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tv   Politics and Public Policy Today  CSPAN  October 15, 2015 3:00pm-5:01pm EDT

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if you missed any of this discussion you can find it online cspan.org. and look here at some of the news from earlier today. house majority leader kevin mccarthy praising president obama's decision to keep troops in afghanistan beyond his term
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as president, but warning against taking them out on an arbitrary time line next year. the president announcing today that he would keep nearly 10,000 troops in the region until october 2016 and then cut back to 5,500 in early 2017. in a statement the majority leader said the decision to reduce troop numbers should be left to the next president. you can read more here at the "washington examiner." we've heard from the chair of the armed services committee, who released a statement saying given the troubling conditions on the ground in afghanistan and the other security problems in the region keeping 9,800 troops through at least 2016 is necessary for our security interests. you can also hear the president's announcement for yourself in its entirety and we'll have it at 8:00 p.m. eastern time over on c-span. known as the city of good neighborhoods, this weekend our c-span cities tour joined by time warner cable explores the
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history and literary life of buffalo wrarks new york, on become tv we'll visit the mark twain room at the buffalo and erie county public library whose centerpiece are pages of the original handwritten manuscript of "adventures of huckleberry finn" and then we'll feature "against the grain" about the history of buffalo's first ward. >> the irish settled in this neighborhood because they were desperate, came over across the atlantic during the famine and the years after the famine things still weren't great. it would take maybe one relative to find out about these plentiful jobs along the waterfront, working in the grain elevators or in the mills. and then word would go back to ire land, you want to come to buffalo, you aren't going to become rich, but you were going to have steady employment. so they came to this neighborhood called the first ward. it has its name because when buffalo first was created in 1832 as a city, it was divided into five political wards. and this area along the
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waterfront, along the buffalo river, has always been the first ward. >> on american history tv, on september 6th, 1901, president william mckinley was assassinated in buffalo. we'll tour the buffalo history museum exploring the mckinley exhibit that features exhibits surrounding his death and the gun used to shoot the president. then discover the history of the buffalo waterfront and how it's adapted from the nation's grain center to modern redevelopment. >> right now we're at silo city. this is a collection of grain elevators built along a bend in the buffalo river. originally built for different companies, but today all owned by rick smith who is the owner of the metals over on ohio street and it's now besides being regenerated for many different purposes, for ats, for music, we do history tours where we take people around the grain elevators and tell the story of the history, but there's opera and poetry readings and all the different uses for the historic
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silos. >> see all the programs from buffalo on c-span 2's book tv and sunday afternoon at 2:00 on american history tv on c-span3. the c-span cities tour working with our cable affiliates and visiting cities across the country. leaive in two hours south korean president park guen-hye today she'll be speaking about her country's relations in the united states at the center for strategic and international studies. we'll take you there live 5:00 eastern. first, though, a recent discussion about u.s. relations with mexico. military and local law enforcement officials talked about cooperation on border security at the offices of the association of the united states army. they talked for about an hour and ten minutes.
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all right, well, good afternoon. i'm not guy swann. he got tied up handing out some awards. my name is george cohen. i work on the national staff. it's an honor and privilege to be here with you. i want to thank you very much for your time. we have a great, great panel for you today. thank you for joining us for a third and final breakout session. this session is entitled the importance of mexico to homeland security. of course, one of the goals of our association and the institute of land warfare is to foster an understanding of the
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emerging security environment. and as your professional organization, association, we are proud to provide events like this one that broaden the knowledge base of army professionals and those who partner with our army in our nation's defense. these presentations are our way of amplifying u.s. army's narrative to audiences inside the army and help to further the association's mission to be the voice for the army and support for the soldier. of course, we can't do this alone. we rely on our members to help tell the story, tell the army's story and to support our soldiers and their families. a strong membership base is vitally important for advocacy efforts in congress with the pentagon and the defense industrial base. as well as the public and communities across the country
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through our 120 local chapters. so, for those of you, army and homeland security professionals and your comrades in arnl arms are not yet members of the association of the ujs army, we encourage you to join with a special introductory offer. you'll find the invitation on your chair. card looks something like this. just bring it to the ausa membership booth, booth 407 in exhibit hall "a." if you are already a member, thank you for staying with us. you're very important to us. so, please give your invitation to a fellow professional so he, too, can enjoy what you enjoy with your membership. you'll be doing a service to the association, to the united states army and to the nation. so, i'll finish banging on about that. and now turn the floor over to dr. richard downing executive vice president for global strategies omni-true technologies. >> thank you, richard.
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>> thank you. >> well, thank you very much, george. good afternoon. you know, it's great to be an audience where there's actually interaction, but, you know, it's -- this is an army -- this is the ausa. this is normally, you know, the kind of spirit we expect. we have our partners from mexico are here down below. so, if you would help me one more time, good afternoon. oh, thank you so much. that's much better. much better. well, as george mentioned, i'm richard downey, and it's really a pleasure for me to be here today as your moderator on this panel on the importance of mexico for u.s. homeland security and it's an honor to be with this very distinguished panel and also with this distinguished audience, so thank you very much for all of you joining us today. when we talk about threats to the united states, typically we tend to immediately think far away, iran, north korea, al
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qaeda, although they certainly are here. but, you know, when you look at a map and we don't have maps to project today. but you've all seen those maps of the arrows coming up from the south of the roots of trafficking from south america through central america through the caribbean through the eastern pacific and they all come up these arrows show how these -- the traffickers take drugs, pirated material, people, and usually the arrows stop at the u.s. border. but we all know the arrows don't really stop at the u.s. border. they continue on. other maps will show you they continue on to los angeles and seattle, dallas, chicago, atlanta, washington, d.c. and they continue on up to canada, too. and the point is that if these -- if these traffickers
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can take illegal drugs and pirated merchandise and people successfully into these areas, what else can they bring? and the problem is we see as a result how closely intertwined our security is with that of mexico, because all those roots coming from the caribbean, eastern pacific, central america, they all converge in mexico going through. and it is so important for us to work with our mexican partners in this. and we have a terrific panel today to address this issue. of what are those things that can pass through our security, that we need to work so closely with our mexican counterparts with. what we'll do today, we'll have -- we're going to have -- this panel will speak, each of them will speak seven or eight minutes or so. we want to leave time for questions because that will be
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the richest part of this dialogue. we want to make it a dialogue. i ask you, please, as you listen to each of the speakers, to be thinking about what you want to ask them. and don't be shy. because they're happy and we want to engage with you on this. so, first up, on the speakers today, will be general -- brigadier general j.t. taylor who is the deputy director for plans, policy and strategy at the u.s. northern command and norad which is the unfied command that focuses on mexico. and he's going to give a strategic overview to start things off. he'll be followed by michael houston who is the principal director for the americas in the policy directorate of the department of homeland security. and he will address -- he actually has spent a lot of time focusing in homeland security on mexico, so he'll be giving us
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the framework that department of homeland security uses to address this. he'll be followed by dr. duncan wood the director of the mexico institute at the woodrow wilson center here in washington, d.c., who has spent tremendous time in mexico as a professor here and has a great overview of all issues related to mexico and particularly our relationship with mexico, and our cleanup batter will be lieutenant general parry wiggins who is the commander of u.s. army north and amongst his many responsibilities army north is the -- the army component that focuses on the relationship with mexico. and during his time he's actually spent six years ago at army north in a variety of positions, so he's seen not only during this administration under the current president of mexico but also on the previous
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administration of lefelipe cald and he'll be addressing some of the strategies -- one of his very close relationships is with general salvador fuegos who is the defense minister of mexico and then we'll get an overview and then your questions. again, be thinking about what you'd like to ask our panelists and let me turn it over to general taylor, please, thank you. >> thank you very much. ladies and gentlemen, i appreciate the opportunity to share a few insights to you of the absolute necessity of mexico to the security of north america from the perspective of u.s. north command, and i'd like to start with a little strategic context from a north american continental perspective writ large. because i think it's essential to understand the role that mexico plays in our security by comparing it a little bit to the role that canada plays in our security. now, history has shown that if
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you want to threaten the united states, there's a number of approaches that you can take to get to north america. you can take an equatorial approach where you come from the east or west coast from the sea. that's a hard approach because there's great distances involved or you can take a polar approach where you go over the north pole. there is less distance involved with that in the aerial domain. that's absolutely inhospitable in the land domain. but our aerial dough maymain th over the pole is an existential threat, so over five decades we have cultivated a very close relationship with canada to address the existential threat that exists coming over the poles that has served north america very well. in fact, our chairman recently articulated four nation-state threats to north america and of those four three of them can
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reach us in the aerial domain over that polar approach. and so we learned of the absolute necessity of a close relationship with canada. we learned that that was in our national interests. and that relationship that we have with canada has enabled us to truly be able to provide aerospace control and maritime warning. that relationship is critical to the security of the united states and canada. both our countries benefit from that against extensioncial threats. that relationship we have with canada is a model that is worthy of emulating. but an aerial threat over the poles is not the only threat that north america faces. the security landscape is evolving and north america faces a threat from the south. now, our threat from the south is not presently an existential threat, but it is a security threat nonetheless. and this threat that is
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transnational in nature exploits seams between countries. it's an organized threat. it is a networked threat. it is agile. it's adaptive. and it can reach the point to where it actually destabilizes regions and it can also challenge sovereignty. and so we broadly describe that threat as transnational organized crime. now, this threat enters the united states through the land domain transiting through mexico and through the maritime domain coming up through the caribbean. and like i said while that threat is not as of yet existential it is a national security matter. and mexico is postured to play every bit an important role against that kind of threat that canada plays against the aerial domain threat that we face from the poles. and so these kinds of threats
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include such things as special interest aliens, the potential smuggling of weapons of mass destruction, the trafficking of drugs and persons moving north or weapons and money moving out of the united states and south. and from a safety or a human rights perspective, the migration of uncompanied children. so, supporting mexico's southern border strategy is in our national interest in the united states. because the threats that mexico sees on their southern border, if not checked, we see then on our southwest border. so, we're working with mexico to provide a cooperative plan that supports the implementation of their strategy. and in the near term we're focusing on providing them with some needed capabilities like biometrics or tactical communications and in the long term we're working on helping build sustainable capacities that will improve what we're terming as regional
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interoperability, enhancing equipment commonality between our forces so we can work together. there's a leadership role that mexico can play in the region to address this kind of a threat and that is something that we are seeking to foster. and what we consider to be a very historical event, we've had the leaders in the staffs from the trilateral meeting of north american defense ministers, that's our defense minister in the united states, the canadian defense minister, mexico's defense minister, they all got together in a meeting and they acknowledged that they share many of the same threats and they've been actively developing what's being termed the continental threat assessment. and that correlates all of the common, shared threats that are facing north america as a continent and so we're already moving closer to recognizing a shared responsibility and collective security and we're working with mexico in the
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development of an externally focused security cooperative capability in our partner capacity development work that we're doing with them. and so right now i'm very pleased to say that from northcom's perspective, we have an unprecedented level of security cooperation with mexico and it continues to increase annually in kind of the four main areas that are necessary for interoperability, training, exercises, engagement and equipment. and this really began a number of years ago with president calderon's mexico's former president's decision to begin fighting transnational criminal organizations and it's really evolved holistically since then. and now as we interact with the leadership of sudana, that's mexico's army and air force and somar, that mexico's navy and
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mari marine force, their leadership is voicing an interest to be interconnected with the united states and they routinely talk of collective defense of north america. and these are good words to be saying. and so we're routinely interfacing at the tactical and at the senior levels. mexico has requested in our work with them that we begin interfacing with them at the operational level. and this kind of capacity development that we're working with them from northcom's perspective promotes interoperability and that's our objective. the cooperative defense of north america against all threats in all domains. and if we can attain unto mexico and the united states and canada all working together in an integrated and cooperative defense of north america, we will increase security on our continent and we'll decrease risk in all domains against both existential threats and national
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security threats. so, from our perspective, it's not inconceivable that we'll one day be able to reach the kind of bilateral structure with mexico that we enjoy with canada. our cooperation on our southwest border and with -- on the mexican southern border has been expanding. northcom sponsors two exercises with mexico that focus on cooperative defense. one is called the eagle and it concentrates on cross-border air intradiction coordination and the other focuses on defense support to civil authority and humanitarian assistance. we have information-sharing agreements in place. we're working on acquisition cross service agreements. and we're also working toward commonality of equipment, communications systems, aircraft, radar, common operating pictures, everything that we need to be able to work
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together interactively. and our commeoperative efforts h mexico on regional security are increasing. so, from the perspective of the united states northern command, a security partnership with mexico is necessary given our security situation. and it's possible and the timing is right to make the investment now&├▒ik with mexico just like d with canada over 50 years ago. i look forward to your questions. >> thanks, general taylor. michael? >> hello, everyone, thank you for letting me come. i appreciate it. so, i'm talking about this from -- i'm going to talk about the u.s.-mexico relationship from a homeland security perspective. we've been around a touch over a decade, we're still learning who we are and frankly the conset of homeland security as a framework for engagement is still maturing. if you look at the difference between the original quadrennial
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homeland security review done in 2004 and the most recent one you'll see there's been a lot of growth and we anticipate that the next quadrennial homeland security review which will be out in a couple years will continue to reflect the maturation of our department. we're also fortunate to have as our head now a man who comes out of the department of defense and who brings a significant amount of expertise and who has been working very hard to help dhs, the department of defense and our partners abroad more closely collaborate. i'll get to that in a moment. i want to start by saying that the story of the u.s.-mexico relationship is in many i was a story about a border. it's a border story. it started roughly you might want to suggest in 1848 at the treaty of guadalupe hidalgo where we delineated the current line that separates our two countries. for a long time that line was
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tr viewed -- it carried all sorts of baggage. it was viewed from the north it was the dividing between us and them. from the south it was, you know, the invaders from the north. this was the line that kept us apart and despite the asymmetrical differences in power the border location where all the asymmetries disappeared. where national sovereignty could be asserted in its most pure form. as a result the border became sort of a symbol of division in some ways. particularly from the national perspectives, from d.c. the border looked that way, but in the border region people that lived there understood that the border itself didn't actually matter. i mean, it didn't really exist. so, the border region became known as the third country. and so we had this very difficult time from a national policy perspective, you go down to a state and a community perspective, trying to reconcile how the border played in the
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u.s.-mexico bilateral relationship. and for a long time it was, like i said, it was a source of tension. there are two things, though, that really forced us to deal with the border at the national level. the first is there was an obvious economic imperative. and this, you know, was thrust into the limelight through the nafta process. our countries can't survive economically if we're not integrated. i mean, i think at this point that's almost beyond question. we have -- our economies depend on each other in a way that's critical to our economic security. and secondly, 9/11 sort of forced this one, we began to recognize that our national security is integrally connected as well. so the two sort of things that nation-states in a sense are most concerned about economic and national security, it became very clear that in the u.s.-mexico biellateral
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relationship, both of those things were sort of omnipresent. we had -- we had to figure out how to make that work. the real sort of break -- i would -- i would -- there was a long history of cooling or -- a long history of warming is i guess the way to say it, a long history of a warming relationship, but really i think it became sort of put on hyperdrive during the calderon administration when he for the first time, you know, sort of stood up and came to the u.s. and said we want to work with you to tackle the transnational criminal groups that are responsible for so much crime and violence. and president bush then stood up and said, yes, and, you know, we own some responsibility for the consumption of drugs and, you know, the availability of weapons and we're going to do our best to fight that. and so beginning then in the early stages of this initiative, we created a frame work that allowed us to start to work together.
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on a parallel track, the department of homeland security was created. and the department of homeland security did something that i think is critical to the evolution of the u.s.-mexico relationship. what it was able to do was take challenges that were previously intractable like what the border was, and redefine the challenge in a way that was mutually beneficial for both countries. so, a good example of this is the dichotomy between security and [ inaudible ] for a long time we used to believe that a secure border meant we had to limit the things that came through and that to facilitate to allow a person or a piece of cargo to move rapidly across the border meant that we were giving up security. and the homeland -- from the department of homeland security perspective, we were finally able to break that dichotomy down and say actually the more we know about a person or a piece of cargo, the more rapidly it can cross the border. so what happens then is we were
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able to say, no, no, the border is actually a place of cooperation. it's a place where u.s. and mexican counterparts can work to rapidly facilitate the movement, the legitimate goods and cargo between our countries. and that -- that sort of twist allowed us to engage in ways on the border that we had never been able to engage before and fostered a level of cooperation and collaboration that had been, you know, for centuries almost unheard of. and right now actually we're sort of -- we're still in the beginning stages of that. just today, in fact, secretary johnson is down in mexico city. he's meeting with secretary chung, and he'll be meeting with secretary ruiz and secretary garay as well as the president and he'll be signing a memorandum of understanding and enshrining a cargo preinspection
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program which will allow us for the first time have officers on both sides of the border preinspecting cargo moving between our two countries. just five years ago that was almost unthinkable. so the perspective of homeland security has played an integral role in developing the relationship. i'll toss two things out to sort of conclude as where we think we're headed. first, and the general mentioned this, north america is really the vision for how we engage. we think in the end the u.s., mexico and canada working together is how we solve many of the challenges we all face sbendly. secondly, and this has become more apparent, too, dhs and dod have worked very hard to try to cross the line between homeland security and homeland defense. and i think our work actually with jtf north and army north down in the border region is potentially one of the best examples of how we've been able to start to cross those bridges. that -- the ability to take the civilian authorities in mexico
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and partner with the defense authorities in areas where there's appropriate overlap really is the next level of integration in terms of how we start to deal with the homeland security challenges. and i guess i'll leave it at that. >> great. well, thank you, michael. and so we've really gone from the strategic alignment piece of general taylor mentioned to sort of a framework of cooperation. and let's go now into a little more of the detail within the countries. duncan? >> thank you, richard. good afternoon, everyone, a great honor to be here and to share this stage with such a distinguished panel. i'm going to try to make three points today. the first focusing on some military traditions so we understand what the reality is with the mexican military. secondly to look at some changes that are under way in the mexican military and thirdly to make some observations about mexico's southern border with guatemala and belize. a colleague and i have returned
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from a weeklong tour from mexico's southern border crossing from the south to the east and seeing the entire border along the way and i wanted to share with you a little bit of what we observed while we were there. some general points about mexico's military that i think are worth mentioning so that we're all on the same page. [ speaking spanish ] first of all, i think it's very -- >> i should just mention, the defense attache of mexico is here, so we just wanted to make sure -- >> we have an auto correct, yes. first observation that i would make about mexico's military is that due to mexican political and military traditions mexico's military has been focused on the homeland, on la pat's, because
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of military doctrine such as the different doctrines and the mexico mirlttary has been prevented from projecting outside of its border and it's been focused on what's happening within the nation's borders. for a large part of mexico military's history has been focused on dealing with some political threats within the country, different movements, et cetera and as i'll say in a second the transition to focusing on organized crime is somewhat of a new task that brings with it challenges and risks. there's no history of military coups in mexico and it stands out when you look at it xacompad to the rest of latin america. there's a mutual respect between the political branch of the government and the military branch of the government and that's always a very fine
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balance that is struck there but it's a very, very important one. lastly i would say on this general observations about mexico's military is that it is the second or third most trusted institution within the country. time after time in opinion polls across the country the mexican military is one of the most trusted -- first of all it's the church, second of all is the army and third of all is the navy and after that teachers, professors, we in academics like myself. but -- you come ahead of us at least. now, that is something that is a source of enormous pride for the mexican military. and part of it, of course, comes from the fact that so many of mexico's citizens have either served in the military or, of course, have family members who have served in the military and it's seen as being a very, very highly respected institution. let me move on to talk about some of the changes i see as under way in the mexican military right now that are relevant for this conversation about homeland security. first of all, the war on organized crime as i mentioned
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earlier on from focusing on sort of political threats, garia threats within the national tater to focusing on organized crime means that there are a number of challenges that the mexican military has to deal with. one is the change in nature of the threat moving from a lot of rural conflicts to now being present on the streets of cities and that's a very, very different operational theater obviously. and secondly with the close contact with mexican citizens there's an enormous concern for questions of human rights and there have been high profile cases where mexican military has been accused of human rights abuses and this is a very sensitive issue within the country. thirdly, mexico's military is being forced to take on somewhat of a police function for which i would argue it's not particularly well prepared. i don't mean that in terms of equipment or in training but i would say in terms of its legal basis. mexico's military does not have the legal function to be able to make arrests.
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it's there to sort of stop the illegal activities, but it can't actually make an arrest. you have to wait for the police to come in and do that. this puts the mexican military in a very, very difficult situation when it's operating on the streets of cities across the country. second factor which is bringing about change within the mexican military i would say is this cooperation with the united states. we've seen that through the initiative, of course, there has been the sharing of training, sharing of intel jenninligence course, we've seen the donation of equipment from the u.s. to mexican military. we've moved very much into the phase now where the equipment side of things is much less important than, in fact, the intelligence sharing and the training that's under way. this is helping to shift perspectives, i would argue, within the mexican military. we've seen it much more -- we saw it much earlier on within the mexican navy and now we're beginning to see it very, very
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strongly within the mexican army. this process as was mentioned earlier on really began under president calderon and his war on organized crime. when we came to the beginning of this government, we reached a point where there was a sort of a stop, a hard stop, and a re-examination of the relationship with the united states. a lot of people within the government did not feel particularly comfortable with the level of interaction that has been reached between u.s. and mexican security agencies, and there was an attempt on the part of the mexican government to try to centralize all control -- sorry, all coordination or cooperation through what they called a single window for cooperation. that really did pose a huge challenge to security cooperation between the two countries in the first 12 months of this administration. but since then we've seen a significant opening up, a flexiblization if you whirl ill
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security relations, so now there's a much higher level of trust and there's a much higher acceptance within the mexican government that this is a necessary thing. of course, key events have played a well of el chapo has played a threat and u.s. security agencies are now saying, well, who is it that we can really trust, who are the competent counterparts on the mexican side. i mentioned that -- a few times, you know, we're talking about the mexican army and the mexican navy. i would mention that -- here that the fact that the navy has been a more progressive, more open institution in mexican military history, recent history, is a very, very important factor. it's seen as being a more trusted institution by u.s. counterparts and increasingly has been seen so by this administration as it was by the calderon administration before it. i think this is something we're
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seeing forcing a change in attitude on the mexican army as well. the mexican army is now beginning to see that there are certain changes world views that need to be adopted if they're going to keep up with the steps that have been taken by the mexican navy. a generational shift within the mexican military, we're seeing younger officers coming through and they've been educated in a different system than their predecessors. they have a much more open attitude to the world and they've been raised in a mexico which is globalized and those attitudes are being seen as well. and with a view to the future peacekeeping. this is something which ilthi t we need to focus on and understand what impact it will have on the mentality of the military. i've gone horribly over time, but let me say a couple of points about mexico's southern border. as we were down there and crossing from west to east, it's
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extraordinary to see the massive investment being undertaken by the mexican government in terms of building installations on the southern border and actually remote from the southern border as well in an attempt to actually get a handle on the scale of illicit traffic that's moving from guatemala in particular northwards through mexico to the united states. a lot of focus in this country has been on immigration and on undocumented migrants as they come through. i would actually argue that far more interesting is what's happening in terms of expanding mexico's military presence in chiappias and tabasco and quintana roo. we've seen fixed location bases that are highly credible and we're seeing mobile units moving around. one informal border crossing that we visited in las americas is just a river crossing. there's a ferry that goes back and forth between the two countries guatemala and mexico, and people use it frequently for commerce.
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what's interesting there is there's no presence from mexican customs, from immigration, from health, et cetera. there are mexican military representatives there to try to stop the illicit flows of drugs and weapons that come in from guatemala. this is something which may seem like a small step, but, in fact, is revolutionary. the fact is that you now have the presence of the mexican state at a much higher level than you've ever seen before in mexican history along mexico's southern border. that provides a whole new area for cooperation both with their counterparts in guatemala and belize and, of course, with the united states. i'll leave it there. thank you. >> thanks, duncan. that was great context for the tremendous transition that's been made over the last years in terms of how the military's role has played in the mexican society and in the relationship with the united states. and, you know, that's a great context to offer the microphone to general wiggins who can
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really talk about how it's going to the ground with the soldiers. >> first i'd like to say thanks to my mexican friends who are here. i think this visually highlights where the relationship is. i've been as you heard a part of army north for the past six years and have been working with my mexican counterparts over those past six years throughout all of mexico. you know, we talk about relationships and relationships are key, you know, general, to show you how important that is, in 2006 standing next to some water in the back of a room meeting with our mexican counterparts a tall, one-star general at that time was standing up against a wall, struck up a conversation, literally now flash forward to -- -- and he's the chief of
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defense, so i have the distinct honor and privilege to be a good, close friend with general salvador sinfuegos who is the guy i think leading the transformation in the mexican army. you've heard a lot here and in the interest of time so we can get to some important questions, i'll just tell you what my perspective is of my friends in mexico particularly the army. i've had the privilege to conduct many training sessions with both the army and the navy. and i think one thing, and i'm not countering your opinion, but i think we got to be careful how we draw conclusions between semar and sedana and who we draw those conclusions from. because i correlate it to teaching somebody to fish or providing them fish. there is a big difference in the process. and i will tell you, we have worked very hard to work through really on the intelligence frame, for example, to talk
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about intel drives maneuvers and how you work site exploitation and other things to drive on to that in order to execute an operation. and i can tell you both semar and sedana have really excelled in that arena. and in some cases we've got to be careful because some agencies that are in mexico and i won't mention who they are, you have to release the controls. you have to do that. and so, you know, i've actually been throughout mexico, like i said, i've seen the program that the general has put in place. a lot of people ask me, you know, southern border strategy, mexico's southern border strategy. that seems like a big country. how do you do that. when i asked him how big they think mexico's army is, i get an answer back, well, the army is 20,000. well, in fact, the army is about 202,000 strong, 106 infantry battalions and not including the parachute brigade nor their
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special forces. they got 45,000 reserves in their army. they've got 13,000 or so in their air force. and in their marine or their semar they've got 32 and 24,000 respectively in their navy and in their marines. it is a sizable force and a very capable force and a very professional force. and as you heard stated here, they are operating in one of the most complex environments in the world and that is your own home. they're operating against an adversary at this particular time that is -- does not respect the rules of law and does not wear a uniform. and so it is a very challenging and complex issue within their own nation. and they have to do it as you also heard and maintain the trust of the people of mexico. and that's a balance. that's a very, very difficult balance. and so i will tell you looking at the vision the general established and the measures he
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put in place to get after human rights is a significant program. i've been on the ground at their equivalent of national training center on a number of occasions. i've actually watched u.s. army 82nd airborne paratroopers train side by side with their troops. they jumped into chihuahua, mexico, they went into the urban complex, they orchestrated operations side by side and within that the comment that came out of the after-action review from the 82nd airborne paratroopers was and the most beneficial training they got out of that was the human rights training that they conduct at that facility. and so they are working very hard to make sure that professionalization and those programs that the general has put forth and really gets after some of the things that you -- that you've heard about, that they're taking care of. and i can tell you, i've seen it personally, i've been on the ground with it, and i've talked specifically with young soldiers within sedana who have been through the training and who
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have been out there prosecuting the fight. so, for me, it's a distinct honor when i go and i take a look and i meet with the human rights directorate that the general has established and i talk to those individuals and i see what they're trying to strive and get after. so, you know, a lot of people approach me. they say we read about things in the paper. you got to realize as well that there's an adversary within mexico right now that deals similar to what we had in afghanistan and iraq. they try to through information campaign and through other measures try to make things seem certain places and ways. but i can also tell you from first hand knowledge that i've seen them on the ground trying to get after these particular issues and things. it's a professional army. it's one i take great pride being side by side with. i, too, have been with the southern border. i've actually trekked through the mountains and the jungles side by side with the sedana
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soldiers, and i can tell you once you get to the top of one of those hills and go through that jungle and sharpen your machete in the seventh time in the first mile that you have trekked, you realize just how difficult it is to operate in that environment and how key it is -- and by the way, you also realize that the adversary is adaptive. he's very cunning. and in a lot of cases they just adjust their tactics, techniques and procedures when they go about smuggling whatever they are going to smuggle. so, for me, i will tell you that it's been a distinct privilege to work side by side. but more importantly, i've seen a maturation process in the military in the relationship on both sides of the border. i've seen the u.s. military gain an appreciation for our counterparts and an understanding of the professionalism and the competence of the mexican military, and i've seen the mexican military on the other side exude that professional
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confidence and increase in their capabilities and capacity to take on. and i will tell you the threat to north america, although we talked about transnational criminal organizations. that is not the threat that i think really we're focusing on or should be focused on with that -- with that security piece. there's a threat out there on the horizon that we have yet to really materialize or understand and that bilateral defense cooperative framework that we build with our partners in mexico is going to be key to create a defense and depth. and that strategy as the general, and i truly believe he's right, needs to incorporate the stabilization of central america and tie itself in to south america with countries like colombia. and we've got to work that. and we've got to make that come to fruition and we got to make sure that we seal off and make it absolutely difficult for adversary of the future that's going to threaten both of our democracies that we take care of that. and that is not transnational
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criminal organizations, although they do pose a significant challenge and danger, but i think there's a huge threat out there on the horizon that we got to prepare ourselves for, and i think by working with our partners in mexico, making sure we stand side by side with them is the only way we're going to find a solution to this threat to north america. so, thanks very much. look forward to your questions. >> well, thank you, general wiggins. i think what you heard is very interesting array of perspectives. you've heard -- let's not mince words, we have three representatives on this panel who are from the government, from u.s. northern command, from homeland -- department of homeland security and from army north. and i think we've heard very encouraging remarks regarding the relationship. duncan is an academic, and he's not from -- he's kind of from the government but not really. he's an academic. so, he's given us a perspective that also is encouraging. it's a little more analytical,
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but he's also ralez eraised some challenges and there are some real difficulties in this relationship. mexico has -- after the change in government, there was this period ofgovernment, there was this period of about a year when things were difficult, things were changing from the very close relationship during the felipe calderon administration to the point where once again we could work together but there are challenges within mexico regarding security. the role of the military in this policing function, the police have not taken on that mission capability yet to be able to address this issue so there's a long way to go, but getting back to our topic of homeland security, the importance of u.s. mexico for u.s. homeland security, i think you're seeing a very positive kind of
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collaboration and cooperation working forward, but i'd very much like to hear your thoughts and your questions on these issues. so i open the floor. i ask you to, we have a microphone here on the side, so if you, and sir, i think you have a microphone to hand to the individuals? >> yes, sir. >> so if you would hand, once you get the microphone, if you'd state your name and what organization or unit you are from, and then ask your question, please, open up the floor. and while we're waiting for someone to get the courage to ask the first question, i'll ask -- yes, we have one here. bob, please. you know, please, join me, this is bob pellegrie, a very courageous man to take the first question, have a big round of applause for bob to ask the
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first question. >> thank you, sir. we go way back. we were together in germany in '79, so. with the -- i've been to mexico contemplating the idea of exporting security under the pko, peacekeeping operations. i guess which do you think will happen first, that or bringing all of the partner nations from the south together and sitting down together and you know, a unified effort to, you know, quell the violence coming from the south? thank you. >> it's a really important question. i've seen how negotiations take place in central america before on less difficult questions than that, and i can tell you that it takes decades. so i think we're likely to see mexican military forces and peace keeping operations before
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that actually happens, and you know, not that there isn't good cooperation. we were actually talking before the panel about the strength of military cooperation across the mexico/guatemalan border. however, government to government cooperation is another issue, and there's an interesting contrast there with the belize case, which is that government to government in the mexico belize case is very, very positive, but with the military, not so much. and another factor we have to remind ourselves is whilst the mexican military of significant size has substantial resources and capacity, their counterparts in central america do not. i had one conversation we had with a vice admiral in chappas was about cooperation with their counterparts in guatemala and he said these guys really want to do a good job. they want to cooperate but they just don't have the resources.
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from the guatemalans themselves we heard a similar story. we say we wish we had the resources that our mexican counterparts have because we'd like to do a lot more. follow-up comment to that was, i think really illuminating, which was they said although we as guatemalan military do not have the resources that the mexicans do, we are the only representatives of the guatemalan state in this particular area of the country. they said nobody else is here. there's nobody from the education ministry, nobody from the health ministry. the people turn to us for their concerns and their interests, and that's something which is radically different as well. so when you try to compare mexico to its central american counterparts i think you see a huge difference and that helps to explain why it's going to be so complicated to do that. >> would you like to add? >> the bottom line, i will tell you and i absolutely concur with every bit of that.
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one thing that's a little disconcerting to me is when i go down to the southern border of mexico and i see the mexican military and the guatemalans patrolling simultaneously using harris radios and communicating with each other and i come to the southwest border and rcvp doesn't have harris radios and can't communicate directly with the humvee across the border. so in some cases what mexico is doing with our partners to the south, particularly guatemala and in a smaller case belize i applaud, because it's something that we're trying to mitigate the seam on our own southwest border and be able to communicate as well. so i truly believe that the peace keeping operations that cezena and semar are embarking on and happening relatively sooner rather than later, they have personnel embedded themselves in some peacekeeping and they are training with some
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countries right now and they're going to look forward to the establishment of peacekeeping center of excellence, per se, within mexico, to train their officers and their soldiers in pea peacekeeping operations and that was initially identified to be established in i think 19, year 19, and now that it's been pushed to the left, not the right, to hopefully get that established so that they can start training their officers in peacekeeping operations. so that's a very positive, a very good sign, and a very capable military that i believe the world could absolutely use that type of partner out there doing peacekeeping operations with the capacity and the capability that the mexican army brings to the world. so thank you very much. >> just a couple of other data points that will illustrate that both processes are happening in parallel, so even though one may occur faster than the other, they are both happening in parallel.
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in our partner capacity work with mexico, we are, we have programmed and we are interfacing with them on the peacekeeping initiatives at the pace that they desire to go, and also on the regional security matters that in a really groundbreaking new initiative, at the instigation of general fuegos, he, north comm and south comm are collaborating together on a meso-american armed forces conference where we will invite the chiefs of defense of central american countries, mexico, united states, south comm, north comm, together to address some of these security matters and threats from a regional perspective, and that is also a positive development. so i think you'll see that this is happening in parallel. >> one very quick point here, and it's kind of a blue sky idea. we were asked recently to think
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of opportunities for mexico, cap da, and the united states to work together on global leadership issues. one of the ideas that we came up at the wilson center was a north america brigade for peacekeeping. it may seem like something way out there but it's a very imtreeging idea if you could see the military forces of the three countries coming together in a peacekeeping operation somewhere around the world, there are enormous benefits that could come out of an operation or exercise like that. >> very interesting. thank you. there's another question over here. yes, thank you. >> colonel de la row so, r north g7. general taylor you mentioned with he had tactical engagement, we had strategic engagement but you identified in your comments that there's an operational gap in between. can you expand on that a little bit more and some of the potential techniques with he can use to close those gaps that you've identified? >> you know, one of the, as we seek to get granularity on that request, one of the immediate
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things was to kind of move our level of training and participation up from the individual level. we have done an awful lot of training with mexican military forces but they have largely individual and small unit training, one of the immediate things in working with both is to move that to larger unit type of operation training, so it's probably the first area where we're focusing on. second is in the staff functionality at larger unit formations on operations, and the specific application is peacekeeping operations. one of the requests that we recently received, for example, was technical english and battle staff training to allow for mexican military individuals to
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embed into staffs that are conducting peacekeeping operations, and so we're seeing requests for a larger type unit operational engagement. >> thank you. other questions? yes? >> good afternoon, major figueroa, army north. sir, like dr. wood mentioned, as he visited the southern border, he's seen a lot of mexico is focusing also a lot of facilities are being built up. have you seen any security cooperation with mexico, with the southern borders, with guatemala and belize and what type of security cooperations are they doing with their southern partners? >> well, you know, one of the things that was enlightening to me and i didn't plant this question although he's from my organization, thanks. [ laughter ] one of the things that was enlightening to me is, when i traveled down my last time to
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the southern border, i actually saw theater security cooperation being done by mexico, with our guatemalan partners to bilk partner capacity and capability within the ghwuatemalan militar which i thought was absolutely stunning, because they were actually doing planning training with the guatemalan army, and there was nobody else around, and then i saw the same thing go on with our belizean partners as well, and i thought to myself at that point in time, when i remember a vignette that took place back when there was a guy name chavez down in venezuela. president chavez at the time said some pretty nasty things about the united states in an open forum, where he had the stage, and our president of the united states at the time went back at president chavez and basically countered his comments, and i remember that a former president in mexico named
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fox stood up as well in mexico and chastised cha slez for his comments and basically told him sort of the same things our president said, but the difference was not a lot of people, not a lot of press, because i read a lot of press down in central and south america, really paid note to what we were saying here as the americans, but when a former president of mexico stood up and said it, it resonated throughout all the latin american press, and to me, i learned a very valuable lesson there, that mexico can resonate with some countries and bring them to the table where we cannot, and that's why i bring up guatemala, belize. i believe that mexico is the key to the southern border as well, because they have an incredible relationship with both those countries that are absolutely key to establishing that secure and mitigate the gaps so the adversary can't be using it.
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what i found out as well down in southern mexico that i thought was absolutely interesting was there are individuals tribal indigenous in southern mexico that don't recognize mexico or guatemala as their country, and they don't speak spanish. they speak mayan, and so when you deal and you have these individuals that don't recognize a border, that creates a complexity all of its own, and therefore smugglers can take advantage of that and other people can take advantage of that, and traffic a number of things across that border, and we have to work together in order to seal that particular piece off and that's why i say the key is really our partners by, with and through. we learned that in the middle east. i think we can take that lesson and we can apply it as well, and what's really neat and i think perfect and we heard it mentioned here, is it really is a north american solution, and if we don't address it and apply it like that, and we make it
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solely an american solution, we will fail. security will not and the solution will not be as good as we can get to, unless we do this as partners. please. >> thank you. i want to get a question from michael as well, and if i may, and i know michael, you want to chime in on this as well. duncan mentioned that after the first year of the administration there was a single window and that was somewhat brought us back from the high point of the felipe calderon administration. can you talk about from the perspective. homeland security, have we overcome that first year and gone beyond or what's the homeland security perspective on that? >> so two things. the first is from a homeland security perspective the change in the administration had almost no effect on our relationship because the types of things that were challenging for the government of mexico at that time were primarily sort of the
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hard law enforcement types of activities, sort of the deas and the atfs, that type of engagement was challenging. we were engaging on facilitating commercial trade and travel which is something that they had not only a desire to continue at the current rate but actually to expand, so while at the beginning of the pinieto administration there was largely a lull in the types of hard security engagement that didn't touch the department of homeland security so we were almost unscathed. that said we've now i think sort of more broadly as a u.s. government i think we're at, and i think duncan's characterization was correct where we are at the place basically where we were before. it doesn't look the same. the channels aren't exactly the same, the way we coordinate isn't exactly the same, but the level of cooperation has certainly met and in many cases surpassed what we were able to accomplish under the calderon administration. >> in terms of intelligence, would you all agree with that as well? >> oh, absolutely.
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absolutely. >> if i could make one comment on the southern border and i'll be quick. the first is this notion of dealing with indigenous peoples is actually something that cvp deals with on a regular basis on the border and this is one of those areas where i think the cooperation between civilian and military expertise is actually highly valuable, from a homeland security perspective, we have a lot of experience in how do you deal with these, with these regions of the border that aren't necessarily under the, you know, the same sort of rules as everywhere else, and so but that's one area where i think we can collaborate and sort of taking that down to the southern border, mexico southern border with ghwuatemala it's not highl publicized but well-known there's a large operation, large i say it's 300 people, and operations being done by mexican immigration to apprehend those using smuggling people. we expect that this year mexican immigration will be 100,000 more
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people than 2013. so in 2013 it was 780,000, they anticipate 187,000, 190,000, which is a remarkably huge number and largely done by 300 immigration officers in addition to the people already deployed and highlights i think the importance of trying again to sort of cross this bridge between civilian and military activities and certainly i'm not advocating the military should arrest people crossing the borders illegally or advocating military activities, but certainly there are places where there's overlap on developing intelligence packages for stash houses or using communications to identify smuggling routes, where there are areas of overlap and i think in the u.s. side we started to cross those bridges and in many cases do well with the military with regard to direct support to action. if we can let the model take
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root in mexico, i think there's a lot of growth that could happen. >> thank you, michael, and thank you all. this is i hope you are all encouraged as i am with the kind of cooperation we've been hearing about. unfortunately the time has passed but general, you had a question? we've passed our time but please, if you have a question or a comment we'd love to hear it. it's coming. >> thank you. i'm general, defense in mexico. thank you. i appreciate your concepts of the mexican army, but unfortunately at this moment in the media, there are the concept about to the mexican soldiers don't have the culture about to
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the human rights, and you know what this concept of in the mexican army, and the navy and the air force, all depend on, do you think to the, this problem, against the drugs for the mexicans, do you say don't have the low against to permit it to mexico on the mexican army to the criminals, do you think it's possible to the soldiers in mexico that have a big problem in this moment because the human rights is a long, cultural in the soldiers, but the media
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maybe don't know what is exactly the problems with the education and the schools in mexico. i don't know. >> i think just a very quick answer to that, i would say that the mexican government in general has done a poor job of sharing information with the mexican public and international media about exactly those kind of programs. lot of people are unaware that those kind of training either national or cooperative with the united states that those programs exist. i think there's also very, very difficult one we're dealing with a huge institution that is the mexican army, to make that transition overnight. it's a huge task to try to change the mentality the way of thinking of your average soldier as well as their leaders within a short period of time. now, the education that has happened within mexico for some of the younger troops that are
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coming in, where human rights has been a standard issue within the education system, i think it's a lot easier, but a lot of it is about changing the culture within an organization, i think, and as we see in large organizations across the world, it's very, very difficult to do that. you can change the organization. you can change the equipment. you can change the operations but actually changing the cull tire and the way of think something a very, very difficult task to do, and it takes a long time, and i think this is where i always come back to with mexico, which is that we have to celebrate a lot more about all the good things that have happened with mexico whilst at the same time recognizing how far we have to go, on all of the issues that we've talked about today, i think that applies, and i would say it's especially true for human rights. >> and very quickly if i could just make a comment on that. the issues in mexico, mexico the army in particular has been trying very hard to work on human rights issues. last year there were a couple
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ofiness departments at which the mexican public became very concerned about human rights and as duncan mentioned earlier the use of the military in this role of a policing function has brought them into a different role so it highlighted this issue of the military's ability to deal with the public in this manner, but i call your attention, general, to the examples from colombia. colombia as duncan said literally had to change the culture, and they did, and one of the things -- the reason i want to highlight this, is that bringing the media in, is so important. if they don't know, they can't talk about it, but if you bring them in, the other side of that is, they're going to want to have an input and shape how you do training, so there's a double edge to this, but changing the culture takes that. but i thank you for your
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question. i thank all of you and i'm sorry that we've gone way over our time, but this has been a fascinating panel. i appreciate all of our perspectives as well as your questions. will you, please, join me in thanking our panelists for a wonderful job. [ applause ] every weekend the c-span networks feature programs on politics, nonfiction books and american history. saturday on c-span editorial cartoonists describe their experiences covering the george w. bush administration and
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sunday afternoon at 4:45, an event honoring the life and political career of former british prime minister margaret thatcher on what would have been her 90th birthday and live this saturday morning, beginning at 11:00 on c-span2's book tv, the 20th annual texas book festival from austin, featuring interviews with nonfiction authors including h.w. brands and his latest book on president reagan, hariette washington and her book on how we can catch mental illness and dennis ross, on the relationship between the u.s. and israel from the truman through obama administrations. and sunday our coverage of the texas book festival continues beginning at noon with author michael weiss on the terror group isis and then a discussion on artificial intelligence with john markoff and louisa hall and later president lyndon and ladybird johnson. on american history tv on c-span3, saturday afternoon just before 5:00 historian alvandi on the relationship between
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president richard nixon and the shah of iran and its effect on u.s. foreign policy and sunday eenlg 6:40, history professor spencer crew on the confederate flag and its history and relation to the legacy of slavery. get our complete weekend schedule at cspan.org. up next a discussion on ways to improve the nation's mental health care system, with congressman tim murphy of pennsylvania, and senator chris murphy of connecticut. hosted by the national journal, this is two hours. >> please welcome the senior vice president of "national journal." [ applause ] >> good morning. i'm delighteded to welcome you to the mental health forum, improving access to care and reducing incarceration made possible by jansen pharmaceuticals. at this time, we just remind you
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to silence your cell phones but please keep them out, because we encourage your engagement during the program via social media. you can use #njmentalhealth. for the audience q and a portion of the event, there are microphones on stands around the room and just please staple and organization if you have a question. you can also submit your question at any time during the program via twitter. use the #asknj. finally if you haven't already, we encourage you to download the "national journal live" mobile app. it includes the event schedule as well as information about today's speakers and underwriter, your fellow attendees and also includes a survey and we would love for to you fill that out so that we can continue to improve our events. this morning we will have a robust discussion about mental health reform. as many suffering from serious mental illness face challenges getting access to care, which
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can result to homelessness and incarceration. at the state and federal levels, there's recognition that lack of effective mental healthcare is a public health issue and a cost driver. as several mental health reforms -- the reform bills await the fate in congress, our conversation will focus on what policy changes are needed and how we can improve access to mental health services. today's event we will hear from representative tim murphy and senator chris murphy. they will each deliver remarks and then sit down for a moderated discussion with lauren fox who is "national journal" staff correspondent. we will conclude with a moderated panel of experts in the mental health arena. now i would like to invite dr. elizabeth fowler, vice president for global health policy at johnson & johnson to the podium. [ applause ] >> thanks. thank you all for joining us to be part of this important
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conversation about mental health reform and policies that can improve outcomes for patients and society at large. the janssen pharmaceuticals companies of johnson & johnson are proud to underwrite this event bringing together leaders and stakeholders from across the policy advocacy and criminal justice communities. for too long we have set the bar too low on how we support those living with mental illness. globally, mental illness costs society more than cancer, diabetes and chronic respiratory disease combined. we're encouraged about all the efforts we see under way to change this at the federal, state and local level. we can and should set the bar higher. enhanced collaboration between the mental health and criminal justice system is critical. opportunities exist to reform the mental health and criminal justice systems and innovative support programs can assist in transitions of care. we are really looking forward to today's discussion of some of the promising collusions
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including diversion of individuals for whom it appropriate away from the criminal justice system, care and continuity during incarceration that better connect individuals to community resources when they come out of institutions. thank you for joining us. we're pleased that you are here. we are pleased to be part of this important discussion on an important topic that affects us all. [ applause ] >> please welcome the honorable tim murphy, co-chair of the congressional mental health caucus. [ applause ] >> good morning. great to be with you. thank you for being here on an issue of such critical importance to our nation. last night when i was sitting on the balcony of the capitol, i
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looked at the beautiful sunset and the twilight sky and the clouds. they're crimson, they're gold, and there are grays against this beautiful pale blue sky darkening. i glanced over to see the house office building and the flags lowered to half staff. i was reminded why during this week, which is mental illness treatment week, that once again we are mourning the loss of so many citizens who have a death that didn't have to happen. this has been the bloody summer of 2015. when many high-profile events occurred in dallas, in houston, in tennessee, in virginia, in oregon. the list goes on and on. and although these are the incidents that get the headlines, it is a tiny fraction of the tragedies that occur in
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the area of mental illness that is untreated. we actually make it the most difficult for those who have the most difficulty with serious mental illness that is untreated, under treated or mistreated. back in the 1950s when we had half a million hospital beds, now we have 40,000. what we have done is we need to close those asylums because they were bad places. we were supposed to open up community centers. the last bill president kennedy signed was deeming with changing the mental health system in america. here it is half a century later. i believe things have gotten worse. despite the knowledge we have in science -- last summer identifying 108 genetic markers,
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despite having more effective treatments, despite breakthroughs in medications, we have federal policies that are quite frankly abusive and neglectful towards people with serious mental illness. they are anti-patient, anti-family, anti-psychiatrist. what is worse is that it is made the most harmful for those who are minorities and low income. when we close those asylums -- we needed to. we ended up reducing the number of psychiatric hospital beds. some got better with treatment. some had community services. that is good. we want them to have productive lives. for so many, they traded the hospital bed for the prison cell. the homeless shelter. the emergency room. and the morgue. not only this year will we have
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somewhere between 1,200 and 1,500 homicides by someone with serious mental illness untreated, we will have thousands who are mentally ill who are victims of crime and rape and assault. we will have 41,000 deaths by suicide. 1.2 million suicide attempts that were bad enough to seek medical help. 43,000 drug overdose deaths. the list goes on and on. the ones that grab our headlines, the ones that tell us what we need to do. in my bill the helping families with mental health crisis act, we address these directly and comprehensively. the first and most comprehensive deal to deal with serious mental illness in america. we have to do that because the key federal agencies has been neglecting and harmful. they have taking taxpayer money to do frivolous, silly and abusive grants. they have.
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they fund such things as over $400,000 website to have sing-a-long songs for children. they recommend drink a fruit smoothie if you are stressed. yes, they do. they have workshops where they tell people to get off their medication. last winter, they had a website to tell people in boston how to deal with their snow anxiety. two days ago, "the washington post" released a story that they have sent money to an agency, a pr agency to tell reporters they will give $175 to the charity of their choice if they write a nice story. when an agency is reduced to that bribery to the media, to say please tell a nice story about us because two reports said that it is not doing its job, there's 112 federal agencies that are supposed to be doing services for the seriously mentally ill. samsa is the agency that's
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supposed to coordinate them. the gao said they haven't met since 2009. the director said, we're going to start meeting now. when we asked about this website for children sing-a-longs, it's for prevention. we will look into that. we are still waiting to see the results. when we said, why did you spend $22,500 on a painting in your office of two people sitting on a rock, they said it was for mental health awareness. here is what i'm aware of. it's a waste of money. it's a waste of our approach. that's the way our country operates. that's why that agency must change. that's why we say now we're going to elevate this to have an assistant secretary of mental health and substance abuse. no more frivolous workshops on stopping taking your medication or employees marching in a circle singing songs. $80,000 on that. no more of that. can you imagine what communities could have done if they would have had this money to treat mental health? in their 40,000 word statement of what they do, they don't even mention the word schizophrenia and bipolar. they don't have a psychiatrist
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on staff. the ones they have quit. they are more concerned about talking about people's rights to refuse treatment instead of people's right to be well. when i hear that judges and police officers say i can't do anything with these folks because it's not illegal to be crazy, i say, what about their rights to be treated? if someone was walking the streets with alzheimer's disease, delusional, not aware of who they are, we wouldn't say, you know, grandma has a right to have alzheimer's. if someone had a stroke and was not aware they had the problem, we wouldn't say, they have a right to be stroke. if someone was passed out on the street with a heart attack, we wouldn't say they have a right to have a heart attack. policies are abusive and neglectful, particularly minorities and poor. when medicaid has a rule that says you can't see two doctors in the same day -- if you have private insurance, you can. if you have medicaid, you can't. that's neglectful towards the poor. you can't have more than 16 hospital beds, that's neglectful towards the poor.
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when medicaid has a policy that says you can't have more than 16 hospital beds, that's neglectful towards the poor. what we need to do is address the needs of persons and get them to see who they need to see. when we have a shortage of child and adolescent psychiatrists -- we only have 9,000. we need 30,000. in a time when serious mental illness emerges by age 14 in 50% of the cases. 75% by age 24. we don't have enough. we need to have incentives to get more psychiatrists, clinical psychologists, clinical social workers. we need more counselors, people who have been through this. we need systems like mental health america has to say we're going work on certifying and getting people the training they need so they could be out there. when you have agency after agency that has to struggle to get dollars to make sure they have the wraparound services to see the waste in washington, d.c., quite frankly, every taxpayer in america should be disgusted. every family that is burying someone from sue identify or homicide and see someone else go off to jail and see the silly
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and frivolous things our federal government spends money on, people should be outraged. and i am. what we're going to do once again is have moments of silence in congress as we mourn the deaths of these people who should not have died because someone should have been in treatment. when i say america wake up, congress wake up, we don't need more moments of silence. we need moments of action. we need moments of shouting out enough is enough. mental illness is a brain illness. it's not according to some of the agencies that they fund and send minions out, it's not a difference in attitude. hallucinations and delusions are not simple non-consensus reality. it's a brain disease that must be treated as such. my bill in addition to having assistant secretary of mental health and substance abuse to organize the 112 agencies to weed out those that aren't doing a good job and elevate those doing a great job, to make sure that we allow states to combine the dollars from mental health and also substance abuse, because a majority of each are abusing drugs and have mental
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health problems. why would we isolate them from treating together? to say we need more hospital beds. we allow the same day doctor rule to be dropped. we make sure that for people who are in the revolving door of prison systems and yet in mental illness that we want states to have wrap around services for them. this is the time in this nation when we have to stop wasting our time on mourning. when we have to put agency and other groups on the sharp microscope to say you will treat mental illness or get out of the way. we will employ the best and brightest of people who are consumers, people who are peer support, providers and families and allow them to be part of it. we will stop families from being kicked out of the treatment method. i find it interesting so often we blame families. why didn't the parents know? why didn't they do anything? because hipaa laws don't allow them to participate. when they have a higher risk of chronic illness because of poor nutrition and poor care or
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because of the medication they take, higher risk for diabetes and cardiovascular disease. but we don't tell family members when their next appointment is, what their diagnosis is, treatment plan is. and yet we blame parents for not taking care of it. what do we have from that? we have millions of americans with serious mental illness untreated. on that bumpy, slow-motion road to death. that's tragic. that is third world. that's embarrassing. as the only person in congress who is a mental health provider currently, i am determined to change this system, to wake up congress and wake up america tov say, there are answers to this. not the answer of continuing to do what we do again. i want the time to be that while we have the twilight of one sun setting of the day of the way we treat serious mental illness
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now, i want american, millions of american families and millions of americans suffering from serious mental illness to look forward to the bright new dawn where we will begin to treat mental illness as an illness, effectively with evidence-based care and make a difference in their lives. that's why today is helping families with mem health crieses, and i will talk to members of congress. during this week of mental illness week, people are speaking out to members of congress. over 40 newspapers have published editorials in support of this. we have over 133 cosponsors. it's time to have leadership call this bill up for a vote. let congress who represents the people vote on this. let's provide hope for those people who have been suffering in silence in the shadows for far too long. thank you very much. [ applause ] >> please welcome lauren fox, staff correspondent at national journal.
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>> thank you for joining us. i wanted to start out with -- because you mentioned in the speech you are the only current mental health provider in congress, when did you first start to realize that there were gaps in the system, that there were issues with getting your clients the help that they needed? >> actually, when i first started doing my first internships in graduate school in the 1970s, when community health centers were just beginning to emerge, i found that here were things i was trained on that i was not allowed to do. i found that the law doesn't allow you to do that. you can't see people. you can't work on those things. it was a matter of recognizing even then the barriers we had. it got worse, however, as chairman of the oversight investigation subcommittee after the shootings at sandy hook elementary school, when we first started having hearings and we heard family after family and providers and consumers talking about the difficulties with getting care. that's when it became very clear
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that much of this was federal policies that got in the way. >> i want to talk about this in the context of shootings and gun deaths. we often talk about mental health after a gun tragedy. i guess i want you to sort of address why the two get interlinked and whether you think that might be a mistake in the way we talk about these issues. >> they get interlinked because those are the cases that get people's attention. we have to be paying attention to what's in their mind, not what's in their hands. because if we miss that, then we're once again going to fail to address the comprehensive reforms we need in mental health treatment. no other area of medicine is controlled by lawyers and by congress the way that mental health is, in a restricted -- it prevents people from getting the care they need. when we look at the suicide deaths and the tens of thousands of people that die every year from jumping in front of a car, from driving a car off a breath,
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from poisoning, drug overdoses, we don't say we need to talk about ropes and bridges and cars. we would understand how that's not what we need to be doing and how that's diminishing our focus we need to have on helping people with serious mental illness. we have set those 4 million people aside and trying to ignore them and treat them with denial. that's not appropriate. as a mental health provider, i cannot let that happen. it is critically important we have the right services for them to get better. >> do you think that discussions after shootings help give your bill a little bit re momentum as people start talking about what are the real solutions here? if it's not something on guns, maybe it's something on mental health. >> i hope so. most people with mental illness
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are not violent. all of us experience some level of transient concerns and we get better. what happens is if we recognize people with serious mental illness not in treatment are 15 times more likely to be violent than someone who is in treatment. a person who is seriously mentally ill is ten types more likely to be in a jail than a hospital. getting services for them is extremely difficult. that is what i hope that this provokes us to have a discussion on. not to say if we treat the mentally ill, violence will go away. it won't. we know ignoring them has been a harmful process. i hope that if anything meaningful can come out of this for families suffering for the rest of their lives because they lost a loved one, know that this motivated congress to get up and do something. >> i want to talk about the families of mentally patients and people would are trying to get family members help. there has been a shortage of hospital beds for individuals. i guess i'm curious, how does your bill address that? do you see a promise for ensuring that families get the help for their loved ones
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that they need? >> what we do is we list the limit on hospital beds from 16 bed cap to say as long as the average length of stay is 30 days or less. it can save money because it covers 98% of people. when we look at the difference between psychiatric hospitals that have this versus having someone in a general hospital bed where they may not have the full services, in the general hospital they may spend twice as much time with fewer services versus one that is focused specialty hospital with that. actually, in many of the cases, the average length of stay is under a week, because they can target services right away. additional to that, there must be wraparound services afterwards. this is where medicaid pays for some things, which is helpful. agencies say they will make sure if someone is moving out, they have services secured for them. housing, supportive education, supportive job placement, making sure they have counseling and other aspects there. but more than having an agency do that, involve the family to whatever extent we can.
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these are -- many times, loving and caring parents who someone is emerged with mental illness for genetic reasons, for other reasons, and we have to stop telling family members, you are cut out of the equation here. >> your bill makes changes to hipaa laws to ensure families can be more involved. >> right, it's two small changes. one is already permitted. doctors are allowed to listen to a family member talk to them. many times lawyers told doctors, don't do that. you will get in trouble. they are allowed to listen. that only works if a family member or a friend or some trusted caregiver comes and says such things as, this is john doe, my friend, son, here is the name of his treating psychologist, psychiatrist, here is the medications he is on. it has been harmful before. that information is vital for mental health professional. history is vital. it's like an x-ray is to an orthopedic surgeon. try and diagnose a broken leg but you are not allowed to look at an x-ray, tell us if there's a tumor, but you can't look at an mri, we would never do that . history is vital. but the second part that is
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needed is, in those circumstances and it's a very narrow keyhole here, where the consumer has diminished capacity can become gravely disabled in absence of treatment, may have other medical complications, heart disease, lung disease, diabetes, infectious disease, the doctor has to make a decision, is this a trusted caregiver? not a stranger but someone who is a trusted caregiver? the doctor can give limited but vital information. diagnosis, treatment plan, doctor's name, time and place of the next appointment and medication list. it's forbidden to give any therapy information. that will remain confidential. if that family member or that friend or that trusted caregiver is going to assist that person to go on the next appointment, that will help. it can save lives. you end up with the issue that mentally ill people die 25 years sooner than the rest of the population. >> i want to discuss the intersection of criminal justice and mental health. 20% of individuals in prisons have some kind of mental
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illness. what can we do to ensure that our jails do not become receptacles for the mentally ill? what can we do to expand care so that it's not sort of the last resort? >> some estimates put that higher, 50% or 60%. more in county and city jails, state penitentiaries are high. federal under 20%. the point is, if that is a major contributor to the -- what has happened, several things need to hoop. happen. if you do prevention early on, you make a world of difference for them. not frivolous prevention like happy sing-a-long songs. i mean targeting a risk group. which is called secondary prevention. this is the high-risk group. or tertiary prevention, for signs showing up. you can use programs such as one called response after initial schizophrenic episode, which is authorized in my bill, which is very valuable. you do these things early on. you make sure you have enough providers. because we have a shortage. make sure there's enough places for treatment. if someone is caught up in the
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cycle, this revolving door, we want states to have some wraparound services for them. in new york, they call it assisted outpatient treatment. states have different things. 46 states have this on the books. they don't always use it. you have a history of violence, incarceration, arrest and mental illness, you are not engaging in treatment, when you are not in treatment, you end up back down into this abyss of troubles, the judge can order you to outpatient care to stay on your medication and stay in treatment. now, this is very important. sometimes people say you should never have involuntary commitment of any kind. to those folks i say, you are wrong. because some people, noting that about 40% of people with serious mental illness are not aware they have a problem. they are not aware that hallucinations, delusions are even in existence. some people who have been harmed by the system don't want to get help. but what happens is, when the state mandates you've got to get help, the state must provide that help. that's important. we want the services flexible.
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we don't want people in the revolving door. let me tell you the alternative. a gentleman in virginia i think last week, 24-year-old was arrested for about $5 worth of theft. so soft drink, candy bar from a 7-eleven. he went into jail because there was no room in a hospital bed for him. he remained in jail for 70 days. filthy, naked, untreated. he died. starved. he died. there is no way that person ever should have been put in a jail. we should have had services to get him in treatment. to work with the state of virginia to say you need places to treat people. tell medicaid to change your rules so someone like this, impoverished minority shouldn't be getting their treatment in jail or shouldn't be ignored in jail, they should get treatment. those kind of services which we believe are vital and the more compassionate thing to do. >> are there mental health services in jails, prisons, in local communities to prevent sort of an individual is put in jail to prevent them from getting more traumatized. >> some yes.
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many are weak, if anything. we have some states who try to save money by not giving medications. some states say let's save money shutting down our institutions and the money is not sent to where it needs to be towards real treatment. that is a troubling ogs. option. there was an article in the "new new york times" at rikers island and found that many people had serious mental illness they get fights with prison guards and other inmates. they had new charges on them. what started off as a minor offense became an elevated offense. they will get tased. you should never do that with people with mental illness. those are terrible things, you should never do that with someone with mental illness. for the same crime, tend to serve as a prison sentence four times longer that be a person without mental illness. and it is part of what is the shame of our system. when we have agencies that don't want to address serious mental illness who want to waste on on silly thing and bribing reporters that tell nice stories about them. this is a shameful story of what's happening here. what we need to do with those
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folks, instead of saying we have to criminalize mental illness before you get help, or say you're going to kill yourself or someone else before you get help. why are we dealing with stage four? we need to be dealing with things at an earlier stage. saving lives, saving money, be more compassionate instead of ignoring it until it gets bad. >> there a local or state program that you've seen works effectively getting in on the ground level so it doesn't get elevated? >> i mentioned the response of schizophrenic episode is very good programs, very targeted, science-based, evidence-based. the national child and adolescent traumatic stress network looking at high risk adolescents or young adults who have been traumatized in some way. very effective, very good. one of the reports that they did said they don't follow through. they don't have scientific standards. many cases they don't have reports that came out. this wasn't me. this is jao. after that we asked the director of samsa how would you score yourself on this? she said i'd give myself ten out of ten, perfect score.
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this shows you how out of touch federal agencies are. they can't even be humble enough to say we need to change. we're going to change for them. that's why people elect us to make these changes. when you have agencies who won't do that. there are excellent programs out there. that's the ones we want to see elevated. we don't need 20 homeless programs. we need better continuity between department of defense and the va. the veterans i work with. for example i'm a navy officer, i work at walter reed hospital with ptsd and traumatic injury patients. we need smooth continuity for them between when they are in the army and they're in the va. otherwise, what do we want to see them end up in jail or homeless? that's not appropriate. >> you have 133 co-sponsors on your bill. >> bipartisan. >> tell us about working across the aisle on this issue and whether or not you feel confident that the time has come in congress to get this on the floor and get it passed. >> the time has come. it is really going to be not necessarily from the political insiders.
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people want to protect the turf of their agencies. this is a grassroots movement across america. there's real dynamic people on both sides of the aisle. some of the leaders, marcy campter of the cleveland area, toledo area. you have a wide range of people, who are really outspoken, hannah esu. from california. the list goes on and on. on the republican side, we have vocal supporters, too. but you know what, it's going to take american people to be picking up a pen, picking up a phone, picking up their computer and contacting members of congress. we can't risk again 80, 90,000 people per year dying from untreated mental illness. >> i wanted to give the audience an opportunity. we're going to start questions in about five minutes. just give you an opportunity to start lining up if you get to that point. i also want to take about the language we use talking about mental illness and how this stigmatizes the issue, makes it difficult for people who don't
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have loved ones with mental illness, how they could perceive it. is there a better way to discuss? issue, how can congress help us understand that? >> we do it a couple ways. we develop a still ma by not having services available. when you don't have enough places to go, sometimes drop-in centers. sometimes peer support you can call, psychologists, psychiatrists, nurse practitioners. we don't have enough of those. that helps reduce the stigma. it makes it easier the get help. when you see breast cancer, heart treatment, they are beautiful buildings. mental health is usually hidden away. it can't transfer the next fiscal year. that's part. part of it is elevating this up. as we are looking at breast cancer month you will see nfl teams wearing pink gloves, socks and even the referee's pink wrist bands.
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the fountain in pittsburgh has pink dye. that's important. i have a sister who died of breast cancer who died last year. it's important to me personally. when you see a football player wearing green shoe leases to bring awareness of his bipolar. that's why i wear a green tie when i talk about mental health. i want people to think of recovery and regrowth like the spring. after the long doldrums of winter, things are new again. i want people to have that kind of hope. it's also a matter of family members speaking out and people who are in recovery speaking out to say we have to get better but we have to have the help. >> you made a few changes to your bill since introducing it a few years ago. most recently one of those changes was giving incentives to states that implement assistant
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outtreatment instead of peoplizing the states that do not. how do you find the right balance when it comes to legislative the balance to make sure people get the help they need and that their civil liberties aren't infringed on? >> one of the primary is the right to make sure people get well. they should be allowed to be sick and wither away and be homeless and die? how cruel and heartless is that? when i hear judges say, well, he has the right to be crazy. we wouldn't say you have the right to have a heart attack and die. we wouldn't say that. you have the right to have alzheimer's. we wouldn't say that. but we perversely assign that bigoted label to people with mental illness. with assisted outpatient treatment many states have it on the books. whether or not they do it is a problem. when new york did this, the money they were saving they put back into the system. that was good. people had better access to services. they found they reduced incarceration 80%. they reduced rehospitalizations and homelessness by 70%. they found consumer satisfaction up above 90% and they cut costs
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in half. that was a duke university center and a virginia law study on the new york system. as other states and counties do this, they actually find -- it is more compassionate to help people who are in that revolving door of problems. we don't want to read more stories of the 100 plus people with mental illness involved in a police altercation and died. we want police to be able to approach folks in a calm and organized way and say, look, we're going to get you help. that is how we will address these issues. >> i want to speak and end on the question of how police officer can be trained better to interact with individuals with mental illness, high percentage of the individuals who are killed by police officers have mental illness. how can these confrontations be deescalated? >> there is crisis intervention training, which the bill authorizes payment on too. this is training for police officers to understand and identify a situation right at the onset. many times they can tell how the person behaves, how they are
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dressed, homeless, et cetera, that this person needs a different point of view. and even if someone is in a threatening posture, how to deescalate that quickly. how to talk to the person calmly. how you have police officers positioned. you have to protect the family how you have police officers positioned. you have to protect the officer's safety and the family's safety, true. especially when the person is threatening. but in many cases someone who may be verbally hostile or frightened or scared or paranoid or hallucinating but there are programs out there. we want police to get that extra training so they're not in an unsafe position so families feel safer, but also and primarily so that individuals with mental illness is treated like a human being so they can be safer and recover as well. >> thank you so much. let's move on to audience "q" and "a" at this point. indiduals who are lined up at the mikes. let's start over here on my right. >> talk into the mike so i can hear you. >> is it on? >> now it is. >> okay.
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i heard about this kind of late last night, so i don't -- i haven't done my background information. but word in the trenches is that your bill is highly threatening to people who have a psychiatric diagnosis, that there are more controls being put in place and more civil liberties -- >> who did you hear that from? >> several people. >> who? what organizations? >> daphne cline, on our own -- >> yeah, so what happens is organizations and many of them get funding from samhsa didn't put the word -- >> they didn't say anything about this. >> they do because they fund a lot of these organizations and they say, hey, make sure you speak out because you may lose your funding. we're not taking away funding from people and we are protecting people's rights to be well. let me finish. >> okay. >> so what happens here is people have the right to get better. there's nothing in our bill that takes away rights. there's nothing in our bill that mandates involuntary commitment zero. i hear people say that.
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one organization told their audience says our bill has something that if a police officer stops you for a traffic acts they can force you to take medication. that's simply not true. they're creating a whole cloud of lies around it. that's simply not true. what we want to see because what we say we want more providers and more places for treatment, we want grants that have accountability to them and innovation and demonstration grants. we want more efficiency and effectiveness. there's a lot of people in the beltway that don't want to see the system changed, but here's the thing, while nih, for example, has worked so hard, put a lot of federal dollars into treatment for other things we've seen a decress in mortality rates for heart disease, cancer, auto accidents, aids. declining rates. at the same time we've seen increases in suicide deaths going up and drug overdose deaths going up. crimes. more people in prisons. more people homeless. those statistics are telling us the system is failing those it's
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supposed to help. while i want to make sure that, you know, there's nothing in our bill that takes away people's rights but i understand people don't want to change. the current system is failing and i tell you what, you want to talk about people's rights, go to the parents whose children died at sandy hook. i've got their photos sitting in my office from the time those parents sat in my office every day i look at those kids' faces. where are those rights? where are the rights of the students who just died in oregon? where are there rights to have a hopeful future? how about the police officer in houston, texas, gunned down simply getting gasoline from someone that had serious mental illness that was untreated. case after case after case after this. where are the rights of the 41,000 people who died of suicide death? where are their rights? i say no. and any of these organizations that want to create the atmosphere of lies to protect their status quo know and what's worse they prey upon people with mental illness and families by frightening them with falsehoods.
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that is unethical for them to do that and so whatever information you have, i'd be glad to tell you. but here's what i want you to do, you show me the word or the line in our bill and i'll change it. but they can't do that. because it's not there. >> thank you so much. >> let's move over to the left side here. >> thank you very much. am i on? good morning, ladies and gentlemen, my name is anthony hernandez, i'm from los angeles, i traveled the redeye to be here to represent over 1,500 families globally on this very issue of how this broken mental health system in our nation has destroyed all of our families. our children are dying. our kids are being incarcerated. and after incarceration they're being put in state mental hospitals. they're being taken away from us. i'd like to do this where i'm talking in front of individuals. how many of us in here have actually been experienced and had a tragedy of mental illness
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amongst them and close to your families? let's see you raise your hands, please, so we consider you all part of our family as well. a couple of months ago we were here in may invited by the congressman and treatment advocacy center to speak our voices and share our stories. our story came out in "the los angeles times." our son was hospitalized eight times and 5150 eight times and on the ninth time after we had the police there the day before we begged them to take our son again. they denied us. they left him there with us. and the next day he woke up because god told him to stab and kill his mother and father and this is what he tried to do and he also killed our dog. so, now he was faced with double attempted murder and cruelty to animals and now he's serving a life sentence in patton state hospital in san bernardino, he's only 20 years old. he's my baby. >> mr. hernandez, along those lines and going with the
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question we just had about protecting rights. what rights does he have in jail? zero? >> he doesn't have any rights. >> that's what i mean. the more compassionate thing to do is get people help. you are probably aware we've had this discussion before there was a case in the state of maine where one of the advocacy groups were there and when a gentleman was asked if he was going to harm himself or someone else the advocacy person told him make sure you say no. he said no. they released him from jail and he went home and hallucinating and thinking his mother was part of al qaeda took an ax and chopped her to pieces. he had the right to get better. he had the right to better treatment. and thank god you and your wife lived and thank god you're there to hem yolp your son in the fut. >> let me share something else with you. what's strange now that he's in patton, he has a psychologist, a psychiatrist, a social worker, a psych tech all to his disposal on a 24-hour, you know, basis. this is what he needed to have
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on the outside. but he had to break the law in order to get what he has now. so, this bill that the doctor is trying to pass, we're all sitting every day waiting to hear congress move forward with this necessity in our nation. and guess what, the rest of the world is watching us to take leadership as we do in many other things to fix our problem that's such an old, ancient problem. it's been around forever. it's time. the momentum is here. our moment is here. we're not going anywhere. we're 1,500 strong and growing. we're only two months old. and we're not going anywhere until this bill's passed. >> thank you. >> thank you. >> thank you, mr. hernandez. i want to take a question from twitter. we have a question here that says for the american health system what barriers are there and how can we better bridge minority health disparities? >> some of the biggest barriers are you can't see two doctors in the same day, not enough
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hospital beds, services for minorities are limited. we don't have enough minority providers in psychiatrist, psychologist and social work, and we make sure minority fellowships are authorized so people are out there having access to treatment. and, again, the issue for many minorities they tend to get their services in prison and so you have generation after generation of people in jail. we need to have easy access for them with quality, visible services early on and continue on with their life. >> thank you. we'll take a question from this side again. >> thank you. representative murphy, i'm stuart gordon with the national association of state mental health program directors. we want to express our appreciation to senators murphy and cassie dy on the other side for all of the work you are doing on the mental health issue. the samhsa administrator who responded with a ten out of ten score after the gao report has been gone for about two months.
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and i understand you've had an opportunity to sit down with the new samhsa administrator to talk about your concerns and that she's told you about some of the things they're doing to strengthen the grant monitoring system and the -- >> really? when did that meeting happen? when is that going to happen? no, no. we had asked samhsa for a document also commenting on this. we're still waiting months later to tell us about some of the programs, some of the messes they have. i would love to have an open conversation but it has to start with this. they've got to change. they cannot continue to have this belief that serious mental illness doesn't exist. they can have frivolous prevention programs and spend whatever money they have unaccounted for. that has to fundamentally change so it gets out there. i welcome conversations with any of these federal agencies because it has to change. the american people are demanding it to have this signed of insensitivity and unresponsiveness has got to change. what happens here is among providers like you and others,
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the most compassionate and caring people i've ever met, i spent 40 years in this career, people, let's face it, you're not going to get rich with what you do. you do it because you love what you do, because you love the people you're working with and because you're always struggling to get them help. federal agencies ought to pay attention and get outside the beltway and hear from people what we need to be doing as providers. >> thank you. we just have about a minute left. quick question from this side. >> unfortunately it's kind of loaded. good morning, mr. murphy. thank you. neat information. i'm the executive director of the june associations in wshlz washington, d.c., how does your bill address the need for cross cultural staff to ensure culturally competent care with the culturally and linguistic service standards? >> it's already required? >> different states have passed i believe eight -- >> are you saying that that's already required? >> that's what i'm trying to

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