[Congressional Record Volume 166, Number 169 (Tuesday, September 29, 2020)]
[House]
[Pages H5012-H5014]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  PURSUING EQUITY IN MENTAL HEALTH ACT

  Mr. PALLONE. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 5469) to address mental health issues for youth, 
particularly youth of color, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 5469

       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 ``Pursuing Equity in Mental 
     Health Act''.

     SEC. 2. TABLE OF CONTENTS.

       The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.

               TITLE I--HEALTH EQUITY AND ACCOUNTABILITY

Sec. 101. Integrated Health Care Demonstration Program.
Sec. 102. Addressing racial and ethnic minority mental health 
              disparities research gaps.
Sec. 103. Health professions competencies to address racial and ethnic 
              minority mental health disparities.
Sec. 104. Racial and ethnic minority behavioral and mental health 
              outreach and education strategy.
Sec. 105. Additional funds for National Institutes of Health.
Sec. 106. Additional funds for National Institute on Minority Health 
              and Health Disparities.

                       TITLE II--OTHER PROVISIONS

Sec. 201. Reauthorization of Minority Fellowship Program.
Sec. 202. Study on the Effects of Smartphone and Social Media Use on 
              Adolescents.

               TITLE I--HEALTH EQUITY AND ACCOUNTABILITY

     SEC. 101. INTEGRATED HEALTH CARE DEMONSTRATION PROGRAM.

       Part D of title V of the Public Health Service Act (42 
     U.S.C. 290dd et seq.) is amended by adding at the end the 
     following:

     ``SEC. 554. INTERPROFESSIONAL HEALTH CARE TEAMS FOR PROVISION 
                   OF BEHAVIORAL HEALTH CARE IN PRIMARY CARE 
                   SETTINGS.

       ``(a) Grants.--The Secretary shall award grants to eligible 
     entities for the purpose of establishing interprofessional 
     health care teams that provide behavioral health care.
       ``(b) Eligible Entities.--To be eligible to receive a grant 
     under this section, an entity shall be a Federally qualified 
     health center (as defined in section 1861(aa) of the Social 
     Security Act), rural health clinic, or behavioral health 
     program, serving a high proportion of individuals from racial 
     and ethnic minority groups (as defined in section 1707(g)).
       ``(c) Scientifically Based.--Integrated health care funded 
     through this section shall be scientifically based, taking 
     into consideration the results of the most recent peer-
     reviewed research available.
       ``(d) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated $20,000,000 
     for each of the first 5 fiscal years following the date of 
     enactment of the Pursuing Equity in Mental Health Act.''.

     SEC. 102. ADDRESSING RACIAL AND ETHNIC MINORITY MENTAL HEALTH 
                   DISPARITIES RESEARCH GAPS.

       Not later than 6 months after the date of the enactment of 
     this Act, the Director of the National Institutes of Health 
     shall enter into an arrangement with the National Academies 
     of Sciences, Engineering, and Medicine (or, if the National 
     Academies of Sciences, Engineering, and Medicine decline to 
     enter into such an arrangement, the Patient-Centered Outcomes 
     Research Institute, the Agency for Healthcare Research and 
     Quality, or another appropriate entity)--
       (1) to conduct a study with respect to mental health 
     disparities in racial and ethnic minority groups (as defined 
     in section 1707(g) of the Public Health Service Act (42 
     U.S.C. 300u-6(g))); and
       (2) to submit to the Congress a report on the results of 
     such study, including--
       (A) a compilation of information on the dynamics of mental 
     disorders in such racial and ethnic minority groups; and
       (B) a compilation of information on the impact of exposure 
     to community violence, adverse childhood experiences, 
     structural racism, and other psychological traumas on mental 
     disorders in such racial and minority groups.

     SEC. 103. HEALTH PROFESSIONS COMPETENCIES TO ADDRESS RACIAL 
                   AND ETHNIC MINORITY MENTAL HEALTH DISPARITIES.

       (a) In General.--The Secretary of Health and Human Services 
     shall award grants to qualified national organizations for 
     the purposes of--
       (1) developing, and disseminating to health professional 
     educational programs best practices or core competencies 
     addressing mental health disparities among racial and ethnic 
     minority groups for use in the training of students in the 
     professions of social work, psychology, psychiatry, marriage 
     and family therapy, mental health counseling, and substance 
     misuse counseling; and
       (2) certifying community health workers and peer wellness 
     specialists with respect to such best practices and core 
     competencies and integrating and expanding the use of such 
     workers and specialists into health care to address mental 
     health disparities among racial and ethnic minority groups.
       (b) Best Practices; Core Competencies.--Organizations 
     receiving funds under subsection (a) may use the funds to 
     engage in the following activities related to the development 
     and dissemination of best practices or core competencies 
     described in subsection (a)(1):
       (1) Formation of committees or working groups comprised of 
     experts from accredited health professions schools to 
     identify best practices and core competencies relating to 
     mental health disparities among racial and ethnic minority 
     groups.
       (2) Planning of workshops in national fora to allow for 
     public input into the educational needs associated with 
     mental health disparities among racial and ethnic minority 
     groups.
       (3) Dissemination and promotion of the use of best 
     practices or core competencies in undergraduate and graduate 
     health professions training programs nationwide.
       (4) Establishing external stakeholder advisory boards to 
     provide meaningful input into policy and program development 
     and best practices to reduce mental health disparities among 
     racial and ethnic minority groups.
       (c) Definitions.--In this section:
       (1) Qualified national organization.--The term ``qualified 
     national organization'' means a national organization that 
     focuses on the education of students in one or more of the 
     professions of social work, psychology, psychiatry, marriage 
     and family therapy, mental health counseling, and substance 
     misuse counseling.
       (2) Racial and ethnic minority group.--The term ``racial 
     and ethnic minority group'' has the meaning given to such 
     term in section 1707(g) of the Public Health Service Act (42 
     U.S.C. 300u-6(g)).

     SEC. 104. RACIAL AND ETHNIC MINORITY BEHAVIORAL AND MENTAL 
                   HEALTH OUTREACH AND EDUCATION STRATEGY.

       Part D of title V of the Public Health Service Act (42 
     U.S.C. 290dd et seq.), as amended by section 101, is further 
     amended by adding at the end the following new section:

     ``SEC. 555. BEHAVIORAL AND MENTAL HEALTH OUTREACH AND 
                   EDUCATION STRATEGY.

       ``(a) In General.--The Secretary shall, in consultation 
     with advocacy and behavioral and mental health organizations 
     serving racial and ethnic minority groups, develop and 
     implement an outreach and education strategy to promote 
     behavioral and mental health and reduce stigma associated 
     with mental health conditions and substance abuse among 
     racial and ethnic minority groups. Such strategy shall--
       ``(1) be designed to--
       ``(A) meet the diverse cultural and language needs of the 
     various racial and ethnic minority groups; and
       ``(B) be developmentally and age-appropriate;
       ``(2) increase awareness of symptoms of mental illnesses 
     common among such groups, taking into account differences 
     within at-risk subgroups;
       ``(3) provide information on evidence-based, culturally and 
     linguistically appropriate and adapted interventions and 
     treatments;
       ``(4) ensure full participation of, and engage, both 
     consumers and community members in the development and 
     implementation of materials; and

[[Page H5013]]

       ``(5) seek to broaden the perspective among both 
     individuals in these groups and stakeholders serving these 
     groups to use a comprehensive public health approach to 
     promoting behavioral health that addresses a holistic view of 
     health by focusing on the intersection between behavioral and 
     physical health.
       ``(b) Reports.--Beginning not later than 1 year after the 
     date of the enactment of this section and annually 
     thereafter, the Secretary shall submit to Congress, and make 
     publicly available, a report on the extent to which the 
     strategy developed and implemented under subsection (a) 
     increased behavioral and mental health outcomes associated 
     with mental health conditions and substance abuse among 
     racial and ethnic minority groups.
       ``(c) Definition.--In this section, the term `racial and 
     ethnic minority group' has the meaning given to that term in 
     section 1707(g).
       ``(d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $10,000,000 for 
     each of fiscal years 2021 through 2025.''.

     SEC. 105. ADDITIONAL FUNDS FOR NATIONAL INSTITUTES OF HEALTH.

       (a) In General.--In addition to amounts otherwise 
     authorized to be appropriated to the National Institutes of 
     Health, there is authorized to be appropriated to such 
     Institutes $100,000,000 for each of fiscal years 2021 through 
     2025 to build relations with communities and conduct or 
     support clinical research, including clinical research on 
     racial or ethnic disparities in physical and mental health.
       (b) Definition.--In this section, the term ``clinical 
     research'' has the meaning given to such term in section 409 
     of the Public Health Service Act (42 U.S.C. 284d).

     SEC. 106. ADDITIONAL FUNDS FOR NATIONAL INSTITUTE ON MINORITY 
                   HEALTH AND HEALTH DISPARITIES.

       In addition to amounts otherwise authorized to be 
     appropriated to the National Institute on Minority Health and 
     Health Disparities, there is authorized to be appropriated to 
     such Institute $650,000,000 for each of fiscal years 2021 
     through 2025.

                       TITLE II--OTHER PROVISIONS

     SEC. 201. REAUTHORIZATION OF MINORITY FELLOWSHIP PROGRAM.

       Section 597(c) of the Public Health Service Act (42 U.S.C. 
     297ll(c)) is amended by striking ``$12,669,000 for each of 
     fiscal years 2018 through 2022'' and inserting ``$25,000,000 
     for each of fiscal years 2021 through 2025''.

     SEC. 202. STUDY ON THE EFFECTS OF SMARTPHONE AND SOCIAL MEDIA 
                   USE ON ADOLESCENTS.

       (a) In General.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall conduct or support research on--
       (1) smartphone and social media use by adolescents; and
       (2) the effects of such use on--
       (A) emotional, behavioral, and physical health and 
     development; and
       (B) disparities in minority and underserved populations.
       (b) Report.--Not later than 5 years after the date of the 
     enactment of this Act, the Secretary shall submit to the 
     Congress, and make publicly available, a report on the 
     findings of research described in this section.

     SEC. 203. TECHNICAL CORRECTION.

       Title V of the Public Health Service Act (42 U.S.C. 290aa 
     et seq.) is amended--
       (1) by redesignating the second section 550 (42 U.S.C. 
     290ee-10) (relating to Sobriety Treatment And Recovery Teams) 
     as section 553; and
       (2) by moving such section, as so redesignated, so as to 
     appear after section 552 (42 U.S.C. 290ee-7).

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Oregon (Mr. Walden) each 
will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material on H.R. 5469.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I rise today in support of H.R. 5469, the Pursuing 
Equity in Mental Health Act.
  We have long known that people of color experience inequities in 
healthcare in the United States. While we have made progress to close 
these gaps in recent years, including with the passage of the 
Affordable Care Act, people of color in America continue to experience 
inequities in care and worse health outcomes compared to White 
Americans.
  These long-term trends are rooted in several social determinants that 
are often driven by structural discrimination and institutionalized 
racism, which has created systemic health inequity.
  The tragic results of these long-term trends are that people of color 
are more likely to suffer from underlying health conditions and have a 
much harder time getting access to care, and when they do, they are far 
more likely to experience bias, discrimination, and poor health 
outcomes.
  The Congressional Black Caucus' Emergency Task Force on Black Youth 
Suicide and Mental Health reiterated these points in a report last year 
that raised concerns about the increasing rates of suicide and mental 
health trends among Black children. The need to address these increased 
suicide rates has been recognized by public health experts, including 
the National Institute of Mental Health Director, Dr. Joshua Gordon. He 
recently wrote about mental health inequities, saying these gaps ``lead 
to worse mental health outcomes in underserved and minority 
communities.''
  In testimony before our committee, the American Psychological 
Association president, Dr. Arthur Evans, also underscored the need to 
diversify our mental health workforce if we are to improve care for 
communities of color.
  The bill before us today, H.R. 5469, is aimed specifically at 
addressing equity in mental health. The bill would invest resources 
into better understanding racial and ethnic minority mental health 
disparities, improve outreach and support for racial and ethnic 
minorities, and expand provider support for students of color entering 
the mental health workforce.
  I am hopeful, Madam Speaker, that this bill will help reduce the 
inequities in mental health. Before I conclude, I want to thank my 
colleague from New Jersey, Representative Bonnie Watson Coleman, and 
her staff for leading this important bill. I also thank Ranking Member 
Walden and his staff for working with us in a bipartisan manner to move 
this bill forward.
  Madam Speaker, I urge my colleagues to support the bill, and I 
reserve the balance of my time.
  Mr. WALDEN. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, I rise today in support of H.R. 5469. This is the 
Pursuing Equity in Mental Health Act, and it is sponsored by 
Representative Watson Coleman. It helps address suicide and mental 
illness in youth for minority and underserved communities.
  Despite improvements in health equity, disparities in mental health 
care persist. The Agency for Healthcare Research and Quality has 
reported that racial and ethnic minority groups in the United States 
are less likely to have access to mental health services and less 
likely to use community mental health services, but more likely to use 
emergency departments and more likely to receive lower quality care.
  Poor mental health care access and quality ultimately contribute to 
poorer outcomes, including suicide among these populations. These 
issues are especially acute in minority youth populations.
  H.R. 5469 would help address these disparities. It authorizes grants 
targeted at high-poverty communities for culturally and linguistically 
appropriate mental health services. It supports mental health 
disparities research, requires the studying of the impact of 
smartphones and social media on adolescents, and authorizes the 
Minority Fellowship Program to support more students of color entering 
the mental health workforce.
  Madam Speaker, I would like to thank the majority for taking the time 
to work with us to get this bill in a really good place. It is an 
important initiative, and I am pleased to see it getting a vote on the 
House floor today, Madam Speaker.
  Madam Speaker, I urge my colleagues to join both the chairman of the 
committee and myself in supporting this legislation, and I yield back 
the balance of my time.
  Mr. PALLONE. Madam Speaker, I also urge support for the bill, and I 
yield back the balance of my time.
  Ms. JACKSON LEE. Madam Speaker, as a cosponsor and senior member of 
the Judiciary and Homeland Security Committees, I rise in strong 
support of H.R. 5469, the ``Pursuing Equity in Mental Health Act of 
2019,'' which addresses mental health issues for youth, particularly 
youth of color.
  According to Mental Health America, Black and African American 
teenagers are more likely to attempt suicide than White teenagers, and 
suicidal thoughts, plans, and attempts have been rising in recent 
years.

[[Page H5014]]

  Furthermore, in the United States, over seven million people who 
identify as Black or African American reported having a mental illness 
in the past year.
  This legislation will combat the issue of suicide and mental health 
in youth from all communities by focusing on a few key areas: support 
in schools, scientific research, and increase funding in existing 
programs.
  Specifically, the bill provides $250 million to schools across the 
country, so they can have more culturally and linguistically 
appropriate mental health services.
  The bill stipulates that priority will be given to schools with 
higher levels of poverty, to reducing the ratio of counselors to 
students and to helping more students of color.
  These grants will also provide training for teachers and other school 
staff, so they can better identify the signs of trauma, mental health 
disorders, and risk of suicide in all students.
  Additionally, H.R. 5469 provides $20 million to establish 
interprofessional health care teams that can provide behavioral health 
care.
  Madam Speaker, I am particularly supportive of this bill's efforts to 
develop cultural competency educational curricula so that students who 
are training to be social workers, psychologists, psychiatrists, and 
therapists will be able to properly treat youth of color.
  This is imperative as we look to improve support for mental health 
for future generations.
  Furthermore, the bill directs the Department of Health and Human 
Services (HHS) to establish a Commission on the Effects of Smartphone 
and Social Media Usage on Adolescents as well as prohibits federal 
funds from being used for conversion therapy and prohibits SAMHSA 
grants from going to states that continue to allow such practices.
  Madam Speaker, I would like to thank Congresswoman Bonnie Watson 
Coleman for her leadership on this key piece of legislation.
  I ask my colleagues on both sides of the aisle to come together and 
pass this important legislation.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 5469, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________