May is Mental Health Awareness Month and to highlight common sense solutions, Dr. Burgess is joined by Congressman Drew Ferguson, DDS to discuss the BIG Act.
Well, hello and welcome to another episode of doctor in the house, you know, may is a mental health awareness month. So I'm so happy today to be joined by my friend, Congressman drew Ferguson from Georgia. We're gonna be discussing legislation that actually passed in the last Congress and is actively be being considered in this Congress. The big act should help equip schools and communities with the tools that they need to ensure safety and health of each student. We certainly can't ignore the mental health ramifications of the coronavirus pandemic and how it challenged every American, including our students. So with students, excuse me, facing unconventional pressures. During these times, it's more important than ever that schools have guidance on how to provide behavioral health resources for their students. We must do what we can to enable prevention, intervention, and early treatment of mental health conditions. So these kids can get help before their conditions worsen or worse yet become more serious. So again, I'm, I'm so pleased to welcome my, my friend, my colleague from Georgia drew Ferguson drew, you and I have worked on, uh, a piece of legislation called the big act for a couple of terms of Congress now. So how did this issue come to your attention and how did you decide it was important, uh, enough to draft a bill?
Speaker 2:Well, first of all, thanks for the chance to be with you today. And, and doc, one of the things that, that I've have seen over my years as, as a healthcare provider, um, even, even though I'm in a dental practice, you know, when you're in a general practice, you see so much of, and you build such deep relationships with patients, you see so much of what goes on, not only with them, but family members. And we saw the devastating effects of untreated mental health and untreated undiagnosed mental health, um, illnesses. And it really profoundly affects families. And so I was on a, I was on a visit to Columbus state university in Columbus, Georgia, and had a meeting with their team. And we were there talking about other things, and this topic came up and they shared with me what they were doing to help students get the resources that needed prior to whatever problems they were having a crisis could
Speaker 3:Not corrected. And I became fascinated with it and became fascinated with how they developed the program. Um, and we we'd, you know, there were other programs that were being talked about, I think Texas a and M had something that was, you know, very innovative as well, very much along these lines. But what we saw here is that if you could, if you could look at data from students and see quick changes in data, okay. Whether it was
Speaker 2:Something in their grades, whether it was,
Speaker 3:Um, something as simple as being the number of reprimands that they may have about, about their dorm room, um, or they behind on financial, you know, financial payments, all of these things kind of add up and they create stress in the student's lives. And when that happens, then the student begins to spiral out of control because they don't have the resources that they need to address the underlying problem. And so what the big act does is it recognizes that there are best, best practices around the country, both in the education system and in communities. And it says, Hey, we want to teach one another, how to recognize the problems and then assign a small team of people to help the person get the resources that they need before the problem spirals outta control.
Speaker 1:So my, my apologies, I should have identified the big act stands for the behavioral intervention guidelines, right. That's
Speaker 3:Right.
Speaker 1:And I also, I apologize. I failed to mention that you're a, a member of the doctor's caucus. We're both members of the how's G P doctors caucus. And most people don't realize that. In fact, we do get together on a weekly basis and we talk about things just such as this and how can we, how can we better help our constituents and how can we pass better legislation? You know, you referenced a college in Texas. I think it was actually Texas tech. And I went out there several years ago, trying to understand more about the, oh, the work they were doing in telehealth, because I mean, they're out there in the middle of nowhere in Lubbock, Texas, and it takes forever for anybody to get anywhere. And one of the things that came up, not just as a part of telehealth, but man, if we have a problem in one of our schools, it's not like, uh, downtown Dallas where help is only 10 or 15 minutes away, help may half an hour away or more. So the ability to identify, and this is what they told me. And, you know, it makes a lot of sense when, when I first heard about it that, uh, you know, it's kinda like everybody in school knows who's got the problem who, who, who is the problem and to be able to help zero in on the kid, who's struggling for whatever reason. And you're right. Maybe a number of, of things that come into play or multiple factors that come into play. But then most importantly, rather not just identifying, but identifying and helping. And that's really why I like the, the focus of legislation that you were working on. I knew from my folks at Texas tech, that it was important to, uh, to provide these interventional guidelines, but, but being able to intervene, that's a, that's a big deal.
Speaker 3:It is a big deal. And you know, there's a story from, uh, Columbus state university, uh, that really highlighted this. And it was a student that had been a, basically a, a top performing student. And then all of a sudden they were looking at their data and saw that the grades had slipped. Um, he was in, he had gotten into two fights. Okay. And it never had any trouble whatsoever. And was beginning to get reports that, you know, there were, there were other problems going on with the behavior. So what this allowed them. And one of the, one of those was that they realized that the, the student was about to not be able to register for the next quarter, cuz he was behind on his payments, tuition payments. And so what they did is they, they identified, they saw the change in behavior. They went and talked to the student to come to find out the father, his father had lost his job, didn't have the resources to help him finish. So he took, started taking jobs. He was working two jobs to earn money, to pay the tuition that was causing him to sleep, which was causing him to fall asleep in class fall further behind miss test. The level of frustration was that he lashed out at his roommates and it all was about about$500. So the university was able through their scholarship fund to find$500 to remedy the problem and help get the young man back on track. Think what would've happened if we had not, if they had not done that and this, this young, this young man would've reached a, a point in a spiral that he couldn't have gotten out of. He never would've finished his education and he could have wound up hurting himself or others. So not only did we help him finish, you know, the school, his schooling, cuz he went on to graduate with honors, which is a good part of this story, but he also kept him in a good state of mental health and he didn't harm himself. Those are big wins and that's the kind of thing that we need to be looking at. I
Speaker 1:Think that's, what's so critical about what we've worked on. It's uh, again, it's not just identification it's, it's the intervention part and literally empowering educators and administrators to be, to be part of the, of the team, if you will, that helps to intervene or intervene or intercede on a kid's behalf.
Speaker 3:And I think if you'd look at this too, everything that they, that they saw with this young man, as one example, was data that they already had. Okay, but this isn't going out and looking for something new or spine on students or anything like that. This is looking at data that they already have, but just recognizing what that data means and being intentional about using it in a way that allows them to, to, to create a healthy environment for their students. And so, you know, a lot of times in a, in an era right now, I think it's, I think we have to acknowledge that there are a lot of folks in the country that go, the last thing we want is the government spine on us. Or we don't want our business spine on us and we don't want, we don't want a school spine on us. I, I, I am firmly in that camp as well, but this data's out there. And if you can look at it in a way that is helpful, um, then, then I think, I think that's, I think we can, we can help a lot of people and we can do them a good service without going in, inviting in, in invading their privacy. And I think that's a, an important distinction because there are some guardrails in the big act that prevent it from being used in an nefarious way.
Speaker 1:Well, and that that's so important cuz you are correct. Uh, people are concerned, privacy right now is, is one of the buzzwords up here and everyone is, is concerned about that. But it's also so critical that there be the, all the positive aspects of this. You, you not just identify, but you're actually making a difference. And uh, I think as you so correctly pointed out, you're, you're utilizing data that's readily available. This is not a, this is not a secret. This is not, uh, going into a black box somewhere. Yeah. This is data that's readily available.
Speaker 3:Yeah. And in this example, in the school, the school knows what the student's grades are. The school knows what the discipline reports are. The school knows what the financial data is around that student. These are things that are all normal functions of being a student and being an administrator in, in, in a, in a institution of higher learning. But this can also go down to, can be used in the K through 12 setting. Um, so the look, the same things exist there that exist in higher ed. And we're what we're seeing as you pointed out in your opening, the effects of the pandemic are traumatic on, on, on our young people and the mental health issues that they are facing. Not only now, but will be facing as they matriculate through the system and go into the workforce or go into or go to college. Uh, these, these big events that have happened in their lives, um, all too often have led to, uh, depression, isolation, um, you know, uncertainty about, about their future. Uh, you know, they, they don't know what to believe about a lot of this stuff. And so you can imagine if someone, if, if a young person is, is anxious about that, it can start a cascade of events that lead them to a crisis moment that will cause them to either harm themselves or God forbid harm others. And that's what that, that's what we're trying to prevent here.
Speaker 1:So yeah, we, we, we're all aware that life gets more complicated as you, uh, as you go along and certainly the problems can compound and become also more complicated. Sure. Which is why the intervention is, uh, such a critical piece of this. And, and really what I think sets it apart from some of the other approaches that I had looked at along the way.
Speaker 3:Yeah. So this is designed to look at, you know, you know, the education setting,
Speaker 1:But I,
Speaker 3:I think, I think we've gotta be realistic in our conversations about, um, things that happen in our communities as well. Um, all too often, we see, we hear of a tragic incident, um, that, that, that may have happened. Um, you know, recently this, you know, the shooting and, and, and Buffalo, New York is an example. Um, again, how do you, how do you balance the privacy of individuals, but also know that there's public information out there about'em that was seen recognized, and yet it was never acted on, okay. Those are the things that, that I think that we, that we've gotta be intentional at looking at and recognize that there's a balance there, you, again, you don't want, you, you, you can't have the government invading your privacy. Um, you, you can't be, you can't have them affected, you know, using your first amendment rights against you, tho those kinds of things. But also if people are volunteering information and they're putting the they're, they're putting the signals out there, you know, you, again, ultimately we wanna prevent tragedy. And the thing that we ultimately don't, we want, we wanna prevent tragedy. We want to help our fellow Americans, and we want to do it in a way that doesn't violate their constitutional rights. And I think if we're smart and thoughtful about that and recognize that protection of constitutional rights is paramount in this country, I think we can do that
Speaker 1:Well. And the intentionality of what you've, what you've laid out in the big act, I think is a, is a big part of that. And, and quite honestly, too, you have to ask yourself, and some of the information that you write, someone puts up there for the public to consume, uh, uh, is, is, is it bravado or are they asking for help? And if they're asking for help, are we responding the correct way? And that's one of the things I, I know that keeps me up at night.
Speaker 3:Well, and, and again, I think it's, again, if you look at something like the big act, it, it, it's not legislation where it says that, Hey, a Congressman from Texas and one from Georgia are telling educators or law enforcement or healthcare professionals exactly what to do. It's simply saying, put congregate all of the best practices and then figure out a system that works for your environment. And, and that's ultimately, I think a much better position to take, because it allows local communities, local school systems, or an educational institution to develop their own model. And it's not being dictated by the federal government,
Speaker 1:Which is not being prescriptive is, is so terribly important in a, in a situation that demands flexibility. You, you really cannot be prescriptive. I know when, uh, when I talked to my, uh, my folks out in, at Texas tech in Lubbock, and I'll, I'll get the numbers wrong, cuz I don't have them in front of me, but the, uh, when they presented their data to me, and if you go to a school district, then they're talking K through 12, you go to a school district and yeah, there's a, a subset of people that everyone can identify, Hey, there's a problem of some sort here. And that number is well large enough. But as you begin to winnow it down and winnow it down, you eventually come to a small subset of people that, uh, really where a crisis may be imminent. But to some degree it's avoidable. I think though the example they gave me was a kid with, uh, undiagnosed dyslexia that had become an increasingly the severe behavioral problem in, in one of the, either middle schools or high schools. And by, by using the data, as you said, that is, that is generally available. They were able to, to winnow that down and, and provide some help. And look, there are gonna be times when the, you know, no matter what help is not gonna be, uh, not gonna be available or the person won't accept it. And then at least, you know, here's a subset of people really you've got to, uh, and it may even be an alternative education situation that they need to be in.
Speaker 3:Again, the bottom line is to get'em in the right environment, get'em the help that they need. Um, again, we, we, we want our fellow Americans to succeed and look the, the mental high, the mental health crisis that America is facing, um, is growing. And it's being driven by a lot of different things. You can point the finger at a lot of different root causes. And I think that, I think we've got to address those, but the damage has already been done. And so we're gonna have to set ourselves up for some long term intentional treatment and some long term steps to deal with this. Um, you know, if, if, if we lose Americans to mental health, it's no different than losing them to, to COVID 19 or to cancer. It's a loss life. And, and the resources that we spend on this are gonna be, you know, could be astronomical. So the sooner that we diagnose and prevent things, the better off we're gonna be. And I, and, and I like you, and a lot of other, a lot of other Americans are very concerned about our capacity, um, to, to deal with the mental health crisis, not our desire, not the money, but we have to, we have to recognize that we've got a big infrastructure problem, human infrastructure problem here, and making sure that we've got enough providers in the pipeline enough, enough facilities, and really the make sure that our processes are efficient, um, and get the best results. We got a long way to go on this in a short time to get there. So we, we, we've gotta stay focused on this.
Speaker 1:Well, we do. And as a member of the budget committee, I'm always mindful of the congressional budget office, but look, we all learned a long time ago, an ounce of prevention is worth pound to cure. And, uh, one of the arguments that I have with the congressional budget office is, Hey, don't always just charge us for the ounce of prevention, give us credit for the pound of cure. When we, when, when these things come up for a, for a budgetary discussion, and I don't know how many times I've said it, but the cost of doing nothing can, in fact be astronomical.
Speaker 3:It is true in every part of healthcare, every part of healthcare.
Speaker 1:And one of the things too, and we worked a lot, uh, a couple of congresses ago on the, what was called the support activist. We dealt with the opiate crisis at the time, and indeed it was, and it was a public health emergency, the president correctly, uh, determined and, and, and called a, a public health crisis. And we worked on it in Congress. We actually worked on legislation and in fact, made a difference began to actually for, I think calendar year, 2018 or 2019, for the first time those numbers came down, they ticked down a little bit now, of course, coronavirus intervened. Um, but the other thing that we can't take our eye off of, it's no longer an opiate crisis. It's a fentanyl crisis and fentanyl is ever so much more deadly than the, than the opiate crisis that the drivers and the symptoms are very similar, but now we're dealing with another order of magnitude as a severity of the crisis.
Speaker 3:And it is terrifying as a parent. It's terrifying. Um, I, I can tell you firsthand that, that parents, uh, including myself worry about this every single day with their kids, um, and there is, and, and it's being driven by the fact the number one, we do have a mental health crisis. We have predators that are in gangs that are selling drugs that are taking advantage of that. And this, the other piece of this is we have to recognize that we have a, we have a Southern border that is wide open, that we're just literally thousands of pounds of this stuff are coming across the border every single day. And, and it is, and it is terrifying. And, you know, again, we can sit back and just let things happen and point fingers, or we can actually do things that are effective. We have to secure the border. We have to deal with, with gang activity. We have to be intentional about, about mental healthcare. And we have to be intentional about drug counseling. This is dangerous. We had a hundred thousand people die fentanyl last year. Okay. If we had a hundred thousand people die of everything else of, of anything else, we would, we would mobilize as a nation, whether it was a foreign, it was a foreign country invading our, uh, coming into the us and killing our citizens, or whether it was a pandemic we'd mobilized our resources, our intellect, and we solved the problem and we should be taking that same approach. Now
Speaker 1:It is one of those all hands on deck moments, um, 107,000 deaths, the last calendar year, twice, the number of people that were lost in the entirety of the Vietnam war were lost in one year due to the fentanyl, uh, epidemic in this country. And, uh, look, you and I are both healthcare providers. We, we recognized a couple of congresses back that maybe healthcare providers, more, some of the responsibility we needed to be careful about the prescriptions we wrote, the drug companies needed to be careful about the deliveries. But I, I, I gotta tell you, uh, Congress of Ferguson, it's, it's morphed into an entirely different topic now, which just, as you said, the difficulties of the Southern border and they, and the toxicity of this compound that is now flooding into our, into our, our, our underworld markets. Uh, I will tell you that a couple of congresses ago, there was an effort to try to, to regulate or, or stop the pill presses that, uh, people are using. Unfortunately, that became a free speech issue. I don't quite understand how, but that may be one of the things that we need to revisit because you're right. It's the, the parent's concern that a kid is gonna be given what they think is a Percocet. Uh, and in fact, it turns out to be a deadly dose of fentanyl. And there's, there's no coming back from that.
Speaker 3:And, and you, you see this, um, it's another interesting piece of, this is a conversation about the legalization of marijuana. Um, and you see so many kids now that are, that are choosing to smoke marijuana, but they're getting it from somebody that they don't know the source, or they claim that they know the source. And by the way, there are no ethical drug dealers on the, on the planet. Um, they, the pot is, is laced with fentanyl. And so they go and they smoke, you know, they may smoke one joint, think that it's not gonna do anything. And you know what their parents, their parents have to go to their funeral. It's a, it, it it's a devastating event for the family.
Speaker 1:And, you know, one of the, one of the aspects of the big act, I, I think it, uh, drawn to its logical conclusion will help identify people who might be at risk for this type of behavior or drug seeking behavior associating with, with people who might lead to those types of decisions. So it's, it's bringing it back to the big act is critically important. We've gotta we've, as you say, we've got a clear and present danger, uh, at our, at our border on, in our midst, it is a chemical attack on the young people in this country. And we literally have to have all hands on deck to try to solve the problem.
Speaker 3:And yeah, we, we, we've got to do everything we can to protect, uh, protect Americans from harm. That's the, the, the first and primary responsibility of the federal government and a chemical attack on our children as you have. So aply called it, um, is something we should be defending against.
Speaker 1:And, and, and of course the mental health crisis feeds right into that. Well, um, I hope people listening to this podcast, uh, get the notion that both Georgia and Texas to states that might seem, uh, it might seem in Congress that, that Texas and Georgia would be the leaders on this, but we're serious about the problem. And, uh, so grateful to you for, um, putting the big act together and, and getting it out there again. I think we passed it in the last Congress, but it didn't, it didn't get through the Senate. So we'll have another opportunity this Congress. So that's, uh, that's a great thing about serving in the, uh, in the people's house. There's always an opportunity to continue to do good, but I really wanna thank you for being with me today and, and thank you for, for putting forward the legislation.
Speaker 3:Well, thank you for the chance to be with you and you know, you and I both know that, uh, we can get things done in the house. And I think, um, you know, I think that this is a bipartisan issue. We've got BI bipartisan support on this bill. Um, as you pointed out last time, it didn't make it through the Senate. As a, as a Georgian. I used to say all the time that I wanted two bulldogs, two Braves, and two Falcons to be my Paul bears at my funeral. So they could let me down one last time.<laugh> when you get, when you, when you get it, when you get to, when you get to Congress, you learn, you just need six senators, cuz they'll do it every time. So hopefully they'll, they'll get on board with this and get it across the finish line.
Speaker 1:Thanks again. Thanks for joining me today. And, uh, this concludes another doc, uh, another episode of doctor in the house, uh, visit the other podcasts that are available on the website and, uh, we'll cue the dramatic music and, uh, see you soon.