[Congressional Record Volume 157, Number 49 (Wednesday, April 6, 2011)]
[Senate]
[Pages S2190-S2194]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REED (for himself, Ms. Murkowski, Mr. Durbin, and Mr. 
        Udall of New Mexico):
  S. 740. A bill to revise and extend provisions under the Garrett Lee 
Smith Memorial Act; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. REED. I am pleased to be joined by Senators Murkowski, Durbin, 
and Tom Udall in the introduction of the Garrett Lee Smith Memorial Act 
Reauthorization.
  This legislation continues the important work of my former colleague 
Senator Gordon Smith, who authored the original law, which was named 
for his 22-year old son, Garrett, who was a student at Utah Valley 
University when he took his own life. I want to once again recognize 
Gordon Smith for his work to champion suicide prevention and mental 
health initiatives.
  Currently, this law supports 35 States, 16 Tribes and Tribal 
organizations, and 38 colleges and universities in their efforts to 
prevent youth suicide. Indeed, with the help of these important 
programs, we have made real progress since the 2004 passage of this law 
in identifying at-risk youth and young adults, providing proven mental 
health and substance use disorder treatments, and educating the public 
about youth suicide prevention efforts.
  Unfortunately, suicide remains the third leading cause of death for 
adolescents and young adults age 10 to 24, and results in 4,400 lives 
lost each year. According to the Centers for Disease Control and 
Prevention, approximately 150,000 individuals in this age group 
annually receive medical care for self-inflicted injuries at Emergency 
Departments across the U.S.
  Suicide is particularly prevalent among college-age students as it is 
the second leading cause of death, resulting in approximately 1,100 
deaths each year. The 2010 National Survey of Counseling Center 
Directors at colleges and universities found that 10.8 percent of 
students seek counseling each year, an increase of nearly 1 percent 
from 2009. At the same time, the average ratio of counselors to 
students has remained constant at one to 1,786.
  Many young people who commit suicide have a treatable mental illness, 
but they don't get the help they need. The legislation we introduced 
today provides critical resources for prevention and outreach programs 
to reach at risk youth before it is too late.
  It would increase the authorized grant level to States, tribes, and 
college campuses for the implementation of proven programs and 
initiatives designed to address mental health and wellness and reduce 
youth suicide.
  Additionally, I am particularly pleased that the bill would enable 
college counseling centers to have greater flexibility in their use of 
Federal resources. Counseling centers will continue to be able to apply 
for funds to operate suicide prevention hotlines and organize 
educational and awareness efforts about youth suicide prevention; 
however, with this bill they will also be able to use funds for the 
provision of counseling services to students and the hiring of 
appropriately trained personnel. These two components are integral to 
identifying and treating students who may be at risk with the goal of 
preventing suicide and attempted suicide on campuses.
  Our bipartisan legislation is supported by 43 coalition members of 
the Mental Health Liaison Group and the American Council on Education.
  Mr. President, I unanimous consent that the text of the bill and a 
letter of support be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                 S. 740

       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 Reauthorization of 2011''.

     SEC. 2. SUICIDE PREVENTION TECHNICAL ASSISTANCE CENTER.

       (a) Repeal.--Section 520C of the Public Health Service Act 
     (42 U.S.C. 290bb-34) is repealed.
       (b) Suicide Prevention Technical Assistance Center.--Title 
     V of the Public Health Service Act (42 U.S.C. 290aa et seq.) 
     (as amended by subsection (a)) is amended by inserting after 
     section 520B the following:

     ``SEC. 520C. SUICIDE PREVENTION TECHNICAL ASSISTANCE CENTER.

       ``(a) Program Authorized.--The Secretary, acting through 
     the Administrator of the Substance Abuse and Mental Health 
     Services Administration, shall establish a research, 
     training, and technical assistance resource center to provide 
     appropriate information, training, and technical assistance 
     to States, political subdivisions of States, federally 
     recognized Indian tribes, tribal organizations, institutions 
     of higher education, public organizations, or private 
     nonprofit organizations concerning the prevention of suicide 
     among all ages, particularly among groups that are at high 
     risk for suicide.
       ``(b) Responsibilities of the Center.--The center 
     established under subsection (a) shall--
       ``(1) assist in the development or continuation of 
     statewide and tribal suicide early intervention and 
     prevention strategies for all ages, particularly among groups 
     that are at high risk for suicide;
       ``(2) ensure the surveillance of suicide early intervention 
     and prevention strategies for all ages, particularly among 
     groups that are at high risk for suicide;
       ``(3) study the costs and effectiveness of statewide and 
     tribal suicide early intervention and prevention strategies 
     in order to provide information concerning relevant issues of 
     importance to State, tribal, and national policymakers;
       ``(4) further identify and understand causes and associated 
     risk factors for suicide for all ages, particularly among 
     groups that are at high risk for suicide;
       ``(5) analyze the efficacy of new and existing suicide 
     early intervention and prevention techniques and technology 
     for all ages, particularly among groups that are at high risk 
     for suicide;
       ``(6) ensure the surveillance of suicidal behaviors and 
     nonfatal suicidal attempts;
       ``(7) study the effectiveness of State-sponsored statewide 
     and tribal suicide early intervention and prevention 
     strategies for all ages particularly among groups that are at 
     high risk for suicide on the overall wellness and health 
     promotion strategies related to suicide attempts;
       ``(8) promote the sharing of data regarding suicide with 
     Federal agencies involved with suicide early intervention and 
     prevention, and State-sponsored statewide and tribal suicide 
     early intervention and prevention strategies for the purpose 
     of identifying previously unknown mental health causes and 
     associated risk factors for suicide among all ages 
     particularly among groups that are at high risk for suicide;
       ``(9) evaluate and disseminate outcomes and best practices 
     of mental health and substance use disorder services at 
     institutions of higher education; and
       ``(10) conduct other activities determined appropriate by 
     the Secretary.
       ``(c) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $5,000,000 for each of the fiscal years 2012 
     through 2016.''.

     SEC. 3. YOUTH SUICIDE INTERVENTION AND PREVENTION STRATEGIES.

       Section 520E of the Public Health Service Act (42 U.S.C. 
     290bb-36) is amended to read as follows:

[[Page S2191]]

     ``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 use disorder programs, mental 
     health programs, foster care systems, and other child and 
     youth support organizations;
       ``(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 a State does not receive more 
     than one grant or cooperative agreement under this section at 
     any one time. For purposes of the preceding sentence, a State 
     shall be considered to have received 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 constructed 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 
     use disorder 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 
     use disorder 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) Consultation and Policy Development.--
       ``(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 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 527, or section 529 shall not be used to pay 
     for or refer for abortion.
       ``(j) Parental Consent.--States and entities receiving 
     funding under this section shall obtain prior written, 
     informed consent

[[Page S2192]]

     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 shall be construed to supersede section 444 of the 
     General Education Provisions Act, including the requirement 
     of prior parental consent for the disclosure of any education 
     records. Nothing in this section 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.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $32,000,000 for each of the fiscal years 2012 
     through 2016.''.

     SEC. 4. MENTAL HEALTH AND SUBSTANCE USE DISORDERS SERVICES 
                   AND OUTREACH ON CAMPUS.

       Section 520E-2 of the Public Health Service Act (42 U.S.C. 
     290bb-36b) is amended to read as follows:

     ``SEC. 520E-2. MENTAL HEALTH AND SUBSTANCE USE DISORDERS 
                   SERVICES ON CAMPUS.

       ``(a) In General.--The Secretary, acting through the 
     Director of the Center for Mental Health Services and in 
     consultation with the Secretary of Education, shall award 
     grants on a competitive basis to institutions of higher 
     education to enhance services for students with mental health 
     or substance use disorders and to develop best practices for 
     the delivery of such services.
       ``(b) Uses of Funds.--Amounts received under a grant under 
     this section shall be used for 1 or more of the following 
     activities:
       ``(1) The provision of mental health and substance use 
     disorder services to students, including prevention, 
     promotion of mental health, voluntary screening, early 
     intervention, voluntary assessment, treatment, and management 
     of mental health and substance abuse disorder issues.
       ``(2) The provision of outreach services to notify students 
     about the existence of mental health and substance use 
     disorder services.
       ``(3) Educating students, families, faculty, staff, and 
     communities to increase awareness of mental health and 
     substance use disorders.
       ``(4) The employment of appropriately trained staff, 
     including administrative staff.
       ``(5) The provision of training to students, faculty, and 
     staff to respond effectively to students with mental health 
     and substance use disorders.
       ``(6) The creation of a networking infrastructure to link 
     colleges and universities with providers who can treat mental 
     health and substance use disorders.
       ``(7) Developing, supporting, evaluating, and disseminating 
     evidence-based and emerging best practices.
       ``(c) Implementation of Activities Using Grant Funds.--An 
     institution of higher education that receives 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;
       ``(5) institution of higher education supported, evidence-
     based, mental health and substance use disorder programs; or
       ``(6) any other entity that provides mental health and 
     substance use disorder services at an institution of higher 
     education.
       ``(d) Application.--To be eligible to receive a grant under 
     this section, an institution of higher education shall 
     prepare and submit to the Secretary an application at such 
     time and in such manner as the Secretary may require. At a 
     minimum, such application shall include the following:
       ``(1) A description of identified mental health and 
     substance use disorder 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, when applicable, to meet the specific mental 
     health and substance use disorder needs of veterans attending 
     institutions of higher education.
       ``(5) A plan to seek input from community mental health 
     providers, when available, community groups and other public 
     and private entities in carrying out the program under the 
     grant.
       ``(6) 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.
       ``(7) An assurance that the institution will submit a 
     report to the Secretary each fiscal year concerning the 
     activities carried out with the grant and the results 
     achieved through those activities.
       ``(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 substance use disorder services, in part by 
     providing information on current ratios of students to mental 
     health and substance use disorder health professionals and
       ``(2) demonstrate the greatest potential for replication.
       ``(f) 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 under 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 health and substance use disorders.
       ``(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 application of 
     paragraph (1) with respect to an institution of higher 
     education if the Secretary determines that extraordinary need 
     at the institution justifies the waiver.
       ``(g) 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 
     health and substance use disorder services at institutions of 
     higher education, including efforts to reduce the incidence 
     of suicide and substance use disorders.
       ``(h) Definitions.--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.
       ``(i) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $7,000,000 for each of the fiscal years 2012 
     through 2016.''.
                                  ____



                                  Mental Health Liaison Group,

                                                    April 5, 2011.
     Hon. Jack Reed,
     U.S. Senate, Washington, DC.
     Hon. Richard J. Durbin,
     U.S. Senate, Washington, DC.
     Hon. Lisa Murkowski,
     U.S. Senate, Washington, DC.
     Hon. Tom Udall,
     U.S. Senate, Washington, DC.
       Dear Senators: The undersigned organizations in the Mental 
     Health Liaison Group are pleased to write in support of the 
     legislation you will soon introduce, the Garrett Lee Smith 
     Memorial Act Reauthorization of 2011. This legislation renews 
     the commitment to critically important youth and college 
     suicide prevention programs administered by the Substance 
     Abuse and Mental Health Services Administration, as well as 
     strengthens those programs, ensuring they are best designed 
     to meet the needs of those they are intended to serve.
       The Garrett Lee Smith Memorial Act (GLSMA) currently 
     supports grants in 35 States and 16 Tribes or Tribal 
     organizations as part of the State/Tribal Youth Suicide 
     Prevention and Early Intervention Program as well as funds 
     programs at 38 institutions of higher education through the 
     Campus Suicide Prevention program. While much has been 
     achieved thanks to the successful grants supported by the 
     GLSMA, there remains much to do. In 2007, suicide was the 
     third leading cause of death for young people ages 15-24 
     years and the second leading cause of death among college 
     students. According to the Center for Disease Control and 
     Prevention, ``a nationwide survey of youth in

[[Page S2193]]

     grades 9-12 in public and private schools in the United 
     States (U.S.) found that 15% of students reported seriously 
     considering suicide, 11% reported creating a plan, and 7% 
     reporting trying to take their own life in the 12 months 
     preceding the survey.'' The 2010 American College Health 
     Association's National College Health Assessment II noted 
     that 45.6% of students surveyed reported feeling that things 
     were hopeless and 30.7% reported feeling so depressed it was 
     difficult to function during the past 12 months.
       Since its creation in 2004, the Garrett Lee Smith Memorial 
     Act has provided resources to communities and college 
     campuses all across the country, and supported needed 
     technical assistance to develop and disseminate effective 
     strategies and best practices related to youth suicide 
     prevention.
       Our organizations support all three elements of the GLSMA, 
     which provide a comprehensive approach to addressing the 
     national problem of youth suicide. Specifically, the State 
     and Tribal program fosters the creation of public-private 
     collaborations and the development of critically needed 
     prevention and early intervention strategies. Next, the 
     Campus Suicide Prevention Program enhances services, outreach 
     and education for students with mental health or substance 
     use disorders and calls for the development of best practice 
     for the delivery of such services. Finally, the Suicide 
     Prevention Resource Center provides information and training 
     to States, Tribes, and tribal organizations, institutions of 
     higher education, and public organizations or private non-
     profit groups in an effort to prevent suicide among all ages, 
     particularly among high risk groups, such as youth.
       We are especially pleased that you have included modest but 
     needed growth in the authorization levels for these programs. 
     This measured increase acknowledges the important efforts 
     that have come from the development of these programs as well 
     as the significant work that remains to build suicide 
     prevention capacity across the country.
       Our organizations are grateful to you and your colleagues 
     for your strong bipartisan approach regarding this program. 
     We thank Senators Murkowski, Durbin and Tom Udall for joining 
     with you in support of this effort and demonstrating 
     extraordinary leadership on youth suicide prevention.
       We are most grateful to you and your staff for your 
     tireless work on this legislation over the past years. Your 
     unwavering leadership and commitment to youth suicide 
     prevention undoubtedly has important implications for the 
     current and future health and wellbeing of our nation's 
     youth. We welcome the opportunity to work with you and your 
     staff to ensure that the Garrett Lee Smith Memorial Act is 
     promptly reauthorized.
           Sincerely,
       American Academy of Child and Adolescent Psychiatry, 
     American Art Therapy Association, American Association for 
     Geriatric Psychiatry, American Association for Marriage and 
     Family Therapy, American Association for Psychoanalysis in 
     Clinical Social Work, American Association of Pastoral 
     Counselors, American Association on Health and Disability*, 
     American Counseling Association, American Dance Therapy 
     Association, American Foundation for Suicide Prevention/SPAN 
     USA, American Group Psychotherapy Association, American 
     Orthopsychiatric Association, American Psychiatric 
     Association, American Psychoanalytic Association, American 
     Psychological Association.
       American Psychotherapy Association, Association for 
     Ambulatory Behavioral Healthcare, Association for the 
     Advancement of Psychology, American Psychiatric Nurses 
     Association, Anxiety Disorders Association of America, 
     Bazelon Center for Mental Health Law, Center for Clinical 
     Social Work, Clinical Social Work Association, Depression and 
     Bipolar Support Alliance, Eating Disorders Coalition for 
     Research, Policy & Action, Mental Health America, NAADAC, the 
     Association for Addiction Professionals, National Association 
     of County Behavioral Health and Developmental Disability 
     Directors, National Association of State Mental Health 
     Program Directors, National Alliance on Mental Illness.
       National Association for Children's Behavioral Health, 
     National Association for Rural Mental Health, National 
     Association of Mental Health Planning & Advisory Councils, 
     National Association of Psychiatric Health Systems, National 
     Association of School Psychologists, National Association of 
     Social Workers, National Coalition for Mental Health 
     Recovery, National Council for Community Behavioral 
     Healthcare, National Council on Problem Gambling, School 
     Social Work Association of America, Therapeutic Communities 
     of America, Tourette Syndrome Association, U.S. Psychiatric 
     Rehabilitation Association, Witness Justice.

     * not a MHLG member

  Mr. DURBIN. Mr. President, three years ago, a mentally disturbed 
gunman walked into a campus lecture hall at Northern Illinois 
University and shot 22 students, killing 5 of them. Northern Illinois 
University is not the first college to experience this kind of tragedy. 
We all remember the horrific events at Virginia Tech in 2007 where 32 
lives were taken by a gunman.
  In the aftermath of these shootings, we asked what could have been 
done to prevent it. And years later, we are still trying to make sense 
of it. Some believe nothing can be done to stop a disturbed person from 
committing acts of violence. But I believe we can and should do more.
  For a long time, we have overlooked the mental health needs of 
students on college campuses. We know now that 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, and the students 
aren't always completely prepared. It is easier for a young person's 
problems to go unnoticed when he or she is away at college than when 
they are at home, in the company of parents, old friends, and high 
school teachers. College also provides a new opportunity for young 
people to experiment with drugs or alcohol.
  The consequences of not detecting or addressing mental health needs 
among students are real. Suicide remains the third leading cause of 
death for adolescents and young adults between ages 10-24. Suicide 
takes the lives of more young adults than AIDS, cancer, heart disease, 
pneumonia, birth defects, and influenza combined. Forty-five percent of 
college students report having felt so depressed that it was difficult 
to function. Ten percent have contemplated suicide. There are over 
1,000 suicides on college campus each year. These heartbreaking and 
traumatic incidents demonstrate the tragic consequences of mental 
instability and help us recognize we need to do more to support 
students during what can be very tough years.
  Fortunately, many students can succeed in college if they have 
appropriate counseling services and access to needed medications. These 
services make a real impact. Students who seek help are six times less 
likely to kill themselves. Colleges are welcoming students today 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.
  But while the needs for mental health services on campus are rising, 
colleges are facing financial pressures and having trouble meeting this 
demand. As I have travelled around my State, I have learned just how 
thin colleges and universities are stretched when it comes to providing 
counseling and other support services to students.
  Take Southern Illinois University in Carbondale. SIUC has 8 full-time 
counselors for 20,000 students. That is 1 counselor for every 2,500 
students. The recommended ratio is 1 counselor for every 1,500 
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 SIUC. 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.
  The story is the same across the country. Colleges are trying to fill 
in the gaps, but because of the shortage of counselors, students' needs 
are overlooked. A recent survey of college counseling centers indicates 
that the average ratio of professional-staff-to-students is 1 to 1,900. 
Although interest in mental health services is high, the recession has 
put pressure on administrators to cut budgets wherever they can. At 
times, counseling centers are in the crosshairs. Ten percent of survey 
respondents said their budgets were cut during the 2007-8 academic 
year, half said their budgets stayed the same, and nearly a quarter 
reported that their funds increased by 3 percent or less.
  With so many students looking for help and so few counselors to see 
them, counseling centers have to cut back on outreach. Without 
outreach, the chances of finding students who need help but don't ask 
for it goes down. This is a serious problem. We know that some students 
exhibit warning signs of a tortured mental state and four out of five 
young adults show warning signs before attempting suicide. But faculty 
and students don't always know how or where to express their concerns. 
Outreach efforts by

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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.
  We need to help schools meet the needs of their students, and that is 
why I am an original cosponsor of the Garrett Lee Smith Memorial Act 
Reauthorization. This bill includes an important provision of the 
Mental Health on Campus Improvement Act, which I introduced last 
Congress that would increase 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 Garrett Lee Smith Memorial Act Reauthorization 
would provide States, tribes/tribal organizations, and universities 
with much needed resources to prevent suicide.
  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 Garrett Lee Smith Memorial Act will help prevent 
the unnecessary loss of more young lives and bright futures.
                                 ______