Congressional Record, Volume 150 Issue 105 (Wednesday, September 8, 2004)

[Congressional Record Volume 150, Number 105 (Wednesday, September 8, 2004)]
[House]
[Pages H6865-H6874]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

GARRETT LEE SMITH MEMORIAL ACT

Mr. BARTON of Texas. Mr. Speaker, I move to suspend the rules and
pass the Senate bill (S. 2634) to amend the Public Health Service Act
to support the planning, implementation, and evaluation of organized
activities involving statewide youth suicide early intervention and
prevention strategies, to provide funds for campus mental and
behavioral health service centers, and for other purposes, as amended.
The Clerk read as follows:

S. 2634

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 ``Garrett Lee Smith Memorial
Act''.

SEC. 2. FINDINGS.

Congress makes the following findings:
(1) More children and young adults die from suicide each
year than from cancer, heart disease, AIDS, birth defects,
stroke, and chronic lung disease combined.
(2) Over 4,000 children and young adults tragically take
their lives every year, making suicide the third overall
cause of death between the ages of 10 and 24. According to
the Centers for Disease Control and Prevention, suicide is
the third overall cause of death among college-age students.
(3) According to the National Center for Injury Prevention
and Control of the Centers for Disease Control and
Prevention, children and young adults accounted for 15
percent of all suicides completed in 2000.
(4) From 1952 to 1995, the rate of suicide in children and
young adults tripled.
(5) From 1980 to 1997, the rate of suicide among young
adults ages 15 to 19 increased 11 percent.
(6) From 1980 to 1997, the rate of suicide among children
ages 10 to 14 increased 109 percent.
(7) According to the National Center of Health Statistics,
suicide rates among Native Americans range from 1.5 to 3
times the national average for other groups, with young
people ages 15 to 34 making up 64 percent of all suicides.
(8) Congress has recognized that youth suicide is a public
health tragedy linked to underlying mental health problems
and that youth suicide early intervention and prevention
activities are national priorities.
(9) Youth suicide early intervention and prevention have
been listed as urgent public health priorities by the
President's New Freedom Commission in Mental Health (2002),
the Institute of Medicine's Reducing Suicide: A National
Imperative (2002), the National Strategy for Suicide
Prevention: Goals and Objectives for Action (2001), and the
Surgeon General's Call to Action To Prevent Suicide (1999).
(10) Many States have already developed comprehensive
statewide youth suicide early intervention and prevention
strategies that seek to provide effective early intervention
and prevention services.
(11) In a recent report, a startling 85 percent of college
counseling centers revealed an increase in the number of
students they see with psychological problems. Furthermore,
the American College Health Association found that 61 percent
of college students reported feeling hopeless, 45 percent
said they felt so depressed they could barely function, and 9
percent felt suicidal.
(12) There is clear evidence of an increased incidence of
depression among college students. According to a survey
described in the Chronicle of Higher Education (February 1,
2002), depression among freshmen has nearly doubled (from 8.2
percent to 16.3 percent). Without treatment, researchers
recently noted that ``depressed adolescents are at risk for
school failure, social isolation, promiscuity, self-
medication with drugs and alcohol, and suicide--now the third
leading cause of death among 10-24 year olds.''.
(13) Researchers who conducted the study ``Changes in
Counseling Center Client Problems Across 13 Years'' (1989-
2001) at Kansas State University stated that ``students are
experiencing more stress, more anxiety, more depression than
they were a decade ago.'' (The Chronicle of Higher Education,
February 14, 2003).
(14) According to the 2001 National Household Survey on
Drug Abuse, 20 percent of full-time undergraduate college
students use illicit drugs.
(15) The 2001 National Household Survey on Drug Abuse also
reported that 18.4 percent of adults aged 18 to 24 are
dependent on or abusing illicit drugs or alcohol. In
addition, the study found that ``serious mental illness is
highly correlated with substance dependence or abuse. Among
adults with serious mental illness in 2001, 20.3 percent were
dependent on or abused alcohol or illicit drugs, while the
rate among adults without serious mental illness was only 6.3
percent.''.
(16) A 2003 Gallagher's Survey of Counseling Center
Directors found that 81 percent were concerned about the
increasing number of students with more serious psychological
problems, 67 percent reported a need for

[[Page H6866]]

more psychiatric services, and 63 percent reported problems
with growing demand for services without an appropriate
increase in resources.
(17) The International Association of Counseling Services
accreditation standards recommend 1 counselor per 1,000 to
1,500 students. According to the 2003 Gallagher's Survey of
Counseling Center Directors, the ratio of counselors to
students is as high as 1 counselor per 2,400 students at
institutions of higher education with more than 15,000
students.

SEC. 3. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

(a) Youth Interagency Research, Training, and Technical
Assistance Centers.--Section 520C of the Public Health
Service Act (42 U.S.C. 290bb-34) is amended--
(1) in subsection (a)--
(A) by striking ``Health, shall award grants'' and
inserting ``Health--
``(1) shall award grants'';
(B) by striking the period at the end and inserting ``;
and''; and
(C) by adding at the end the following:
``(2) shall award a competitive grant to 1 additional
research, training, and technical assistance center to carry
out the activities described in subsection (d).'';
(2) in subsection (c), in the matter preceding paragraph
(1), by striking ``grant or contract under subsection (a)''
and inserting ``grant or contract under subsection (a)(1)'';
(3) in subsection (d)--
(A) by striking ``Appropriations.--For the purpose of
carrying out this section'' and inserting ``Appropriations.--
``(1) For the purpose of awarding grants or contracts under
subsection (a)(1)''; and
(B) by adding at the end the following:
``(2) For the purpose of awarding a grant under subsection
(a)(2), there are authorized to be appropriated $3,000,000
for fiscal year 2005, $4,000,000 for fiscal year 2006, and
$5,000,000 for fiscal year 2007.'';
(4) by redesignating subsection (d) as subsection (e); and
(5) by inserting after subsection (c) the following:
``(d) Additional Center.--The additional research,
training, and technical assistance center established under
subsection (a)(2) shall provide appropriate information,
training, and technical assistance to States, political
subdivisions of a State, Federally recognized Indian tribes,
tribal organizations, institutions of higher education,
public organizations, or private nonprofit organizations
for--
``(1) the development or continuation of statewide or
tribal youth suicide early intervention and prevention
strategies;
``(2) ensuring the surveillance of youth suicide early
intervention and prevention strategies;
``(3) studying the costs and effectiveness of statewide
youth suicide early intervention and prevention strategies in
order to provide information concerning relevant issues of
importance to State, tribal, and national policymakers;
``(4) further identifying and understanding causes and
associated risk factors for youth suicide;
``(5) analyzing the efficacy of new and existing youth
suicide early intervention techniques and technology;
``(6) ensuring the surveillance of suicidal behaviors and
nonfatal suicidal attempts;
``(7) studying the effectiveness of State-sponsored
statewide and tribal youth suicide early intervention and
prevention strategies on the overall wellness and health
promotion strategies related to suicide attempts;
``(8) promoting the sharing of data regarding youth suicide
with Federal agencies involved with youth suicide early
intervention and prevention, and State-sponsored statewide or
tribal youth suicide early intervention and prevention
strategies for the purpose of identifying previously unknown
mental health causes and associated risk factors for suicide
in youth;
``(9) evaluating and disseminating outcomes and best
practices of mental and behavioral health services at
institutions of higher education; and
``(10) other activities determined appropriate by the
Secretary.''.
(b) Suicide Prevention for Youth.--Title V of the Public
Health Service Act (42 U.S.C. 290aa et seq.) is amended--
(1) in section 520E (42 U.S.C. 290bb-36)--
(A) in the section heading by striking ``CHILDREN AND
ADOLESCENTS'' and inserting ``YOUTH'';
(B) by striking subsection (a) and inserting the following:
``(a) In General.--The Secretary shall award grants or
cooperative agreements to public organizations, private
nonprofit organizations, political subdivisions, consortia of
political subdivisions, consortia of States, or Federally
recognized Indian tribes or tribal organizations to design
early intervention and prevention strategies that will
complement the State-sponsored statewide or tribal youth
suicide early intervention and prevention strategies
developed pursuant to section 520E.'';
(C) in subsection (b), by striking all after
``coordinated'' and inserting ``with the relevant Department
of Health and Human Services agencies and suicide working
groups.'';
(D) in subsection (c)--
(i) in the matter preceding paragraph (1), by striking ``A
State'' and all that follows through ``desiring'' and
inserting ``A public organization, private nonprofit
organization, political subdivision, consortium of political
subdivisions, consortium of States, or federally recognized
Indian tribe or tribal organization desiring'';
(ii) by redesignating paragraphs (1) through (9) as
paragraphs (2) through (10), respectively;
(iii) by inserting before paragraph (2) (as so
redesignated) the following:
``(1)(A) comply with the State-sponsored statewide early
intervention and prevention strategy as developed under
section 520E; and
``(B) in the case of a consortium of States, receive the
support of all States involved;'';
(iv) in paragraph (2) (as so redesignated), by striking
``children and adolescents'' and inserting ``youth'';
(v) in paragraph (3) (as so redesignated), by striking
``best evidence-based,'';
(vi) in paragraph (4) (as so redesignated), by striking
``primary'' and all that follows and inserting ``general,
mental, and behavioral health services, and substance abuse
services;'';
(vii) in paragraph (5) (as so redesignated), by striking
``children and'' and all that follows and inserting ``youth
including the school systems, educational institutions,
juvenile justice system, substance abuse programs, mental
health programs, foster care systems, and community child and
youth support organizations;'';
(viii) by striking paragraph (8) (as so redesignated) and
inserting the following:
``(8) offer access to services and care to youth with
diverse linguistic and cultural backgrounds;''; and
(ix) by striking paragraph (9) (as so redesignated) and
inserting the following:
``(9) conduct annual self-evaluations of outcomes and
activities, including consulting with interested families and
advocacy organizations;'';
(E) by striking subsection (d) and inserting the following:
``(d) Use of Funds.--Amounts provided under a grant or
cooperative agreement under this section shall be used to
supplement, and not supplant, Federal and non-Federal funds
available for carrying out the activities described in this
section. Applicants shall provide financial information to
demonstrate compliance with this section.'';
(F) in subsection (e)--
(i) by striking ``, contract,''; and
(ii) by inserting after ``Secretary that the'' the
following: ``application complies with the State-sponsored
statewide early intervention and prevention strategy as
developed under section 520E and the'';
(G) in subsection (f), by striking ``, contracts,'';
(H) in subsection (g)--
(i) by striking ``A State'' and all that follows through
``organization receiving'' and inserting ``A public
organization, private nonprofit organization, political
subdivision, consortium of political subdivisions, consortium
of States, or Federally recognized Indian tribe or tribal
organization receiving''; and
(ii) by striking ``, contract,'' each place such term
appears;
(I) in subsection (h), by striking ``, contracts,'';
(J) in subsection (i)--
(i) by striking ``A State'' and all that follows through
``organization receiving'' and inserting ``A public
organization, private nonprofit organization, political
subdivision, consortium of political subdivisions, consortium
of States, or Federally recognized Indian tribe or tribal
organization receiving''; and
(ii) by striking ``, contract,'';
(K) in subsection (k), by striking ``5 years'' and
inserting ``3 years'';
(L) in subsection (l)--
(i) in paragraph (2), by striking ``21'' and inserting
``24''; and
(ii) in paragraph (3), by striking ``which might have
been'';
(M) in subsection (m)--
(i) by striking ``Appropriation.--'' and all that follows
through ``For'' in paragraph (1) and inserting
``Appropriation.--For''; and
(ii) by striking paragraph (2);
(N) by redesignating subsection (m) as subsection (n); and
(O) by inserting after subsection (l) the following:
``(m) Definitions.--In this section, the terms `early
intervention', `educational institution', `institution of
higher education', `prevention', `school', and `youth' have
the meanings given to those terms in section 520E.''; and
(2) by redesignating section 520E as section 520E-1.
(c) Youth Suicide and Early Intervention and Prevention
Strategies.--Title V of the Public Health Service Act (42
U.S.C. 290aa et seq.) is amended by inserting before section
520E-1 (as redesignated by subsection (b)) the following:

``SEC. 520E. YOUTH SUICIDE EARLY INTERVENTION AND PREVENTION
STRATEGIES.

``(a) In General.--The Secretary, acting through the
Administrator of the Substance Abuse and Mental Health
Services Administration, shall award grants or cooperative
agreements to eligible entities to--
``(1) develop and implement State-sponsored statewide or
tribal youth suicide early intervention and prevention
strategies in schools, educational institutions, juvenile
justice systems, substance abuse programs, mental health
programs, foster care systems, and other child and youth
support organizations;

[[Page H6867]]

``(2) support public organizations and private nonprofit
organizations actively involved in State-sponsored statewide
or tribal youth suicide early intervention and prevention
strategies and in the development and continuation of State-
sponsored statewide youth suicide early intervention and
prevention strategies;
``(3) provide grants to institutions of higher education to
coordinate the implementation of State-sponsored statewide or
tribal youth suicide early intervention and prevention
strategies;
``(4) collect and analyze data on State-sponsored statewide
or tribal youth suicide early intervention and prevention
services that can be used to monitor the effectiveness of
such services and for research, technical assistance, and
policy development; and
``(5) assist eligible entities, through State-sponsored
statewide or tribal youth suicide early intervention and
prevention strategies, in achieving targets for youth suicide
reductions under title V of the Social Security Act.
``(b) Eligible Entity.--
``(1) Definition.--In this section, the term `eligible
entity' means--
``(A) a State;
``(B) a public organization or private nonprofit
organization designated by a State to develop or direct the
State-sponsored statewide youth suicide early intervention
and prevention strategy; or
``(C) a Federally recognized Indian tribe or tribal
organization (as defined in the Indian Self-Determination and
Education Assistance Act) or an urban Indian organization (as
defined in the Indian Health Care Improvement Act) that is
actively involved in the development and continuation of a
tribal youth suicide early intervention and prevention
strategy.
``(2) Limitation.--In carrying out this section, the
Secretary shall ensure that each State is awarded only 1
grant or cooperative agreement under this section. For
purposes of the preceding sentence, a State shall be
considered to have been awarded a grant or cooperative
agreement if the eligible entity involved is the State or an
entity designated by the State under paragraph (1)(B).
Nothing in this paragraph shall be construed to apply to
entities described in paragraph (1)(C).
``(c) Preference.--In providing assistance under a grant or
cooperative agreement under this section, an eligible entity
shall give preference to public organizations, private
nonprofit organizations, political subdivisions, institutions
of higher education, and tribal organizations actively
involved with the State-sponsored statewide or tribal youth
suicide early intervention and prevention strategy that--
``(1) provide early intervention and assessment services,
including screening programs, to youth who are at risk for
mental or emotional disorders that may lead to a suicide
attempt, and that are integrated with school systems,
educational institutions, juvenile justice systems, substance
abuse programs, mental health programs, foster care systems,
and other child and youth support organizations;
``(2) demonstrate collaboration among early intervention
and prevention services or certify that entities will engage
in future collaboration;
``(3) employ or include in their applications a commitment
to evaluate youth suicide early intervention and prevention
practices and strategies adapted to the local community;
``(4) provide timely referrals for appropriate community-
based mental health care and treatment of youth who are at
risk for suicide in child-serving settings and agencies;
``(5) provide immediate support and information resources
to families of youth who are at risk for suicide;
``(6) offer access to services and care to youth with
diverse linguistic and cultural backgrounds;
``(7) offer appropriate postsuicide intervention services,
care, and information to families, friends, schools,
educational institutions, juvenile justice systems, substance
abuse programs, mental health programs, foster care systems,
and other child and youth support organizations of youth who
recently completed suicide;
``(8) offer continuous and up-to-date information and
awareness campaigns that target parents, family members,
child care professionals, community care providers, and the
general public and highlight the risk factors associated with
youth suicide and the life-saving help and care available
from early intervention and prevention services;
``(9) ensure that information and awareness campaigns on
youth suicide risk factors, and early intervention and
prevention services, use effective communication mechanisms
that are targeted to and reach youth, families, schools,
educational institutions, and youth organizations;
``(10) provide a timely response system to ensure that
child-serving professionals and providers are properly
trained in youth suicide early intervention and prevention
strategies and that child-serving professionals and providers
involved in early intervention and prevention services are
properly trained in effectively identifying youth who are at
risk for suicide;
``(11) provide continuous training activities for child
care professionals and community care providers on the latest
youth suicide early intervention and prevention services
practices and strategies;
``(12) conduct annual self-evaluations of outcomes and
activities, including consulting with interested families and
advocacy organizations;
``(13) provide services in areas or regions with rates of
youth suicide that exceed the national average as determined
by the Centers for Disease Control and Prevention; and
``(14) obtain informed written consent from a parent or
legal guardian of an at-risk child before involving the child
in a youth suicide early intervention and prevention program.
``(d) Requirement for Direct Services.--Not less than 85
percent of grant funds received under this section shall be
used to provide direct services, of which not less than 5
percent shall be used for activities authorized under
subsection (a)(3).
``(e) Coordination and Collaboration.--
``(1) In general.--In carrying out this section, the
Secretary shall collaborate with relevant Federal agencies
and suicide working groups responsible for early intervention
and prevention services relating to youth suicide.
``(2) Consultation.--In carrying out this section, the
Secretary shall consult with--
``(A) State and local agencies, including agencies
responsible for early intervention and prevention services
under title XIX of the Social Security Act, the State
Children's Health Insurance Program under title XXI of the
Social Security Act, and programs funded by grants under
title V of the Social Security Act;
``(B) local and national organizations that serve youth at
risk for suicide and their families;
``(C) relevant national medical and other health and
education specialty organizations;
``(D) youth who are at risk for suicide, who have survived
suicide attempts, or who are currently receiving care from
early intervention services;
``(E) families and friends of youth who are at risk for
suicide, who have survived suicide attempts, who are
currently receiving care from early intervention and
prevention services, or who have completed suicide;
``(F) qualified professionals who possess the specialized
knowledge, skills, experience, and relevant attributes needed
to serve youth at risk for suicide and their families; and
``(G) third-party payers, managed care organizations, and
related commercial industries.
``(3) Policy development.--In carrying out this section,
the Secretary shall--
``(A) coordinate and collaborate on policy development at
the Federal level with the relevant Department of Health and
Human Services agencies and suicide working groups; and
``(B) consult on policy development at the Federal level
with the private sector, including consumer, medical, suicide
prevention advocacy groups, and other health and education
professional-based organizations, with respect to State-
sponsored statewide or tribal youth suicide early
intervention and prevention strategies.
``(f) Rule of Construction; Religious and Moral
Accommodation.--Nothing in this section shall be construed to
require suicide assessment, early intervention, or treatment
services for youth whose parents or legal guardians object
based on the parents' or legal guardians' religious beliefs
or moral objections.
``(g) Evaluations and Report.--
``(1) Evaluations by eligible entities.--Not later than 18
months after receiving a grant or cooperative agreement under
this section, an eligible entity shall submit to the
Secretary the results of an evaluation to be conducted by the
entity concerning the effectiveness of the activities carried
out under the grant or agreement.
``(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, collaborations, and consultations under this
section.
``(h) Rule of Construction; Student Medication.--Nothing in
this section or section 520E-1 shall be construed to allow
school personnel to require that a student obtain any
medication as a condition of attending school or receiving
services.
``(i) Prohibition.--Funds appropriated to carry out this
section, section 520C, section 520E-1, or section 520E-2
shall not be used to pay for or refer for abortion.
``(j) Parental Consent.--States and entities receiving
funding under this section and section 520E-1 shall obtain
prior written, informed consent from the child's parent or
legal guardian for assessment services, school-sponsored
programs, and treatment involving medication related to youth
suicide conducted in elementary and secondary schools. The
requirement of the preceding sentence does not apply in the
following cases:
``(1) In an emergency, where it is necessary to protect the
immediate health and safety of the student or other students.
``(2) Other instances, as defined by the State, where
parental consent cannot reasonably be obtained.
``(k) Relation to Education Provisions.--Nothing in this
section or section 520E-1 shall be construed to supersede
section 444 of the General Education Provisions Act,
including the requirement of prior parental

[[Page H6868]]

consent for the disclosure of any education records. Nothing
in this section or section 520E-1 shall be construed to
modify or affect parental notification requirements for
programs authorized under the Elementary and Secondary
Education Act of 1965 (as amended by the No Child Left Behind
Act of 2001; Public Law 107-110).
``(l) Definitions.--In this section:
``(1) Early intervention.--The term `early intervention'
means a strategy or approach that is intended to prevent an
outcome or to alter the course of an existing condition.
``(2) Educational institution; institution of higher
education; school.--The term--
``(A) `educational institution' means a school or
institution of higher education;
``(B) `institution of higher education' has the meaning
given such term in section 101 of the Higher Education Act of
1965; and
``(C) `school' means an elementary or secondary school (as
such terms are defined in section 9101 of the Elementary and
Secondary Education Act of 1965).
``(3) Prevention.--The term `prevention' means a strategy
or approach that reduces the likelihood or risk of onset, or
delays the onset, of adverse health problems that have been
known to lead to suicide.
``(4) Youth.--The term `youth' means individuals who are
between 10 and 24 years of age.
``(m) Authorization of Appropriations.--
``(1) In general.--For the purpose of carrying out this
section, there are authorized to be appropriated $7,000,000
for fiscal year 2005, $18,000,000 for fiscal year 2006, and
$30,000,000 for fiscal year 2007.
``(2) Preference.--If less than $3,500,000 is appropriated
for any fiscal year to carry out this section, in awarding
grants and cooperative agreements under this section during
the fiscal year, the Secretary shall give preference to
States that have rates of suicide that significantly exceed
the national average as determined by the Centers for Disease
Control and Prevention.''.
(d) Mental and Behavioral Health Services on Campus.--Title
V of the Public Health Service Act (42 U.S.C. 290aa et seq.)
is amended by inserting after section 520E-1 (as redesignated
by subsection (b)) the following:

``SEC. 520E-2. MENTAL AND BEHAVIORAL HEALTH SERVICES ON
CAMPUS.

``(a) In General.--The Secretary, acting through the
Director of the Center for Mental Health Services, in
consultation with the Secretary of Education, may award
grants on a competitive basis to institutions of higher
education to enhance services for students with mental and
behavioral health problems that can lead to school failure,
such as depression, substance abuse, and suicide attempts, so
that students will successfully complete their studies.
``(b) Use of Funds.--The Secretary may not make a grant to
an institution of higher education under this section unless
the institution agrees to use the grant only for--
``(1) educational seminars;
``(2) the operation of hot lines;
``(3) preparation of informational material;
``(4) preparation of educational materials for families of
students to increase awareness of potential mental and
behavioral health issues of students enrolled at the
institution of higher education;
``(5) training programs for students and campus personnel
to respond effectively to students with mental and behavioral
health problems that can lead to school failure, such as
depression, substance abuse, and suicide attempts; or
``(6) the creation of a networking infrastructure to link
colleges and universities that do not have mental health
services with health care providers who can treat mental and
behavioral health problems.
``(c) Eligible Grant Recipients.--Any institution of higher
education receiving a grant under this section may carry out
activities under the grant through--
``(1) college counseling centers;
``(2) college and university psychological service centers;
``(3) mental health centers;
``(4) psychology training clinics; or
``(5) institution of higher education supported, evidence-
based, mental health and substance abuse programs.
``(d) Application.--An institution of higher education
desiring a grant under this section shall prepare and submit
an application to the Secretary at such time and in such
manner as the Secretary may require. At a minimum, the
application shall include the following:
``(1) A description of identified mental and behavioral
health needs of students at the institution of higher
education.
``(2) A description of Federal, State, local, private, and
institutional resources currently available to address the
needs described in paragraph (1) at the institution of higher
education.
``(3) A description of the outreach strategies of the
institution of higher education for promoting access to
services, including a proposed plan for reaching those
students most in need of mental health services.
``(4) A plan to evaluate program outcomes, including a
description of the proposed use of funds, the program
objectives, and how the objectives will be met.
``(5) An assurance that the institution will submit a
report to the Secretary each fiscal year on the activities
carried out with the grant and the results achieved through
those activities.
``(e) Requirement of Matching Funds.--
``(1) In general.--The Secretary may make a grant under
this section to an institution of higher education only if
the institution agrees to make available (directly or through
donations from public or private entities) non-Federal
contributions in an amount that is not less than $1 for each
$1 of Federal funds provided in the grant, toward the costs
of activities carried out with the grant (as described in
subsection (b)) and other activities by the institution to
reduce student mental and behavioral health problems.
``(2) Determination of amount contributed.--Non-Federal
contributions required under paragraph (1) may be in cash or
in kind. Amounts provided by the Federal Government, or
services assisted or subsidized to any significant extent by
the Federal Government, may not be included in determining
the amount of such non-Federal contributions.
``(3) Waiver.--The Secretary may waive the requirement
established in paragraph (1) with respect to an institution
of higher education if the Secretary determines that
extraordinary need at the institution justifies the waiver.
``(f) Reports.--For each fiscal year that grants are
awarded under this section, the Secretary shall conduct a
study on the results of the grants and submit to the Congress
a report on such results that includes the following:
``(1) An evaluation of the grant program outcomes,
including a summary of activities carried out with the grant
and the results achieved through those activities.
``(2) Recommendations on how to improve access to mental
and behavioral health services at institutions of higher
education, including efforts to reduce the incidence of
suicide and substance abuse.
``(g) 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.
``(h) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $5,000,000 for fiscal year 2005, $5,000,000 for
fiscal year 2006, and $5,000,000 for fiscal year 2007.''.

The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Texas (Mr. Barton) and the gentleman from Ohio (Mr. Brown) each will
control 20 minutes.
For what purpose does the gentleman from New Jersey (Mr. Garrett)
rise? Do any of the gentlemen oppose this legislation?
Mr. BROWN of Ohio. Mr. Speaker, I support the legislation.
The SPEAKER pro tempore. Is the gentleman from Ohio opposed?
Mr. BROWN of Ohio. I do not oppose. I support.
The SPEAKER pro tempore. Under the rule, half the time will go to the
gentleman from New Jersey (Mr. Garrett).
The gentleman from Texas (Mr. Barton) is recognized.
Mr. BARTON of Texas. Mr. Speaker, I ask unanimous consent that of the
20 minutes that I control, the gentleman from Ohio (Mr. Brown) have the
right to control 10 minutes of that time.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.

General Leave

Mr. BARTON of Texas. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days within which to revise and extend
their remarks and include extraneous material on this bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. BARTON of Texas. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise in support of S. 2634, as amended. I am pleased
that the House is considering this legislation which is authored with
the intent to improve access to quality health care to individuals
suffering from mental and behavioral health problems that can lead to
suicide.

{time} 1930

Last year, over 4,000 young men and women in our great country
resorted to the ultimate act of denial by committing suicide. Senator
Gordon Smith of the other body has been the lead advocate for this
legislation, and the bill is named in his son's honor, who,
unfortunately, committed suicide last year, I think on this date. So we
are here under the leadership of Senator Gordon Smith to try to do
something legislatively to prevent future young Americans from
resorting to suicide.
I have had a young staff member on my staff last spring also commit
suicide; so while I have not had the sacrifice or the tragedy that
Senator

[[Page H6869]]

Smith has had, I have been touched by suicide on my congressional staff
down in Texas. I can tell you, as one would expect, that it is a very
devastating experience. It is incredibly painful. It is a pain that is
exacerbated when you see how your family and friends are burdened with
grief because of an action like this. It is my sincere hope that the
legislation the House is considering this evening, which the other body
has already passed, will indeed help those who are troubled and are
thinking about committing suicide in the future.
This bill is a 3-year authorization bill that provides educational
and support programs for children at risk of suicide. These suicide
programs would be administered through a grant program through the
States. It reflects a balanced and reasonable compromise that allows
parents to have a direct role in determining whether their children
participate in these long-range programs. At the same time, when there
is a young man or woman in our country who is actively contemplating
suicide, the bill would allow that emergency intervention could be done
without any consent so that we stabilize that individual and prevent
them from actually committing the suicide act at the time they are
contemplating it.
The compromise before us this evening does not modify in any way or
affect any existing requirement under the No Child Left Behind Act. It
is my hope that in the next Congress the House Committee on Energy and
Commerce, which I have the privilege to chair, will systematically
reauthorize many of the expired programs and even expired agencies at
the Department of Health and Human Services.
One of those agencies that we intend to look at very closely is the
Substance Abuse and Mental Health Services Administration, or SAMSHA,
which has primary responsibility to improve mental health services
across this country. I am strongly inclined to rework several of the
mental health service programs currently in effect at SAMSHA so that we
are sure that the funding programs actually produce measurable results
and the kind of results we intend those programs to produce. Without a
doubt, as a part of our review of the SAMSHA program, I will pay close
attention to SAMSHA's work in the area of suicide prevention.
Mr. Speaker, I want to thank the subcommittee chairman, the gentleman
from Florida (Mr. Bilirakis); the ranking member of the full committee,
the gentleman from Michigan (Mr. Dingell); and the subcommittee ranking
member, the gentleman from Ohio (Mr. Brown), for their cooperation in
this legislation. I would also like to commend the gentleman from
Tennessee (Mr. Gordon) and the gentleman from Oregon (Mr. Walden) for
their help on the House side in improving this legislation. And,
finally, I would like to thank the Speaker of the House and the
majority leader for their assistance in expediting this bill as it
comes to the floor today.
Mr. Speaker, I would encourage my colleagues to support the
legislation.
Mr. Speaker, I reserve the balance of my time.
Mr. GARRETT of New Jersey. Mr. Speaker, I yield myself such time as I
may consume.
There is probably no more serious topic that we could be discussing
this evening than we are right now when we are discussing suicide,
especially when we are discussing suicide of young people. It is a
serious topic, and it is an emotional topic.
Earlier today, Mr. Speaker, I heard someone say in the Chamber that
this House, as we move along and make changes, we do not always make
large changes or great changes at one time; we may only be making
changes incrementally. And my response to that was I am all in favor of
incrementally moving the agenda along, just so long as we are moving it
in the right direction and not in the wrong direction, a harmful
direction, or a hurtful direction. I want to be moving the agenda along
in a direction that is guided by facts and thought and planning and not
by emotion.
We just heard that this bill is moving along in an expedited fashion,
and that is true. We are here tonight on a bill, on a piece of
legislation, spending $82 million that would create two new Federal
programs that never existed before, a new technical center that will
deal with this issue as well; and yet there has never been an
opportunity for input, discussion, a vote, or consideration in a
committee. This bill has never gone in this House to a committee for a
hearing, for a complete markup in a formal manner.
If you are a parent and you have thoughts on this topic, you are
concerned about your children or other children in your community, you
have not had the opportunity to have your say, to have your feelings,
to have your thoughts heard in a committee on this subject. If you are
an expert in this field, a psychologist, psychiatrist, mental health
association or the like, and you have thoughts about what would be best
for our children or what would be harmful to our children, you too have
not had the opportunity to have your thoughts or your opinions heard in
a formal committee manner.
So it is correct when we hear that this legislation is moving in an
expedited format, without the committee process and already to the
floor.
Now, before this bill came up, we were talking about another topic,
and I heard a lot of talk about the deficit and what grave financial
straits we are in. I hope they continue with those feelings when we
consider a bill that is $82 million in the making for the first 3
years, and how much after that no one knows.
There was an article today in National Review that addresses this
piece of legislation. It says, ``Occasionally a bill hits Capitol Hill
over which there is remarkably little debate. This bill is an extreme
example of that. Actually, according to news reports, there is no
debating the bill, which provides additional Federal funding for
suicide prevention programs in U.S. schools.'' It goes on, ``Well, of
course if you are against suicide, you are for the bill; right?''
Well, we really do not know. I am certainly against suicide. Everyone
in this House is against suicide. But are we all for the bill? Are
parents all for the bill? Are the experts all for the bill? The article
goes on to point out that, ``No, the experts are not all for the
bill.'' The Journal of the American Medical Association, the American
Academy of Child and Adolescent Psychiatry have reported on this topic
of suicide prevention programs, such as this bill addresses, and they
reported, ``Suicide awareness programs in schools have not been shown
to be effective either in reducing suicidal behavior or in increasing
help-seeking behavior. Most kids who take their own lives are mentally
ill. They need help, help that a school suicide prevention program is
not going to provide them.''
``For some of the children, these new federally funded programs,'' as
it says in the article, ``would reach awareness, putting ideas in their
already normally confused adolescent heads.'' Conclusion: ``Such
programs,'' as we are talking about tonight, ``could actually be
harmful.''
Let me go back to the issue of family and the like. We have to ask:
Is this yet again another encroachment on the family, on the parent-
child relationship, one in which the Federal Government should at least
ask for input and thought before we start creating new Federal programs
on this level?
In the end, are these programs, we should be asking ourselves, more
harmful than helpful? The experts seem to indicate more harmful.
Another expert, David Shaffer, M.D., Columbia College of Physicians and
Surgeons, talking on the subject and doing research at Columbia
University supported by grants for the Centers for Disease Control,
suggests that ``case findings that involve giving lessons or lectures
about suicide either to encourage suicidal students to identify
themselves or to teach other students or teachers how to identify the
suicidal teenager is not effective, and in some instances may undermine
protective attitudes about suicide.''
Furthermore, from Dr. Shaffer and others, ``self-identified
attempters were less likely to approve of these programs, and there was
little evidence that the programs were successful in influencing their
views. There was some evidence that previous attempters were more upset
by the programs than nonattempters were.''
Again, the experts are showing that these programs that we are now
spending money on may be more harmful than good.

[[Page H6870]]

There was a case several years ago in Michigan where a second grade
boy killed himself in the spring of the year, the day after watching a
film in a suicide prevention class such as what we are talking about
today. People who knew the young boy said that he was a happy child who
had just been accepted into the school's gifted and talented program,
and he was not depressed at all at the time of his death. Many think
that he was merely mimicking what he saw in the movie in the suicide
prevention program and had no intention to die. In the movie, the boy
who tries to hang himself to commit suicide is rescued by his friends.
In real life, that did not occur, and the 8-year-old boy, having
attended a suicide prevention program, killed himself.
As a parent, one also has to ask, where does the time come to do all
these things in our schools? We already ask of our teachers so much, to
teach all the curriculum already. Now we are adding an additional
burden on the schools as well. I have talked to parents who have had
their kids in public schools and have taken them out and either put
them into private schools, Catholic schools, parochial schools, or home
schooling. When I ask them why they do it, they say, because they
realize the public schools are no longer focused on what they are
supposed to be focusing on, and that is educating their kids. Instead,
they are involved in so much other social programming, such as this.
So we have to ask ourselves this question as well: Does this program
address the needs of our schools as being able to fulfill their
obligation to teach our kids?
Next, we have to ask the question: Is this enough money, $82 million?
Now, to me, that sounds like a lot of money; but if we are talking
across the entire country for a 3-year period of time, I hazard a guess
that next year and the year after that that people will be coming back
and saying this was just a drop in the bucket and that we will have to
spend even more.
I figured it out just briefly in my head sitting over there earlier.
This would provide my county in New Jersey maybe one new counselor, if
it was spread evenly across the country. One counselor for my entire
county. What about all the schools in that county? Will they not be
looking for assistance as well, all the other services in the county?
$82 million is not going to go that far.
Now, it is set up as a 3-year program. In actuality, the bill that I
am looking at talks about how much money we spend for the first 3
years; but if we look at the fine print, it details $7 million one
year, $16 million the next year, and $25 million the next year. That is
3 years. But thereafter it says ``and such sums as may be necessary for
each of the fiscal years 2008 and 2009.'' So, in reality, it is saying
we know how much it is going to cost for the first 3 years, but after
that it is anybody's question, as people come back asking for more.
In the end, suicide is an emotional topic. The legislation we are
dealing with today is an emotional topic. It is one that deserves our
thoughtful time, it is one that deserves input from parents and experts
alike, and so, therefore, Mr. Speaker, I would recommend to vote
against this bill, or, better yet, to allow this bill to go back to
committee for further consideration.
Mr. Speaker, I reserve the balance of my time.
Mr. BROWN of Ohio. Mr. Speaker, I yield myself 1 minute.
Mr. Speaker, I want to thank my colleagues, the gentleman from
Tennessee (Mr. Gordon), the gentleman from Texas (Mr. Barton), the
gentleman from Florida (Mr. Bilirakis), and the gentleman from Michigan
(Mr. Dingell), for their dedication to this bill. I also want to
commend Cheryl Jaeger and John Ford of the staff of the Committee on
Energy and Commerce for their good work.
Youth suicide is an issue that strikes a deeply personal chord for
all too many Americans. An intern in my office lost five classmates to
suicide, the most in her school's history. This legislation recognizes
that the causes of youth suicide are complex and individual; but every
one of these tragedies is, in fact, preventable. It reflects the fact
that preventing suicide requires an approach that is both comprehensive
in its scope and targeted toward the populations most at risk.
We will continue to work with the Department of Health and Human
Services and mental health advocates to address one outstanding issue
concerning parental consent; however, it makes sense to move forward
and ensure that the good ideas in this bill are implemented as soon as
possible.
This legislation honors the courage of the families both within this
Congress and across the country who have endured the tragedy of youth
suicide and who seek to stop this crisis in its tracks. I am pleased to
support this important legislation.
Mr. BARTON of Texas. Mr. Speaker, I yield 3 minutes to the gentleman
from Oregon (Mr. Walden).

{time} 1945

Mr. WALDEN of Oregon. Mr. Speaker, I rise today in support of the
Garrett Lee Smith Memorial Act. I extend sincere condolences to my
colleague, friend, constituent and fellow Oregonian, Senator Gordon
Smith, sponsor of this act, and his family.
It was exactly 1 year ago today that the Smith family was changed
forever when Garrett Lee Smith took his life. As the father of a son
myself, my heart aches for Gordon and Sharon, and the Smith family
remains in our prayers. After Garrett's death, the Smith family's
selfless dedication to shining the public spotlight on the tragedy of
youth suicide and saving other families from the devastation of suicide
is truly inspiring.
Upon realizing that suicide is the third leading cause of death for
15- to 24-year-olds, Senator Smith identified gaps in our public health
infrastructure and crafted a bill to assist States, localities, tribal
communities and college campuses in establishing youth suicide
prevention programs. These programs will include prevention screening,
early intervention, management and education activities.
Suicide is an unspeakable tragedy. However, the provisions of the
Garrett Lee Smith Memorial Act encourage young people to speak up about
suicide, importantly to seek assistance when they are feeling hopeless
or depressed, and to make sure they have access to trained specialists
to help them make sense of the emotions that are overwhelming them. It
also provides families and friends of at-risk youth with information
and resources to support these very fragile people.
There may be a misconception about this useful bill by some of my
colleagues here in the House. Under no circumstances will this bill
force parents to medicate their children as a condition of attending
public school. In fact, it explicitly prohibits funds to be spent in
such a way. Additionally, it does not allow schools to force children
to attend school assemblies, undergo screenings for depression or
receive treatment for depression without the written consent of a
parent or guardian. It requires parental consent and involvement.
The bill requires that States and entities receiving funding under
this grant program shall obtain prior written informed consent from the
child's parent or legal guardian for assessment services, school-
sponsored programs, and treatment involving medication related to the
youth suicide conducted in elementary and secondary schools. So there
is a very important provision for parents to be involved. Prior
requirements do not apply if it is an emergency, as the chairman talked
about.
This bill comes to the House floor as a result of delicate
negotiation at the Member level and hard work at the staff level. I
want to thank especially the gentleman from Texas (Chairman Barton) and
the subcommittee chairman, the gentleman from Florida (Mr. Bilirakis),
and the gentleman from Ohio (Mr. Brown) and others for facilitating
this bill's swift movement to the floor. All of these gentlemen were
gracious and worked closely with Senator Smith to ensure that the
Garrett Lee Smith Memorial Act would be considered by the House on this
very day.
I encourage my colleagues to support the Garrett Lee Smith Memorial
Act. In closing, I echo the words of Senator Smith, my constituent.
``Suicide and attempts do not simply leave an impression on the
individual's life, it leaves a deep impact on everyone who knows the
person or a family member of that person. No family should experience
the pain we have suffered and no

[[Page H6871]]

child should suffer the challenges of mental illness alone.''
Mr. GARRETT of New Jersey. Mr. Speaker, I yield such time as he may
consume to the gentleman from Iowa (Mr. King).
Mr. KING of Iowa. Mr. Speaker, I thank the gentleman for yielding me
this time.
Mr. Speaker, I believe every life is a precious creation and that
suicide is a tragic and terrible way to lose a family member or friend.
One would automatically assume if you are against suicide, you will
vote in favor of this bill; however, nothing could be further from the
truth. We all want to stop suicide. Some of our most precious resources
are our young people, and that resource must be preserved and promoted.
Our children and teenagers are too valuable to be used as guinea pigs
on this issue. The gentleman from New Jersey spoke of the movie
Nobody's Useless, and I will not reiterate that here now, but that will
not be the only case across this country where exposure to suicide
discussion has actually brought on suicide. While this legislation does
not fund suicide education for children under the age of 10, it did
start out younger than the age of 10. I do not think we need to take
chances with our young people. Awareness could put ideas into the heads
of children and teenagers that are already at an awkward time in their
lives.
I would point out what happens when we do sex education and antidrug
education. It is hard to find a program that resulted in less drug use
or less sexual activity on the part of young people because they are
made aware of something they may be afraid of. The more they talk about
something, the more comfortable they get with it, the more likely they
are to experiment.
Research at Columbia University has suggested that encouraging
suicidal students to identify themselves or to teach other students or
teachers how to identify the suicidal teenager is not effective and in
some instances may even undermine protective attitudes about suicide.
In other words, the creation of this program can actually be harmful to
our youth.
In addition, we should also be asking ourselves is this really the
role of the Federal Government. Federal money usually has strings
attached to it. We do not know enough about how the grants will be
distributed to know what these strings will be, but this legislation is
just one more way that the government is encroaching on the lives and
health care of private citizens and the parental role. Suicide
prevention is best done through private counseling, faith-based groups,
and within the nucleus of the family unit.
I know of no successful suicide prevention programs. We should be
able to find at least one successful model program somewhere in this
world before we invest $82 million in a new, untried program.
In conclusion, while I believe this bill is offered with good will
and absolutely with the best intentions, and with broken hearts as
well, we need to take a step back and realize that suicide is based on
emotion, and it was from emotion that this bill was created.
My heart goes out to those who have lost loved ones to suicide, and
for that reason I ask my colleagues to vote no on this bill.
Mr. BROWN of Ohio. Mr. Speaker, I yield 4 minutes to the gentleman
from Tennessee (Mr. Gordon), the sponsor of the bill, who has been a
leader on this issue.
Mr. GORDON. Mr. Speaker, I thank the gentleman from Ohio for helping
bring this bill forward.
Mr. Speaker, let me first follow up on the comments of the gentleman
from Texas (Mr. Barton) that this bill really originated from a tragedy
in Senator Gordon Smith's family. We all respect him for his courage in
bringing this up, and our condolences go out to the Smith family on the
first anniversary of that tragedy.
I also thank the gentleman from Texas (Chairman Barton) for his hard
work in expediting this bill. When this was taken to him earlier, he
said he would do his best to bring it up. And as he always does, he not
only did his best, he accomplished it, and I thank him for that.
Unfortunately, it is certainly no fault of the chairman that this
Garrett Lee Smith Memorial Act which started out as a bipartisan
agreement is now mired in political extremism and really bizarre
anecdotes. Let me be clear. I support the Senate version of this bill.
The bill passed that body unanimously with the support of the White
House. I sponsored the companion bill in the House. Unfortunately, a
small group in the House have insisted on inserting language that
undermines the very programs we are seeking to encourage.
The language would require schools to treat suicide prevention
programs differently from all other school-sponsored programs,
requiring prior written parental permission for a child to even attend
a suicide prevention and awareness event. This would make suicide-
prevention programs the only type of school-sponsored program with such
a requirement.
Suicide is a silent epidemic in this country. There are about 600,000
teen suicide attempts each year that require emergency room care and
hundreds of thousands more that are never reported. It is the third
leading cause of death for older teens and the fourth leading cause of
death for ages 10 to 14. Making it harder for schools to sponsor
suicide-prevention programs undermines the goals of this legislation,
and it perpetuates the very stigma that we are trying to overcome, and
that is it is not okay to talk about youth suicide.
Groups which have advised on this bill, including the National Mental
Health Association, the Suicide Prevention Action Network, and the
American Academy of Child and Adolescent Psychiatry, oppose this
language. It puts passage in the Senate in question, and it puts hope
of seeing this measure quickly reach the President in jeopardy.
Mr. Speaker, while in Congress I have witnessed some frustrating
moments, and this one ranks right up there at the top. Regrettably, it
is increasingly rare these days for Members of Congress to set aside
partisan politics, but we tried to do so on this bill because it was in
the best interest of our Nation.
However, in memory of our constituents and my colleagues' children
who have lost their lives to suicide, I will reluctantly vote for this
bill to keep this critically important legislation from dying in the
House. I hope that this problematic language will be modified in the
Senate.
Mr. BARTON of Texas. Mr. Speaker, I yield 2 minutes to the gentleman
from Nebraska (Mr. Osborne) who has been directly involved in these
programs.
Mr. OSBORNE. Mr. Speaker, I would like to thank the gentleman from
Texas for his help on this bill. I am going to suspend my otherwise
prepared remarks and try to address some of the concerns that we have
heard here this evening about this bill.
Mr. Speaker, 4,000 young people die per year from suicide, and I
guess what we are being told here is we do not know of anything that
will work, and this bill really may make things worse, and we may
actually cause some people to take their lives. I would just like to
mention what the bill is all about.
Part 1 provides grant funding to States for development of a youth
suicide prevention and intervention strategy. That does not necessarily
mean that you go in and show films to kids of other kids killing
themselves. It does not mean that you go out and hire a bunch of
counselors to go into schools and tell kids do not kill yourselves. It
may mean that you work with coaches and teachers to identify the signs,
because there are very, very few suicides which occur where there are
not some indications. It may be a term paper, a theme, it may be a
comment in the locker room. So we can build awareness with those people
who work with young people, and that is important.
Some young people do not know that steroids are a leading cause of
suicide. This is an education issue. Steroid precursors can be bought
over the counter and cause untold number of suicides each year. People
are not aware of that.
This bill provides for screening programs that can identify mental
health and behavioral conditions. There are certain medical conditions
out there that make people more subject to suicide. It may be a
personal tragedy that has occurred; it may be a friend who has
committed suicide. These people can be watched more closely. There

[[Page H6872]]

may be things which could be done. You do not have to go tell them, do
not kill yourself.
Lastly, the bill establishes the Federal Suicide Prevention Technical
Assistance Center. People have said here, we do not know what works.
That is what this center is for, to find out what strategies do work.
That is the whole thing about it.
Mr. GARRETT of New Jersey. Mr. Speaker, I yield myself 1 minute to
respond.
Many times in this House we do things for symbolic purposes, and I am
not suggesting that this legislation is being done for symbolic
purposes, but I do have to raise the question, as I did earlier, as to
just what extent this bill may be successful if everything goes right.
As I indicated before, we are spending at $82 million. That
translates into around the addition of one new guidance counselor in
every county in my State. So we have to question really are we
providing any new services to the majority of kids, or are we just
lifting up hopes and also the expectations of future calls for greater
spending on these programs?
As to the aspect of additional harm that may come from this, that is
the very nature of the question that I raise here. We have yet to hear
of any testimony in this body as to what is the nature of the benefits
of this, from academic institutions, parents or otherwise, how this may
benefit the students. Anecdotally we may have some, but I would think
before we get into such a critical area as dealing with the mental
state of our kids that we would want to have that information on hand.
Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman
from Illinois (Mr. Davis).
(Mr. DAVIS of Illinois asked and was given permission to revise and
extend his remarks.)
Mr. DAVIS of Illinois. Mr. Speaker, I rise in support of S. 2634 and
commend Senator Gordon Smith and his family for helping to put the
spotlight on this problem. I am happy to be the original sponsor, along
with the gentleman from Nebraska (Mr. Osborne), for the second part of
this legislation dealing with the mental and behavioral health of young
people on our college campuses.

{time} 2000

I was pleased to have our bill, H.R. 3593, the Campus Care and
Counseling Act, combined with the gentleman from Tennessee's suicide
bill to produce the Garrett Lee Smith Memorial Act. According to a
survey described in the Chronicle of Higher Education in 2002,
depression among college freshmen has nearly doubled, from 8.2 percent
to 16.3. Along with depression, the number of suicidal students tripled
and the number of students seen after a sexual assault quadrupled.
Without treatment, researchers noted that depressed adolescents are at
risk for school failure, social isolation, promiscuity, self-medication
with drugs and alcohol, and suicide.
I agree with the gentleman from Tennessee relative to some of the
parental consent language. However, it is a good bill that leads us in
the direction of dealing with a major health problem. Again I thank the
gentleman from Ohio for yielding me this time.
Mr. BARTON of Texas. Mr. Speaker, I reserve the balance of my time.
Mr. GARRETT of New Jersey. Mr. Speaker, I yield myself such time as I
may consume.
Again I have to say it, the topic that we are dealing with is an
extremely emotional one; and I take nothing away from what the sponsors
are attempting to do with this legislation. And I take nothing away
from the families that have suffered from the pains and arrows of going
through this. All I say is that the best method of addressing this
issue was perhaps, not perhaps, absolutely not followed in this
procedure, that the parents in our communities have the right to have
their say to make sure that we have the best system of taking care of
their kids; that the experts, the doctors, the academies, have the
right to have their say as to what are the best procedures as far as
addressing the issue of suicide in schools. Finally, it ultimately
falls upon our families and our parents to make sure that we are
bringing our kids up in the correct manner.
This legislation does not address that at all. This legislation
simply expands once again the size and the scope of the Federal
Government into an area where we have not heard any testimony tonight
and never had the opportunity to hear testimony in the past to say
whether this system will do more harm than good.
Therefore, Mr. Speaker, I would suggest a ``no'' on this bill.
Mr. Speaker, I yield the balance of my time to the gentleman from
Texas (Mr. Barton).
The SPEAKER pro tempore (Mr. Pearce). Without objection, the
gentleman from Texas will control the balance of the time.
There was no objection.
Mr. BARTON of Texas. Mr. Speaker, could I ask since the distinguished
gentleman from New Jersey has yielded to me the balance of his time,
how much time that means I now have.
The SPEAKER pro tempore. The gentleman from Texas has 6\1/2\ minutes,
and the gentleman from Ohio (Mr. Brown) has 4 minutes.
Mr. BROWN of Ohio. Mr. Speaker, I yield the balance of my time to the
gentleman from Oregon (Mr. Blumenauer).
The SPEAKER pro tempore. The gentleman from Oregon is recognized for
4 minutes.
Mr. BLUMENAUER. Mr. Speaker, I appreciate the gentleman's courtesy,
and I appreciate the way that we are reallocating time a little bit to
permit serious discussion of a serious topic. I deeply appreciate the
expeditious way that the Committee on Energy and Commerce has moved
forward with this. As my friend and colleague from Oregon pointed out,
we have sort of a special sense in our State, but I must take exception
with our colleagues who are rising in opposition of the philosophy
somehow if we do not talk about this with our young people, if we do
not establish programs, that it is going to go away.
I would suggest that one of the reasons we have an epidemic of
teenage suicide, especially among young men in this country, is because
too few people do focus on the big picture, what it really means.
Perhaps because it is so horrible, we do not really allow the reality
to penetrate. But in a typical week in our State, there is more than
one teenager who will take their life and about three in a typical day
will be treated in an emergency room because of a failed attempt.
Somebody who has worked to bring this out of the shadows and to put a
face on these serious tragedies, to spare other families, not to tuck
it away and assume that everything is going to be all right but to see
what we can do to craft a solution that will spare people is our friend
and colleague Senator Gordon Smith. As has been noted on the floor,
Gordon and his wife, Sharon, lost their son who is memorialized in this
act. This is a tremendously positive response that has grown out of a
personal family tragedy.
Frankly, I was disappointed in the changes that were added to this
legislation, but I would take this for what it is, a positive start;
and I appreciate what the committee has done. We are authorizing $82
million over the next 3 fiscal years. In our great country of almost
300 million people, this is truly a very small and modest beginning,
but it is important.
I am pleased that it speaks to the establishment of a national
center, so perhaps we will have more compelling evidence for people to
step forward and join in this effort. I am pleased that it will provide
resources for statewide programs and especially programs run by Native
American tribes where that need is especially acute. It is encouraging
that we would establish new grants for mental and behavioral health
services at colleges and universities. This is an important start, to
let these young people who sadly have wrestled with these demons, let
them know that they are not alone, let them know that there are
services, that people do care and for us to experiment in ways to do a
better job.
In Oregon, we have a special interest not only in the courageous way
that the Smith family has responded to trying to help other families
but ours is a State with a suicide rate that is 40 percent higher than
the national average. We all have an incentive to do our part. There is
not a Member in this Chamber that has not either been touched directly
in their family or by people

[[Page H6873]]

close to them that they know and love. We have had cases on the floor
of our colleagues just in the short time that I have been in Congress.
I am hopeful that we can seize on the opportunity to approve and then
improve this legislation, build upon it and to share in carrying this
message to Congress and through Congress back to our communities. By
our action, we can join the Smith family to help spare others this pain
in the future. I appreciate the work of my colleagues on the committee.
Mr. BARTON of Texas. Mr. Speaker, I yield 2 minutes to the
distinguished gentleman from Nebraska (Mr. Osborne), who has been
involved in programs to prevent suicide in Nebraska for a number of
years.
Mr. OSBORNE. Mr. Speaker, I thank the chairman for yielding me this
time. I am sorry I had to be rushed earlier, and I thank him for giving
me this extra time.
In regard to the expeditious manner in which this bill has
progressed, it actually started back in July. I know that there has
been a tremendous amount of interplay and work over the last 6, 7, 8
weeks. There has been a lot of give-and-take and a lot of valuable
discussion. The thing that I did not get to talk about that I wanted to
mention is that from 1952 to 1995, we have three times the number, the
rate of suicides, in this country as we did in 1952. This is a national
epidemic. So to say that we really should not do anything or we should
really go slow for some reason rubs me the wrong way.
The other aspect of the program that I wanted to mention today is the
college mental health services. A survey regarding college students
indicated that 60 percent of college students feel hopeless. More than
40 percent report being depressed. And 9 percent are suicidal. On the
college campus, we have tremendous problems with this issue. You do not
have to again go to these students and say, do not kill yourself. We do
not have to show them films, but we do have to persuade them that it is
not unmanly or it is not weak on the part of a woman to express your
problems, to go to a mental health service, to talk things out, to be
open with what is bothering you. These are the kinds of things that
need to happen.
Part of this funding will simply go to enhance the mental health
services on the college campus. This is not money that will be badly
spent. This is something that is desperately needed. Again, Mr.
Speaker, I thank the gentleman from Texas for his work.
Mr. BARTON of Texas. Mr. Speaker, I yield myself the balance of my
time.
First of all, I want to comment on the procedural aspects of the
consideration of this legislation. I think the gentleman from Tennessee
(Mr. Gordon) pointed out a bill similar to this passed the other body
100 to zero. That is a phenomenal accomplishment considering that the
other body this year many days has not even agreed on whether the Sun
rises in the east or the west. But on this particular piece of
legislation, they passed it 100 to zero.
The President of the United States, President Bush, and his
legislative aides contacted my office immediately and asked us to
expedite consideration of this legislation on the floor of the House.
We took the bill that passed the other body, we looked at it and we
felt like, as well-meaning as it was, that in many cases it was
duplicative and it could be improved if we made some changes.
To his credit, when we called Senator Smith, he agreed to work with
us on that process. We attempted to bring the bill up the last day
before we adjourned for the August work period. There were still some
concerns that could not be worked out. That bill could only come up
under unanimous consent. The minority leader, the gentlewoman from
California, agreed to it, the majority leader the gentleman from Texas
agreed to the unanimous consent, but there were some Members on the
Republican side that still had concerns, so we pulled the bill that
night. We spent the August work period working at the staff level to
try to iron out the differences. I submit with no apology that the bill
that is before us today as a result of those extra days and hours of
consultation is a better bill.
It requires that 85 percent of the funds expended have to be spent on
direct services. So this is not an overhead bill. This is a direct-
services bill. It requires that when grants are awarded to institutions
that have existing programs, there be a dollar-for-dollar match, that
the institution that already has a program has to match through
services or in-kind contribution or direct dollars, dollar for dollar,
the amount of the grant that they are receiving. There is a requirement
in the legislation before us that there is an outcome-based assessment
each year, so that as we begin to implement some of these programs, we
actually go in and make sure that in future years we only award grants
to programs that actually do have results in a positive way. I am very
proud of that.
In terms of the parental consent section of the bill, which was the
most difficult to find a compromise, we agreed that if there is an
emergency situation where direct intervention needs to be conducted to
prevent an individual from committing suicide, that that can be done
immediately and to whatever extent is necessary so that we stabilize
that individual and prevent him from taking his life. But once that
occurs, before there is any entry into a long-term program, the parents
have to be notified and they have to consent in writing that their
child can be involved in that long-term program. I personally think
that is a very, very reasonable compromise.
One can argue that the Federal Government should not be involved in
early intervention and suicide prevention. That is a reasonable
position to take. But given the fact that 4,000 of our young people
killed themselves last year and that, as the gentleman from Nebraska
has pointed out, suicide rates among our young people have tripled in
the last 40 years, I think it is wise for the Federal Government to be
involved. Every life that we save is a future productive citizen who is
going to contribute to our society and to our country. I strongly agree
that we should be involved with a Federal program that helps in that
area.
I would point out that this bill is a 3-year authorization bill. It
is not a permanent expansion of any program. It is a 3-year
authorization. As I said earlier, as we go through each year, the
programs that are granted have to be evaluated on an outcomes basis. I
think Members on both sides of the aisle, whether they are
conservatives or liberals or moderates, regardless of whatever region
of the country they come from, can sincerely and enthusiastically
support this bill tomorrow when it comes to a vote. It is a good bill.
I am proud that we have helped Senator Smith memorialize his son, the
late Garrett Lee Smith; and I would hope that we get a unanimous vote
tomorrow on this important piece of legislation.
Mr. Speaker, I yield back the balance of my time.
Mr. DINGELL. Mr. Speaker, I rise in support of S. 2634, the ``Garrett
Lee Smith Memorial Act.'' This bill contains a variety of programs
aimed at youth suicide early intervention and prevention, including
campus mental and behavioral health service centers.
Mr. Speaker, I urge my colleagues to read the findings in this bill.
They contain alarming statistics on the incidence of youth suicide in
this country. For example, according to the CDC, suicide is the third
overall cause of death among college age students. More than 4,000
children and young adults take their life each year, and the rate of
youth suicides in increasing. The American College Health Association
reports that 9 percent of college students have felt suicidal.
While this bill contains many find provisions, it does contain
language on parental consent that has drawn expressions of concern from
a variety of mental health advocates. I hope that as this bill moves
further along in the legislative process we can modify it further so
that these concerns are reduced or eliminated. I also note that the
bill before us contains an important rule of construction that makes
clear that this legislation does not modify or affect current law on
parental consent applicable to elementary and secondary education
programs, including the law popularly known as No Child Left Behind.
Mr. Speaker, I want to compliment my colleagues for the fine work
they have done on this bill and I want to take particular note of the
outstanding work of my good friend, Representative

[[Page H6874]]

Bart Gordon and our Chairman, Representative Barton.
Mr. WU. Mr. Speaker, I rise in strong support of the Garrett Lee
Smith Memorial Act.
I wish this bill were not necessary. Unfortunately, it is. Youth
suicide is a growing problem that knows no geographic, cultural,
racial, or socioeconomic bounds. More children and young adults die
each year from suicide than from cancer, heart disease, AIDS, birth
defects, stroke and chronic lung disease combined.
More troubling, the rate of youth suicide has tripled in the last 50
years. A recent study by the American College Health Association found
that 61 percent of college students report feeding hopeless, 45 percent
said they feel so depressed they could barely function, and 9 percent
felt they were suicidal.
The Garrett Lee Smith Memorial Act would provide critically important
resources to help families, educators, and medical professionals better
understand the warnings signs of a child in danger and foster better
coordination and communication to come up with the best ways to prevent
another painful loss.
Specifically, the bill would authorize $82 million over 3 years to
support efforts at the community, state, and Federal levels to enhance
early intervention and prevention services. Federal funds would provide
mental health services (e.g., screening, assessment, mentoring,
counseling etc.) to children and young adults in a variety of youth-
oriented settings such as schools, juvenile justice systems, foster
care, substantive abuse and mental programs. It would also help
establish, and coordinate evaluation of the efficacy of early
intervention and prevention programs specifically related to youth
suicide.
Mr. Speaker, this bill is named in memory and in honor of Senator
Gordon Smith's son who tragically took his life after struggling with
bipolar disorder. I admire Senator Smith and his wife, Sharon, who
returned their family tragedy into something that will benefit other
families. By sharing their story with others, they are raising
awareness of this growing problem that I know will help prevent other
youth suicides.

{time} 2015

The SPEAKER pro tempore (Mr. Pearce). The question is on the motion
offered by the gentleman from Texas (Mr. Barton) that the House suspend
the rules and pass the Senate bill, S. 2634, as amended.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds of
those present have voted in the affirmative.
Mr. GARRETT of New Jersey. Mr. Speaker, on that I demand the yeas and
nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this motion will be
postponed.

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