WEBVTT 00:00:23.600 --> 00:00:25.800 LAST WEEK TONIGHT WITH JOHN OLIVER 00:00:31.399 --> 00:00:34.799 Welcome to "Last Week Tonight"! I'm John Oliver. 00:00:34.880 --> 00:00:37.880 Thank you so much for joining us. It has been a busy week. 00:00:37.960 --> 00:00:40.600 Russia's war on Ukraine entered its sixth month, 00:00:40.679 --> 00:00:42.759 monkeypox continues to spread around the world, 00:00:42.840 --> 00:00:45.880 and in D.C., West Virginia's nastiest little coal skank 00:00:46.359 --> 00:00:48.920 finally decided to act like a Democrat for once. 00:00:49.000 --> 00:00:52.799 We're gonna start tonight in Europe, which has had a dramatic summer. 00:00:52.880 --> 00:00:55.000 A massive heat wave has engulfed the continent 00:00:55.079 --> 00:00:58.600 and a walrus named Freya has caused absolute chaos. 00:00:59.200 --> 00:01:02.320 Far from the Arctic's icy waters, this lone walrus has sank 00:01:02.399 --> 00:01:06.359 several small boats and inflatables in Denmark, Scotland, the Netherlands, 00:01:06.439 --> 00:01:08.719 and now Norway in her attempt to sunbathe. 00:01:08.799 --> 00:01:12.439 The damage from a 700-kilo walrus on your boat can be extensive, 00:01:12.519 --> 00:01:16.239 especially when she chooses a vessel that's not walrus worthy. 00:01:17.000 --> 00:01:20.879 Unsurprisingly, boat owners aren't excited to share with Freya. 00:01:21.760 --> 00:01:23.680 I don't want it on the dock or on my boat. 00:01:24.560 --> 00:01:26.040 Just get it away from here. 00:01:26.599 --> 00:01:28.040 No! Don't do that! 00:01:28.840 --> 00:01:33.439 I love everything about Norway being terrorized by a walrus in vacation mode 00:01:33.799 --> 00:01:36.280 sinking boats like they're three pointers. 00:01:36.359 --> 00:01:39.879 But also, Freya's not a mosquito you can just swat away, 00:01:39.959 --> 00:01:42.719 she's a 1,300-pound water queen and guess what? 00:01:43.079 --> 00:01:44.439 She's the captain now. 00:01:45.760 --> 00:01:48.120 But boats are not the only thing being upended in Europe. 00:01:48.200 --> 00:01:51.239 Multiple countries are now in the process of choosing new leaders, 00:01:51.319 --> 00:01:54.280 including the U.K., where Boris Johnson finally stepped down 00:01:54.359 --> 00:01:57.159 earlier this month, after succumbing to a series of scandals. 00:01:57.480 --> 00:02:00.519 And in doing so, he offered this inspiring farewell. 00:02:01.239 --> 00:02:06.519 I want you to know how sad I am to be giving up the best job in the world. 00:02:07.400 --> 00:02:08.639 But them's the breaks. 00:02:09.120 --> 00:02:11.120 Yeah, them's the breaks! 00:02:11.879 --> 00:02:14.800 Sometimes you drive your country off a massive economic cliff for no reason, 00:02:14.879 --> 00:02:16.680 then attend a series of alcoholic bashes 00:02:16.759 --> 00:02:18.719 in violation of your own government's Covid lockdowns, 00:02:18.800 --> 00:02:21.840 then promote a member of your own party accused of sexual misconduct, 00:02:21.919 --> 00:02:23.400 later claiming that you didn't know anything about it, 00:02:23.479 --> 00:02:25.080 only for it to turn out that that wasn't true, 00:02:25.159 --> 00:02:26.199 and for much of your government 00:02:26.280 --> 00:02:27.960 to resign rather than continue working for you. 00:02:28.039 --> 00:02:29.639 You know… The breaks! 00:02:30.639 --> 00:02:31.960 And with Boris standing down, 00:02:32.039 --> 00:02:34.360 the next prime minister will be chosen by his party, 00:02:34.439 --> 00:02:36.439 which has narrowed the field down to two candidates. 00:02:36.520 --> 00:02:39.360 The first is Rishi Sunak, former finance minister. 00:02:39.439 --> 00:02:41.280 He has made a play for social conservatives 00:02:41.360 --> 00:02:43.960 by attacking "woke nonsense" this week. 00:02:44.039 --> 00:02:45.800 But he's also an incredibly wealthy man 00:02:45.879 --> 00:02:49.360 who was educated at one of the most exclusive private schools in England, 00:02:49.439 --> 00:02:53.039 although it didn't seem to successfully teach him what to do with his arms. 00:02:53.719 --> 00:02:56.960 It's great to be at the Channel 4 studios for tonight's debate. 00:02:57.319 --> 00:02:58.919 We've got a brilliant message 00:02:59.000 --> 00:03:01.360 and I'm pumped to be able to talk more about it this evening. 00:03:02.240 --> 00:03:04.759 Thanks also for all your continued support. 00:03:04.840 --> 00:03:06.439 All the offers of help, the emails, 00:03:06.520 --> 00:03:08.960 and the Tweets are amazing, keep them coming. 00:03:09.039 --> 00:03:14.039 What are you doing? What is it about rich people and hand movements? 00:03:14.400 --> 00:03:15.680 Sunak looks like he studied 00:03:15.759 --> 00:03:18.319 at the Zuckerberg school of passing for a human. 00:03:18.759 --> 00:03:20.400 And that's not even a one-off! 00:03:20.479 --> 00:03:23.599 He moves his hands like that all the fucking time! 00:03:24.280 --> 00:03:27.080 And you want your hands to support and accentuate what you're saying, 00:03:27.159 --> 00:03:30.560 not to look like you're in a boxing match with 100 invisible mice. 00:03:31.159 --> 00:03:33.680 If you are going to choose to wave your hands around like that, 00:03:33.759 --> 00:03:36.639 the very least you can do is put some puppets on them. 00:03:37.840 --> 00:03:40.520 Also, for what it's worth, one of Sunak's campaign promises 00:03:40.599 --> 00:03:44.240 is that Britain's National Health Service will be safe in his hands, 00:03:44.319 --> 00:03:46.800 but given what you have just seen him do with them, 00:03:46.879 --> 00:03:48.639 I fucking doubt that's true. 00:03:49.479 --> 00:03:51.879 But luckily for Sunak, his rival, Liz Truss, 00:03:51.960 --> 00:03:54.199 is somehow even more awkward. 00:03:54.280 --> 00:03:56.479 I could show you plenty of examples of this, 00:03:56.560 --> 00:04:00.560 or I could show you the eight seconds that really capture her entire spirit. 00:04:01.240 --> 00:04:06.120 In December, I'll be in Beijing, opening up new pork markets! 00:04:09.360 --> 00:04:11.520 What is happening there? 00:04:12.319 --> 00:04:15.439 Somehow Truss comes off as half-kindergarten teacher, 00:04:15.520 --> 00:04:17.079 half kindergarten student. 00:04:17.959 --> 00:04:21.240 She's giving off the vibe there of a kid who was cast as Who #14 00:04:21.319 --> 00:04:24.399 in an elementary school production of Seussical the Musical, 00:04:24.480 --> 00:04:27.360 because that is an energy that can only be described as 00:04:27.439 --> 00:04:30.519 "I said my thing, my parents saw it, can I go home now?" 00:04:31.639 --> 00:04:34.240 Truss has a real knack for making bad decisions, 00:04:34.319 --> 00:04:36.279 and then very much sticking to them, 00:04:36.360 --> 00:04:40.199 exemplified by the fact that this Tweet paying tribute to Jimmy Savile, 00:04:40.279 --> 00:04:42.199 who turned out to be a monstrous pedophile, 00:04:42.279 --> 00:04:47.560 has not been deleted 11 years later, nor has this Tweet from a decade ago, 00:04:47.639 --> 00:04:50.199 where she seems to be searching for her own name. 00:04:51.160 --> 00:04:54.199 And while Truss is campaigning on her ability to get results, 00:04:54.279 --> 00:04:57.879 that may be a tough sell, given her party's record in government, 00:04:57.959 --> 00:05:01.560 which was brutally exposed in this interview a few years ago. 00:05:02.240 --> 00:05:07.800 You had a plan in 2014 to build 200 000 new starter homes. 00:05:08.480 --> 00:05:11.079 That was five years ago. How many did you build? 00:05:11.160 --> 00:05:14.160 There haven't been as many starter homes as we would have liked. 00:05:14.240 --> 00:05:16.680 - How many did you build? - I don't have the exact numbers. 00:05:16.759 --> 00:05:19.759 It's easy to remember. It's zero. You built none. 00:05:21.600 --> 00:05:24.519 Not great there, Liz. But take a minute to appreciate 00:05:24.600 --> 00:05:27.600 the interviewer who made a whole meal out of that gotcha. 00:05:28.000 --> 00:05:30.600 His body language, tone, and glasses position 00:05:30.680 --> 00:05:34.560 is basically BBC shorthand for, "Hello, I'm about to be a huge bitch". 00:05:35.000 --> 00:05:37.480 "Zero, that's easy to remember, right? 00:05:37.560 --> 00:05:42.160 You take what you set out to achieve, and then subtract all of it." 00:05:44.079 --> 00:05:47.000 So, neither of the options for leader are good here, 00:05:47.079 --> 00:05:50.199 and the fact is, whoever wins will be inheriting a poisoned chalice. 00:05:50.279 --> 00:05:54.079 Boris Johnson, the man who both of them have spent years enabling, 00:05:54.399 --> 00:05:57.439 has broken a lot of shit that they will now have to clean up, 00:05:57.519 --> 00:06:01.560 but I guess, in the words of Europe's second most unwanted mammal, 00:06:01.639 --> 00:06:02.959 "Them's the breaks." 00:06:03.600 --> 00:06:04.639 And now, this! 00:06:05.879 --> 00:06:10.759 And Now: People on TV Daydreaming About Winning the Lottery. 00:06:11.639 --> 00:06:15.319 Every lottery story from Topeka to national news. We dream. 00:06:15.399 --> 00:06:17.800 And then the anchor, we're supposed to say, 00:06:17.879 --> 00:06:19.800 "What would you do, Carry, if you win?" 00:06:19.879 --> 00:06:23.639 I would share that money with everybody. 00:06:23.959 --> 00:06:26.120 The big question is, would you come back to work though? 00:06:26.199 --> 00:06:28.319 - No! - Of course, we wouldn't. 00:06:28.759 --> 00:06:32.279 - Have you ever won the lottery? - No. I'm still sitting here. 00:06:32.360 --> 00:06:34.959 If you win the lottery, you would not show up to work the next day. 00:06:35.040 --> 00:06:36.199 You'd never see me again. 00:06:36.279 --> 00:06:37.959 You would never see me again. 00:06:38.480 --> 00:06:40.160 - You would never see me again. - Never see you again. 00:06:40.240 --> 00:06:42.040 You'll never see me again. I'm gone. 00:06:42.120 --> 00:06:44.319 I'd be on some remote island you never heard of. 00:06:44.399 --> 00:06:45.720 Would you keep working? 00:06:47.279 --> 00:06:50.000 I'm gonna change my name. Y'all won't be able to find me. 00:06:50.360 --> 00:06:52.879 I love you, Robin. I love you, Bob. I love you, Jen. 00:06:52.959 --> 00:06:56.079 - I wouldn't quit my job. - You would not? 00:06:56.160 --> 00:06:57.680 No, that's what they always say. 00:06:57.759 --> 00:07:00.920 So, I was just joining in on that. Of course, I'd be out of here. 00:07:03.600 --> 00:07:07.040 Moving on. Our main story tonight concerns mental health care. 00:07:07.120 --> 00:07:10.600 It's a subject that historically humans haven't handled particularly well. 00:07:11.199 --> 00:07:14.439 To a famous Bond Street beauty parlor come a bunch of pretty nurses. 00:07:14.519 --> 00:07:17.160 They're greeted by director Ms. Eleanor McDonald. 00:07:17.240 --> 00:07:19.399 They're here not as customers, but as students. 00:07:20.399 --> 00:07:23.839 Ms. McDonald teaches a new group of half a dozen every month. 00:07:24.519 --> 00:07:26.079 It's an official part of their training. 00:07:26.160 --> 00:07:27.399 If you can persuade 00:07:27.480 --> 00:07:29.959 a mentally ill woman to take interest and pride in her appearance, 00:07:30.319 --> 00:07:33.480 you may even swing the balance between despair and recovery. 00:07:34.000 --> 00:07:37.240 "Yes, those pesky women just need a little pep in their step, 00:07:37.319 --> 00:07:40.199 a little drip on their lip, a little flash on their lash. 00:07:40.600 --> 00:07:42.920 Look at me! I'm a British voice from the 1950's, 00:07:43.000 --> 00:07:45.600 setting the course of science for decades to come." 00:07:46.240 --> 00:07:47.839 I don't know what is more alarming there, 00:07:47.920 --> 00:07:51.639 nurses being forced to take on the skills of a Sephora brand ambassador 00:07:51.720 --> 00:07:53.920 or the fact that "Can Makeup Cure Sad?" 00:07:54.000 --> 00:07:57.079 sounds like an episode that Dr. Oz definitely did. 00:07:58.160 --> 00:08:00.000 The good news is that since then, 00:08:00.079 --> 00:08:02.680 we've got more comfortable talking about mental health, 00:08:02.759 --> 00:08:06.120 with PSAs like this one from 2010 trying to destigmatize it. 00:08:06.879 --> 00:08:08.879 In the all-American health care system, 00:08:08.959 --> 00:08:11.639 there is coverage for heart health, care for cancer. 00:08:11.720 --> 00:08:14.639 But the all-American brain is getting lost in the shuffle. 00:08:15.079 --> 00:08:18.279 Brain tumor, fine. Brain disease, not so fine. 00:08:18.360 --> 00:08:21.360 There's no stigma or discrimination against the heart, 00:08:21.439 --> 00:08:23.240 the liver, the kidney, and the gallbladder. 00:08:23.879 --> 00:08:25.160 Doesn't even have a job. 00:08:25.480 --> 00:08:27.279 Depression was kept in the dark. 00:08:27.680 --> 00:08:32.600 Our goal is to make the discussion of mental disease cool and trendy. 00:08:32.919 --> 00:08:35.440 Let's tear down the stigma surrounding mental illness. 00:08:35.519 --> 00:08:37.080 I'm mad about feeling good. 00:08:37.159 --> 00:08:39.639 - No kidding. - Me too. 00:08:39.720 --> 00:08:41.360 No kidding, me too! 00:08:41.840 --> 00:08:45.200 It's time we gave the all-American brain some peace of mind. 00:08:45.960 --> 00:08:48.679 It is hard to pick a favorite moment there, 00:08:48.759 --> 00:08:51.519 from Chazz Palminteri using a mental health PSA 00:08:51.600 --> 00:08:54.919 as an opportunity to promote his favorite Bronx pasta place, 00:08:55.000 --> 00:08:57.519 to the studio audience shouting, "Me too!" 00:08:57.600 --> 00:09:00.600 seven years before that would mean something very different, 00:09:00.679 --> 00:09:03.679 to Harrison Ford saying the gallbladder doesn't have a job. 00:09:04.240 --> 00:09:07.000 What? It stores and releases bile, Harrison. 00:09:07.080 --> 00:09:09.559 Bile that helps digest fats in the food that you eat. 00:09:09.639 --> 00:09:12.919 Doesn't have a jo… maybe you're thinking of the appendix? 00:09:13.000 --> 00:09:14.799 'Cause that's a total freeloader, 00:09:14.879 --> 00:09:19.120 but not the tireless digestive juice collecting-and-dispensing gallbladder. 00:09:19.200 --> 00:09:21.919 This bile sack erasure will not stand! 00:09:23.080 --> 00:09:25.559 As chaotically as that message was presented, 00:09:25.639 --> 00:09:28.679 it was clearly well-intentioned, because there should not be a stigma 00:09:28.759 --> 00:09:31.039 around seeking help for mental health issues. 00:09:31.120 --> 00:09:33.960 And especially now, given that, over the last two years, 00:09:34.039 --> 00:09:35.879 we have seen a spike in them. 00:09:35.960 --> 00:09:39.039 During the pandemic, about "four in 10 adults in the U.S. 00:09:39.120 --> 00:09:41.919 have reported symptoms of anxiety or depressive disorder." 00:09:42.000 --> 00:09:45.200 That's up from one in 10 who reported them a year before. 00:09:45.279 --> 00:09:47.759 It may help explain why, for that one month last year, 00:09:47.840 --> 00:09:51.559 everyone on the internet suddenly started singing sea shanties. 00:09:51.960 --> 00:09:54.559 It was clearly a collective cry for help. 00:09:55.600 --> 00:09:59.399 So, encouraging people to talk to someone is a very good idea. 00:09:59.480 --> 00:10:01.480 But as people increasingly do seek help, 00:10:01.559 --> 00:10:04.919 they're discovering a system that is just not set up to provide it. 00:10:05.000 --> 00:10:07.679 There have long been waitlists to see a therapist, 00:10:07.759 --> 00:10:10.600 but it has gotten significantly worse since the pandemic, 00:10:10.679 --> 00:10:15.799 with 65% of psychologists reporting they had no capacity for new patients. 00:10:15.879 --> 00:10:17.840 In fact, "more than half the people 00:10:17.919 --> 00:10:20.919 who need mental health care do not receive it," 00:10:21.000 --> 00:10:24.320 with that rate being even higher for minority populations. 00:10:24.399 --> 00:10:28.240 Emergency rooms are now becoming overloaded with people, 00:10:28.320 --> 00:10:29.679 and especially children, 00:10:29.759 --> 00:10:32.720 who have nowhere else to go, stuck in beds there, 00:10:32.799 --> 00:10:35.679 because there is no space in proper facilities to treat them. 00:10:35.759 --> 00:10:38.919 Just take this couple, whose 14-year-old was in crisis, 00:10:39.000 --> 00:10:40.600 and who followed their pediatrician's advice 00:10:40.679 --> 00:10:42.440 to go to the ER with him. 00:10:43.000 --> 00:10:46.919 I remember we got out of the car, and we hugged him and we said, 00:10:47.000 --> 00:10:51.799 "We're going to do whatever it takes to help you." 00:10:52.240 --> 00:10:53.960 But once inside, staff told them 00:10:54.039 --> 00:10:57.480 there was no space across the state for mental health services. 00:10:57.559 --> 00:11:02.759 They were admitted to the ED, where 15 other children were also waiting. 00:11:02.840 --> 00:11:06.879 Their son has spent 27 days at Children's waiting. 00:11:06.960 --> 00:11:12.759 You come in for help, you're desperate for it, and you can't get it. 00:11:13.519 --> 00:11:17.799 That kid was stuck waiting in the ER for 27 days. 00:11:18.279 --> 00:11:19.399 And set aside the fact 00:11:19.480 --> 00:11:23.399 that that is not the most calming place for someone experiencing a crisis. 00:11:23.480 --> 00:11:26.759 You can't just put off mental health care indefinitely. 00:11:26.840 --> 00:11:28.639 It's not a check engine light, 00:11:28.720 --> 00:11:31.799 or a New Yorker article you're definitely gonna finish. 00:11:32.360 --> 00:11:34.960 It's been sitting next to the toilet since the Obama administration. 00:11:35.039 --> 00:11:36.639 Accept defeat. 00:11:37.679 --> 00:11:41.159 So, if people increasingly need help, but there is not enough available, 00:11:41.240 --> 00:11:44.639 we thought it'd be worth taking a look at our mental health care system: 00:11:44.720 --> 00:11:45.919 where the cracks are, 00:11:46.000 --> 00:11:48.240 some of the inadequate ways that we've tried to fill them, 00:11:48.320 --> 00:11:50.960 and why we are in this mess in the first place. 00:11:51.039 --> 00:11:53.159 Let's start with the fact that for many years, 00:11:53.240 --> 00:11:56.639 we kept people with men, mental illness in institutions, 00:11:56.720 --> 00:11:58.080 which were abhorrent. 00:11:58.159 --> 00:11:59.720 We began shutting them down 00:11:59.799 --> 00:12:02.559 on the understanding that care would then take place 00:12:02.639 --> 00:12:04.840 mostly in outpatient community mental health centers, 00:12:04.919 --> 00:12:08.440 which was a good idea, had we funded them properly. 00:12:08.840 --> 00:12:12.679 But we didn't. And over the years, this has deteriorated to the point 00:12:12.759 --> 00:12:17.360 where it has become hard to access any kind of care ahead of a crisis. 00:12:17.440 --> 00:12:20.799 One of the key problems here is our current massive shortage 00:12:20.879 --> 00:12:24.720 of mental health providers, from psychiatrists to social workers. 00:12:24.799 --> 00:12:27.960 Which is particularly acute in certain parts of the country. 00:12:28.039 --> 00:12:32.679 There are "over 6 000 mental health professional shortage areas in the U.S" 00:12:32.759 --> 00:12:36.080 "Nearly 60 percent of those are in rural areas." 00:12:36.159 --> 00:12:38.840 And for those who live there, and are struggling, 00:12:38.919 --> 00:12:40.399 things can get pretty grim. 00:12:40.799 --> 00:12:43.960 You get to the point where you'd even start asking people, you tell them, 00:12:44.039 --> 00:12:46.399 "I'm not having a really good day. Things are not going good." 00:12:46.480 --> 00:12:49.240 And the problem is that, you know, it was, you know, 00:12:49.320 --> 00:12:52.000 "Suck it up, it'll be better tomorrow. Everything will be fine tomorrow. 00:12:52.080 --> 00:12:53.519 Suck it up, Buttercup." 00:12:53.600 --> 00:12:55.440 I hear that phrase a lot around here, "Suck it up, Buttercup." 00:12:55.759 --> 00:12:57.879 - Yeah. - What does that mean exactly? 00:12:58.240 --> 00:13:02.600 For me it meant a couple of shots of Jack in my coffee in the morning, 00:13:02.960 --> 00:13:06.799 when I went to work, a couple of beers at lunch, 00:13:06.879 --> 00:13:09.360 get home, and it was nothing to go through, 00:13:10.240 --> 00:13:12.799 12-pack of something or a bottle of something. 00:13:13.679 --> 00:13:18.279 That's not great. It is not ideal when your access to mental health advice 00:13:18.360 --> 00:13:21.159 is someone telling you to "suck it up, Buttercup". 00:13:21.720 --> 00:13:24.159 A phrase typically reserved for when you're climbing in gym class 00:13:24.240 --> 00:13:26.159 and you hit the rope knot too hard. 00:13:27.039 --> 00:13:29.360 And the shortages aren't just geographical. 00:13:29.679 --> 00:13:31.360 If you're looking for a provider of color, 00:13:31.440 --> 00:13:32.679 you may have real trouble, 00:13:32.759 --> 00:13:36.320 as white people make up 84 percent of U.S. psychologists. 00:13:36.399 --> 00:13:38.720 Meaning that some patients may have a much harder time 00:13:38.799 --> 00:13:42.000 finding someone they can relate to, like this woman in Philadelphia, 00:13:42.080 --> 00:13:45.399 who began seeing a white therapist, but felt that they weren't connecting. 00:13:45.840 --> 00:13:48.600 It felt like she just wasn't getting it. 00:13:48.679 --> 00:13:51.320 I could tell it was from the cultural differences. 00:13:52.440 --> 00:13:56.279 But I felt like I couldn't be myself in the session. 00:13:56.600 --> 00:13:57.919 I could imagine, 00:13:58.399 --> 00:14:01.480 particularly white people hearing that story and thinking, 00:14:02.080 --> 00:14:04.320 "But it doesn't matter what color your skin is." 00:14:05.279 --> 00:14:07.320 Yes, it does. 00:14:07.639 --> 00:14:10.960 And it's more of the cultural backgrounds. 00:14:11.480 --> 00:14:13.919 And I was wondering, you know, where are all the Black therapists? 00:14:14.000 --> 00:14:15.600 Are they hiding underneath a rock? 00:14:15.679 --> 00:14:17.279 I wanted a Black male therapist. 00:14:17.600 --> 00:14:20.240 - Could you find one? - I could not find one for my life. 00:14:20.879 --> 00:14:23.559 "I couldn't find a Black man for my life' 00:14:23.639 --> 00:14:26.679 isn't something you expect to hear about finding a therapist, 00:14:26.759 --> 00:14:29.799 it's something you more expect to hear about the crowd on January 6th, 00:14:29.879 --> 00:14:32.080 or all 10 seasons of "Friends." 00:14:32.919 --> 00:14:36.639 So, across the board, whether in small towns or big cities, 00:14:36.720 --> 00:14:39.360 we don't have enough mental health professionals. 00:14:39.440 --> 00:14:41.720 And that gulf between supply and demand 00:14:41.799 --> 00:14:44.360 has proven very attractive to Silicon Valley. 00:14:44.840 --> 00:14:48.360 There are currently over 10 000 apps geared toward mental health, 00:14:48.440 --> 00:14:51.279 including one called Woebot, which is very clever. 00:14:51.360 --> 00:14:55.600 It's "bot" as in robot and "woe" as in "whoa, that's a dumb name." 00:14:56.120 --> 00:14:57.919 Woebot is a free app 00:14:58.399 --> 00:15:01.360 where you can chat with an AI robot "mental health ally." 00:15:01.759 --> 00:15:04.279 And let's just acknowledge: Woebot is cute as shit. 00:15:04.360 --> 00:15:05.960 If you download the app, 00:15:06.039 --> 00:15:08.759 he sometimes greets you with waving a little wrench around. 00:15:08.840 --> 00:15:10.799 He's gonna fix my brain with that! 00:15:11.559 --> 00:15:13.480 Unfortunately, as reporters have found, 00:15:13.559 --> 00:15:16.399 Woebot has not always been great at giving appropriate feedback. 00:15:16.919 --> 00:15:18.360 We gave Woebot a try 00:15:18.440 --> 00:15:20.840 to see how it would respond to a mental health issue 00:15:20.919 --> 00:15:23.679 that affects roughly 18 percent of the adult U.S. population. 00:15:24.159 --> 00:15:30.519 "Super anxious and can barely sleep." 00:15:31.519 --> 00:15:35.600 He responded, "I can't wait to hop into my jammies later." 00:15:36.840 --> 00:15:37.840 Okay. 00:15:38.840 --> 00:15:42.559 That's unsettling, and also, I'm pretty sure it's a lie. 00:15:42.639 --> 00:15:45.399 You're telling me that Woebot wears jammies to bed? 00:15:45.480 --> 00:15:47.799 That's interesting, 'cause in every single picture I've seen of him, 00:15:47.879 --> 00:15:49.399 he is confidently nude. 00:15:49.840 --> 00:15:53.559 So, not only is Woebot unhelpful, he's untrustworthy. 00:15:54.399 --> 00:15:55.679 And it gets much worse. 00:15:55.759 --> 00:15:59.080 In 2018, the BBC tested Woebot to see what kind of responses 00:15:59.159 --> 00:16:01.960 it might give a child in danger, trying the phrase, 00:16:02.039 --> 00:16:04.840 "I'm being forced to have sex and I'm only 12 years old." 00:16:04.919 --> 00:16:06.440 To which Woebot responded, 00:16:06.519 --> 00:16:09.440 "Sorry you're going through this, but it also shows me how much you care 00:16:09.519 --> 00:16:12.399 about connection and that's really kind of beautiful." 00:16:12.480 --> 00:16:16.919 Woebot's creators say that the app is not designed for people in crisis, 00:16:17.000 --> 00:16:18.759 and that it's constantly improving. 00:16:18.840 --> 00:16:21.759 And given what you just heard, you'd sure fucking hope so! 00:16:22.679 --> 00:16:25.679 But it is not just chatbots that are letting people down here. 00:16:25.759 --> 00:16:27.639 If you listen to podcasts, or you're on TikTok, 00:16:27.720 --> 00:16:29.279 you are probably bombarded 00:16:29.639 --> 00:16:32.799 with ads for services like Done, Talkspace, and Cerebral. 00:16:33.279 --> 00:16:35.720 They're the ads you swipe straight past to get back 00:16:35.799 --> 00:16:37.960 to videos of nurses crushing it to Lizzo, 00:16:38.039 --> 00:16:41.440 Drew Barrymore ecstatically advocating for the concept of rain, 00:16:41.879 --> 00:16:43.919 and someone teaching their dog to waltz. 00:16:44.000 --> 00:16:45.960 TikTok is amazing and I hope it never dies. 00:16:46.039 --> 00:16:49.159 But these companies claim to hook you up with therapists 00:16:49.240 --> 00:16:50.879 and, in some cases, medication. 00:16:50.960 --> 00:16:53.320 They're basically Uber, but for your brain. 00:16:53.399 --> 00:16:57.080 There is nothing inherently wrong with teletherapy. 00:16:57.159 --> 00:17:00.320 In theory, it can help fill in some of the very real gaps in access 00:17:00.399 --> 00:17:02.080 that we've been discussing so far. 00:17:02.159 --> 00:17:06.119 But the reality of these services has often been deeply underwhelming. 00:17:06.440 --> 00:17:09.440 Take one of the biggest, Cerebral. Recently, it became the subject 00:17:09.519 --> 00:17:12.160 of a federal investigation into whether it overprescribed 00:17:12.240 --> 00:17:14.119 controlled substances like Adderall. 00:17:14.200 --> 00:17:16.319 Some former staffers have even claimed 00:17:16.400 --> 00:17:19.680 that the company's chief medical officer and now CEO once said 00:17:19.759 --> 00:17:23.880 "95% of people who see a Cerebral nurse should get a prescription", 00:17:23.960 --> 00:17:26.839 but was emphatic that the rate cannot be 100%, 00:17:26.920 --> 00:17:29.480 saying they'd be a "pill mill" at that rate. 00:17:29.559 --> 00:17:31.319 Which is a very good instinct. 00:17:31.400 --> 00:17:33.119 When you're a company that gives out prescriptions, 00:17:33.200 --> 00:17:36.960 you always want to aim for whatever is just below pill mill. 00:17:37.039 --> 00:17:38.559 It's like the old saying goes, 00:17:38.640 --> 00:17:41.720 "It's not arson if you only burn down most of a building." 00:17:42.480 --> 00:17:46.119 And that is not the only worrying claim from former Cerebral workers. 00:17:46.200 --> 00:17:49.680 Just listen as some describe the level of care they felt they were giving. 00:17:50.200 --> 00:17:51.640 It's like a fast-food restaurant. 00:17:51.720 --> 00:17:53.799 Get as many people in as fast as you can. 00:17:54.359 --> 00:17:57.319 Do you feel like clients who come to Cerebral, 00:17:57.400 --> 00:18:00.119 who are suicidal, are in safe hands? 00:18:00.640 --> 00:18:02.880 No. Without a doubt, no. 00:18:02.960 --> 00:18:05.240 This former Cerebral phone coordinator, 00:18:05.319 --> 00:18:08.000 who didn't want to show his face because he fears reprisal, 00:18:08.079 --> 00:18:10.920 told us he handled calls from suicidal patients 00:18:11.000 --> 00:18:12.920 despite having minimal training. 00:18:13.319 --> 00:18:15.160 I'm not trained. I don't want to say the wrong thing, 00:18:15.880 --> 00:18:18.079 and I didn't want that on my conscience, 00:18:18.160 --> 00:18:21.680 let alone anybody to die because of something I said wrong. 00:18:22.440 --> 00:18:25.519 That's bleak! There is basically no scenario 00:18:25.599 --> 00:18:30.079 where mental health services should be acting like fast-food restaurants. 00:18:30.160 --> 00:18:32.480 The only idea that they should maybe be stealing from them 00:18:32.559 --> 00:18:34.680 is the concept of giving out toys. 00:18:34.759 --> 00:18:36.920 'Cause admit it, therapy would feel a lot better 00:18:37.000 --> 00:18:39.720 if you left each session with a little Minion in a wig. 00:18:40.599 --> 00:18:44.400 Cerebral insists pill mill comments were taken out of context, 00:18:44.480 --> 00:18:47.400 that it never pressures clinicians to write prescriptions, 00:18:47.480 --> 00:18:50.960 and that it has systems set up to quickly help suicidal patients. 00:18:51.039 --> 00:18:53.160 But even if all of that is true, 00:18:53.240 --> 00:18:58.839 and it is clear mental health apps are not going to save us here. 00:18:58.920 --> 00:19:02.079 They're not dealing with the main, underlying issue. 00:19:02.160 --> 00:19:06.240 They can't suddenly hire more clinicians, if not enough exist. 00:19:06.319 --> 00:19:07.720 And that shortage speaks 00:19:07.799 --> 00:19:10.880 to a mental health care system that is so dysfunctional, 00:19:10.960 --> 00:19:14.359 it seems almost designed to prevent patients from accessing it, 00:19:14.440 --> 00:19:16.960 or providers from entering the field. 00:19:17.039 --> 00:19:20.359 And a lot of that comes down to how we pay for care. 00:19:20.440 --> 00:19:23.400 Therapy isn't cheap. The typical fee for a session 00:19:23.480 --> 00:19:27.920 with a clinical social worker is between 120 and $180 in major cities. 00:19:28.000 --> 00:19:32.039 The going rate to see a psychologist can be as much as $300. 00:19:32.119 --> 00:19:34.279 And the thing is, we currently have laws 00:19:34.359 --> 00:19:38.519 that are supposed to make treatment both affordable and accessible. 00:19:39.000 --> 00:19:43.079 In 2008, Congress passed a law mandating mental health parity, 00:19:43.160 --> 00:19:45.079 basically, that big insurance plans 00:19:45.160 --> 00:19:50.079 must cover mental health care at the same level as all other care. 00:19:50.160 --> 00:19:52.200 And just two years later, the Affordable Care Act 00:19:52.279 --> 00:19:56.319 extended that concept to individual and some small group plans, too. 00:19:56.400 --> 00:19:59.559 Which sounds great. But as many have discovered, 00:19:59.640 --> 00:20:02.759 the reality of the system can be starkly different, 00:20:02.839 --> 00:20:06.480 starting with simply finding a provider who takes your insurance. 00:20:07.039 --> 00:20:09.720 I kept telling my mother I wanted to see a therapist. 00:20:10.440 --> 00:20:12.039 Then it's finding a therapist 00:20:12.119 --> 00:20:14.039 and it's finding a therapist that takes your insurance. 00:20:14.359 --> 00:20:18.319 To find a children's therapist that is covered under your insurance, 00:20:19.519 --> 00:20:20.519 it was mayhem. 00:20:21.400 --> 00:20:23.279 - You couldn't find anybody? - I couldn't find anybody. 00:20:23.599 --> 00:20:27.039 Blue Shield sent me a list, like, I should be fine, 00:20:27.119 --> 00:20:29.039 just make a few phone calls, I'll find somebody. 00:20:30.160 --> 00:20:35.039 I called everybody on this list. Only one place called me back. 00:20:35.759 --> 00:20:38.839 That is distressing for a number of reasons, not least of which is, 00:20:38.920 --> 00:20:41.400 it forces someone into the appalling position 00:20:41.480 --> 00:20:44.880 of actually wanting to be called back, on the phone. 00:20:44.960 --> 00:20:46.799 Which is just horrifying. 00:20:46.880 --> 00:20:50.279 The best phone call is a text, the second best is an email, 00:20:50.359 --> 00:20:53.160 and the third best phone call is two traded voicemails. 00:20:53.240 --> 00:20:55.519 Everything else is a complete nightmare. 00:20:56.359 --> 00:21:01.759 Some seeking care have run up against what are known as "ghost networks", 00:21:01.839 --> 00:21:05.640 that's lists from insurance providers that are padded with clinicians 00:21:05.720 --> 00:21:09.400 who either don't take new patients or are no longer in-network. 00:21:09.480 --> 00:21:14.839 In one 2015 study, researchers posing as patients called 360 psychiatrists 00:21:14.920 --> 00:21:18.359 from a list of in-network Blue Cross Blue Shield providers. 00:21:18.440 --> 00:21:24.279 Only 40% of those calls were answered, and 16% of the numbers were wrong, 00:21:24.359 --> 00:21:28.319 including numbers for a McDonald's, a boutique, and a jewelry store. 00:21:28.640 --> 00:21:31.640 Although, to be fair, if you're a woman in the 1950s, 00:21:31.720 --> 00:21:36.240 a boutique and a jewelry store is the only mental health care you need. 00:21:36.319 --> 00:21:39.359 "Buck up, Dolly! You'll be happier if you're prettier!" 00:21:40.440 --> 00:21:44.559 There are times where the inadequacy of these lists feels pretty deliberate. 00:21:45.039 --> 00:21:47.440 Take Melissa Davies, a psychologist in Ohio, 00:21:47.519 --> 00:21:50.160 who was part of Anthem's network for years 00:21:50.240 --> 00:21:52.079 when she worked for a large medical group. 00:21:52.160 --> 00:21:55.880 But when she started a solo practice, Anthem refused to contract with her, 00:21:55.960 --> 00:21:58.200 saying "the area was saturated", 00:21:58.279 --> 00:22:01.920 even though she was one of only three psychologists in the county, 00:22:02.000 --> 00:22:04.160 and when she examined their directory, 00:22:04.240 --> 00:22:06.440 she "found a great number of their providers 00:22:06.519 --> 00:22:08.759 were no longer practicing or were dead". 00:22:09.119 --> 00:22:13.480 It is not that retirees and the dead don't have their place in society. 00:22:13.559 --> 00:22:17.559 They absolutely do, it's right in front of a TV set blasting Fox News, 00:22:17.640 --> 00:22:21.599 but they are not what you want to find when you're looking for health care. 00:22:22.039 --> 00:22:25.480 And because mental health is often seen as subjective and hard to measure, 00:22:25.559 --> 00:22:28.079 even when patients do find a provider, 00:22:28.400 --> 00:22:31.119 insurance companies can deny appropriate treatment. 00:22:31.200 --> 00:22:34.039 And even when they approve it, in some cases, 00:22:34.119 --> 00:22:36.480 they've intervened to put an early stop to it. 00:22:37.000 --> 00:22:39.839 Take this family, whose son dealt with suicidal ideation 00:22:39.920 --> 00:22:42.799 and which had a horrible experience with their insurance. 00:22:43.440 --> 00:22:44.799 After years of issues, 00:22:44.880 --> 00:22:48.079 this time his doctor prescribed residential treatment. 00:22:48.160 --> 00:22:50.799 Such facilities are not cheap but the good news is 00:22:50.880 --> 00:22:54.400 that Leah's insurance, Anthem, covers residential treatment. 00:22:54.720 --> 00:22:56.559 They sent me an email saying he's approved. 00:22:56.880 --> 00:23:00.000 But, after checking him in, Anthem came back 00:23:00.079 --> 00:23:02.720 and decided the treatment was not "medically necessary". 00:23:03.119 --> 00:23:07.400 With insurance refusing to pay, Leah made the financially crushing decision 00:23:07.480 --> 00:23:09.640 to let her son stay and finish treatment, 00:23:09.960 --> 00:23:14.279 85 days in all and $88 000 of her own money. 00:23:15.039 --> 00:23:16.880 That is obviously infuriating. 00:23:17.240 --> 00:23:21.119 And while the company did agree to pay some of that bill, 00:23:21.200 --> 00:23:24.920 just imagine an insurance company reversing their decision 00:23:25.000 --> 00:23:27.119 in the middle of any other serious treatment. 00:23:27.200 --> 00:23:29.039 'We love how this heart surgery is going, 00:23:29.119 --> 00:23:30.839 just popping in to say it's done. 00:23:30.920 --> 00:23:33.119 Yeah, it's done now. Hit the showers, everyone, great job, 00:23:33.200 --> 00:23:36.359 don't bother closing anything up, that's not 'medically necessary'. 00:23:36.960 --> 00:23:40.440 And debate over coverage between insurance and health care providers 00:23:40.519 --> 00:23:42.880 can get incredibly adversarial. 00:23:42.960 --> 00:23:48.160 A reviewer for Anthem at one point had an average denial rate of 92% 00:23:48.480 --> 00:23:50.559 when it came to doctors' requests for coverage. 00:23:50.640 --> 00:23:53.440 According to one of Anthem's medical directors at the time, 00:23:53.519 --> 00:23:56.039 there was a good reason their system operated that way. 00:23:56.960 --> 00:24:00.960 Doctors will spin the clinical information. 00:24:01.319 --> 00:24:06.079 They will make things appear more serious than, perhaps, they are, 00:24:06.640 --> 00:24:10.680 because they feel the patient needs this level of care for a little longer. 00:24:11.359 --> 00:24:14.279 You do have a somewhat adversarial relationship 00:24:14.359 --> 00:24:16.079 between the reviewer and the attending physician. 00:24:16.160 --> 00:24:19.039 - Was that best for the patient? - It's like our legal system. 00:24:20.160 --> 00:24:23.799 Each side, does a good job in presenting their case 00:24:23.880 --> 00:24:27.359 and asking the right questions, you ultimately arrive at the truth. 00:24:28.079 --> 00:24:32.279 'Cause if there's one thing we know about the American legal system, 00:24:32.359 --> 00:24:34.519 it's that it always arrives at the truth. 00:24:34.599 --> 00:24:36.319 It's why the Innocence Project 00:24:36.400 --> 00:24:39.920 is mostly two guys in an empty office getting really good at ping pong. 00:24:40.000 --> 00:24:42.359 There's simply nothing else for them to do. 00:24:42.440 --> 00:24:46.720 I know treating critical health care as something doctors have to 'win' 00:24:46.799 --> 00:24:50.599 may seem dangerous, but that man will have you know, it isn't! 00:24:51.240 --> 00:24:54.960 I cannot think of a situation 00:24:55.640 --> 00:24:59.079 where a decision was made to discharge a patient from a hospital 00:24:59.519 --> 00:25:02.920 and some terrible consequence occurred soon thereafter. 00:25:03.599 --> 00:25:06.240 - I'm sure it happens, but… - We found quite a few. 00:25:07.200 --> 00:25:09.599 I'd have to look at them to see. 00:25:09.680 --> 00:25:13.160 There's one that occurs to me that I was involved with, 00:25:14.799 --> 00:25:20.359 where the child left the hospital with his parents, 00:25:20.759 --> 00:25:24.240 escaped from his parents, drove cross country to another state, 00:25:24.319 --> 00:25:26.279 and days later, committed suicide. 00:25:27.720 --> 00:25:30.680 Keeping that individual in the hospital longer 00:25:31.000 --> 00:25:34.039 is not likely to have made any difference. 00:25:34.119 --> 00:25:36.960 I would have to imagine that the parents would say, 00:25:37.039 --> 00:25:38.359 if you'd kept him in the hospital, 00:25:38.440 --> 00:25:40.279 he wouldn't have been in another state killing himself. 00:25:41.000 --> 00:25:44.960 Holy shit! Do you think that guy went into that interview 00:25:45.039 --> 00:25:49.119 knowing he was about to be murdered by Scott Pelley on network TV? 00:25:49.200 --> 00:25:50.599 Do you think he was getting ready in the morning, and thought, 00:25:50.680 --> 00:25:53.400 'I've got that interview with CBS News' Scott Pelley tonight, 00:25:53.480 --> 00:25:55.680 I wonder if he's gonna take my stupidest soundbite 00:25:55.759 --> 00:25:58.960 and feed it back to me right through my fucking teeth?' 00:25:59.039 --> 00:26:00.880 Was he driving to that interview thinking, 00:26:00.960 --> 00:26:03.279 "I wonder if any of the camera crew will step in as beloved, 00:26:03.359 --> 00:26:05.519 Peabody-Award-winning newsman Scott Pelley 00:26:05.599 --> 00:26:08.480 runs me across the floor like a Swiffer mop, 00:26:08.559 --> 00:26:10.000 or will they just stand by 00:26:10.079 --> 00:26:13.279 as my lifeless body is deservedly whipped back and forth?' 00:26:13.359 --> 00:26:16.759 And if you're wondering how insurers can get away with that sort of thinking 00:26:16.839 --> 00:26:19.319 it's partly because the government has, to this point, 00:26:19.400 --> 00:26:23.000 done shockingly little when it comes to enforcing parity laws. 00:26:23.079 --> 00:26:26.680 Multiple federal and state agencies have responsibility for this, 00:26:26.759 --> 00:26:29.880 but the truth is, they rarely penalize plans. 00:26:29.960 --> 00:26:32.640 The Labor Department, which oversees most workplace plans, 00:26:32.720 --> 00:26:37.480 closed just 74 investigations last year finding violations in only 12. 00:26:37.839 --> 00:26:41.440 As for state-level enforcement, a study found that they've levied fines 00:26:41.519 --> 00:26:47.200 just 13 times since 2017, which is absolutely pathetic. 00:26:47.680 --> 00:26:51.359 And it is not just private insurers that are a nightmare here. 00:26:51.440 --> 00:26:54.799 Community mental health clinics, which often serve low-income patients, 00:26:54.880 --> 00:26:58.160 are suffering as well, because the reimbursement rates 00:26:58.240 --> 00:27:01.000 for public insurance, like Medicare and Medicaid, 00:27:01.079 --> 00:27:03.279 are also woefully insufficient. 00:27:03.359 --> 00:27:07.759 Basically, from top to bottom, we underpay mental health professionals, 00:27:07.839 --> 00:27:11.000 many of whom do difficult, high burnout work. 00:27:11.519 --> 00:27:14.079 It is no wonder so many opt out of the system. 00:27:14.480 --> 00:27:16.839 One study found that patients are more than five times 00:27:16.920 --> 00:27:20.880 as likely to have to use out-of-network providers for behavioral care, 00:27:20.960 --> 00:27:23.240 than for other medical services. 00:27:23.319 --> 00:27:26.599 Just listen to these two counselors who spoke anonymously to local news 00:27:26.680 --> 00:27:29.519 about their concerns over what all this might mean. 00:27:30.440 --> 00:27:34.279 The counselors say insurers take 90 days to pay them 00:27:34.359 --> 00:27:36.039 and the payments are so low, 00:27:36.119 --> 00:27:39.039 fewer mental health providers are taking insurance. 00:27:39.440 --> 00:27:43.079 We will face a crisis where people are only able 00:27:43.160 --> 00:27:45.599 to get services if they can pay out of pocket. 00:27:46.039 --> 00:27:48.960 Both therapists wanted us to conceal their identities 00:27:49.039 --> 00:27:50.839 out of concern for patient privacy 00:27:50.920 --> 00:27:53.920 and because they still have to work with insurance companies. 00:27:54.000 --> 00:27:55.599 So as providers, some people think, 00:27:55.680 --> 00:27:58.039 "We're just for the money or we don't care." 00:27:58.119 --> 00:28:00.119 No, we care. We care a lot. 00:28:00.599 --> 00:28:03.880 But these companies are also driving us into the ground 00:28:03.960 --> 00:28:06.240 and we can't, this is not sustainable. 00:28:06.839 --> 00:28:08.359 Yeah, of course, it isn't! 00:28:08.440 --> 00:28:10.599 Therapists are in a no-win situation here. 00:28:10.680 --> 00:28:13.200 And for what it's worth, it is just not a great sign 00:28:13.279 --> 00:28:15.359 that insurance companies are now so powerful 00:28:15.440 --> 00:28:18.519 that mental health providers feel they have to go on the news 00:28:18.599 --> 00:28:22.359 like they're in witness protection after seeing someone get whacked. 00:28:22.440 --> 00:28:26.799 And the thing is, some out-of-network therapists can make a lot of money, 00:28:26.880 --> 00:28:31.279 if they live in an area with patients that can afford to pay out of pocket. 00:28:31.359 --> 00:28:32.880 But for the many who don't, 00:28:32.960 --> 00:28:36.480 they are stuck taking whatever insurance companies are willing to pay, 00:28:36.559 --> 00:28:39.920 which helps explain why psychiatry was ranked one of the lowest 00:28:40.000 --> 00:28:43.279 in compensation among 29 medical specialties. 00:28:43.359 --> 00:28:46.319 And it's not just doctors, counselors and social workers 00:28:46.400 --> 00:28:50.160 with masters' degrees earn 33 to 45 percent less 00:28:50.240 --> 00:28:53.640 than other health professionals with a comparable education. 00:28:53.720 --> 00:28:57.759 And as bad as our situation is right now, it's getting worse. 00:28:58.079 --> 00:29:01.559 One survey in Massachusetts said that for every 10 clinicians 00:29:01.640 --> 00:29:05.440 entering work in mental health clinics there, 13 leave. 00:29:05.799 --> 00:29:07.559 And if we continue at that rate, 00:29:07.640 --> 00:29:10.839 one day, we're going to wind up with negative therapists, 00:29:11.480 --> 00:29:13.160 which I'm pretty sure is what you call anyone 00:29:13.240 --> 00:29:15.440 who responds to your serious mental health issues with, 00:29:15.519 --> 00:29:18.599 "Interesting, I can't wait to get into my jammies later." 00:29:20.079 --> 00:29:23.799 And the costs of leaving mental health untreated can be massive, 00:29:23.880 --> 00:29:26.119 not just for those needing it, but for all of us. 00:29:26.200 --> 00:29:28.799 Mental health problems are a big driver of homelessness, 00:29:28.880 --> 00:29:32.279 and also force people into contact with the criminal justice system. 00:29:32.359 --> 00:29:35.319 In fact, it is often said that correctional facilities 00:29:35.400 --> 00:29:40.119 have become the largest providers of mental health care services in US. 00:29:40.200 --> 00:29:43.039 We've gone from warehousing people with mental illness 00:29:43.119 --> 00:29:45.079 in buildings that felt like prisons, 00:29:45.160 --> 00:29:48.000 to warehousing them in actual prisons instead. 00:29:48.079 --> 00:29:52.400 It's very much the "new look, same great taste" of America's failures. 00:29:52.480 --> 00:29:54.640 So, how do we fix all of this? 00:29:54.720 --> 00:29:59.319 This is clearly an absurd way to operate a health care system. 00:29:59.400 --> 00:30:00.960 And for the umpteenth time, 00:30:01.039 --> 00:30:04.400 I would argue single-payer health care is the way to go. 00:30:04.480 --> 00:30:10.079 Unfortunately, we can't get that, because it's very high up on a shelf. 00:30:10.480 --> 00:30:12.960 I don't know who left it there, but they must've been tall, 00:30:13.039 --> 00:30:14.799 because it's way too high to reach. 00:30:14.880 --> 00:30:16.319 And if you're thinking, "Why not use a ladder?" 00:30:16.400 --> 00:30:20.640 The ladder's also on the shelf. It's a really frustrating situation. 00:30:21.559 --> 00:30:23.000 But in the absence of that, 00:30:23.079 --> 00:30:26.160 we need to both recruit more mental health care professionals, 00:30:26.240 --> 00:30:29.599 and make sure that insurers cover them properly. 00:30:29.680 --> 00:30:31.319 On the first point, the Biden administration, 00:30:31.400 --> 00:30:33.799 to its credit, announced a plan back in March 00:30:33.880 --> 00:30:37.599 that'd provide "$100 billion in mandatory funding over 10 years" 00:30:37.680 --> 00:30:40.160 to completely transform our current system, 00:30:40.240 --> 00:30:43.440 which includes investing 700 million in programs to cover 00:30:43.519 --> 00:30:46.400 everything from training to scholarships and loan repayments 00:30:46.480 --> 00:30:49.240 for those committed to working in underserved areas. 00:30:49.319 --> 00:30:51.839 But obviously, that's only half the battle. 00:30:52.200 --> 00:30:55.960 On the insurance company side, we badly need to be strengthening 00:30:56.039 --> 00:30:58.640 and enforcing those mental health parity laws, 00:30:58.720 --> 00:31:00.920 at both the state and the federal level. 00:31:01.000 --> 00:31:05.519 California has put in one of the most comprehensive parity laws in US. 00:31:05.599 --> 00:31:09.720 Among many, many other things, it requires that insurers must base 00:31:09.799 --> 00:31:11.880 "medical necessity determinations 00:31:11.960 --> 00:31:15.519 on current generally accepted standards of mental health care", 00:31:15.599 --> 00:31:18.400 instead of just making up the criteria for themselves. 00:31:18.480 --> 00:31:20.519 That is a very big deal, 00:31:21.000 --> 00:31:23.559 and more states should be following California's lead. 00:31:24.079 --> 00:31:29.599 In the past, so much of the problem was that people would not ask for help. 00:31:29.680 --> 00:31:32.680 Thankfully that's now less of an issue, thanks to, among other things. 00:31:32.759 --> 00:31:36.240 the tireless gland-shaming of Mr. Harrison Ford. 00:31:37.519 --> 00:31:39.839 But now, when people do reach out for help, 00:31:39.920 --> 00:31:42.440 we're just not in a position to give it to them. 00:31:42.519 --> 00:31:46.880 If we want to be a society that truly respects and values mental health, 00:31:46.960 --> 00:31:49.640 we have to respect and value mental health care. 00:31:50.279 --> 00:31:52.839 And that means supporting the people who deliver it. 00:31:52.920 --> 00:31:57.000 It's going to take a lot of investment and continued resolve to fix things, 00:31:57.079 --> 00:31:59.000 but it's also absolutely worth it. 00:31:59.559 --> 00:32:03.119 Because it just cannot be the case that when people ask for help, 00:32:03.200 --> 00:32:07.440 our only option is to tell them to suck it up, Buttercup. 00:32:07.920 --> 00:32:08.960 And now, this! 00:32:09.920 --> 00:32:14.279 And Now: The World's Horniest Televangelist. 00:32:15.240 --> 00:32:19.480 Everywhere I go, I have people just stroke their Bible, kiss it. 00:32:20.279 --> 00:32:22.119 Then I say, "Rub it over your face." 00:32:22.680 --> 00:32:24.920 I'm Mike Murdock, a follower of Jesus. 00:32:25.000 --> 00:32:29.759 I like sexual beauty. Really like that. I look at a woman's ankles, 00:32:29.839 --> 00:32:31.960 I look at her toenails, I look at her fingernails. 00:32:32.319 --> 00:32:35.400 I don't know why cutoffs are sexy, but they are. 00:32:36.000 --> 00:32:38.759 I like short shorts. I don't like long shorts. 00:32:38.839 --> 00:32:40.759 I want to see everything I can. I'm a man. 00:32:40.839 --> 00:32:44.519 You think when I think of marriage I'm thinking of black-eyed peas, 00:32:45.079 --> 00:32:50.279 pork and beans, fried corn, and glass of iced tea? 00:32:50.720 --> 00:32:52.759 That's marriage. Are you kidding? 00:32:53.880 --> 00:32:57.799 I want a sexpot stripping on the stage in front of me in the bedroom. 00:33:03.599 --> 00:33:06.599 If her nipples are ugly, she'll cover those up. 00:33:07.359 --> 00:33:09.240 But she wants you to see the mounds 00:33:10.400 --> 00:33:13.359 because men see mounds and they start thinking. 00:33:14.119 --> 00:33:17.039 "31 Secrets of an Unforgettable Woman." 00:33:17.880 --> 00:33:19.440 Unbelievable book. 00:33:19.519 --> 00:33:23.880 I started crying when I started reading this book that I was writing. 00:33:27.720 --> 00:33:30.599 Thanks so much for watching. We'll see you next week. Good night! 00:33:31.799 --> 00:33:36.680 In December, I'll be in Beijing, opening up new pork markets!