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Personal Low, Career Peak
After Drug-Fueled Crash, Patrick Kennedy Turned Focus to Mental Health-Care Reform

By Vincent Bzdek
Washington Post Staff Writer
Tuesday, April 28, 2009 12:21 AM

Political aides counseled Rep. Patrick Kennedy not to mention the incident when he was campaigning for reelection in 2006. "Don't bring it up," they insisted, as Kennedy recounts their reaction. "Everybody already knows about it." Talking about it only reminded Rhode Island voters of other Kennedy family misdeeds and misfortunes, they said.

The incident was the pre-dawn drive the congressman took straight into a security barrier outside of the Capitol on May 4, 2006. At about 2:45 a.m., the bleary-eyed scion of America's royal family staggered out of his green 1997 Ford Mustang convertible and informed police he was late for a vote.

The incident prompted another national rolling of the eyes over the foibles and addictions of the well-loved and well-ridiculed Kennedy family. When Kennedy held a news conference 36 hours later to announce that he was on his way to the Mayo Clinic to treat an addiction to prescription medication, fresh obituaries were written -- again -- for the once-glorious Camelot legacy.

But Kennedy's story didn't end at the wall. The congressman -- who had already disclosed a battle with bipolar disorder, also known as manic depression, as well as treatment for cocaine use during his teenage years -- chose not to listen to the advice of his handlers on the campaign trail nearly three years ago. He may have sensed an opportunity, or decided to make the best of a personal tragedy or realized he had no option but honesty. Whatever the reason, he chose to reshape the incident as part of a broader story about the need for better insurance coverage for mental health issues, one of several issues he'd been championing for years. Now that pet concern had become a cause.

Last September, the Rhode Island Democrat -- together with colleagues including his Alcoholics Anonymous sponsor, former representative Jim Ramstad (R-Minn.), former senator Pete Domenici (R-N.M.) and, crucially, his ailing father, Sen. Ted Kennedy (D-Mass.) -- pushed through a bill, signed by President Bush last October, that requires equal coverage of mental and physical illnesses by insurance companies.

In turning his crash into a crusade, Kennedy, who at age 41 is serving his eighth term, performed an act of political jujitsu that transformed one of the lowest moments of his life into his greatest political achievement. And he made a powerful argument for mental-health parity as a civil-rights issue for his generation, giving voice to the idea that the stigma surrounding alcoholism and mental illness is akin to the prejudice experienced once upon a time by gays, African Americans and Irish Catholics back in his uncle John's day.

"In our heads we knew better than to treat this as a second-class illness," said Kennedy during one of two interviews last fall. "We just couldn't get over the prejudice. That nagging sense of judgmentalism. Far be it for those winos -- those people who are drunkards that can't hold their liquor -- for them to get treatment, because they should be able to pick themselves up by their bootstraps."

This is the story of how Patrick Kennedy, in just more than two years, got from the wall to a higher ground.

Politician and Addict

During most of his adult years, Kennedy had been leading two lives -- the life of a politician and the life of an addict. For years, he abused "the whole panoply of pain medication," from codeine-fortified Tylenol to oxycodone, he told the Providence Journal after the crash. At times, he said, he would binge-drink. While he'd disclosed some of his problems before the crash, he'd never before admitted to binge drinking or said that substance abuse was the cause of his erratic behavior over the years. Now he spoke about it all with brutal honesty, embracing a new persona as "the public face of alcoholism and addiction." The crash had forced his reckoning onto a much more prominent stage.

"He and I had similar experiences," said Ramstad, who was arrested for disorderly conduct and resisting arrest during an alcoholic blackout on July 31, 1981. "It was law enforcement officials who took care of any problems we had maintaining anonymity."

The arrest, Ramstad said, was in some ways liberating, as was Kennedy's incident for him. "When I could finally tell the truth about my drinking and for Patrick to tell the truth about his addiction made both of us whole," he said. (Although Kennedy's participation in AA has been well-publicized, he still abides by the organization's anonymity rules, generally referring to it as "the program.")

Being a Kennedy means living not only with the legacy of politics and social progressivism but with the legacy of substance abuse. It has affected several member of his family, including his own mother, Joan, who has struggled with severe alcoholism.

"Frankly no one, no one can argue who has ever witnessed what I've seen in my life, in terms of the tragic circumstances of people I've seen who have gone through this disease -- friends, family and the like -- that people would actually put themselves through what they put themselves through," Kennedy said during a phone interview, his voice rising in that Kennedyesque way his father's and uncles' voices always did toward the end of their best speeches. "Voluntarily. You just don't do this to your life out of choice. Out of choice! It's not a choice."

The struggle's not over for Kennedy, as he well knows. Every day can be difficult, though Darrell West, a Brookings Institution scholar who wrote a book on the congressman, "Patrick Kennedy: The Rise to Power," believes Kennedy is sustaining himself in his sobriety, as does Ramstad.

"It's a chronic illness," Kennedy said. "The big issue is when the press makes a big deal out of these things, it stigmatizes it. People really hold it inside. When I have an asthma attack, it's not a big deal. If I go out on a bender, believe me, it's going to be a big story."

Ten years before the 2006 incident, when he was a freshman congressman, Kennedy co-sponsored a bill with Ramstad to put insurance coverage of mental illness and treatment for substance abuse and alcoholism on the same footing as coverage for physical illnesses such as diabetes and asthma, building on a similar bill proposed the same year by Domenici, who has a daughter with schizophrenia, and Sen. Paul Wellstone (D-Minn.), whose brother had severe mental illness. Insurance companies were charging higher deductibles and co-pays for mental health care and putting stricter limits on treatment for addiction and mental illness.

Kennedy, Ramstad and Domenici championed the proposed legislation for a decade but kept hitting roadblocks in Congress, where foes of parity feared spiraling new costs would make health insurance even less affordable than it already is.

It wasn't until 2006 that things finally started moving, when Kennedy's high-profile accident and consequent treatment galvanized his efforts -- and when Democrats took control of Congress.

Kennedy began to emerge as the leading spokesman in Congress for parity and the rights of the mentally ill. He talked frankly about his 20-year, often-losing battle to overcome an addiction to prescription pain killers. He talked with voters about his bipolar disorder, and revealed how he sometimes slept 17 hours a day when he was a college student, unable to get out of bed to go to class. He described to reporters in granular detail the elements of his latest efforts at recovery: the weekly urine tests, twice-weekly meetings with a probation officer, near-daily AA meetings and a weekly meeting of recovering addicts led by a Navy captain.

"I know that recovery works," Kennedy recalled telling his audiences over and over. "I believe more Americans ought to be able to get access to treatment themselves."

After finishing one of his first events, at a senior citizen center in a Providence high rise, the little old ladies all began to talk at once, Kennedy recalled. They came up to him, speaking about the ways they'd experienced mental illness in their lives.

"My son took me to McLean hospital in Boston," one woman told him, "and I'm on medication, but I can't tell any of my friends here, because they'd think I'm crazy. You're the only one who knows aside from my son."

And on the floor of the House, colleagues also unburdened themselves.

"I'd be sitting back in the cloakroom watching TV in between votes," Kennedy said, "and one of them would sit down next to me and say, 'My father committed suicide.' "

That fall, Rhode Island voters returned him to office with 67 percent of the vote, a higher percentage than he'd received in the previous two elections. The heavily Democratic district probably would have reelected Kennedy regardless, but West believes the congressman's frankness was crucial to his high numbers: "That's the type of problem that could have torpedoed his career. But his constituents accepted his explanation at face value. Because he was honest. And he got help."

The irony of Kennedy's situation wasn't lost on him. He'd long considered himself "damaged goods politically" because of his struggles.

"I grew up thinking, here I come from this amazing family involved in all this social justice and civil rights, you know, and that I was born at the wrong time," Kennedy said. "I couldn't see the forest for the trees, that this thing was a civil rights fight. . . . I was so ashamed of my own mental health problems . . . and the fact that in my family, which is so competitive and prides itself on its 'strength' in so many ways, that I fell short of my family's ideal."

Now, out of those struggles he felt himself continuing the legacy of the family name:

"How could I have ever imagined that this subject, which I think is going to be my undoing, becomes the platform that connects me to my family's legacy? And continues it."

Fighting for Parity

After holding a nationwide series of field hearings on mental health coverage, Ramstad and Kennedy fashioned a new bill and presented it to the House.

And then they called in the secret weapon: Dad.

In the Senate, Ted Kennedy took up his son's cause, teaming with Domenici and Sen. Mike Enzi (R-Wyo.) to quietly forge a broad bipartisan coalition after gathering input from mental-health advocates, health-insurance industry representatives and private businesses. With Ted Kennedy pulling the levers, the parity bill cleared the Senate with no dissent in September 2007.

"There aren't any coincidences when it comes to the Senate with my dad around," Patrick Kennedy said. The House's more expansive bill passed six months later.

House and Senate negotiators were hammering out compromises between the two versions when the legislation stalled over differences on unrelated budget procedures. Kennedy began to worry that the bill wouldn't get finished in time for his father to see it happen. The 77-year-old veteran lawmaker is battling a cancerous brain tumor that required surgery last summer.

In Hyannis Port, Mass., recovering from his chemotherapy and radiation treatments, Ted got on the phone. According to Patrick, his father talked nonstop to Senate Majority Leader Harry Reid (D-Nev.), Sen. Chris Dodd (D-Conn.) and others, wheedling and cajoling his way toward passage, asking them to find a way to bring it up for a vote on the floor during a crowded schedule.

As Congress rushed to adjourn last fall, the bill was attached to the first emergency bailout of the financial industry steaming its way toward passage in late September -- and passed both the House and Senate. The only senator who wasn't there to vote was Patrick's father, who has made only a handful of visits to the Hill since his tumor was diagnosed.

Federal officials say the law, which President Bush signed Oct. 3, will improve coverage for 113 million people, including 82 million in employer-sponsored plans. Beginning in 2010, insurance companies will be required to charge the same co-pays, deductibles and out-of-pocket expenses for addiction and mental health treatments as those for all other illnesses. The legislation is expected to raise health-care premiums 0.2 percent to 0.4 percent on average and cost taxpayers about $3.4 billion over 10 years.

Ted Kennedy counts the bill among his greatest achievements as a senator. "I am enormously proud of Patrick's unwavering commitment to fairness and justice for all Americans struggling with mental illness," he said in an e-mail. "He is a true champion for the cause and a voice for the voiceless."

Patrick sent a note to his father the night after the bill became law. He wanted his thanks to be written down, something his father could forever hold and keep.

"Because in a sense," he explained, "in his fighting for it, he was fighting for something that was not only important to me, personally, as a son, but he was fighting against the stigma and shame that I've always felt at being 'lesser than' because I've had this illness. And that meant the world to me."

Vincent Bzdek is the author of "The Kennedy Legacy: Jack, Bobby and Ted and a Family Dream Fulfilled" (Palgrave Macmillan 2009), which is published today.

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