[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 2685 Introduced in Senate (IS)]

<DOC>






114th CONGRESS
  2d Session
                                S. 2685

To amend the Public Health Service Act to improve mental and behavioral 
    health services on campuses of institutions of higher education.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 15, 2016

 Mr. Durbin (for himself, Ms. Collins, and Mr. Bennet) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to improve mental and behavioral 
    health services on campuses of institutions of higher education.

    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 2014 Association of University and College 
        Counseling Center Directors Survey found that the average ratio 
        of counselors to students on campus is nearly 1 to 1,833 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 percent of enrolled 
        students sought counseling in 2014.
            (3) More than 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 2015 American College Health Association survey of 
        more than 93,000 college and university students revealed that, 
        within the last 12 months, 57 percent of students report having 
        felt overwhelming anxiety, 35 percent felt so depressed it was 
        difficult to function, and 48 percent felt hopeless. However, 
        only 12 percent of students reported receiving professional 
        treatment for anxiety within the past 12 months, and 11 percent 
        reported receiving treatment for depression within the past 12 
        months.
            (7) The 2015 American College Health Association survey 
        also found that 9 percent of students have seriously considered 
        suicide in the past 12 months, a 20-percent increase compared 
        to 2012.
            (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 were 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 student counseling center at 
        the University of Idaho 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 a 11.4-percent higher retention 
        rate than the general college and university population.
            (11) A national survey of college and university students 
        living with mental health conditions, conducted by the National 
        Alliance on Mental Illness, found that 64 percent of students 
        who experience mental health problems in college or a 
        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 
settings at institutions of higher education, 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 campuses of institutions of 
higher education.
    ``(c) Eligibility.--To be eligible to receive a grant under 
subsection (b), an entity shall--
            ``(1) be an institution of higher education; 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, including 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, including peer support strategies;
            ``(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 institution of higher education 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 
        students through clinical services, outreach, prevention, or 
        academic success, in a manner that is in compliance with the 
        health privacy and security rules promulgated under section 
        264(c) of the Health Insurance Portability and Accountability 
        Act of 1996 (42 U.S.C. 1320d-2 note);
            ``(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, including athletic 
        teams, 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 
        institutions of higher education.
    ``(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 the Mental Health on Campus Improvement Act, 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) Definition.--In this section, the term `institution of higher 
education' has the meaning given such term in section 101 of the Higher 
Education Act of 1965 (20 U.S.C. 1001).
    ``(k) 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 to ensure that students at institutions of higher education 
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 
the campuses of institutions of higher education. 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 convened under subsection (b) 
shall include--
            ``(1) mental health consumers, including students and 
        family members;
            ``(2) representatives of institutions of higher education;
            ``(3) representatives of national mental and behavioral 
        health associations and associations of institutions of higher 
        education;
            ``(4) representatives of health promotion and prevention 
        organizations at institutions of higher education;
            ``(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--
            ``(1) targets promotional and educational efforts to the 
        age population of students at institutions of higher education 
        and individuals who are employed in settings of institutions of 
        higher education, including through the use of roundtables;
            ``(2) develops and proposes the implementation of research-
        based public health messages and activities;
            ``(3) provides support for local efforts to reduce stigma 
        by using the National Health Information Center as a primary 
        point of contact for information, publications, and service 
        program referrals; and
            ``(4) develops and proposes the implementation of a social 
        marketing campaign that is targeted at the population of 
        students attending institutions of higher education and 
        individuals who are employed in settings of institutions of 
        higher education.
    ``(e) Definition.--In this section, the term `institution of higher 
education' has the meaning given such term in section 101 of the Higher 
Education Act of 1965 (20 U.S.C. 1001).
    ``(f) 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 to provide for the 
establishment of a College Campus Task Force to discuss mental and 
behavioral health concerns on campuses of institutions of higher 
education.
    (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'') to discuss mental and behavioral health concerns on campuses 
of institutions of higher education.
    (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, in 
        consultation with the Secretary, determines 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 
                age population of students attending institutions of 
                higher education in the United States;
                    (B) to determine the range of effective, feasible, 
                and comprehensive actions to improve mental and 
                behavioral health on campuses of institutions of higher 
                education;
                    (C) to examine and better address the needs of the 
                age population of students attending institutions of 
                higher education 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 age population of students attending 
                institutions of higher education 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 campuses of institutions of higher education;
                    (I) to make recommendations to improve Federal 
                efforts relating to mental and behavioral health 
                promotion on campuses of institutions of higher 
                education 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 settings of institutions of higher education;
            (2) consult with national organizations with expertise in 
        mental and behavioral health, especially those organizations 
        working with the age population of students attending 
        institutions of higher education; and
            (3) consult with and seek input from mental health 
        professionals working on campuses of institutions of higher 
        education as appropriate.
    (e) Meetings.--
            (1) In general.--The Task Force shall meet not less than 3 
        times each year.
            (2) Annual conference.--The Secretary shall sponsor an 
        annual conference on mental and behavioral health in settings 
        of institutions of higher education to enhance coordination, 
        build partnerships, and share best practices in mental and 
        behavioral health promotion, data collection, analysis, and 
        services.
    (f) Definition.--In this section, the term ``institution of higher 
education'' has the meaning given such term in section 101 of the 
Higher Education Act of 1965 (20 U.S.C. 1001).
    (g) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section.
                                 <all>