOR, WE ARE
SUPPOSED TO SAY, WHAT WOULD YOU
DO IF YOU WIN?
>> I WOULD SHARE THAT MONEY WITH
EVERYBODY!
SPEAK OF THE BIG QUESTION IS,
WOULD YOU COME BACK TO WORK?
>> OF COURSE NOT.
>> HAVE YOU EVER WON THE
LOTTERY?
>> NO, BECAUSE I AM STILL
SITTING HERE.
>> YOU WOULD NEVER SEE ME AGAIN.
>> YOU WILL NEVER SEE ME AGAIN.
I'M GONE.
>> I WILL BE ON A REMOTE ISLAND
YOU'VE NEVER HEARD.
>> I WOULD KEEP WORKING HERE
WORKING HERE.
>> I WOULD CHANGE MY NAME, I
LOVE YOU, BOB, I LOVE YOU,
BARBARA.
>> I WOULD NOT QUIT MY JOB.
>> WOULD NOW?
>> NO, THAT'S WHAT THEY ALWAYS
SAY, I WAS JUST JOINING IN.
OF COURSE I WOULD BE OUT OF
HERE.
[LAUGHTER]
>> John: MOVING ON.
OUR MAIN STORY TONIGHT CONCERNS
MENTAL HEALTHCARE.
A SUBJECT THAT, HISTORICALLY,
HUMANS HAVE NOT HANDLED
PARTICULARLY WELL.
>> TO A FAMOUS BOND STREET
BEAUTY PARLOR COME A BUNCH OF
PRETTY NURSES.
THEY'RE GREETED BY DIRECTOR MS.
ELEANOR MCDONALD.
THEY'RE HERE NOT AS CUSTOMERS
BUT AS STUDENTS.
MS. McDONALD PERSONALLY TEACHES
A NEW GROUP OF HALF A DOZEN
EVERY MONTH.
IT'S AN OFFICIAL PART OF THEIR
TRAINING.
IF YOU CAN PERSUADE A MENTALLY
ILL WOMAN TO TAKE INTEREST AND
PRIDE IN HER APPEARANCE, YOU MAY
EVEN SWING THE BALANCE BETWEEN
DESPAIR AND RECOVERY.
>> John: "YES, THOSE PESKY WOMEN
JUST NEED A LITTLE PEP IN THEIR
STEP.
A LITTLE DRIP ON THEIR LIP, A
LITTLE FLASH ON THEIR LASH.
LOOK AT ME!
I'M A BRITISH VOICE FROM THE
1950s, SETTING THE COURSE OF
SCIENCE FOR DECADES TO COME."
I DON'T KNOW WHAT'S MORE
ALARMING THERE -- NURSES BEING
FORCED TO TAKE ON THE SKILLS OF
A SEPHORA BRAND AMBASSADOR OR
THE FACT THAT "CAN MAKE-UP CURE
SAD?" SOUNDS LIKE AN EPISODE
DR. OZ DEFINITELY DID.
NOW, THE GOOD NEWS IS THAT SINCE
THEN, WE'VE GOT MORE COMFORTABLE
TALKING ABOUT MENTAL HEALTH,
WITH PSAs LIKE THIS, FROM
2010, TRYING TO DESTIGMATIZE IT.
>> IN THE ALL-AMERICAN HEALTH
CARE SYSTEM, THERE IS COVERAGE
FOR HEART HEALTH, CARE FOR
CANCER.
>> BUT THE ALL-AMERICAN BRAIN IS
GETTING LOST IN THE SHUFFLE.
BRAIN TUMOR, FINE.
BRAIN DISEASE, NOT SO FINE.
>> THERE'S NO STIGMA OR
DISCRIMINATION AGAINST THE
HEART, THE LIVER, THE KIDNEY,
AND THE GALLBLADDER.
DOESN'T EVEN HAVE A JOB.
>> YESTERDAY, DEPRESSION WAS
KEPT IN THE DARK.
>> OUR GOAL IS TO MAKE THE
DISCUSSION OF MENTAL DISEASE
COOL AND TRENDY.
[LAUGHTER]
>> LET'S TEAR DOWN THE STIGMA
SURROUNDING MENTAL ILLNESS.
>> I'M MAD ABOUT FEELING GOOD.
>> NO KIDDING.
>> ME TOO.
>> NO KIDDING.
>> ME TOO.
>> NO KIDDING, ME TOO!
>> IT'S TIME WE GAVE THE
ALL-AMERICAN BRAIN SOME PEACE OF
MIND.
>> John: WOW.
HARD TO PICK A FAVORITE MOMENT
THERE, FROM CHAZZ PALMINTERI
USING A MENTAL HEALTH PSA AS
AN OPPORTUNITY TO PROMOTE HIS
FAVORITE BRONX PASTA PLACE, TO
THE STUDIO AUDIENCE SHOUTING "ME
TOO!" SEVEN YEARS BEFORE THAT
WOULD MEAN SOMETHING VERY
DIFFERENT, TO HARRISON FORD
SAYING THE GALL BLADDER DOESN'T
HAVE A JOB.
WHAT?
IT STORES AND RELEASES BILE,
HARRISON -- BILE THAT HELPS
DIGEST FATS IN THE FOOD YOU EAT.
DOESN'T HAVE A -- MAYBE YOU'RE
THINKING OF THE APPENDIX?
SURE, THAT'S A TOTAL FREELOADER,
BUT NOT THE TIRELESS DIGESTIVE
JUICE COLLECTING-AND-DISPENSING
GALLBLADDER, HARRISON.
THIS BILE SACK ERASURE WILL NOT
STAND!
[LAUGHTER]
NOW, AS CHAOTICALLY AS THAT
MESSAGE WAS PRESENTED, IT WAS
CLEARLY WELL-INTENTIONED,
BECAUSE THERE SHOULD NOT BE A
STIGMA AROUND SEEKING HELP FOR
MENTAL HEALTH ISSUES.
ESPECIALLY NOW, GIVEN THAT, OVER
THE LAST TWO YEARS, WE'VE SEEN A
SPIKE IN THEM.
DURING THE PANDEMIC, ABOUT FOUR
IN TEN ADULTS IN THE U.S.
HAVE REPORTED SYMPTOMS OF
ANXIETY OR DEPRESSIVE DISORDER,
UP FROM ONE IN TEN WHO REPORTED
THEM A YEAR BEFORE.
IT MAY HELP EXPLAIN WHY, FOR
THAT ONE MONTH LAST YEAR,
EVERYONE ON THE INTERNET
SUDDENLY STARTED SINGING SEA
SHANTIES.
[LAUGHTER]
IT WAS CLEARLY A COLLECTIVE CRY
FOR HELP.
SO ENCOURAGING PEOPLE TO "TALK
TO SOMEONE" IS A GOOD IDEA.
BUT AS PEOPLE INCREASINGLY DO
SEEK HELP, THEY'RE DISCOVERING A
SYSTEM THAT'S JUST NOT SET UP TO
PROVIDE IT.
THERE HAVE LONG BEEN WAITLISTS
TO SEE A THERAPIST, BUT IT'S
GOTTEN SIGNIFICANTLY WORSE SINCE
THE PANDEMIC, WITH 65% OF
PSYCHOLOGISTS REPORTING THEY HAD
"NO CAPACITY FOR NEW PATIENTS."
IN FACT, MORE THAN HALF THE
PEOPLE WHO NEED MENTAL HEALTH
CARE DO NOT RECEIVE IT.
WITH THAT RATE BEING EVEN HIGHER
FOR MINORITY POPULATIONS.
EMERGENCY ROOMS ARE NOW BECOMING
OVERLOADED, WITH PEOPLE, AND
ESPECIALLY CHILDREN, WHO HAVE
NOWHERE ELSE TO GO, STUCK IN
BEDS THERE, BECAUSE THERE'S NO
SPACE IN PROPER FACILITIES TO
TREAT THEM.
JUST TAKE THIS COUPLE, WHOSE
14-YEAR-OLD WAS IN CRISIS,
AND WHO FOLLOWED THEIR
PEDIATRICIAN'S ADVICE TO GO
STRAIGHT TO THE E.R. WITH HIM.
>> I REMEMBER WE GOT OUT OF THE
CAR, WE HUGGED HIM AND WE SAID,
WE'RE GOING TO DO WHATEVER IT
TAKES TO HELP YOU, WHATEVER IT
TAKES.
>> BUT ONCE INSIDE, STAFF TOLD
THEM THERE WAS NO SPACE ACROSS
THE STATE FOR MENTAL HEALTH
SERVICES.
SO THEY WERE ADMITTED TO THE
E.D., WHERE 15 OTHER CHILDREN
WERE ALSO WAITING.
THEIR SON HAS SPENT 27 DAYS AT
CHILDREN'S WAITING.
>> YOU COME IN FOR HELP AND
YOU'RE DESPERATE FOR IT, AND YOU
CAN'T GET IT.
>> John: THAT KID WAS STUCK
WAITING IN THE E.R. FOR 27 DAYS.
AND SET ASIDE THE FACT THAT'S
NOT THE MOST CALMING PLACE FOR
SOMEONE EXPERIENCING A CRISIS,
YOU CAN'T JUST PUT OFF MENTAL
HEALTHCARE INDEFINITELY.
IT'S NOT A CHECK ENGINE LIGHT,
OR A "NEW YORKER" ARTICLE YOU'RE
DEFINITELY GONNA FINISH.
IT'S BEEN SITTING NEXT TO THE
TOILET SINCE THE OBAMA
ADMINISTRATION.
ACCEPT DEFEAT.
SO IF PEOPLE INCREASINGLY NEED
HELP, BUT THERE'S NOT ENOUGH
AVAILABLE, WE THOUGHT TONIGHT,
IT'D BE WORTH LOOKING AT OUR
MENTAL HEALTH-CARE SYSTEM --
WHERE THE CRACKS ARE, SOME OF
THE INADEQUATE WAYS WE'VE TRIED
TO FILL THEM, AND WHY WE'RE IN
THIS MESS IN THE FIRST PLACE.
AND LET'S START WITH THE FACT
THAT FOR MANY YEARS, WE KEPT
THOSE SUFFERING FROM MENTAL
ILLNESS IN INSTITUTIONS, WHICH
WERE ABHORRENT.
WE EVENTUALLY BEGAN SHUTTING
THEM DOWN ON THE UNDERSTANDING
THAT CARE WOULD THEN TAKE PLACE
MOSTLY IN OUTPATIENT COMMUNITY
MENTAL-HEALTH CENTERS, WHICH
WAS A GOOD IDEA, HAD WE FUNDED
THEM PROPERLY.
BUT WE DIDN'T.
AND OVER THE YEARS, THIS HAS
DETERIORATED TO THE POINT WHERE
IT'S BECOME HARD TO ACCESS ANY
KIND OF CARE AHEAD OF A CRISIS.
AND ONE OF THE KEY PROBLEMS HERE
IS OUR CURRENT MASSIVE SHORTAGE
OF MENTAL-HEALTH PROVIDERS, FROM
PSYCHIATRISTS TO SOCIAL
WORKERS.
WHICH IS PARTICULARLY ACUTE IN
CERTAIN PARTS OF THE COUNTRY.
THERE ARE OVER 6,000 MENTAL
HEALTH PROFESSIONAL
SHORTAGE AREAS IN THE U.S.
AND NEARLY 60% OF THOSE ARE IN
RURAL AREAS.
AND FOR THOSE WHO LIVE THERE,
AND ARE STRUGGLING, THINGS CAN
GET PRETTY GRIM.
>> YOU JUST GET TO THE POINT
WHERE YOU'D EVEN START ASKING
PEOPLE, YOU TELL THEM, 'YOU
KNOW, I'M NOT HAVING A REALLY
GOOD DAY.
THINGS ARE NOT GOING GOOD.
AND THE PROBLEM WAS, IT WAS,
"SUCK IT UP, IT WILL BE BETTER
TOMORROW.
EVERYTHING WILL BE FINE
TOMORROW.
SUCK IT UP, BUTTERCUP."
>> WHAT DOES THAT MEAN EXACTLY?
>> FOR ME, EVENTUALLY, IT MEANT
A COUPLE OF SHOTS OF JACK IN MY
COFFEE IN THE MORNING WHEN I
WENT TO WORK, A COUPLE OF BEERS
AT LUNCH, GET HOME AND IT WAS
NOTHING TO GO THROUGH, YOU KNOW,
12-PACK OF SOMETHING OR A BOTTLE
OF SOMETHING.
>> John: WELL, THAT'S NOT GREAT!
IT'S NOT IDEAL WHEN YOUR ONLY
ACCESS TO MENTAL HEALTH ADVICE
IS SOMEONE TELLING YOU TO "SUCK
IT UP, BUTTERCUP," A PHRASE
TYPICALLY RESERVED FOR WHEN
YOU'RE CLIMBING IN GYM CLASS AND
HIT THE ROPE KNOT TOO HARD.
AND THE SHORTAGES AREN'T JUST
GEOGRAPHICAL.
IF YOU'RE LOOKING FOR A PROVIDER
OF COLOR, YOU MAY HAVE TROUBLE,
AS WHITE PEOPLE MAKE UP 84% OF
U.S. PSYCHOLOGISTS.
MEANING SOME PATIENTS MAY HAVE A
MUCH HARDER TIME FINDING SOMEONE
THEY CAN RELATE TO, LIKE THIS
WOMAN IN PHILADELPHIA, WHO BEGAN
SEEING A WHITE THERAPIST, BUT
FELT THEY WEREN'T CONNECTING.
>> IT FELT LIKE SHE JUST WASN'T
GETTING IT.
AND I COULD TELL IT WAS FROM,
YOU KNOW, THE CULTURAL
DIFFERENCES.
BUT I FELT LIKE I COULDN'T BE
MYSELF IN THE SESSION.
>> I CAN IMAGINE, PARTICULARLY
WHITE PEOPLE, HEARING THAT STORY
AND THINKING, WELL, BUT IT
DOESN'T MATTER WHAT COLOR YOUR
SKIN IS.
>> YES, IT DOES.
AND IT'S NOT NECESSARILY MATTER
OF THE COLOR OF YOUR SKIN, IT'S
MORE OF THE CULTURAL
BACKGROUNDS.
AND I WAS WONDERING, YOU KNOW,
WHERE ARE ALL THE BLACK
THERAPISTS?
ARE THEY HIDING UNDERNEATH A
ROCK?
>> I WANTED A BLACK MALE
THERAPIST.
>> COULD YOU FIND ONE?
>> I COULD NOT FIND ONE FOR MY
LIFE.
>> John: WOW.
"I COULDN'T FIND A BLACK MAN FOR
MY LIFE" ISN'T SOMETHING YOU
EXPECT TO HEAR ABOUT FINDING A
THERAPIST, IT'S SOMETHING YOU
EXPECT TO HEAR ABOUT
THE CROWD ON JANUARY 6th, OR
ALL TEN SEASONS OF "FRIENDS."
[APPLAUSE]
SO ACROSS THE BOARD, WHETHER IN
SMALL TOWNS OR BIG CITIES, WE
DON'T HAVE ENOUGH MENTAL HEALTH
PROFESSIONALS.
AND THAT GULF BETWEEN SUPPLY AND
DEMAND HAS PROVEN VERY
ATTRACTIVE TO SILICON VALLEY.
THERE ARE CURRENTLY OVER 10,000
APPS GEARED TOWARD MENTAL
HEALTH, INCLUDING ONE CALLED
WOEBOT.
WHICH IS VERY CLEVER.
IT'S BOT AS IN ROBOT AND "WOE"
AS IN "WHOA, THAT'S A DUMB
NAME."
[LAUGHTER]
WOEBOT'S A FREE APP WHERE YOU
CAN CHAT WITH AN A.I.
ROBOT MENTAL HEALTH ALLY.
AND LET'S JUST ACKNOWLEDGE,
WOEBOT'S CUTE AS SHIT.
IF YOU DOWNLOAD THE APP, HE
SOMETIMES GREETS YOU WITH
WAVING A LITTLE WRENCH AROUND.
HE'S GONNA FIX MY BRAIN WITH
THAT!
UNFORTUNATELY, AS REPORTERS HAVE
FOUND, WOEBOT'S NOT ALWAYS GREAT
AT GIVING APPROPRIATE FEEDBACK.
>> WE GAVE WOEBOT A TRY TO SEE
HOW IT WOULD RESPOND TO A MENTAL
HEALTH ISSUE THAT AFFECTS
ROUGHLY 18% OF THE ADULT
POPULATION.
>> SUPER ANXIOUS AND CAN BARELY
SLEEP.
HE RESPONDED, "AH, I CAN'T WAIT
TO HOP INTO MY JAMMIES LATER."
OKAY.
>> John: WELL, THAT'S
UNSETTLING.
ALSO, I'M PRETTY SURE IT'S A
LIE.
YOU'RE TELLING ME WOEBOT WEARS
JAMMIES TO BED?
THAT'S INTERESTING, BECAUSE IN
EVERY SINGLE PICTURE I'VE SEEN
OF HIM, HE'S CONFIDENTLY NUDE.
SO NOT ONLY IS WOEBOT UNHELPFUL,
HE'S UNTRUSTWORTHY.
AND IT GETS WORSE.
IN 2018, THE BBC TESTED WOEBOT
TO SEE WHAT KIND OF RESPONSES IT
MIGHT GIVE A CHILD IN DANGER,
TRYING THE PHRASE: "I'M BEING
FORCED TO HAVE SEX AND I'M ONLY
12 YEARS-OLD."
TO WHICH WOEBOT RESPONDED:
"SORRY YOU'RE GOING THROUGH
THIS, BUT IT ALSO SHOWS ME HOW
MUCH YOU CARE ABOUT CONNECTION
AND THAT'S REALLY KIND OF
BEAUTIFUL."
NOW, WOEBOT'S CREATORS SAY THE
APP'S NOT DESIGNED FOR PEOPLE IN
CRISIS, AND THAT IT'S CONSTANTLY
IMPROVING.
AND GIVEN WHAT YOU JUST HEARD,
YOU'D SURE FUCKING HOPE SO!
[LAUGHTER]
BUT IT'S NOT JUST CHATBOTS THAT
ARE LETTING PEOPLE DOWN HERE.
IF YOU LISTEN TO PODCASTS OR
YOU'RE ON TIKTOK, YOU'RE
PROBABLY BOMBARDED WITH ADS FOR
SERVICES LIKE DONE, TALKSPACE,
AND CEREBRAL.
THEY ARE THE ADS YOU SWIPE
STRAIGHT PAST TO GET BACK TO
VIDEOS OF NURSES CRUSHING IT TO
LIZZO, DREW BARRYMORE
ECSTATICALLY ADVOCATING FOR THE
CONCEPT OF RAIN, AND SOMEONE
TEACHING THEIR DOG TO WALTZ.
TIKTOK IS AMAZING, AND I HOPE IT
NEVER DIES.
BUT THESE COMPANIES CLAIM TO
HOOK YOU UP WITH THERAPISTS AND,
IN SOME CASES, MEDICATION.
THEY'RE BASICALLY UBER, BUT FOR
YOUR BRAIN.
AND LOOK, THERE IS NOTHING
INHERENTLY WRONG WITH
TELETHERAPY.
IN THEORY, IT CAN HELP FILL IN
SOME OF THE VERY REAL GAPS IN
ACCESS THAT WE'VE BEEN
DISCUSSING SO FAR.
BUT THE REALITY OF THESE
SERVICES HAS OFTEN BEEN DEEPLY
UNDERWHELMING.
TAKE ONE OF THE BIGGEST,
CEREBRAL.
RECENTLY, IT BECAME THE SUBJECT
OF A FEDERAL INVESTIGATION INTO
WHETHER IT OVERPRESCRIBED
CONTROLLED SUBSTANCES LIKE
ADDERALL.
SOME FORMER STAFFERS HAVE EVEN
CLAIMED THE COMPANY'S CHIEF
MEDICAL OFFICER, AND NOW CEO,
ONCE SAID, 95% OF PEOPLE WHO
SEE A CEREBRAL NURSE SHOULD GET
A PRESCRIPTION, BUT WAS EMPHATIC
THAT THE RATE CANNOT BE 100%,
SAYING THEY'D BE A "PILL MILL"
AT THAT RATE.
WHICH IS A VERY GOOD INSTINCT.
WHEN YOU'RE A COMPANY THAT GIVES
OUT PRESCRIPTIONS, YOU ALWAYS
WANT TO AIM FOR WHATEVER'S JUST
BELOW PILL MILL.
IT'S LIKE THE OLD SAYING, "IT'S
NOT ARSON IF YOU ONLY BURN
MOST OF A BUILDING DOWN."
AND THAT'S NOT THE ONLY WORRYING
CLAIM FROM FORMER CEREBRAL
WORKERS.
JUST LISTEN AS SOME DESCRIBE THE
LEVEL OF CARE THEY FELT THEY
WERE GIVING:
>> IT'S LIKE A FAST-FOOD
RESTAURANT.
GET AS MANY PEOPLE IN AS FAST AS
YOU CAN.
>> DO YOU FEEL LIKE CLIENTS WHO
COME TO CEREBRAL, WHO ARE
SUICIDAL, ARE IN SAFE HANDS?
>> NO.
WITHOUT A DOUBT, NO.
>> THIS FORMER CEREBRAL PHONE
COORDINATOR, WHO DIDN'T WANT TO
SHOW HIS FACE BECAUSE HE FEARS
REPRISAL, TOLD US HE HANDLED
CALLS FROM SUICIDAL PATIENTS
DESPITE HAVING MINIMAL TRAINING.
>> I'M NOT TRAINED.
I DON'T WANT TO SAY THE WRONG
THING, AND I DIDN'T WANT THAT ON
MY CONSCIENCE, LET ALONE ANYBODY
TO DIE BECAUSE OF SOMETHING I
SAID WRONG.
>> John: WELL, THAT'S BLEAK.
THERE'S BASICALLY NO SCENARIO
WHERE MENTAL HEALTH SERVICES
SHOULD BE ACTING LIKE FAST-FOOD
RESTAURANTS.
IN FACT, THE ONLY IDEA THEY
SHOULD BE STEALING FROM THEM IS
THE CONCEPT OF GIVING OUT TOYS.
ADMIT IT, THERAPY WOULD FEEL A
LOT BETTER IF YOU LEFT EACH
SESSION WITH A LITTLE MINION IN
A WIG.
[LAUGHTER]
NOW, CEREBRAL INSISTS THOSE
"PILL MILL" COMMENTS WERE TAKEN
OUT OF CONTEXT, THAT IT NEVER
PRESSURES CLINICIANS TO WRITE
PRESCRIPTIONS, AND THAT IT HAS
SYSTEMS SET UP TO QUICKLY HELP
SUICIDAL PATIENTS.
BUT EVEN IF ALL OF THAT IS TRUE,
AND, YOU KNOW!
IT'S CLEAR MENTAL HEALTH APPS
ARE NOT GOING TO SAVE US HERE
BECAUSE THEY'RE NOT DEALING WITH
THE MAIN ISSUE.
THEY CAN'T SUDDENLY HIRE MORE
CLINICIANS IF NOT ENOUGH EXIST.
AND THAT SHORTAGE SPEAKS TO A
MENTAL HEALTHCARE SYSTEM THAT'S
SO DYSFUNCTIONAL, IT SEEMS
ALMOST DESIGNED TO PREVENT
PATIENTS FROM ACCESSING IT, OR
PROVIDERS FROM ENTERING THE
FIELD.
AND A LOT OF THAT COMES DOWN TO
HOW WE PAY FOR CARE.
THERAPY ISN'T CHEAP.
THE TYPICAL FEE FOR A SESSION
WITH A CLINICAL SOCIAL WORKER IS
BETWEEN $120 AND $180.
AND THE GOING RATE TO SEE A
PSYCHOLOGIST CAN BE AS MUCH AS
$300.
AND THE THING IS, WE CURRENTLY
HAVE LAWS THAT ARE SUPPOSED TO
MAKE TREATMENT BOTH AFFORDABLE
AND ACCESSIBLE.
IN 2008, CONGRESS PASSED A LAW
MANDATING MENTAL-HEALTH PARITY:
BASICALLY, THAT BIG INSURANCE
PLANS MUST COVER MENTAL HEALTH
CARE AT THE SAME LEVEL AS ALL
OTHER CARE.
AND JUST TWO YEARS LATER, THE
AFFORDABLE CARE ACT EXTENDED
THAT CONCEPT TO INDIVIDUAL AND
SOME SMALL GROUP PLANS, TOO.
WHICH SOUNDS GREAT.
BUT AS MANY HAVE DISCOVERED, THE
REALITY OF THE SYSTEM CAN BE
STARKLY DIFFERENT, STARTING
WITH SIMPLY FINDING A PROVIDER
WHO TAKES YOUR INSURANCE.
>> I KEPT TELLING MY MOTHER I
WANTED TO SEE A THERAPIST.
THEN IT'S FINDING A THERAPIST,
AND IT'S FINDING A THERAPIST
THAT TAKES YOUR INSURANCE.
>> TO FIND A CHILDREN'S
THERAPIST THAT IS COVERED UNDER
YOUR INSURANCE, IT WAS MAYHEM.
>> YOU COULDN'T FIND ANYBODY?
>> I COULDN'T FIND
ANYBODY.
>> BLUE SHIELD SENT ME A LIST,
LIKE, I SHOULD BE FINE, JUST
MAKE A FEW PHONE CALLS, I'LL
FIND SOMEBODY.
I CALLED EVERYBODY ON THIS LIST.
ONLY ONE PLACE CALLED ME BACK.
>> John: NOW, THAT'S DISTRESSING
FOR A NUMBER OF REASONS, NOT
LEAST OF WHICH, IT FORCES
SOMEONE INTO THE HARROWING
POSITION OF ACTUALLY WANTING TO
BE CALLED BACK, ON THE PHONE.
WHICH IS HORRIFYING.
THE BEST PHONE CALL IS A TEXT,
THE SECOND BEST IS AN EMAIL, AND
THE THIRD BEST PHONE CALL IS TWO
TRADED VOICEMAILS.
EVERYTHING ELSE IS A NIGHTMARE.
[APPLAUSE]
SOME SEEKING CARE HAVE EVEN RUN
UP AGAINST WHAT ARE KNOWN AS
"GHOST NETWORKS," LISTS FROM
INSURANCE PROVIDERS THAT ARE
PADDED WITH CLINICIANS WHO
EITHER DON'T TAKE NEW PATIENTS
OR ARE NO LONGER IN-NETWORK.
IN ONE 2015 STUDY, RESEARCHERS
POSING AS PATIENTS CALLED THREE
360 PSYCHIATRISTS FROM A LIST OF
IN-NETWORK BLUE CROSS BLUE
SHIELD PROVIDERS.
BUT ONLY 40% OF THOSE CALLS WERE
ANSWERED, AND 16% OF THE NUMBERS
WERE WRONG, INCLUDING NUMBERS
FOR A MCDONALD'S, A BOUTIQUE,
AND A JEWELRY STORE.
ALTHOUGH, TO BE FAIR, IF YOU'RE
A WOMAN IN THE 1950s, A BOUTIQUE
AND A JEWELRY STORE IS
APPARENTLY THE ONLY MENTAL
HEALTHCARE YOU NEED.
[LAUGHTER]
"BUCK UP, DOLLY!
YOU'LL BE HAPPIER IF YOU'RE
PRETTIER!"
AND THERE ARE TIMES WHERE THE
INADEQUACY OF THESE LISTS FEELS
PRETTY DELIBERATE.
TAKE MELISSA DAVIES, A
PSYCHOLOGIST IN OHIO, WHO WAS
PART OF ANTHEM'S NETWORK FOR
YEARS WHEN SHE WORKED FOR A
LARGE MEDICAL GROUP.
BUT WHEN SHE STARTED A SOLO
PRACTICE, ANTHEM REFUSED TO
CONTRACT WITH HER, SAYING
THE AREA WAS SATURATED, EVEN
THOUGH SHE WAS ONE OF ONLY THREE
PSYCHOLOGISTS IN THE COUNTY, AND
WHEN SHE EXAMINED THEIR
DIRECTORY, SHE FOUND A GREAT
NUMBER OF THEIR PROVIDERS WERE
NO LONGER PRACTICING OR WERE
DEAD.
LOOK, IT'S NOT THAT RETIREES AND
THE DEAD DON'T HAVE THEIR PLACE
IN SOCIETY.
THEY ABSOLUTELY DO, IT'S RIGHT
IN FRONT OF A TV SET BLASTING
FOX NEWS, BUT THEY'RE NOT WHAT
YOU WANT TO FIND WHEN LOOKING
FOR HEALTHCARE.
AND BECAUSE MENTAL HEALTH IS
OFTEN SEEN AS SUBJECTIVE AND
HARD TO MEASURE, EVEN WHEN
PATIENTS DO FIND A PROVIDER,
INSURANCE COMPANIES CAN DENY
APPROPRIATE TREATMENT.
AND EVEN WHEN THEY APPROVE IT,
IN SOME CASES, THEY'VE
INTERVENED TO PUT AN EARLY STOP
TO IT.
TAKE THIS FAMILY, WHOSE SON
DEALT WITH SUICIDAL IDEATION AND
HAD A HORRIBLE EXPERIENCE WITH
THEIR INSURANCE.
>> AFTER YEARS OF ISSUES, THIS
TIME HIS DOCTOR PRESCRIBED
RESIDENTIAL TREATMENT.
SUCH FACILITIES ARE NOT CHEAP
BUT THE GOOD NEWS IS THAT LEAH'S
INSURANCE, ANTHEM, COVERS
RESIDENTIAL TREATMENT.
>> THEY SENT ME AN EMAIL SAYING
HE'S APPROVED.
>> BUT, AFTER CHECKING HIM IN,
ANTHEM CAME BACK AND DECIDED THE
TREATMENT WAS NOT MEDICALLY
NECESSARY.
WITH INSURANCE REFUSING TO PAY,
LEAH MADE THE FINANCIALLY
CRUSHING DECISION TO
LET HER SON STAY AND FINISH
TREATMENT, 85 DAYS IN ALL AND
$88,000 OF HER OWN MONEY.
>> John: THAT'S OBVIOUSLY
INFURIATING.
AND WHILE THE COMPANY DID
EVENTUALLY AGREE TO PAY SOME OF
THAT BILL, JUST IMAGINE AN
INSURANCE COMPANY REVERSING
THEIR DECISION IN THE MIDDLE OF
ANY OTHER SERIOUS TREATMENT.
"HEY, WE LOVE HOW THIS HEART
SURGERY IS GOING, JUST POPPING
IN TO SAY, IT'S DONE.
YEAH, IT'S DONE NOW.
HIT THE SHOWERS, EVERYONE, GREAT
JOB.
DON'T BOTHER CLOSING ANYTHING
UP, THAT'S NOT MEDICALLY
NECESSARY."
[LAUGHTER]
AND DEBATES OVER COVERAGE
BETWEEN INSURANCE AND
HEALTH-CARE PROVIDERS CAN GET
INCREDIBLY ADVERSARIAL.
A REVIEWER FOR ANTHEM AT ONE
POINT HAD AN AVERAGE DENIAL RATE
OF 92% WHEN IT CAME TO DOCTORS'
REQUESTS FOR COVERAGE.
AND YET, ACCORDING TO ONE OF
ANTHEM'S MEDICAL DIRECTORS AT
THE TIME, THERE WAS A GOOD
REASON THEIR SYSTEM OPERATED
THAT WAY.
>> DOCTORS WILL SPIN THE
CLINICAL INFORMATION.
THEY WILL MAKE THINGS APPEAR
MORE SERIOUS THAN, PERHAPS, THEY
ARE BECAUSE THEY FEEL STRONGLY
THE PATIENT NEEDS THIS LEVEL OF
CARE FOR A LITTLE LONGER.
SO YOU DO HAVE A SOMEWHAT
ADVERSARIAL RELATIONSHIP BETWEEN
THE REVIEWER AND THE ATTENDING
PHYSICIAN.
>> WAS THAT BEST FOR THE
PATIENT?
>> WELL, IT'S LIKE OUR LEGAL
SYSTEM.
IF YOU -- EACH SIDE, DOES A GOOD
JOB IN PRESENTING THEIR CASE AND
ASKING THE RIGHT QUESTIONS, YOU
ULTIMATELY ARRIVE AT THE TRUTH.
>> John: OH, YEAH.
BECAUSE IF THERE'S ONE THING WE
KNOW ABOUT THE AMERICAN LEGAL
SYSTEM, IT'S THAT IT ALWAYS
ARRIVES AT THE TRUTH.
IT'S WHY THE INNOCENCE PROJECT
IS MOSTLY JUST TWO GUYS IN AN
EMPTY OFFICE GETTING REALLY GOOD
AT PING PONG.
THERE'S SIMPLY NOTHING ELSE FOR
THEM TO DO.
NOW, I KNOW TREATING CRITICAL
HEALTH CARE AS SOMETHING DOCTORS
HAVE TO "WIN" MAY SEEM
DANGEROUS, BUT THAT MAN WILL
HAVE YOU KNOW: IT ISN'T!
>> I CANNOT, OFFHAND, THINK OF A
SITUATION WHERE A DECISION WAS
MADE TO DISCHARGE A PATIENT FROM
A HOSPITAL AND SOME TERRIBLE
CONSEQUENCE OCCURRED SOON
THEREAFTER.
I'M SURE IT HAPPENS, BUT --
>> WE FOUND QUITE A FEW.
[LAUGHTER]
>> I'D HAVE TO LOOK AT THEM TO
SEE.
THERE'S ONE THAT OCCURS TO ME
THAT I WAS INVOLVED WITH WHERE
THE CHILD LEFT THE HOSPITAL WITH
HIS PARENTS, ESCAPED FROM HIS
PARENTS, DROVE CROSS COUNTRY TO
ANOTHER STATE, AND DAYS LATER,
COMMITTED SUICIDE.
KEEPING THAT INDIVIDUAL IN THE
HOSPITAL LONGER IS NOT LIKELY TO
HAVE MADE ANY DIFFERENCE.
>> I WOULD HAVE TO IMAGINE THAT
THE PARENTS WOULD SAY, IF YOU'D
KEPT HIM IN THE HOSPITAL, HE
WOULDN'T HAVE BEEN IN ANOTHER
STATE KILLING HIMSELF.
>> John: HOLY SHIT.
DO YOU THINK THAT GUY WENT INTO
THAT INTERVIEW KNOWING HE WAS
ABOUT TO BE ABSOLUTELY MURDERED
BY SCOTT PELLEY ON NETWORK TV?
DO YOU THINK HE WAS GETTING
READY IN THE MORNING, AND
THOUGHT "I'VE GOT THAT INTERVIEW
WITH CBS NEWS'S SCOTT PELLEY
TONIGHT, I WONDER IF HE'S GOING
TO TAKE MY STUPIDEST SOUNDBITE
AND FEED IT BACK TO ME RIGHT
THROUGH MY FUCKING TEETH?"
[LAUGHTER]
WAS HE DRIVING TO THE INTERVIEW
THINKING "I WONDER IF ANY OF THE
CAMERA CREW WILL STEP IN AS
BELOVED, PEABODY-AWARD-WINNING
NEWSMAN SCOTT PELLEY RUNS ME
ACROSS THE FLOOR LIKE A SWIFFER
MOP, OR WILL THEY JUST STAND BY
AS MY LIFELESS BODY IS
DESERVEDLY WHIPPED BACK AND
FORTH?"
[LAUGHTER]
AND IF YOU'RE WONDERING HOW
INSURERS CAN GET AWAY WITH THAT
SORT OF THINKING, IT'S PARTLY
BECAUSE THE GOVERNMENT HAS, TO
THIS POINT, DONE SHOCKINGLY
LITTLE WHEN IT COMES TO
ENFORCING PARITY LAWS.
MULTIPLE FEDERAL AND STATE
AGENCIES HAVE RESPONSIBILITY FOR
THIS, BUT THE TRUTH IS, THEY
RARELY PENALIZE PLANS.
THE LABOR DEPARTMENT, WHICH
OVERSEES MOST WORKPLACE PLANS,
CLOSED JUST 74 INVESTIGATIONS
LAST YEAR, FINDING VIOLATIONS IN
ONLY 12.
AS FOR STATE-LEVEL ENFORCEMENT,
A STUDY FOUND THEY'VE LEVIED
FINES JUST 13 TIMES SINCE 2017,
WHICH IS ABSOLUTELY PATHETIC.
AND IT'S NOT JUST PRIVATE
INSURERS THAT ARE A NIGHTMARE.
COMMUNITY MENTAL HEALTH CLINICS,
WHICH OFTEN SERVE LOW-INCOME
PATIENTS, ARE SUFFERING AS WELL,
BECAUSE THE REIMBURSEMENT RATES
FOR PUBLIC INSURANCE, LIKE
MEDICARE AND MEDICAID, ARE ALSO
WOEFULLY INSUFFICIENT.
BASICALLY, FROM TOP TO BOTTOM,
WE SIGNIFICANTLY UNDERPAY MENTAL
HEALTH PROFESSIONALS, MANY OF
WHOM DO DIFFICULT, HIGH-BURNOUT
WORK.
IT'S NO WONDER SO MANY OPT OUT
OF THE SYSTEM.
ONE STUDY FOUND PATIENTS ARE
MORE THAN FIVE TIMES AS LIKELY
TO HAVE TO USE OUT OF NETWORK
PROVIDERS FOR BEHAVIORAL CARE,
THAN FOR OTHER MEDICAL SERVICES.
JUST LISTEN TO THESE TWO
COUNSELORS WHO SPOKE ANONYMOUSLY
TO LOCAL NEWS ABOUT THEIR
CONCERNS OVER WHAT ALL THIS
MIGHT MEAN.
>> THE COUNSELORS SAY INSURERS
TAKE 90 DAYS TO PAY THEM AND THE
PAYMENTS ARE SO LOW, FEWER
MENTAL HEALTH PROVIDERS ARE
TAKING INSURANCE.
>> WE WILL FACE A CRISIS WHERE
PEOPLE ARE ONLY ABLE TO GET
SERVICES IF THEY CAN PAY OUT OF
POCKET.
>> BOTH THERAPISTS WANTED US TO
CONCEAL THEIR IDENTITIES OUT OF
CONCERN FOR PATIENT PRIVACY AND
BECAUSE THEY STILL HAVE TO WORK
WITH INSURANCE COMPANIES.
>> SO AS PROVIDERS WHEN PEOPLE
THINK, OH, YOU KNOW, WE'RE JUST
FOR THE MONEY, OR WE DON'T CARE.
OH, NO, WE CARE.
WE CARE A LOT.
BUT THESE COMPANIES ARE ALSO
DRIVING US INTO THE GROUND AND
WE CAN'T -- THIS IS NOT
SUSTAINABLE.
>> John: YEAH, OF COURSE IT
ISN'T.
THERAPISTS ARE IN A NO-WIN
SITUATION HERE.
AND FOR WHAT IT'S WORTH, IT'S
NOT A GREAT SIGN THAT INSURANCE
COMPANIES ARE NOW SO POWERFUL
THAT MENTAL HEALTH PROVIDERS
FEEL THEY HAVE TO GO ON THE NEWS
LIKE THEY'RE IN WITNESS
PROTECTION AFTER SEEING SOMEONE
GET WHACKED.
[LAUGHTER]
AND THE THING IS, SOME
OUT-OF-NETWORK THERAPISTS CAN
MAKE A LOT OF MONEY, IF THEY
LIVE IN AN AREA WITH PATIENTS
THAT CAN AFFORD TO PAY OUT OF
POCKET.
BUT FOR THE MANY WHO DON'T,
THEY'RE STUCK TAKING WHATEVER
INSURANCE COMPANIES ARE WILLING
TO PAY, WHICH EXPLAINS WHY
PSYCHIATRY WAS RANKED ONE OF THE
LOWEST IN COMPENSATION AMONG
29 MEDICAL SPECIALTIES.
AND IT'S NOT JUST DOCTORS.
COUNSELORS AND SOCIAL WORKERS
WITH MASTERS DEGREES EARN 33% TO
45% LESS THAN OTHER HEALTH
PROFESSIONALS WITH A COMPARABLE
EDUCATION.
AND AS BAD AS OUR SITUATION IS
RIGHT NOW, IT'S GETTING WORSE.
ONE SURVEY IN MASSACHUSETTS SAID
THAT FOR EVERY TEN CLINICIANS
ENTERING WORK IN MENTAL HEALTH
CLINICS THERE, 13 LEAVE.
AND IF WE CONTINUE AT THAT RATE,
ONE DAY, WE'RE GOING TO WIND UP
WITH NEGATIVE THERAPISTS, WHICH
I'M PRETTY SURE IS WHAT YOU CALL
ANYONE WHO RESPONDS TO YOUR
SERIOUS MENTAL HEALTH ISSUES
WITH "INTERESTING, I CAN'T WAIT
TO GET INTO MY JAMMIES LATER."
[LAUGHTER]
AND THE COSTS OF LEAVING MENTAL
HEALTH UNTREATED CAN BE MASSIVE,
NOT JUST FOR THOSE NEEDING
IT, BUT FOR ALL OF US.
MENTAL HEALTH PROBLEMS ARE A BIG
DRIVER OF HOMELESSNESS, AND ALSO
FORCE PEOPLE INTO CONTACT WITH
THE CRIMINAL JUSTICE SYSTEM.
IN FACT, IT'S OFTEN SAID THAT
CORRECTIONAL FACILITIES HAVE
BECOME THE LARGEST PROVIDERS OF
MENTAL HEALTH CARE SERVICES IN
OUR COUNTRY.
BASICALLY, WE'VE GONE FROM
WAREHOUSING PEOPLE WITH MENTAL
ILLNESS IN BUILDINGS THAT FELT
LIKE PRISONS, TO WAREHOUSING
THEM IN ACTUAL PRISONS INSTEAD.
IT'S VERY MUCH THE "NEW LOOK,
SAME GREAT TASTE" OF AMERICA'S
FAILURES.
[LAUGHTER]
SO HOW DO WE FIX ALL THIS?
WELL, FIRST, THIS IS CLEARLY AN
ABSURD WAY TO OPERATE A HEALTH
CARE SYSTEM.
AND FOR THE UMPTEENTH TIME, I'D
ARGUE SINGLE-PAYER HEALTH CARE
IS THE WAY TO GO.
[APPLAUSE]
UNFORTUNATELY, WE CAN'T GET
THAT, BECAUSE IT'S VERY HIGH UP
ON A SHELF.
[LAUGHTER]
I DON'T KNOW WHO LEFT IT THERE,
BUT THEY MUST'VE BEEN TALL
BECAUSE IT IS WAY TOO HIGH TO
REACH.
AND IF YOU'RE THINKING, WHY NOT
USE A LADDER?
THE LADDER'S ALSO ON THE SHELF.
[LAUGHTER]
IT'S A REALLY FRUSTRATING
SITUATION.
BUT IN THE ABSENCE OF THAT, WE
NEED TO BOTH RECRUIT MORE MENTAL
HEALTHCARE PROFESSIONALS, AND
MAKE SURE THAT INSURERS COVER
THEM PROPERLY.
NOW, ON THE FIRST POINT, THE
BIDEN ADMINISTRATION, TO ITS
CREDIT, ANNOUNCED A PLAN BACK IN
MARCH THAT'D PROVIDE $100
BILLION IN MANDATORY FUNDING
OVER TEN YEARS TO TRANSFORM OUR
CURRENT SYSTEM, WHICH INCLUDES
INVESTING $700 MILLION IN
PROGRAMS TO COVER EVERYTHING
FROM TRAINING TO SCHOLARSHIPS
AND LOAN REPAYMENTS FOR THOSE
COMMITTED TO WORKING IN
UNDERSERVED AREAS.
BUT OBVIOUSLY, THAT'S ONLY HALF
THE BATTLE.
ON THE INSURANCE COMPANY SIDE,
WE BADLY NEED TO BE
STRENGTHENING AND ENFORCING
THOSE MENTAL-HEALTH PARITY LAWS,
AT BOTH THE STATE AND FEDERAL
LEVEL.
CALIFORNIA HAS ACTUALLY PUT IN
ONE OF THE MOST COMPREHENSIVE
PARITY LAWS IN THE COUNTRY.
AMONG MANY, MANY OTHER THINGS,
IT REQUIRES THAT INSURERS MUST
BASE MEDICAL NECESSITY
DETERMINATIONS ON
CURRENT, GENERALLY ACCEPTED
STANDARDS OF MENTAL HEALTH CARE,
INSTEAD OF JUST MAKING UP THE
CRITERIA FOR THEMSELVES.
THAT IS A VERY BIG DEAL, AND
MORE STATES SHOULD FOLLOW
CALIFORNIA'S LEAD.
IN THE PAST, SO MUCH OF THE
PROBLEM WAS THAT PEOPLE WOULDN'T
ASK FOR HELP, AND THANKFULLY
THAT'S NOW LESS OF AN ISSUE NOW,
THANKS TO, AMONG OTHER THINGS,
THE TIRELESS GLAND SHAMING OF
MR. HARRISON FORD.
[LAUGHTER]
BUT NOW, WHEN PEOPLE DO REACH
OUT FOR HELP, WE'RE JUST NOT IN
A POSITION TO GIVE IT TO THEM.
IF WE WANT TO BE A SOCIETY THAT
TRULY RESPECTS AND VALUES MENTAL
HEALTH, WE HAVE TO RESPECT AND
VALUE MENTAL HEALTH CARE.
AND THAT MEANS SUPPORTING THE
PEOPLE WHO DELIVER IT.
LOOK, IT'S GOING TO TAKE A LOT
OF INVESTMENT AND CONTINUED
RESOLVE TO FIX THINGS, BUT IT'S
ALSO WORTH IT.
BECAUSE IT CAN'T BE THE CASE
THAT, WHEN PEOPLE ASK FOR HELP,
OUR ONLY OPTION IS TO TELL THEM
TO "SUCK IT UP, BUTTERCUP."
AND NOW, THIS.
>> Announcer: AND NOW,
THE WORLD'S HORNIEST
TELEVANGELIST.
SPEAKER EVERYWHERE I GO I TELL
PEOPLE TO STROKE THEIR BIBLE,
RUB IT OVER YOUR FACE.
>> I REALLY LIKE THAT.
I LOOK AT A WOMAN'S ANKLES, HER
TOENAILS, HER FINGERNAILS.
>> I DON'T KNOW WHY CUTOFFS ARE
SEXY, BUT THEY ARE.
I DON'T LIKE LONG SHORTS COME I
WANT TO SEE EVERYTHING I CAN, I
AM A MAN.
>> YOU THINK WHEN I THINK OF
MARRIAGE I AM THINKING OF
BLACK-EYED PEAS, CORN, GLASS OF
ICED TEA?
THAT IS MARRIED?
ARE YOU KIDDING ME?
I WANT A SEX POT STRIPPING ON
STAGE IN FRONT OF ME IN THE
BEDROOM.
♪ ♪
>> COVER THOSE UP, BUT SHE WANTS
YOU TO SEE THE MOUNTAINS BECAUSE
MEN SEE MOUNTAINS AND THEY
START THINKING.
>> 31 SECRETS OF AN
UNFORGETTABLE WOMAN.
UNBELIEVABLE BOOK, I STARTED
CRYING WHEN I STARTED READING
THIS BOOK THAT I WAS WRITING.
[LAUGHTER]
[APPLAUSE]
>> John: THAT'S OUR SHOW,
THANKS SO MUCH FOR WATCHING.
TO SEE YOU NEXT WEEK, GOOD
NIGHT.
>> IN DECEMBER, I'LL BE IN
BEIJING, OPENING UP NEW PORK