[Congressional Record Volume 154, Number 121 (Wednesday, July 23, 2008)]
[Senate]
[Pages S7150-S7153]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN:
  S. 3311. A bill to amend the Public Health Service Act to improve 
mental and behavioral health services on college campuses; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. DURBIN: Mr. President, this February, on Valentine's Day, a young

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man walked into a lecture hall at Northern Illinois University and 
opened fire. Five students were killed and 17 were wounded before the 
shooter took his own life. Northern Illinois University was not the 
first college to experience this kind of tragedy. We all remember the 
horrific events at Virginia Tech only months earlier--where 32 lives 
were taken by a gunman. The magnitude of heartbreak for friends and 
families and communities of those killed is hard to imagine. So, too, 
is the continuing trauma experienced by those who survived. These 
tragedies opened our eyes to a reality that needs attention.
  Since February I have learned just how thin colleges and universities 
are stretched when it comes to providing counseling and other support 
services to students, and I think we need to help them. So today I am 
introducing the Mental Health on Campus Improvement Act, which would 
establish grant programs to help schools meet the rising need for 
mental health services on campus.
  The ratio of counselors to students on campus is widening. Currently 
there is only one counselor for every 2,000 students on our college 
campuses. At some colleges, the situation is even more dismal. Studies 
show that 10 percent of college students have contemplated suicide. Mr. 
President, 45 percent have felt so depressed that it was difficult to 
function. Colleges are also encountering students who 10 or 20 years 
ago would not have been able to attend school due to mental illness, 
but who can today because of advances in treatment of mental illness.
  Taking care of mental health needs on our college campuses is 
somewhat unique. Many mental illnesses start to manifest in this period 
when young people leave the security of home and regular medical care. 
The responsibility for the students' well-being often shifts from 
parents to students, who aren't always completely prepared. The 
colleges try to fill in the gaps, but with so few services and 
counselors, we are beginning to recognize how many needs are 
overlooked. This is a very real problem, even for schools that have 
made mental health services a dedicated priority.
  Take Southern Illinois University in Carbondale. SIUC has eight full-
time counselors for 21,000 students. That is one counselor for every 
2,500 students. And there is another problem. Like many rural 
communities, Carbondale only has one community mental health agency. 
That agency is overwhelmed by the mental health needs of the community 
and refuses to serve students from SIU. The campus counseling center is 
the only mental health option for students. The eight hard-working 
counselors at SIUC do their best under impossible conditions. They 
triage students who come in seeking help so that the ones who might be 
a threat to themselves or others are seen first. The waitlist of 
students seeking services has reached 45 students.
  With so many students looking for help and so few counselors to see 
them, the counseling center has to cut back on outreach. Without 
outreach, the chances diminish of finding students who need help but 
don't ask for it. This is a serious problem. We know that the shooter 
at Virginia Tech exhibited many warning signs of a tortured mental 
state. But faculty and students did not know how or where to express 
their concerns. Outreach efforts by campus counseling centers can help 
educate the community about warning signs to look for as well as how to 
intervene. Of the students who committed suicide across the country in 
2007, only 22 percent had received counseling on campus. That means 
that of the 1,000 college students who took their own lives, 800 may 
never have looked for help. How many of those young lives could have 
been saved if our college counseling centers had the resources they 
needed to identify those students and help them? Our students deserve 
better.
  The Mental Health on Campus Improvement Act would create a grant 
program to provide funding for colleges and universities to improve 
their mental health services. Colleges could use the funding to hire 
personnel, increase outreach, and educate the campus community about 
mental health. The bill also would direct the Department of Health and 
Human Services to develop a public, nation-wide campaign to education 
campus communities about mental health.
  Reflecting on the loss of his own son, the well known minister Rev. 
William Sloan Coffin once said, ``When parents die, they take with them 
a portion of the past. But when children die, they take away the future 
as well.'' I hope the bill I am introducing today will help prevent the 
unnecessary loss of more young lives and bright futures.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
placed in the Record, as follows:

                                S. 3311

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

     SECTION 1. SHORT TITLE.

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

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) The 2007 National Survey of Counseling Center Directors 
     found that the average ratio of counselors to students on 
     campus is nearly 1 to 2,000 and is often far higher on large 
     campuses. The International Association of Counseling 
     Services accreditation standards recommend 1 counselor per 
     1,000 to 1,500 students.
       (2) College counselors report that 8.5 percent of enrolled 
     students sought counseling in the past year, totaling an 
     estimated 1,600,000 students.
       (3) Over 90 percent of counseling directors believe there 
     is an increase in the number of students coming to campus 
     with severe psychological problems. The majority of 
     counseling directors report concern that the demand for 
     services is growing without an increase in resources.
       (4) A 2006 American College Health Association survey 
     revealed that 44 percent of students at colleges and 
     universities report having felt so depressed it was difficult 
     to function, and one out of every 11 students seriously 
     considered suicide within the past year.
       (5) Research conducted from 1989 to 2002 found that 
     students seen for anxiety disorders doubled, for depression 
     tripled, and for serious suicidal intention tripled.
       (6) Many students who need help never receive it. 
     Counseling directors report that of the students who 
     committed suicide on their campuses, only 22 percent were 
     current or former counseling center clients. Directors did 
     not know the previous psychiatric history of 60 percent of 
     these students.
       (7) A survey conducted by the University of Idaho Student 
     Counseling Center (2000) found that 77 percent of students 
     who responded reported that they were more likely to stay in 
     school because of counseling and that their school 
     performance would have declined without counseling.
       (8) A 6-year longitudinal study of college students found 
     that personal and emotional adjustment was an important 
     factor in retention and predicted attrition as well as or 
     better than academic adjustment (Gerdes & Mallinckrodt, 
     1994).

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

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

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

       ``(a) Purpose.--It is the purpose of this section, with 
     respect to college and university settings, to--
       ``(1) increase access to mental and behavioral health 
     services;
       ``(2) foster and improve the prevention of mental and 
     behavioral health disorders, and the promotion of mental 
     health;
       ``(3) improve the identification and treatment for students 
     at risk;
       ``(4) improve collaboration and the development of 
     appropriate level of mental and behavioral health care; and
       ``(5) improve the efficacy of outreach efforts.
       ``(b) Grants.--The Secretary, acting through the 
     Administrator and in consultation with the Secretary of 
     Education, shall award competitive grants to eligible 
     entities to improve mental and behavioral health services and 
     outreach on college and university campuses.
       ``(c) Eligibility.--To be eligible to receive a grant under 
     subsection (b), an entity shall--
       ``(1) be an institution of higher education (as defined in 
     section 101 of the Higher Education Act of 1965 (20 U.S.C. 
     1001)); and
       ``(2) submit to the Secretary an application at such time, 
     in such manner, and containing such information as the 
     Secretary may require, including the information required 
     under subsection (d).
       ``(d) Application.--An application for a grant under this 
     section shall include--
       ``(1) a description of the population to be targeted by the 
     program carried out under the grant, the particular mental 
     and behavioral health needs of the students involved, and the 
     Federal, State, local, private, and institutional resources 
     available for meeting the needs of such students at the time 
     the application is submitted;
       ``(2) an outline of the objectives of the program carried 
     out under the grant;

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       ``(3) a description of activities, services, and training 
     to be provided under the program, including planned outreach 
     strategies to reach students not currently seeking services;
       ``(4) a plan to seek input from community mental health 
     providers, when available, community groups, and other public 
     and private entities in carrying out the program;
       ``(5) a plan, when applicable, to meet the specific mental 
     and behavioral health needs of veterans attending 
     institutions of higher education;
       ``(6) a description of the methods to be used to evaluate 
     the outcomes and effectiveness of the program; and
       ``(7) an assurance that grant funds will be used to 
     supplement, and not supplant, any other Federal, State, or 
     local funds available to carry out activities of the type 
     carried out under the grant.
       ``(e) Special Considerations.--In awarding grants under 
     this section, the Secretary shall give special consideration 
     to applications that describe programs to be carried out 
     under the grant that--
       ``(1) demonstrate the greatest need for new or additional 
     mental and behavioral health services, in part by providing 
     information on current ratios of students to mental and 
     behavioral health professionals;
       ``(2) propose effective approaches for initiating or 
     expanding campus services and supports using evidence-based 
     practices;
       ``(3) target traditionally underserved populations and 
     populations most at risk;
       ``(4) where possible, demonstrate an awareness of and a 
     willingness to coordinate with a community mental health 
     center or other mental health resource in the community, to 
     support screening and referral of students requiring 
     intensive services;
       ``(5) identify how the college or university will address 
     psychiatric emergencies, including how information will be 
     communicated with families or other appropriate parties; and
       ``(6) demonstrate the greatest potential for replication 
     and dissemination.
       ``(f) Use of Funds.--Amounts received under a grant under 
     this section shall be used to--
       ``(1) provide mental and behavioral health services to 
     students, including prevention, promotion of mental health, 
     screening, early intervention, assessment, treatment, 
     management, and education services relating to the mental and 
     behavioral health of students;
       ``(2) provide outreach services to notify students about 
     the existence of mental and behavioral health services;
       ``(3) educate families, peers, faculty, staff, and 
     communities to increase awareness of mental health issues;
       ``(4) employ appropriately trained staff;
       ``(5) expand mental health training through internship, 
     post-doctorate, and residency programs;
       ``(6) develop and support evidence-based and emerging best 
     practices; and
       ``(7) evaluate and disseminate best practices to other 
     colleges and universities.
       ``(g) Duration of Grants.--A grant under this section shall 
     be awarded for a period of not to exceed 3 years.
       ``(h) Evaluation and Reporting.--
       ``(1) Evaluation.--Not later than 18 months after the date 
     on which a grant is received under this section, the eligible 
     entity involved shall submit to the Secretary the results of 
     an evaluation to be conducted by the entity concerning the 
     effectiveness of the activities carried out under the grant 
     and plans for the sustainability of such efforts.
       ``(2) Report.--Not later than 2 years after the date of 
     enactment of this section, the Secretary shall submit to the 
     appropriate committees of Congress a report concerning the 
     results of--
       ``(A) the evaluations conducted under paragraph (1); and
       ``(B) an evaluation conducted by the Secretary to analyze 
     the effectiveness and efficacy of the activities conducted 
     with grants under this section.
       ``(i) Technical Assistance.--The Secretary may provide 
     technical assistance to grantees in carrying out this 
     section.
       ``(j) Authorization of Appropriations.--There is authorized 
     to be appropriated, such sums as may be necessary to carry 
     out this section.

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

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

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

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

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     health, especially those organizations working with the 
     college age population; and
       (3) consult with and seek input from mental heath 
     professionals working on college and university campuses as 
     appropriate.
       (e) Meetings.--
       (1) In general.--The Task Force shall meet at least 3 times 
     each year.
       (2) Annual conference.--The Secretary shall sponsor an 
     annual conference on mental and behavioral health in college 
     and university settings to enhance coordination, build 
     partnerships, and share best practices in mental and 
     behavioral health promotion, data collection, analysis, and 
     services.
       (f) Authorization of Appropriations.--There are authorized 
     to be appropriated, such sums as may be necessary to carry 
     out this section.
                                 ______