Rep. Moulton on the New 988 Suicide and Crisis Lifeline

SARA SIDNER, HOST: A new initiative in the United States for suicide prevention is already changing lives. The National Suicide Prevention Lifeline is now an easy-to-remember three digit dialing code, 988. The hot line saw a 45 percent increase in calls and messages the very first week the new number came into effect. U.S. House of Representatives’ Seth Moulton co-wrote the bill to change the number after revealing his own experience with post-traumatic stress disorder, or PTSD. To discuss his mission reforming mental health care, the congressman joins Michel Martin.

(BEGIN VIDEOTAPE)

MICHEL MARTIN, CORRESPONDENT: Sara, thank you, Congressman Moulton, thank you so much for talking with us today.

REP. SETH MOULTON (D-MA): It’s good to be here. Thanks, Michel.

MARTIN: So, you’re a sitting member of Congress. You’re a former Marine. Right or wrong, this isn’t the profile we normally associate with people who are open and aggressive and out-there mental health advocates. So, as briefly as you can, just tell us, how did you become engaged with this subject?

MOULTON: Well, I mean, frankly, I’m really trying to change that. And I think we have to change that, because so many people in America every single year die by suicide or go through a mental health crisis, without even trying to get help, because of the stigma around it. And this was true for me too. I mean, when I got back from Iraq, I started having bad dreams and night sweats and difficulty with relationships, some of the typical post-traumatic stress symptoms you read about. But it took me a long time to come to terms myself with the fact that I probably had post-traumatic stress. And, by the way, I call it post- traumatic stress because one of my best friends in the Marines said to me once, he said: “Seth, after what we have been through, it would be a disorder if you didn’t have a reaction to it, if you weren’t affected.”

MARTIN: Fair.

MOULTON: So, it was really the younger Marines that I served with, younger Marines in my platoon, who first sought help for post-traumatic stress and started talking about it that really inspired me to do the same. Now, when I was elected to Congress, I kept this totally hidden. I kept it hidden the fact that I had dealt with post-traumatic stress or, even worse from a political perspective, that I had sought help for my mental health issue, because that’s for a long time in American politics basically been a death sentence for any political career. But I decided, you know what, that’s not leadership, I have got to lead the same way these young Marines set the example for me and get out there and talk about my story. So I took a leap of faith and thought that it might end my political career. But, a few years ago, I told my story of dealing with post-traumatic stress. And, instead, it’s really, rather than ending my career, it’s sent me on a bit of a crusade to improve mental health for all Americans.

MARTIN: Was there a eureka moment that allowed you to embrace this as part of your story? Do you know what I mean? Was there something that said to you, look, it’s time for me to let the world in to who I really am and what I have really gone through? Do you recall?

MOULTON: I think it was a time when, sadly, my platoon was together for a funeral of one of the great Marines I served with who died after we got home. And I saw what a difference it made for these young guys that someone in my position would be willing to talk about this and tell my story. And that’s been my experience ever since. I mean, I have had people all over the country come up to me and say, Seth, thank you. Thank you for sharing your story. Now I feel like I can share mine.

MARTIN: So, 988, you’re one of the authors of the legislation that created 988 as an alternative to 911. What does this do? What is the benefit of this?

MOULTON: Well, of course, the most obvious benefit is that it is a number of people can remember. You wake up in the middle of the night and your house is on fire, you don’t have to Google the local fire department. Everyone knows you dial 911. And now, if you or a loved one has a mental health crisis, you just know you can dial 988 to immediately get help. But the other thing I hope it addresses is this stigma, because there’s two fundamental problems with mental health care in America. The first is that people don’t know where to call or where to turn in that desperate moment. But the second is that they’re afraid to do so. They’re embarrassed to do so. That’s why so many Americans every single year don’t get any help for their mental health condition. I mean, imagine if half the Americans who broke a leg every year never saw a doctor, never got a cast, never got it set. That’s where we are with mental health. And the beauty of 988 is, just because we’re having conversations like this, we’re chipping away at that stigma. We’re telling Americans it’s OK to talk about mental health. It’s OK to get help for an issue in your brain, the same way you would for any other organ in your body. And my dream is to get to a point where mental health care is so routine, so routine, that it’s just like getting an annual physical, that you take care of your mental health even if you don’t think you have an illness. You check in on it. In fact, you proactively make yourself mentally stronger, the same way that you go to the gym or go for a run in the morning to take care of your physical health.

MARTIN: Talk a little bit more about what you see as the scope of the issue. I mean, you just cited some pretty powerful statistics there of just about the number of people, the breadth of this problem in American life. And it’s not just returning veterans who are struggling. I mean, we know that – – we know that adolescents over the course of the last couple of years, because of COVID, have had a really tough time. We know that LGBTQ youths are having a difficult time. We know that African-American youth, younger people are experiencing a great deal of stress, even relative to their peers who are of other ethnic groups. So, give me a sense — your sense of the scope of the issue.

MOULTON: Well, you’re absolutely right. It is skyrocketing among our youth. Mental health issues have skyrocketed because of the pandemic. And the end result is that over 45,000 Americans die by suicide every year. Every one of them alone. And all because they just don’t get help in that desperate moment. I think one of the most encouraging statistics out there is that somewhere around nine out of 10 Americans who attempt suicide but do not succeed. So, they’re not successful. They don’t try it again. Once they get help, they realize, I don’t want to do that. I want to continue living. But it’s so critical to get help in that moment, in that desperate moment, and that’s exactly what 9-8-8 is trying to solve.

MARTIN: What happens when you call 9-8-8? The number has just gone live, like, within the last — as we are speaking now, it’s just gone live within the last couple of weeks. What will happen when people call 9-8-8? And how does that differ from what — some of what we’ve seen in the past when people — if they called for help at all, they would call, say 9-1-1?

MOULTON: Right. Well, you’re going to get connected directly to a trained professional who is experienced in helping with these mental health crises, to help you get through that critical moment. And they have an amazing track record of success. Now, we try to connect you directly to someone who can share your experience. So, if you’re a veteran, you can talk to a fellow veteran or someone who’s trained in veterans’ issues, or if you’re in LGBTQ plus youth, you’re going to talk to someone who’s had that experience as well. But just simply being able to talk to someone who knows how to work through an issue like this, and then once you get through your crisis, connect you to long-term care, that is exactly what 9-8-8 is designed to do. What won’t happen is you’re not going to have police rushing to your house. You’re not going to be put on some list. You’re not going to be — you know, parents aren’t going to be called if you’re young. This is not about getting in trouble. It’s just about getting help. And that is one of the most important things for people to know.

MARTIN: You know, you said earlier, and you’ve said it a couple of times that you also co-authored a piece for “Time” with Zak Williams every — people, I think, remember the late comedian Robin Williams who took his own life and his son, Zak, and you have worked together on some of these issues and trying to highlight them. What are other things you say in your piece, and you just said now is that there are two basic reasons why so many Americans don’t address mental health? They’re either afraid or discouraged from getting help or they don’t know how to get it. I mean — but, forgive me, but isn’t there a third problem here which is that our access points are broken? I mean, health care in the United States is expensive. It is not widely available in some places that leave the kind of, culturally competent pair that you’re talking about that is so essential. I mean, it’s part of the problem that our delivery systems are broken. I mean, I guess, there’s no other way of asking, are the people to offer the service really there? Do we really have the infrastructure to treat this problem?

MOULTON: It’s a great question because there are a lot of issues with mental health care in America. And we’ve highlighted the top two. But you raise a third which is simply getting access to that care, like if you — you might be able to talk to someone at 9-8-8, but then how are you going to get the long-term therapy that you need? A fourth or fifth issue is that we just don’t have the clinicians. We just don’t have the therapists out there who can provide this long-term care. So, you know, you’re absolutely right. There’s a lot of work we have to do on mental health care in America. But the most important thing we can do to save lives is just get people help in that critical moment. If you can get them through that, then they’re in a much better position to survive long term. But as someone who still see the therapist, myself, just to proactively take care of my mental health, to check in every once in a while, because I think it makes me a better dad, a better husband, a better Congressman to do so. I know that it’s hard to get an appointment with a therapist. And that’s a problem all over America. So, don’t get me wrong, this is a first step. But there’s a lot more work to do.

MARTIN: What is that work though? What’s the plan for that? For increasing the capacity there?

MOULTON: Well, we have to get more people to go into the field, it’s one thing we have to do. So, we’re looking at ways that we can incentivize more people to go into mental health. One of the things that I’ve always fought for is called parity health care. So, mental health is treated the same as physical health. That also means that it’s reimbursed the same for our caregivers. Because, you know, a lot of doctors don’t go into mental health because they don’t see the kind of financial returns that you get from being a surgeon or something like that. That is something we need to change, as well. We also just need to normalize care. I mean, my vision is to get to a point where everyone has a mental and annual mental health checkup the same way that you have an annual physical. I mean, if I told you that after this interview I was going for my annual physical, you wouldn’t look at me and say, oh my God, what’s wrong with you, or you wouldn’t think that. You would say, of course, you’re getting your annual physical. That doesn’t mean you’re sick, you’re just getting a checkup. Well, imagine the difference if I told you, right after this interview, I’m going to see a psychiatrist. I’m going to get a mental health appointment. You know, the natural reaction that we all have to that is, my gosh, what’s wrong? We’ve got to change that. We’ve got to get to a point where getting a mental health checkup is as routine as an annual physical. And I’d like to see that happen for every high-schooler in America. That’s really my vision here and my goal. To set an example when kids are pretty young that this is OK. But to get there will require a lot more clinicians. You’re absolutely right. And so that’s another issue that my colleagues and I in Congress on the mental health caucus, people who really care about these issues and recognize what a difference addressing them can make in people’s lives. And this is one of the many things that we continue to work on.

MARTIN: Do you feel that you’ve helped in — to diminish the stigma in some way, even among your colleagues and your peer group?

MOULTON: A little. I mean, my colleagues tell me that. They tell that — they tell me that it’s made a difference to hear me share my story. But I’ll tell you, I mean, I thought this could very well end my political career. It’s a bit gamble for me to come out and publicly share this. You know, when you run for office, your friends ask you, OK, what’s the skeleton closet? You know, what’s the thing that you don’t want people to hear about? And this was it for me. This was my big skeleton when I first ran — I mean, I only told a couple of people on my team that I saw a therapist because I knew how damaging this could be to a career in politics. So, we have a long way to go. But I do think — so we got a long way to go but I do think we are making progress. And I do think it is getting better.

MARTIN: What about people who have security clearances? I mean, that’s been a factor — you know, that’s another factor, frankly. I know it’s very specific to certain fields. But, you know, is this the kind of thing that’s going to be held against you if you need a security clearance to work in, say, intelligence or in law enforcement, for example?

MOULTON: That is a great question because the short answer is often yes. And that’s something that we need to change. We had a vote on that recently in the House of Representatives to try to change that policy. Because, look — I mean, honestly, it’s some of the people who have the most experience who have been in the worst situations overseas who you want working in these positions. And yet, they are obviously the people who are most susceptible to these issues. But what Americans need to know is that if you treat these issues, you can get through them. You can get better. I mean, I’d like to think that I’m living proof of that. And it’s no different than, you know, you may not be hired as a security guard if you have a broken leg. But if you get that broken like treated and it’s all better, then sure, you can get that job. It should be exactly the same with mental health.

MARTIN: Before I let you go, is there anybody, in particular, who you think is doing this particularly well? Like is there any place that you could point to where you think people have kind of figured this out? You — I don’t know, there’s just so many — there’s just so many factors here. There are certain peoples, kind of, religious beliefs. There are certain peoples’ concept of what it means to be a strong person. People tell us that there are certain cultural barriers, right, within certain groups where people follow? That’s just not something we do, you know, that’s fine for them. That’s not something my group, you know, does. Do you feel like, there’s a place that’s done this well that you can point to or is this just so uncharted territory for all of us?

MOULTON: I don’t know anyone that’s doing perfectly. But I do know a community that improved a lot. It is the veterans’ community. And the place we were 20 years ago, when the Iraq and Afghanistan wars began, is so different than where we are today. I mean, I remember back in 2004, one of the absolute heroes in my company who did it. I mean, it’s something truly heroic in combat. The thing you read about in history books. Naturally, he came back with post-traumatic stress. And to make a long story short, he was just kicked out of the marine corps. In fact, he was made ineligible for VA care. Imagine that, someone who deserved it more than any of us was actually made ineligible because of the way he was just booted out of the marine corps for how he came back. Well, that’s changed a lot now. I mean, now you have our most elite special forces units practicing mindfulness, doing mental health training to make them better at their jobs, to proactively improve their mental health before they go into combat. You have great organizations like Home Base up in Massachusetts, based at Mass General Hospital and partnered with the Red Sox that are encouraging veterans to come in and just take care of these issues when they get home. So, my hope is that while the military and veteran community certainly hasn’t figured it all out, the progress that we’ve made should be an inspiration to other groups of people as well. And it should help set an example for how we take care of mental health for all of America.

MARTIN: Congressman Seth Moulton, thank you so much for talking with us today.

MOULTON: Thank you.

(END VIDEO CLIP)

SIDNER: Extraordinary interview. And if you or anyone you know is suffering and in need of help, a reminder the new 9-8-8 suicide prevention hotline is available in the United States. And you can find a worldwide directory of resources and international hotlines through the International Association for Suicide Prevention, or you can turn to Befrienders Worldwide.