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Remarks of the President during the Roundtable Discussion

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The Briefing Room

Office of the Press Secretary
(Nashville, Tennessee)

For Immediate Release June 22, 1998


Vanderbilt University
Nashville, Tennessee

THE PRESIDENT: Is there any kind of national organizationofpeople like you, who are working for family-centered care everywhere andadvocating it?

MS. MORETZ: There is. There actually is -- the InstituteforFamily-Centered Care, as a matter of fact. And there are also a lot offamilysupport programs, such as Parent To Parent, because, as anyone knows,parentsneed to be around other parents who have gone through similar situations.Andthere is a lot of support out there and I do encourage parents who havebeenthrough situations like this to get involved. And that is one way parentscanget involved.

THE PRESIDENT: Don't you believe that recovery rates arebetter when there's family involvement when the people are in the hospital,whether it's children or parents or siblings?

MS. MORETZ: There is no question about it. Daniel has had atleast 47 doctors -- that I can count -- 47 doctors come in and come out ofhisroom at some given point over seven years. And I have to recognize that weDavid and I -- we are the constant, and his brother and sister, we are theconstant in his life and we are the ones that can help to promote andfacilitate his health care. Yes -- and I have to say that his health carehasbeen extremely wonderful. Obviously, he wouldn't be here today if itwasn't.So, thank goodness, and we are very proud of the health care that he hasreceived.

THE PRESIDENT: If I could just reinforce something Tonysaid-- and I thank you for everything you said -- you may hear this in thedebatein the Congress when this comes up this year -- there may be some whoreallydon't want this to pass who say, well, look, a lot of companies areembracingthese principles anyway. If a company is willing to say all the thingsTonysaid -- if you've got to go to an emergency room, you can go; if you need aspecialist, you can have it; the doctors can't be gagged, they canrecommendwhatever good care is; if you have a problem with your plan, you can haveanappeal -- if you have all those things -- if he does that, why shouldsomebodyelse be able to put him at a financial disadvantage in whether his plan canmake money as compared to their plan by simply not following the samething?

It's even more unfair to the good HMOs and the goodmanaged-care operations in this country not to have thislegislation, because if they go out and do the right thing, thenother people who are unscrupulous can come in and try to undercutthem by appearing to offer the same service at a lower cost. Sohe just made a terrific argument for why this bill ought to passthis year -- by doing the right thing and because he's doing theright thing.

I thank you very much. (Applause.)

THE PRESIDENT: I would just like to thank you forwhat you said. I hope that this order that I'm signing todaywill deal with that by essentially telling all the governmentagencies that whenever possible they have to work through peoplelike you to do the outreach -- because -- well, this weekendHillary and I spent some time with some friends of ours, and oneof them commented that he'd just been to a high school graduationin Northern Virginia where it was announced that the graduates,just a few hundred kids, came from 70 different national andethnic groups. That's just one high school. We have so manycommunities -- the Asian communities, alone, if you think -- fromSoutheast Asia and all the different language groups, that a lotof these people, as you pointed out, two-thirds or more, areworking people; many of them, their first language is notEnglish; and if there is not some affirmative attempt to reachthem through someone they know and trust, their children will notget on this program -- I don't care how many flyers we put out orPSAs we do or anything else.

This is very valuable what you've said and I thinkwe need to work a little harder on it. But I thank you for beinghere.

THE PRESIDENT: First of all, I'd like to thank youfor the work you do. And I'd also like to thank Mrs. Gore forbeing our administration's leading person on mental healthissues. If it hadn't been for her, we wouldn't have had a strongmental health component in the child health insurance program orthe mental health parity legislation. And I'm very grateful forthat.

I'd like to ask a question which may be a littleunfair, because I know you haven't been prepared for it exactly,but I'm sure you've thought about it. I just got back from avery moving trip out west, and you may have seen it. I visitedSpringfield, Oregon, where they had one of the many, many schoolshootings we've seen. And I've been studying the facts of allthese cases, and it does appear that in each case -- or, in mostof the cases where we've had these terrible tragedies -- I mightadd, against a background of dropping juvenile crime overall --that there was some kind of early warning. And I wonder if youcould recommend to me, because the Congress wants to do somethingon this, everybody is interested in this, this is -- how do youthink we ought to deal with children who -- 6,100 kids wereremoved from school last year for bringing a gun to school. I'dbe very surprised if more than 10 percent of them got some sortof comprehensive mental health analysis as a result of it.

We have -- goodness knows how many kids made threatsthat they had no earthly intention of doing anything about it,but in one of these school shootings there was an explicit threatmade beforehand. What advice can you give us about what the roleof mental health ought to be and, sort of, early warning systems,preventive care, and that sort of thing, and particularly -- likeI said, I don't want to put you on the spot on the Springfieldthing, but it's very much on my mind because of what was told tome out there about the facts, and because the young man did havea gun in the school the day before and was sent home.

MS. SAVANNAH: Well, one of the responses that wehave pulled together is we have a family resource center in anelementary school and so we work with the teachers. And we'vehad to a lot of training of teacher, of youth developmentworkers, of child care workers, to really identify the earlysigns of mental health needs.

There are so many children with unmet needs. And sooften their activities get interpreted as behavior problems, asdiscipline actions, and we don't ever stop and do a strongassessment of what are the needs of these children. Childrenthat carry guns are afraid. They really have very strong reasonsfor carrying them. And we work with a lot of children that havebeen suspended or expelled because they've been carrying weaponsto school, and we've been real fortunate in Houston. But I knowit's of growing concern because there are so many children thatdon't think that they'll live to see 20. And so those are kidsthat carry guns to protect themselves.

We've spent a lot of time and a lot of preventionefforts that focus on children being okay. And so I've seen alot of children who suppress their emotional disturbance. Theysee violence on the streets, they see violence in their homes,and rather than being emotionally disturbed, they're beingtrained to be okay. And so when children respond that way, theirsensitivity becomes dull and they can act out in those kinds ofways that really hurt humanity.

And I think one of the things we need to do is makesure that everyone is well aware of some of the signs of mentalhealth needs, and really work to make sure that we remove thestigmatism to receiving mental health services. (Applause.)


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