[Congressional Record Volume 153, Number 155 (Monday, October 15, 2007)]
[House]
[Pages H11511-H11513]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   MELANIE BLOCKER-STOKES POSTPARTUM DEPRESSION RESEARCH AND CARE ACT

  Ms. BALDWIN. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 20) to provide for research on, and services for individuals 
with, postpartum depression and psychosis, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 20

       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 ``Melanie Blocker-Stokes 
     Postpartum Depression Research and Care Act''.

     SEC. 2. FINDINGS.

       The Congress finds as follows:
       (1) Postpartum depression is a devastating mood disorder 
     which strikes many women during and after pregnancy.
       (2) Postpartum mood changes are common and can be broken 
     into three subgroups: ``baby blues'', which is an extremely 
     common and the less severe form of postpartum depression; 
     postpartum mood and anxiety disorders, which are more severe 
     than baby blues and can occur during pregnancy and anytime 
     within the first year of the infant's birth; and postpartum 
     psychosis, which is the most extreme form of postpartum 
     depression and can occur during pregnancy and up to 12 months 
     after delivery.
       (3) ``Baby blues'' is characterized by mood swings, 
     feelings of being overwhelmed, tearfulness, irritability, 
     poor sleep, mood changes, and a sense of vulnerability.
       (4) The symptoms of postpartum mood and anxiety disorders 
     are the worsening and the continuation of the baby blues 
     beyond the first days or weeks after delivery.
       (5) The symptoms of postpartum psychosis include losing 
     touch with reality, distorted thinking, delusions, auditory 
     hallucinations, paranoia, hyperactivity, and rapid speech or 
     mania.
       (6) Each year over 400,000 women suffer from postpartum 
     mood changes, with baby blues afflicting up to 80 percent of 
     new mothers; postpartum mood and anxiety disorders impairing 
     around 10 to 20 percent of new mothers; and postpartum 
     psychosis striking 1 in 1,000 new mothers.
       (7) Postpartum depression is a treatable disorder if 
     promptly diagnosed by a trained provider and attended to with 
     a personalized regimen of care including social support, 
     therapy, medication, and when necessary hospitalization.
       (8) All too often postpartum depression goes undiagnosed or 
     untreated due to the social stigma surrounding depression and 
     mental illness, the myth of motherhood, the new mother's 
     inability to self-diagnose her condition, the new mother's 
     shame or embarrassment over discussing her depression so near 
     to the birth of her child, the lack of understanding in 
     society and the medical community of the complexity of 
     postpartum depression, and economic pressures placed on 
     hospitals and providers.
       (9) Untreated, postpartum depression can lead to further 
     depression, substance abuse, loss of employment, divorce and 
     further social alienation, self-destructive behavior, or even 
     suicide.
       (10) Untreated, postpartum depression impacts society 
     through its effect on the infant's physical and psychological 
     development, child abuse, neglect, or death of the infant or 
     other siblings, and the disruption of the family.

        TITLE I--RESEARCH ON POSTPARTUM DEPRESSION AND PSYCHOSIS

     SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVITIES.

       (a) In General.--The Secretary of Health and Human 
     Services, acting through the Director of the National 
     Institutes of Health and the Director of the National 
     Institute of Mental Health (in this title referred to as the 
     ``Institute''), is encouraged to continue aggressive work on 
     postpartum depression and postpartum psychosis.
       (b) Coordination With Other Institutes.--The Director of 
     the Institute should continue to coordinate activities of the 
     Director under subsection (a) with similar activities 
     conducted by the other national research institutes and 
     agencies of the National Institutes of Health to the extent 
     that such Institutes and agencies have responsibilities that 
     are related to postpartum conditions.
       (c) Programs for Postpartum Conditions.--In carrying out 
     subsection (a), the Director of the Institute is encouraged 
     to continue research to expand the understanding of the 
     causes of, and to find a cure for, postpartum conditions. 
     Activities under such subsection shall include conducting and 
     supporting the following:
       (1) Basic research concerning the etiology and causes of 
     the conditions.
       (2) Epidemiological studies to address the frequency and 
     natural history of the conditions and the differences among 
     racial and ethnic groups with respect to the conditions.
       (3) The development of improved screening and diagnostic 
     techniques.
       (4) Clinical research for the development and evaluation of 
     new treatments, including new biological agents.
       (5) Information and education programs for health care 
     professionals and the public.

     SEC. 102. NATIONAL PUBLIC AWARENESS CAMPAIGN.

       (a) In General.--The Director of the National Institutes of 
     Health and the Administrator of the Health Resources and 
     Services Administration are encouraged to carry out a 
     coordinated national campaign to increase the awareness and 
     knowledge of postpartum depression and postpartum psychosis.
       (b) Public Service Announcements.--Activities under the 
     national campaign under subsection (a) may include public 
     service announcements through television, radio, and other 
     means.

     SEC. 103. BIENNIAL REPORTING.

       Section 403(a)(5) of the Public Health Service Act (42 
     U.S.C. 283(a)(5)) is amended--
       (1) by redesignating subparagraph (L) as subparagraph (M); 
     and
       (2) by inserting after subparagraph (K) the following:
       ``(L) Depression.''.

     SEC. 104. LONGITUDINAL STUDY OF RELATIVE MENTAL HEALTH 
                   CONSEQUENCES FOR WOMEN OF RESOLVING A 
                   PREGNANCY.

       (a) Sense of Congress.--It is the sense of Congress that 
     the Director of the Institute may conduct a nationally 
     representative longitudinal study (during the period of 
     fiscal years 2008 through 2018) of the relative mental health 
     consequences for women of resolving a pregnancy (intended and 
     unintended) in various ways, including carrying the pregnancy 
     to term and parenting the child, carrying the pregnancy to 
     term and placing the child for adoption, miscarriage, and 
     having an abortion. This study may assess the incidence, 
     timing, magnitude, and duration of the immediate and long-
     term mental health consequences (positive or negative) of 
     these pregnancy outcomes.
       (b) Report.--Beginning not later than 3 years after the 
     date of the enactment of this Act, and periodically 
     thereafter for the duration of the study under subsection 
     (a), the Director of the Institute should prepare and submit 
     to the Congress reports on the findings of the study.

  TITLE II--DELIVERY OF SERVICES REGARDING POSTPARTUM DEPRESSION AND 
                               PSYCHOSIS

     SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS.

       (a) In General.--The Secretary of Health and Human Services 
     (in this title referred to as the ``Secretary'') should in 
     accordance with this title make grants to provide for 
     projects for the establishment, operation, and coordination 
     of effective and cost-efficient systems for the delivery of 
     essential services to individuals with postpartum depression 
     or postpartum psychosis (referred to in this section as a 
     ``postpartum condition'') and their families.
       (b) Recipients of Grants.--A grant under subsection (a) may 
     be made to an entity only if the entity is a public or 
     nonprofit private entity, which may include a State or local 
     government; a public or nonprofit private hospital, 
     community-based organization, hospice, ambulatory care 
     facility, community health center, migrant health center, or 
     homeless health center; or any other appropriate public or 
     nonprofit private entity.
       (c) Certain Activities.--To the extent practicable and 
     appropriate, the Secretary shall ensure that projects under 
     subsection (a) provide services for the diagnosis and 
     management of postpartum conditions. Activities that the 
     Secretary may authorize for such projects may also include 
     the following:
       (1) Delivering or enhancing outpatient and home-based 
     health and support services, including case management, 
     screening, and comprehensive treatment services for 
     individuals with or at risk for postpartum conditions; and 
     delivering or enhancing support services for their families.
       (2) Delivering or enhancing inpatient care management 
     services that ensure the well-being of the mother and family 
     and the future development of the infant.
       (3) Improving the quality, availability, and organization 
     of health care and support services (including transportation 
     services, attendant care, homemaker services, day or respite 
     care, and providing counseling on financial assistance and 
     insurance) for individuals with postpartum conditions and 
     support services for their families.
       (d) Integration With Other Programs.--To the extent 
     practicable and appropriate, the Secretary should integrate 
     the program under this title with other grant programs 
     carried out by the Secretary, including the program under 
     section 330 of the Public Health Service Act.

     SEC. 202. CERTAIN REQUIREMENTS.

       A grant may be made under section 201 only if the applicant 
     involved makes the following agreements:
       (1) Not more than 5 percent of the grant will be used for 
     administration, accounting, reporting, and program oversight 
     functions.
       (2) The grant will be used to supplement and not supplant 
     funds from other sources related to the treatment of 
     postpartum conditions.
       (3) The applicant will abide by any limitations deemed 
     appropriate by the Secretary on any charges to individuals 
     receiving services pursuant to the grant. As deemed 
     appropriate by the Secretary, such limitations on charges may 
     vary based on the financial circumstances of the individual 
     receiving services.

[[Page H11512]]

       (4) The grant will not be expended to make payment for 
     services authorized under section 201(a) to the extent that 
     payment has been made, or can reasonably be expected to be 
     made, with respect to such services--
       (A) under any State compensation program, under an 
     insurance policy, or under any Federal or State health 
     benefits program; or
       (B) by an entity that provides health services on a prepaid 
     basis.
       (5) The applicant will, at each site at which the applicant 
     provides services under section 201(a), post a conspicuous 
     notice informing individuals who receive the services of any 
     Federal policies that apply to the applicant with respect to 
     the imposition of charges on such individuals.

     SEC. 203. TECHNICAL ASSISTANCE.

       The Secretary may provide technical assistance to assist 
     entities in complying with the requirements of this title in 
     order to make such entities eligible to receive grants under 
     section 201.

                     TITLE III--GENERAL PROVISIONS

     SEC. 301. AUTHORIZATION OF APPROPRIATIONS.

       To carry out this Act and the amendments made by this Act, 
     there are authorized to be appropriated--
       (1) $3,000,000 for fiscal year 2008; and
       (2) such sums as may be necessary for fiscal years 2009 and 
     2010.
  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
Wisconsin (Ms. Baldwin) and the gentleman from New York (Mr. Fossella) 
each will control 20 minutes.
  The Chair recognizes the gentlewoman from Wisconsin.


                             General Leave

  Ms. BALDWIN. Madam Speaker, I ask unanimous consent that all Members 
have 5 legislative days to revise and extend their remarks and include 
extraneous material on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Wisconsin?
  There was no objection.
  Ms. BALDWIN. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I rise in strong support of H.R. 20, the Melanie 
Blocker-Stokes Postpartum Depression Research and Care Act of 2007.
  The birth of a child can be a joyous and exciting time, but following 
childbirth, some women may experience postpartum disorders that can 
adversely affect a woman's mental health. According to the American 
College of Obstetricians and Gynecologists, about 10 percent of new 
moms experience postpartum depression, a form of depression that can 
develop within the first 6 months after giving birth.
  For women with postpartum depression, feelings such as sadness, 
anxiety, and restlessness can be so strong that they interfere with 
daily tasks. Rarely, a more extreme form of depression known as 
postpartum psychosis can develop. Postpartum depression and psychosis 
can have an adverse effect on a woman's mental health and impair their 
ability to bond with their newborn child.
  The legislation before us today will go a long way towards helping to 
increase awareness of postpartum depression and psychosis. H.R. 20 
encourages the Secretary of Health and Human Services and the Director 
of the National Institutes of Health to expand and intensify research 
on postpartum depression and to conduct and support research in an 
effort to find a cure for postpartum depression and psychosis.
  Furthermore, this legislation encourages the NIH to carry out a 
national campaign to increase awareness of postpartum depression, and 
it directs Health and Human Services to make grants to help with 
coordinating the effective delivery of essential services to 
individuals with postpartum depression, as well as their families.
  I would like to extend a special thank you to our Commerce, Trade and 
Consumer Protection Subcommittee chairman, Mr. Rush, who has championed 
this bill's cause. His commitment to ensuring that women who suffer 
from postpartum depression better understand their condition and have 
access to the resources that they need has been unwavering. I commend 
him for his hard work, and I urge all of my colleagues to join me in 
supporting this life-saving legislation.
  Madam Speaker, I reserve the balance of my time.
  Mr. FOSSELLA. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I rise today in support of H.R. 20, the Melanie 
Blocker-Stokes Postpartum Depression Research and Care Act, and join my 
colleagues in commending Mr. Rush for bringing the bill to the floor.
  As has been mentioned, the bill highlights the need to increase 
awareness of postpartum depression and expand the knowledge of its 
terrible side effects.
  It's important to note that as many as 80 percent of women experience 
some mood disturbances after pregnancy, and for most women the symptoms 
are mild and go away on their own; but 10 to 20 percent of women 
develop a more disabling form of mood disorder called postpartum 
depression.
  This legislation encourages the continuation of research being done 
by Federal agencies as to the cause of postpartum depression and how it 
can be better treated. And with my colleagues, I stand in support of 
the legislation and hope my colleagues will join me.
  Madam Speaker, I reserve the balance of my time.
  Ms. BALDWIN. Madam Speaker, I am pleased to yield 7 minutes to the 
gentleman from Illinois, the bill's author, Mr. Rush.
  Mr. RUSH. Madam Speaker, I want to thank the gentlelady from 
Wisconsin for yielding me this time on this very important matter.
  Madam Speaker, I rise today in strong support of H.R. 20, the Melanie 
Blocker-Stokes Postpartum Depression Research and Care Act.
  I would like to thank Chairman Dingell; Ranking Member Barton; my 
colleague, Congressman Pitts; and the members of the Energy and 
Commerce Committee who unanimously supported this legislation's passage 
out of committee.
  Madam Speaker, after 6 long, arduous years, today marks an important 
step in the protracted journey for Congress to recognize postpartum 
depression as a national priority. I am so proud that nearly 130 
bipartisan cosponsors have united with me today to say no longer will 
postpartum depression be dismissed as mere ``baby blues.''
  By passing H.R. 20, Congress will finally put significant money and 
attention into research, screening, treatment, and education for 
mothers suffering from this disease.
  Sadly, Madam Speaker, I was moved to author H.R. 20 after watching 
the news accounts of the missing Melanie Stokes, a new mother, a 
successful businesswoman, and my constituent. Despite her family's 
valiant interventions, Melanie's psychosis was so severe that she 
slipped away from her family and from her friends and tragically ended 
her life.
  Afterwards, I reached out to Melanie's mother, Carol Blocker, and was 
told of her daughter's diagnosis and suicide that occurred as a result 
of postpartum psychosis. And sometime later, Madam Speaker, I talked 
with Dr. Nada Stotland of the American Psychiatric Association, who is 
another constituent of mine, and she detailed the value in additional 
research. And she discussed the underreporting and mixed diagnosis of 
postpartum depression and psychosis in our country.
  There is no denying, the needs for resources to combat postpartum 
depression grow more and more and more each year. Here are the facts, 
Madam Speaker:
  Research indicates that some form of postpartum depression affects 
approximately one in 1,000 new mothers, resulting in up to 800,000 
cases annually. Of the new postpartum cases this year, less than 15 
percent of mothers will receive treatment. However, with treatment, 
over 90 percent of these mothers could overcome their depression. And 
approximately every 50 seconds, a new mother will begin struggling with 
the affects of mental illness.
  Madam Speaker, these facts are profound. And in the words of Carol 
Blocker, ``Hundreds of thousands of women who have suffered from 
postpartum depression and psychosis are still waiting for this Congress 
to act 6 years after the legislation has been introduced.''
  Madam Speaker, I want to thank you for this day, because today Ms. 
Blocker and hundreds of thousands of mothers will not have to wait any 
longer for Congress to act.
  My legislation, to sum it up, would encourage the Secretary of Health 
and Human Services to further research at the National Institutes of 
Health on postpartum depression.

[[Page H11513]]

  My legislation would also finance a national public awareness 
campaign to bring this illness out of the dark and shed new light on 
how to screen and treat mothers. It would also add depression to the 
biennial report the National Institutes of Health must submit to the 
Congress.
  Lastly, my bill will finance much-needed grants to public and 
nonprofit organizations to establish and operate programs that provide 
screening, treatment and various health care and support services to 
individuals with postpartum depression or postpartum psychosis.
  Moreover, Madam Speaker, this bill is an affordable approach to 
research and services. The CBO estimates that H.R. 20 costs less than 
$500,000 per year, and $18 million over 5 years.
  This is good policy, Madam Speaker. This is good politics. And this 
is a good public health bill.
  I want to take a moment, Madam Speaker, just to thank the many 
organizations and groups, groups like Postpartum Support International, 
whose president right now sits in the gallery, Ms. Susan Stone; the 
Family Mental Health Foundation; the American Psychological 
Association; the American Psychiatric Association; the American College 
of Obstetricians and Gynecologists; and groups like the Children's 
Defense Fund, the Melanie Blocker-Stokes Foundation, Suicide Prevention 
Action Network, Planned Parenthood Federation of America Depression and 
Bipolar Support Alliance, the Mental Health Alliance, NARAL, so many 
organizations, including the National Alliance for Mental Illness, the 
Community Behavioral Healthcare Association, and the March of Dimes. I 
want to thank these individuals and various activists for their 
testimony at hearings, for their support, and for their participation.
  Madam Speaker, lastly, I want to thank the Members of this Congress, 
those who, when I asked to become cosponsors, they indicated that they 
were familiar because they had personal involvement, this dreaded 
disease has touched them personally; and I want to thank them for their 
support.
  Madam Speaker, I urge that this body pass this much-needed 
legislation, that this body, indeed, give women the help that they need 
in fighting this very, very difficult disease.
  Mr. FOSSELLA. Madam Speaker, I yield back the balance of my time.
  Ms. BALDWIN. Madam Speaker, in closing, I wish to urge my colleagues 
to support this important bill. As we have heard, postpartum depression 
is a very serious women's health issue. This bill will raise awareness 
about postpartum depression and will further research in an effort to 
find a cure.

                              {time}  1615

  Again I want to commend my colleague (Mr. Rush) for his incredibly 
hard work on this bill, and I urge my colleagues to support its 
passage.
  Ms. RICHARDSON. Madam Speaker, I rise today to support H.R. 20, the 
Melanie Blocker-Stokes Postpartum Depression Research and Care Act.
  Postpartum depression is a serious mental health problem that can 
have significant consequences for both the new mother and family. 
Statistics show up to 800,000 women annually develop this diagnosable 
prenatal mood disorder; shockingly, less than 15 percent of mothers 
will receive treatment for the disease.
  In California, the results from a 2004 California Women's Health 2007 
study indicated that younger females were most at risk for postpartum 
depression. Females 19 and younger had rates of risk of more than 20 
percent: woman 35 and older had the lowest rate, 6.4 percent. In 
California, woman who are young and/or without health insurance would 
benefit most from the screening, counseling, diagnosis, and treatment 
for postpartum depression that this legislation authorizes.
  H.R. 20, the Melanie Blocker-Stokes Postpartum Depression Research 
and Care Act, would ensure that woman at risk for or with postpartum 
depression are provided adequate and timely prevention and mental 
health services.
  If we are to have any hope of preventing deaths among new mothers and 
children from this disease, we must identify ways by which we can 
effectively treat and prevent postpartum psychosis.
  I extend my gratitude and thanks to Representative Rush for bringing 
this important piece of legislation to the House. His commitment to 
this issue is commendable.
  Ms. BALDWIN. Madam Speaker, I yield back the remainder of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentlewoman from Wisconsin (Ms. Baldwin) that the House suspend the 
rules and pass the bill, H.R. 20, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Ms. BALDWIN. Madam 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.

                          ____________________