[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4374 Introduced in House (IH)]

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114th CONGRESS
  2d Session
                                H. R. 4374

To amend the Public Health Service Act to improve mental and behavioral 
          health services on college and university campuses.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 12, 2016

  Ms. Schakowsky (for herself and Mr. Tonko) introduced the following 
 bill; which was referred to the Committee on Energy and Commerce, and 
  in addition to the Committee on Education and the Workforce, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to improve mental and behavioral 
          health services on college and university campuses.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Mental Health on Campus Improvement 
Act''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) The 2011 Association of University and College 
        Counseling Center Directors Survey found that the average ratio 
        of counselors to students on campus is nearly 1 to 1,879 and is 
        often far higher on large campuses. The International 
        Association of Counseling Services accreditation standards 
        recommends 1 counselor per 1,000 to 1,500 students.
            (2) College Counselors report that 10.8 percent of enrolled 
        students sought counseling in the past year, totaling an 
        estimated 2,000,000 students.
            (3) Over 90 percent of counseling directors believe there 
        is an increase in the number of students coming to campus with 
        severe psychological problems; today, 44 percent of the 
        students who visit campus counseling centers are dealing with 
        severe mental illness, up from 16 percent in 2000, and 24 
        percent are on psychiatric medication, up from 17 percent in 
        2000.
            (4) The majority of campus counseling directors report that 
        the demand for services and the severity of student needs are 
        growing without an increase in resources.
            (5) Many students who need help never receive it. Only 15 
        percent of college and university students who commit suicide 
        received campus counseling. Of students who seriously consider 
        suicide each year, only 52 percent of them seek any 
        professional help at all.
            (6) A 2012 American College Health Association (ACHA) 
        survey of more than 98,000 college and university students 
        revealed that, within the last 12 months, 51 percent of 
        students report having felt overwhelming anxiety, 31 percent 
        felt so depressed it was difficult to function, and 46 percent 
        felt hopeless. The ACHA survey found that 7.5 percent of 
        students have seriously considered suicide in the past 12 
        months.
            (7) The National Research Consortium of Counseling Centers 
        in Higher Education found that 6 percent of students have 
        seriously considered suicide in the past 12 months. The 
        Research Consortium found that of those who have seriously 
        considered suicide in the past 12 months, 52 percent sought no 
        preferred help and only 54 percent told anyone that they were 
        considering suicide.
            (8) Research conducted between 1997 and 2009, and presented 
        at the 118th Annual Convention of the American Psychological 
        Association found that more students are grappling with 
        depression and anxiety disorders than did a decade ago. The 
        study found that of students who sought college or university 
        counseling, 41 percent had moderate to severe depression in 
        2009, that number was 34 percent in 1997.
            (9) A survey conducted by the University of Idaho Student 
        Counseling Center in 2000 found that 77 percent of students who 
        responded reported that they were more likely to stay in school 
        because of counseling and that their school performance would 
        have declined without counseling.
            (10) Students with psychological issues often struggle 
        academically and are at risk for dropping out of school. 
        Counseling has been shown to address these issues while having 
        a positive impact on students remaining in school. A 6-year 
        longitudinal study found college and university students 
        receiving counseling to have an 11.4 percent higher retention 
        rate than the general college and university population (Turner 
        & Berry, 2000).
            (11) A national survey of college and university students 
        living with mental health conditions, conducted by the National 
        Alliance on Mental Health, found that 64 percent of students 
        who experience mental health problems in college or university 
        and withdraw from school do so because of their mental health 
        issues. The survey also found that 50 percent of that group 
        never accessed mental health services and supports.

SEC. 3. IMPROVING MENTAL AND BEHAVIORAL HEALTH ON COLLEGE CAMPUSES.

    Title V of the Public Health Service Act is amended by inserting 
after section 520E-2 (42 U.S.C. 290bb-36b) the following:

``SEC. 520E-3. GRANTS TO IMPROVE MENTAL AND BEHAVIORAL HEALTH ON 
              COLLEGE CAMPUSES.

    ``(a) Purpose.--It is the purpose of this section, with respect to 
college and university settings, to--
            ``(1) increase access to mental and behavioral health 
        services;
            ``(2) foster and improve the prevention of mental and 
        behavioral health disorders, and the promotion of mental 
        health;
            ``(3) improve the identification and treatment for students 
        at risk;
            ``(4) improve collaboration and the development of 
        appropriate levels of mental and behavioral health care;
            ``(5) reduce the stigma for students with mental health 
        disorders and enhance their access to mental health services; 
        and
            ``(6) improve the efficacy of outreach efforts.
    ``(b) Grants.--The Secretary, acting through the Administrator and 
in consultation with the Secretary of Education, shall award 
competitive grants to eligible entities to improve mental and 
behavioral health services and outreach on college and university 
campuses.
    ``(c) Eligibility.--To be eligible to receive a grant under 
subsection (b), an entity shall--
            ``(1) be an institution of higher education (as defined in 
        section 101 of the Higher Education Act of 1965 (20 U.S.C. 
        1001)); and
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require, including the information required under 
        subsection (d).
    ``(d) Application.--An application for a grant under this section 
shall include--
            ``(1) a description of the population to be targeted by the 
        program carried out under the grant, the particular mental and 
        behavioral health needs of the students involved;
            ``(2) a description of the Federal, State, local, private, 
        and institutional resources available for meeting the needs of 
        such students at the time the application is submitted;
            ``(3) an outline of the objectives of the program carried 
        out under the grant;
            ``(4) a description of activities, services, and training 
        to be provided under the program, including planned outreach 
        strategies to reach students not currently seeking services;
            ``(5) a plan to seek input from community mental health 
        providers, when available, community groups, and other public 
        and private entities in carrying out the program;
            ``(6) a plan, when applicable, to meet the specific mental 
        and behavioral health needs of veterans attending institutions 
        of higher education;
            ``(7) a description of the methods to be used to evaluate 
        the outcomes and effectiveness of the program; and
            ``(8) an assurance that grant funds will be used to 
        supplement, and not supplant, any other Federal, State, or 
        local funds available to carry out activities of the type 
        carried out under the grant.
    ``(e) Special Considerations.--In awarding grants under this 
section, the Secretary shall give special consideration to applications 
that describe programs to be carried out under the grant that--
            ``(1) demonstrate the greatest need for new or additional 
        mental and behavioral health services, in part by providing 
        information on current ratios of students to mental and 
        behavioral health professionals;
            ``(2) propose effective approaches for initiating or 
        expanding campus services and supports using evidence-based 
        practices;
            ``(3) target traditionally underserved populations and 
        populations most at risk;
            ``(4) where possible, demonstrate an awareness of, and a 
        willingness to, coordinate with a community mental health 
        center or other mental health resource in the community, to 
        support screening and referral of students requiring intensive 
        services;
            ``(5) identify how the college or university will address 
        psychiatric emergencies, including how information will be 
        communicated with families or other appropriate parties;
            ``(6) propose innovative practices that will improve 
        efficiencies in clinical care, broaden collaborations with 
        primary care, or improve prevention programs; and
            ``(7) demonstrate the greatest potential for replication 
        and dissemination.
    ``(f) Use of Funds.--Amounts received under a grant under this 
section may be used to--
            ``(1) provide mental and behavioral health services to 
        students, including prevention, promotion of mental health, 
        voluntary screening, early intervention, voluntary assessment, 
        treatment, management, and education services relating to the 
        mental and behavioral health of students;
            ``(2) conduct research through a counseling or health 
        center at the institution of higher education involved 
        regarding improving the mental and behavioral health of college 
        and university students through clinical services, outreach, 
        prevention, or academic success;
            ``(3) provide outreach services to notify students about 
        the existence of mental and behavioral health services;
            ``(4) educate students, families, faculty, staff, and 
        communities to increase awareness of mental health issues;
            ``(5) support student groups on campus that engage in 
        activities to educate students, including activities to reduce 
        stigma surrounding mental and behavioral disorders, and promote 
        mental health wellness;
            ``(6) employ appropriately trained staff;
            ``(7) provide training to students, faculty, and staff to 
        respond effectively to students with mental and behavioral 
        health issues;
            ``(8) expand mental health training through internship, 
        post-doctorate, and residency programs;
            ``(9) develop and support evidence-based and emerging best 
        practices, including a focus on culturally and linguistically 
        appropriate best practices; and
            ``(10) evaluate and disseminate best practices to other 
        colleges and universities.
    ``(g) Duration of Grants.--A grant under this section shall be 
awarded for a period not to exceed 3 years.
    ``(h) Evaluation and Reporting.--
            ``(1) Evaluation.--Not later than 18 months after the date 
        on which a grant is received under this section, the eligible 
        entity involved shall submit to the Secretary the results of an 
        evaluation to be conducted by the entity (or by another party 
        under contract with the entity) concerning the effectiveness of 
        the activities carried out under the grant and plans for the 
        sustainability of such efforts.
            ``(2) Report.--Not later than 2 years after the date of 
        enactment of this section, the Secretary shall submit to the 
        appropriate committees of Congress a report concerning the 
        results of--
                    ``(A) the evaluations conducted under paragraph 
                (1); and
                    ``(B) an evaluation conducted by the Secretary to 
                analyze the effectiveness and efficacy of the 
                activities conducted with grants under this section.
    ``(i) Technical Assistance.--The Secretary may provide technical 
assistance to grantees in carrying out this section.
    ``(j) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section.

``SEC. 520E-4. MENTAL AND BEHAVIORAL HEALTH OUTREACH AND EDUCATION ON 
              COLLEGE CAMPUSES.

    ``(a) Purpose.--It is the purpose of this section to increase 
access to, and reduce the stigma associated with, mental health 
services so as to ensure that college and university students have the 
support necessary to successfully complete their studies.
    ``(b) National Public Education Campaign.--The Secretary, acting 
through the Administrator and in collaboration with the Director of the 
Centers for Disease Control and Prevention, shall convene an 
interagency, public-private sector working group to plan, establish, 
and begin coordinating and evaluating a targeted public education 
campaign that is designed to focus on mental and behavioral health on 
college and university campuses. Such campaign shall be designed to--
            ``(1) improve the general understanding of mental health 
        and mental health disorders;
            ``(2) encourage help-seeking behaviors relating to the 
        promotion of mental health, prevention of mental health 
        disorders, and treatment of such disorders;
            ``(3) make the connection between mental and behavioral 
        health and academic success; and
            ``(4) assist the general public in identifying the early 
        warning signs and reducing the stigma of mental illness.
    ``(c) Composition.--The working group under subsection (b) shall 
include--
            ``(1) mental health consumers, including students and 
        family members;
            ``(2) representatives of colleges and universities;
            ``(3) representatives of national mental and behavioral 
        health and college and university associations;
            ``(4) representatives of college and university health 
        promotion and prevention organizations;
            ``(5) representatives of mental health providers, including 
        community mental health centers; and
            ``(6) representatives of private- and public-sector groups 
        with experience in the development of effective public health 
        education campaigns.
    ``(d) Plan.--The working group under subsection (b) shall develop a 
plan that shall--
            ``(1) target promotional and educational efforts to the 
        college- and university-age population and individuals who are 
        employed in college and university settings, including the use 
        of roundtables;
            ``(2) develop and propose the implementation of research-
        based public health messages and activities;
            ``(3) provide support for local efforts to reduce stigma by 
        using the National Mental Health Information Center as a 
        primary point of contact for information, publications, and 
        service program referrals; and
            ``(4) develop and propose the implementation of a social 
        marketing campaign that is targeted at the college or 
        university population and individuals who are employed in 
        college and university settings.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this 
section.''.

SEC. 4. INTERAGENCY WORKING GROUP ON COLLEGE MENTAL HEALTH.

    (a) Purpose.--It is the purpose of this section, pursuant to 
Executive Order 13263 (and the recommendations issued under section 
6(b) of such Order), to provide for the establishment of a College 
Campus Task Force under the Federal Executive Steering Committee on 
Mental Health, to discuss mental and behavioral health concerns on 
college and university campuses.
    (b) Establishment.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall establish a 
College Campus Task Force (referred to in this section as the ``Task 
Force''), under the Federal Executive Steering Committee on Mental 
Health, to discuss mental and behavioral health concerns on college and 
university campuses.
    (c) Membership.--The Task Force shall be composed of a 
representative from each Federal agency (as appointed by the head of 
the agency) that has jurisdiction over, or is affected by, mental 
health and education policies and projects, including--
            (1) the Department of Education;
            (2) the Department of Health and Human Services;
            (3) the Department of Veterans Affairs; and
            (4) such other Federal agencies as the Administrator of the 
        Substance Abuse and Mental Health Services Administration and 
        the Secretary jointly determine to be appropriate.
    (d) Duties.--The Task Force shall--
            (1) serve as a centralized mechanism to coordinate a 
        national effort--
                    (A) to discuss and evaluate evidence and knowledge 
                on mental and behavioral health services available to, 
                and the prevalence of mental health illness among, the 
                college- and university-age population of the United 
                States;
                    (B) to determine the range of effective, feasible, 
                and comprehensive actions to improve mental and 
                behavioral health on college and university campuses;
                    (C) to examine and better address the needs of the 
                college- and university-age population dealing with 
                mental illness;
                    (D) to survey Federal agencies to determine which 
                policies are effective in encouraging and how best to 
                facilitate outreach without duplicating efforts 
                relating to mental and behavioral health promotion;
                    (E) to establish specific goals within and across 
                Federal agencies for mental health promotion, including 
                determinations of accountability for reaching those 
                goals;
                    (F) to develop a strategy for allocating 
                responsibilities and ensuring participation in mental 
                and behavioral health promotions, particularly in the 
                case of competing agency priorities;
                    (G) to coordinate plans to communicate research 
                results relating to mental and behavioral health 
                amongst the college- and university-age population to 
                enable reporting and outreach activities to produce 
                more useful and timely information;
                    (H) to provide a description of evidence-based best 
                practices, model programs, effective guidelines, and 
                other strategies for promoting mental and behavioral 
                health on college and university campuses;
                    (I) to make recommendations to improve Federal 
                efforts relating to mental and behavioral health 
                promotion on college and university campuses and to 
                ensure Federal efforts are consistent with available 
                standards and evidence and other programs in existence 
                as of the date of enactment of this Act; and
                    (J) to monitor Federal progress in meeting specific 
                mental and behavioral health promotion goals as they 
                relate to college and university settings;
            (2) consult with national organizations with expertise in 
        mental and behavioral health, especially those organizations 
        working with the college- and university-age population; and
            (3) consult with and seek input from mental health 
        professionals working on college and university campuses as 
        appropriate.
    (e) Meetings.--
            (1) In general.--The Task Force shall meet at least 3 times 
        each year.
            (2) Annual conference.--The Secretary shall sponsor an 
        annual conference on mental and behavioral health in college 
        and university settings to enhance coordination, build 
        partnerships, and share best practices in mental and behavioral 
        health promotion, data collection, analysis, and services.
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section.
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