Keynote #3 | Perspectives on Mental Health Policy from Secretary Becerra

July 20, 2022

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra provided a keynote address on HHS’ top priorities in mental health, promising advancements to date, and insights on future objectives.

  • Xavier Becerra, J.D., Secretary, Department of Health and Human Services
  • Sarah J. Dash, MPH, President and CEO, Alliance for Health Policy (moderator)


Perspectives on Mental Health Policy from Secretary Becerra
Sarah Dash:
It has been an incredibly insightful day, as we have heard from so many panelists and keynote speakers
on the status of mental health in America and what our ideal system could look like.
Sarah Dash:
And now it is my absolute honor and privilege to introduce our final keynote speaker of the day, the
25th secretary of the Department of Health and Human Services and the first Latino to hold the office,
Secretary Xavier Becerra. Secretary Becerra previously served 12 terms in the House of Representatives,
where he was also the first Latino to serve as a member of the powerful Committee on Ways and
Means. An attorney by training, he then served as the attorney general of the state of California for four
Sarah Dash:
We are so honored to have the secretary here today to discuss how the Department of Health and
Human Services under his leadership is working to improve mental health and substance use care in the
United States. First we’ll hear some brief opening remarks from the secretary, and then I’ll have the
opportunity to sit down with him for a brief fireside chat. And so with that, please join me in welcoming
Secretary Xavier Becerra.
Xavier Becerra:
Thank you.
Sarah Dash:
Thank you. Thank you.
Xavier Becerra:
Thank you. Good afternoon.
Good afternoon.
Xavier Becerra:
Okay. One more time, one more time. Good afternoon.
Good afternoon.
Xavier Becerra:
You’re almost done, you’re almost done. I want to say first thanks to Sarah and to all the team that has
made it possible for you to have this great conversation.
Xavier Becerra:
I’m going to be brief in my opening remarks because I know we’re going to have a chance to chat, but I
do want to emphasize a couple of things. First, I hope you agree with me that never again will we return
to the days where we did not consider mental healthcare or substance use disorder services when we
talked about healthcare, period. And if there’s anything the pandemic has taught us, above and beyond
the fact that COVID is really dangerous and deadly, is that there are a whole bunch of Americans who
are suffering, sometimes suffering quietly in the shadows, but nonetheless suffering.
Xavier Becerra:
And so we have to be ready to take on the task of being there for our brothers and sisters. And just to
give you a quick example of that. As many of you know, this past weekend 988 launched, the suicide
prevention lifeline that went from 10 digits in a phone number down to three, 988. And because of the
work that our team at HHS has done, it’s not just calls, it’s now texts and chats as well.
Xavier Becerra:
The weekend before this past weekend, there were some 17,000 people who called the various lifeline
numbers that existed throughout the country. Last weekend we got the report that there were 28,000
people who called the new 988 talk, text and chat line. In one weekend we went up 60%. There are
people out there who want to reach out. There are people who are asking for help. There are people
who are hoping we’ll be there. And just as 911 is now there if you are in an emergency and you want
rescue, we should tell everyone in America, if you are in crisis, there is rescue. And hopefully 988 gets to
the point of not only giving you the service when you call, or when you text or chat, but the follow-up
care that you’ll need as well afterwards.
Xavier Becerra:
The final point I want to make is that we’re in a moment, President Biden has made a commitment if
you heard his State of the Union address. We’ve never seen a president make such a historic investment
in his budget in mental health and drug use disorder services as we’ve seen under President Biden.
Some $50 billion is what he’d like to invest over the next five years. What I will tell you is that we’re not
going to wait until the budget is approved by Congress, we’ve already begun. In the last year and a half,
that at least since I’ve been secretary and the president has been in office, we have invested 20 times
what had been invested the year before for the 988 lifeline. $24 million is what had been invested the
year before President Biden came in office. So far today $432 million is what we’ve invested in standing
up to suicide prevention lifeline.
Xavier Becerra:
We’re going to make investments like that because we believe that when you call in your moment of
crisis, you should get help. But it’s on a daily basis. And the thing that we have to remember is that when
we talk behavioral healthcare, we have to start thinking of it as primary healthcare. Not some specialty
care, but that every primary care provider, physician provider, at the very beginning starts to talk to you
about offering you services that involve behavioral health. Not just checking your blood pressure, not
just checking your height and your weight, but also asking you, “How are you feeling? What’s going on in
your life?” Because we need to make sure that there is true wellness, whole body, whole mind and spirit
wellness in the American people.
Xavier Becerra:
And so at HHS we’ve got to charge. And so if you’re willing to join us, I will leave you with the words that
I always tell my team. When you’re put in a place where you can make a difference, a big difference in
the life of people, never do mild. And so I urge you, I plead with you, as you do your work, do not do
mild. There are a whole lot of Americans who are waiting for you to really just be there to charge. So
thank you for inviting me, look forward to the questions I’ll get asked.
Sarah Dash:
Thank you. Thank you so much, Mr. Secretary, for those remarks. And you’ve served as a member of
Congress, as an attorney general. Now, of course, you’re the Secretary of Health and Human Services,
such a powerful role. How have these professional experiences and the policies that you have shaped
really affected your leadership on mental health?
Xavier Becerra:
I’ve had the chance to do the policy side, the enforcement side, and now the execution side. But I’ll tell
you, probably the most informative for me was my very first job, which was as a legal services attorney
in Worcester, Massachusetts, helping folks with mental disability who are low income. And there you
see it firsthand, people who desperately need service, can’t afford it, and sometimes end up in places
that even the law says they shouldn’t be.
Xavier Becerra:
And so for me, the commitment started there when I saw … As someone who grew up as a minority and
didn’t have very much in my life, I also saw that you have to work with other communities that don’t
necessarily have the same challenges you do, because it’s ultimately the same thing. Someone is being
left out and we have to work hard to make sure they’re included. And so for me, the commitment
towards mental healthcare started way back when I was a new attorney working for legal services.
Sarah Dash:
Wow. In Worcester, Mass.
Xavier Becerra:
In Worcester, Mass.
Sarah Dash:
There you go.
Xavier Becerra:
Worcester, Worcester. Yes.
Sarah Dash:
And you mentioned of course, since the 988 lifeline has officially started to transition, we heard about
that a little bit earlier today. What role does HHS now play in ensuring that the lifeline is a success?
Xavier Becerra:
Yeah, and this is where a lot of folks are confused. We’re simply the glue. The services are actually
administered at the state level, territorial level, tribal government level. Federal government does not
run 988, nor the lifeline that existed before. But because the president said he really wanted us to tackle
this issue on behavioral health, he’s given us the resources.
Xavier Becerra:
So what we did was we brought the states, territorial governments and the tribal governments together
to say, “We’re going to be there to help.” We’re going to try to sew everyone together, because no one
should have to worry about being in the wrong … Actually, the way now with DOS, you see women have
to be in the right state in order to be able to have rights to receive their care. What we don’t want is in
behavioral health for you to be in the wrong state when you’re having a crisis and not get the services.
We’re trying to make sure we glue together all the crisis centers that are out there, make them work
well so that regardless of where you are, when you call or text, you’ll get responded to.
Sarah Dash:
Yeah, certainly that tells us why the lifeline is so important to communities across the country. And at
the very local level, it sounds like.
Xavier Becerra:
Sarah Dash:
Yeah. Yeah, and as we heard earlier today from bipartisan leaders, mental health is a topic that has a lot
of bipartisan interest and ideas around improving the system. I’m curious where you see the most
opportunity for progress in this area, and how do you think recent bipartisan actions like the Bipartisan
Safer Communities Act will have an impact?
Xavier Becerra:
I know you heard from Chairman Wyden and Senator Crapo earlier, and they have worked together
really well on a bipartisan basis. I just came from a meeting with Senator Stabenow and Senator Blunt,
Michigan and Missouri. They have been champions of the Certified Community Behavioral Health
Xavier Becerra:
And I think that CCBHC model is going to be one that we really work on expanding because it’s worked.
We’re finding that it’s keeping people in the community and not in institutions. It’s keeping people out
of jail. It’s helping them find jobs. I think CCBHC has really done, in the short time that it’s been around,
a lot to prove that if we just put a little bit of money, so a few resources into providing the services in
community, a lot of folks will be able to give back to where they want to be.
Sarah Dash:
Yeah, thank you. As we certainly heard this morning from some of those very local community
providers, and I want to ask you of course about youth mental health. And we certainly know and have
heard the isolation of the pandemic, technology have had a profound, probably interrelated, impact on
children and youth mental health. What would you say to a parent or a teenager who’s struggling right
now about how your administration is really attempting to address these issues?
Xavier Becerra:
Well, as with 988, we want people to reach out, and sometimes it’s more difficult for someone who’s an
adolescent to feel comfortable reaching out. They don’t yet know as much about the world and they’re
probably not as prepared to stand up for themselves, so it makes it doubly important. We certainly have
to have the professionals where they are, where the kids are. That means our schools to do a far better
job of having psychologists available to them early, during the school hours.
Xavier Becerra:
But what I will tell you is that for young people, and I say this because I just was in Philadelphia for the
launch of 988, where I also had time to go visit a children’s crisis center. Young people yearn for a
chance to just reach out. And I met a young woman. She’s a rising sophomore in high school who lost
her brother, her brother was murdered. Her older brother, who was her idol and her role model. She
lives in a difficult circumstance. Her mom doesn’t have a lot of money, and she had begun to close up
because of the killing of her brother back in October of last year.
Xavier Becerra:
She was willing to come and chat because her mother really encouraged her and so did her counselors,
so she could tell her story. Her grief was from the trauma that she witnessed or she’s going through,
experiencing. The mental stress that she’s going through is something that if we are there, we can
probably help her get past that. But if we don’t, there are so many young people who, the day before
that trauma occurred, were probably like you and me, very normal. But Kai had this circumstance
occurred to her brother and now she’s trying to work through it. And it was actually amazing to watch
her in the short hour, hour and a half, that we were there, watch her open up.
Xavier Becerra:
And at the end of the session, one of the things they do at this crisis center, is they always ask everyone
at the end, “Tell us a saying or something that you think is appropriate. Tell us how you’re feeling, and
tell us what you’re thinking at this moment.” And I’m trying to remember the word, but I think she said,
her word was “heard.” “I feel heard.”
Xavier Becerra:
And I got to tell you it is both heartening, but it’s also very sad to think that a young … She’s not even a
woman yet, a young girl doesn’t feel like she’s heard. And can you imagine how much she wants to say
after losing her older brother? Her older brother had started a program to try to help young people,
who were on the verge of going in the wrong direction, get back on track. And she has decided that she
wants to try to take up that cause and continue that nonprofit that her older brother started. He was far
older. He was, I think, 32 or so when he was murdered.
Xavier Becerra:
Kai is just an example of the many kids that are out there who probably people never worried about as
having to get mental health services. But now all of a sudden she got to that cliff. And when her brother
was murdered, she started falling without parachute. Just doesn’t take a lot for us to try to reach out
and let her know there’s a parachute there. And so I think for many of us, there are so many young
people we could capture. Frederick Douglas had a … I mean, there are so many ways of saying it, but
Frederick Douglas 160 years or so years ago said, “It’s easier to build strong children than to repair
broken men.” We need to build strong children. And so at HHS, we’re going to take up that charge and
try to help build strong children.
Sarah Dash:
Wow. Well, Mr. Secretary, thank you so much for being with us today. We started this morning talking
about the importance of listening, and humbly listening to those in our communities. And so I think that
is a perfect place to conclude today, is with the story of somebody who ended up feeling heard. And so I
think you for your leadership and for joining us today, and we wish you all the best in this really
incredibly important endeavor. Thank you.
Xavier Becerra:
Thank you, Sarah. Thank you. Thank you.
Sarah Dash:
Thank you so much, sir.
Xavier Becerra:
Thank you.
Sarah Dash:
Thank you.
Xavier Becerra:
[inaudible 00:16:04].
Sarah Dash:
Take care.
Xavier Becerra:
Thank you.
Sarah Dash:
Thank you.