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Mr. WELLSTONE. Mr. President, I will be quite brief. I apologize. I didn't realize the amendment was coming up now. Senator REID and I were doing this together. Probably 10 minutes is what I will need. My understanding is that the Senator from Pennsylvania, who has been focused on suicide prevention and trying to do better with mental he alth tr eatment, would accept

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   Mr. REID. Mr. President, I was going to take 15 minutes, but 10 minutes would be fine.

   Mr. SPECTER. Mr. President, I ask unanimous consent that we proceed to the Wellstone amendment on a 10-minute time agreement.

   The PRESIDING OFFICER. The Chair advises Senators that there is no time agreement, unless we get this unanimous consent agreement.

   Mr. SPECTER. Mr. President, I ask unanimous consent that the time on the Wellstone amendment be divided with 7 minutes for Senator WELLSTONE and 3 minutes for this Senator.

   Mr. REID. I haven't spoken yet. I have only spoken for 1 minute.

   Mr. WELLSTONE. I object. I say to my colleague from Pennsylvania, I haven't been out here on the amendment. He knows that, and I don't want the Senator from Nevada to only have a few moments. It is an important issue. I don't think we can do it in that time.

   Mr. SPECTER. I withdraw my request and suggest that we

   proceed.

   The PRESIDING OFFICER. The Senator from Minnesota is recognized.

   Mr. WELLSTONE. Mr. President, we will move forward and not go through any unnecessary delay. This amendment would support a certification program to improve and evaluate the effectiveness and responsiveness of suicide hotlines and crisis centers in the U.S. and to help support and evaluate a national hotline and crisis center network.

   Let me go through these figures here on the chart.

   Suicide facts for our country:

   Every 42 seconds someone attempts suicide.

   Each 16.9 minutes someone completes suicide.

   Suicide is the eighth leading cause of all deaths.

   Death rates from suicide are highest for those over age 75.

   The incidence of suicide among 15- to 24-year-olds has tripled over the past 40 years, making it the third leading killer in that age group of 15- to 24-year-olds.

   In the State of Minnesota, it is the second leading killer of young people from age 15 to 24. These statistics that deal with mental il lness and suicides are disturbing. I point out to my colleagues that one of the factors that makes it so disturbing is that so much of suicide is connected to mental il lness, especially depression or substance abuse, and so much of it is diagnosable. Frankly, it is treatable.

   Really, there should be a hue and cry in the country for corrective action. I do a lot of work with Senator DOMENICI, and I get to do this work with Senator REID and Senator KENNEDY as well. There are a whole host of issues that deal with our failure to provide decent mental he alth co verage fo r people.

   I thank Surgeon General David Satcher for doing marvelous work. The Surgeon General's report, which came out recently, talks about 500,000 people every year in our country requiring emergency room treatment as a result of attempted suicide. In 1996, nearly 31,000 Americans took their own lives.

   I think of Al and Mary Kluesner in the State of Minnesota who started this organization called SAVE. They themselves have lost two children to suicide. Several of their other children have been unbelievably successful in their lives. There has been, up until fairly recently, this shame and people feeling as if it is their own moral failure. But it has so little to do with that.

   I met a couple weeks ago with Dr. David Shaffer from Columbia University and Kay Jamison from Johns Hopkins University. She has done some of the most powerful writing. It was Dr. Jamison who said before Senator SPECTER's committee, ``The gap between what we know and what we do is lethal.''

   We know so much about the ways in which we can treat this illness and we can prevent people from taking their lives, but we have not done nearly as much. We have many different organizations that support this amendment. I ask unanimous consent that this list be printed in the RECORD.

   There being no objection, the material was ordered to be printed in the RECORD, as follows:

   Organizations Supporting the Wellstone-Reid-Kennedy Suicide Prevention Amendment to the LHHS Appropriations Bill, June 28, 2000

   38 ORGANIZATIONS

   American Association of Suicidology (AAS).

   American Foundation for Suicide Prevention (AFSP).

   Suicide Prevention and Advocacy Network (SPAN).

   Suicide Awareness/Voices of Education (SA/VE).

   National Mental He alth As sociation (NMHA).

   National Alliance for the Mentally Ill (NAMI).

   Bazelon Center for Mental He alth La w.

   American Psychiatric Association.

   American Psychological Association.

   National Mental He alth Aw areness Campaign.

   Light for Life Foundation (Yellow Ribbon Campaign).

   QPR Institute (Question/Persuade/Refer).

   National Organization of People of Color Against Suicide (NOPCAS).

   National Institute for Gay, Lesbian, Bisexual, Transgender (NIGLBT).

   With One Voice.

   Contact USA.

   Crisis Support Services of Alameda County.

   Contra Costa Crisis Center.

   Didi Hirsch Community Mental He alth Ce nter.

   San Mateo Crisis Intervention and Suicide Prevention Center.

   Pueblo Suicide Prevention Center.

   Alachua County Crisis Center.

   CrisisLine of Lantana.

   Switchboard of Miami.

   Cedar Rapids Foundation 2.

   Prince George's County Hotline and Suicide Prevention Center.

   St. Louis Life Crisis Services.

   Crisis Call Center, Reno, Nevada.

   Covenant House.

   Fargo HotLine.

   HelpLine of Delaware County.

   HelpLine of Morrow County.

   CONTACT of Pittsburgh.

   Sioux Falls, Volunteer Information Center HelpLine.

   Nashville Crisis Intervention Center.

   Houston Crisis Center.

   Crisis Link of Northern Virginia.

   Friends of Mental He alth of Loudon County.

   Mr. WELLSTONE. Mr. President, what this amendment does is add $3 million to SAMHSA to support, through grants, a certification program that would evaluate the effectiveness and responsiveness of crisis centers and suicide hotlines across the United States.

   It also helps to support a national hot line and crisis center network. There are 750 such crisis services in place across the country today. These centers are documented in the directory kept by the American Association of Suicidology.

   To date, there has been little or no funding to help support the training and to improve the quality of guidance through these hot line and crisis services. This amendment does exactly that. These funds will be used to improve the training and the skills of the staff at the crisis hot lines for suicides. There will be a variety of ways in which we can get the money to people so this work can be done.

   In awarding these grants, I encourage the Secretary of Health an d Human Services to collect an experienced nonprofit organization with significant expertise to administer this program.

   According to U.S. Surgeon General David Satcher, approximately 500,000 people each year require emergency room treatment as a result of attempted suicide. In 1996 alone, nearly 31,000 Americans took their own lives. In the U.S., suicide is the third leading cause of death of people age 15-34. A suicide takes place in our country every 17 minutes.

   In some parts of our country, including my own state of Minnesota, suicide is the second leading cause of death for these young people. Three times the number of Minnesotans die from suicide than from homicide.

   We know, without a doubt, that 90 percent of all completed suicides are linked to untreated or inadequately treated mental il lness or addiction. To prevent suicide requires an all-out public health ef fort that will recognize this problem, and will educate our country that we can no longer afford to turn our eyes away from the unthinkable reality that our citizens, even our children, may want to die.

   Dr. Satcher and other national mental he alth ex perts, such as Dr. Steve Hyman, Director of the National Institute of Mental He alth, h ave helped bring this issue forward, and to help us understand that, with proper treatment, this is one of the most preventable tragedies that we face as a country.

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   In 1996, the World Health Or ganization also issued a report urging members worldwide to address the problem of suicide, and one result was the creation of a public/private partnership to seek a national strategy for the U.S., involving many government agencies and advocacy groups. This is clearly a serious problem throughout the world.

   For too long, mental il lness has been stigmatized, or viewed as a character flaw, rather than as the serious disease that it is. A cloak of secrecy has surrounded this disease, and people with mental il lness are often ashamed and afraid to seek treatment, for fear that they will be seen as admitting a weakness in character. For this reason, they may delay treatment until their situation becomes so severe that they may feel incapable of reaching out.

   Although mental he alth re search has well-established the biological, genetic, and behavioral components of many of the forms of serious mental il lness, the illness is still stigmatized as somehow less important or serious other than illnesses. Too often, we try to push the problem away, deny coverage, o r blame those with the illness for having the illness. We forget that someone with mental il lness can look just like the person we see in the mirror, or the person who is sitting next to us on a plane. It can be our mother, our brother, our son, or daughter. It can be one of us. We have all known someone with a serious mental il lness, within our families or our circle of friends, or in public life. Many people have courageously come forward to speak about their personal experiences with their illness, to help us all understand better the effects of this illness on a person's life, and I commend them for their courage.

   The statistics concerning mental il lness, and the state of health ca re coverage fo r adults and children with this disease are startling, and disturbing.

   One severe mental il lness affecting millions of Americans is major depression. The National Institute of Mental He alth, a n NIH research institute, within the U.S. Department of Health an d Human Services, describes serious depression as a critical public health pr oblem. More than 18 million people in the United States will suffer from a depressive illness this year, and many will be unnecessarily incapacitated for weeks or months, because their illness goes untreated. Many will die.

   I recently had the good fortune to meet with a group of some of the foremost experts on suicide prevention, including Dr. David Shaffer, from Columbia University, and Dr. Kay Jamison, from John Hopkins

   University. They gave me an extraordinary overview of the many critical points of intervention where suicide may be prevented, and it is my intention to develop a larger bill, in collaboration with Senator HARRY REID, and hopefully many of my colleagues, that will address many of these issues.

   But this amendment will meet an important need right now, one that is timely, and even with its modest funding can help save many lives. This amendment has the support of Senators REID and KENNEDY, as well as the support of the national groups:

   American Association of Suicidology,

   American Foundation for Suicide Prevention,

   SPAN (Suicide Prevention and Advocacy Network),

   National Mental He alth As sociation,

   National Alliance for the Mentally Ill,

   American Psychiatric Association,

   American Psychological Association,

   Bazelon Center for Mental He alth La w, and SA/VE, a group based in Minnesota (Suicide Awareness/Voices of Education), headed by Al and Mary Kluesner.

   My amendment will add $3 million to SAMHSA to support through grants a certification program to improve and evaluate the effectiveness and responsiveness of crisis centers and suicide hotlines across the United States, and to help support a national hotline and crisis center network. Although there are 750 such crisis services in place across our country--these centers are documented in the directory kept by the American Association of Suicidology--to date there has been little or no funding to help support the training and improve the quality of the guidance that is provided through these hotline and crisis services.

   This amendment will do exactly that. These funds will be used to help improve the training and skills of the staff at crisis hotline suicides, through guidance provided by the American Society of Suicidology, the Center for Mental He alth Se rvices, the National Institute Mental He alth, a nd other mental he alth pr ofessionals. It will also help support the development of a national hotline and network of certified crisis centers.

   In the awarding of grants, I would encourage the Secretary of HHS to select an experienced non-profit organization with significant expertise in this area to administer the certification process, so that this process of training can begin as quickly as possible.

   Telephone hotlines are only one of the points of intervention, and are not and cannot be the only solution to those who suffer from severe mental il lness and the extraordinary despair that leads to suicide. Our country also needs to ensure that Americans have fair access to medical care, that the stigma associated with mental il lness is reduced, and more education and training for health ca re providers is made available. But the hotline does provide a lifeline for those who need to reach out for help and have nowhere else to turn too when they reach the point of despair.

   The crisis centers that run suicide hotlines are often patched together through a variety of funding sources, and struggle to keep their staff trained and their services of the highest quality. Although some centers are certified by the American Association of Suicidology, and some are connected through the Hope Line Network that is working to establish a national network, this process has only just begun. These centers perform a critically important service and would benefit enormously from a national certification process and regular staff training. The time is right to fund such a process.

   Staff at crisis centers need to be trained to conduct a suicide risk assessment to determine the seriousness and urgency of someone who may be contemplating suicide. They also need to know when to refer the individual to a local community mental he alth pr ovider if the person is not in crisis. But most importantly, they need to know when to send the police to the person's home or workplace if the staff person is convinced that a suicide is about to take place.

   Most people think that there is a national suicide hotline already in place that links people throughout the country. But until recently, this was not so. Crisis centers operated on their own, with volunteer help, and few resources. Recently, a national hotline number (1-800-SUICIDE) was established through the Hope Line Network, through the National Mental He alth Aw areness Campaign. As an example of the incredible need for such a number, the national hotline found itself flooded with calls after recently advertising on MTV and Fox Family Channel. Additionally, 1.5 million Americans logged onto their website during the 2 weeks after this advertising began. There are obviously many people who are in need of this service. And it needs to be the best possible service, and linked as best it can be to local help.

   By improving the training and skills of crisis hotline operators, such contact can be of the highest quality. Certification would require rigorous on site training and visits, evaluation of operations, records reviews, verification of staff training and skills, and the like.

   The Surgeon General is to be commended for bringing this issue of suicide forward as a major public health cr isis in his 1999 report, Call to Action to Prevent Suicide. In his report, he specifically cited the need for instituting training programs concerning suicide risk assessment and recognition, treatment, management, and aftercare intervention. He also asked that community care resources be enhanced as referral points for mental he alth se rvices. This amendment helps to support both of these requests.

   I must emphasize that suicide is often linked to severe depression and other forms of mental il lness. These illnesses are not the normal ups and downs everyone experiences. They are illnesses that affect mood, body, behavior, and mind. Depressive disorders interfere with individual and family functioning. Without treatment, the person with a depressive disorder is

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   The issue of suicide prevention is one that we have discussed before, at a hearing held by Senator SPECTER, and during other discussions about mental he alth re search and treatment. I am proud of my colleagues who have supported these efforts, including the cosponsors of this amendment, Senator REID and Senator KENNEDY. I am proud to join them in bringing this amendment forward, and I ask you for your support.

   There is a piece of legislation I have with Senator DOMENICI called the Mental He alth Eq uitable Treatment Act. We believe, especially when it comes to physician visits and days in hospitals, that people with a mental il lness should be treated the same way as people with a physical illness. We think it is time to end this discrimination.

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