[Congressional Record (Bound Edition), Volume 150 (2004), Part 13]
[House]
[Pages 17745-17754]
[From the U.S. Government Publishing Office, www.gpo.gov]




                     GARRETT LEE SMITH MEMORIAL ACT

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

                                S. 2634

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Garrett Lee Smith Memorial 
     Act''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) More children and young adults die from suicide each 
     year than from cancer, heart disease, AIDS, birth defects, 
     stroke, and chronic lung disease combined.
       (2) Over 4,000 children and young adults tragically take 
     their lives every year, making suicide the third overall 
     cause of death between the ages of 10 and 24. According to 
     the Centers for Disease Control and Prevention, suicide is 
     the third overall cause of death among college-age students.
       (3) According to the National Center for Injury Prevention 
     and Control of the Centers for Disease Control and 
     Prevention, children and young adults accounted for 15 
     percent of all suicides completed in 2000.
       (4) From 1952 to 1995, the rate of suicide in children and 
     young adults tripled.
       (5) From 1980 to 1997, the rate of suicide among young 
     adults ages 15 to 19 increased 11 percent.
       (6) From 1980 to 1997, the rate of suicide among children 
     ages 10 to 14 increased 109 percent.
       (7) According to the National Center of Health Statistics, 
     suicide rates among Native Americans range from 1.5 to 3 
     times the national average for other groups, with young 
     people ages 15 to 34 making up 64 percent of all suicides.
       (8) Congress has recognized that youth suicide is a public 
     health tragedy linked to underlying mental health problems 
     and that youth suicide early intervention and prevention 
     activities are national priorities.
       (9) Youth suicide early intervention and prevention have 
     been listed as urgent public health priorities by the 
     President's New Freedom Commission in Mental Health (2002), 
     the Institute of Medicine's Reducing Suicide: A National 
     Imperative (2002), the National Strategy for Suicide 
     Prevention: Goals and Objectives for Action (2001), and the 
     Surgeon General's Call to Action To Prevent Suicide (1999).
       (10) Many States have already developed comprehensive 
     statewide youth suicide early intervention and prevention 
     strategies that

[[Page 17746]]

     seek to provide effective early intervention and prevention 
     services.
       (11) In a recent report, a startling 85 percent of college 
     counseling centers revealed an increase in the number of 
     students they see with psychological problems. Furthermore, 
     the American College Health Association found that 61 percent 
     of college students reported feeling hopeless, 45 percent 
     said they felt so depressed they could barely function, and 9 
     percent felt suicidal.
       (12) There is clear evidence of an increased incidence of 
     depression among college students. According to a survey 
     described in the Chronicle of Higher Education (February 1, 
     2002), depression among freshmen has nearly doubled (from 8.2 
     percent to 16.3 percent). Without treatment, researchers 
     recently noted that ``depressed adolescents are at risk for 
     school failure, social isolation, promiscuity, self-
     medication with drugs and alcohol, and suicide--now the third 
     leading cause of death among 10-24 year olds.''.
       (13) Researchers who conducted the study ``Changes in 
     Counseling Center Client Problems Across 13 Years'' (1989-
     2001) at Kansas State University stated that ``students are 
     experiencing more stress, more anxiety, more depression than 
     they were a decade ago.'' (The Chronicle of Higher Education, 
     February 14, 2003).
       (14) According to the 2001 National Household Survey on 
     Drug Abuse, 20 percent of full-time undergraduate college 
     students use illicit drugs.
       (15) The 2001 National Household Survey on Drug Abuse also 
     reported that 18.4 percent of adults aged 18 to 24 are 
     dependent on or abusing illicit drugs or alcohol. In 
     addition, the study found that ``serious mental illness is 
     highly correlated with substance dependence or abuse. Among 
     adults with serious mental illness in 2001, 20.3 percent were 
     dependent on or abused alcohol or illicit drugs, while the 
     rate among adults without serious mental illness was only 6.3 
     percent.''.
       (16) A 2003 Gallagher's Survey of Counseling Center 
     Directors found that 81 percent were concerned about the 
     increasing number of students with more serious psychological 
     problems, 67 percent reported a need for more psychiatric 
     services, and 63 percent reported problems with growing 
     demand for services without an appropriate increase in 
     resources.
       (17) The International Association of Counseling Services 
     accreditation standards recommend 1 counselor per 1,000 to 
     1,500 students. According to the 2003 Gallagher's Survey of 
     Counseling Center Directors, the ratio of counselors to 
     students is as high as 1 counselor per 2,400 students at 
     institutions of higher education with more than 15,000 
     students.

     SEC. 3. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

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

[[Page 17747]]

       (ii) by striking ``, contract,'' each place such term 
     appears;
       (I) in subsection (h), by striking ``, contracts,'';
       (J) in subsection (i)--
       (i) by striking ``A State'' and all that follows through 
     ``organization receiving'' and inserting ``A public 
     organization, private nonprofit organization, political 
     subdivision, consortium of political subdivisions, consortium 
     of States, or Federally recognized Indian tribe or tribal 
     organization receiving''; and
       (ii) by striking ``, contract,'';
       (K) in subsection (k), by striking ``5 years'' and 
     inserting ``3 years'';
       (L) in subsection (l)--
       (i) in paragraph (2), by striking ``21'' and inserting 
     ``24''; and
       (ii) in paragraph (3), by striking ``which might have 
     been'';
       (M) in subsection (m)--
       (i) by striking ``Appropriation.--'' and all that follows 
     through ``For'' in paragraph (1) and inserting 
     ``Appropriation.--For''; and
       (ii) by striking paragraph (2);
       (N) by redesignating subsection (m) as subsection (n); and
       (O) by inserting after subsection (l) the following:
       ``(m) Definitions.--In this section, the terms `early 
     intervention', `educational institution', `institution of 
     higher education', `prevention', `school', and `youth' have 
     the meanings given to those terms in section 520E.''; and
       (2) by redesignating section 520E as section 520E-1.
       (c) Youth Suicide and Early Intervention and Prevention 
     Strategies.--Title V of the Public Health Service Act (42 
     U.S.C. 290aa et seq.) is amended by inserting before section 
     520E-1 (as redesignated by subsection (b)) the following:

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

       ``(a) In General.--The Secretary, acting through the 
     Administrator of the Substance Abuse and Mental Health 
     Services Administration, shall award grants or cooperative 
     agreements to eligible entities to--
       ``(1) develop and implement State-sponsored statewide or 
     tribal youth suicide early intervention and prevention 
     strategies in schools, educational institutions, juvenile 
     justice systems, substance abuse programs, mental health 
     programs, foster care systems, and other child and youth 
     support organizations;
       ``(2) support public organizations and private nonprofit 
     organizations actively involved in State-sponsored statewide 
     or tribal youth suicide early intervention and prevention 
     strategies and in the development and continuation of State-
     sponsored statewide youth suicide early intervention and 
     prevention strategies;
       ``(3) provide grants to institutions of higher education to 
     coordinate the implementation of State-sponsored statewide or 
     tribal youth suicide early intervention and prevention 
     strategies;
       ``(4) collect and analyze data on State-sponsored statewide 
     or tribal youth suicide early intervention and prevention 
     services that can be used to monitor the effectiveness of 
     such services and for research, technical assistance, and 
     policy development; and
       ``(5) assist eligible entities, through State-sponsored 
     statewide or tribal youth suicide early intervention and 
     prevention strategies, in achieving targets for youth suicide 
     reductions under title V of the Social Security Act.
       ``(b) Eligible Entity.--
       ``(1) Definition.--In this section, the term `eligible 
     entity' means--
       ``(A) a State;
       ``(B) a public organization or private nonprofit 
     organization designated by a State to develop or direct the 
     State-sponsored statewide youth suicide early intervention 
     and prevention strategy; or
       ``(C) a Federally recognized Indian tribe or tribal 
     organization (as defined in the Indian Self-Determination and 
     Education Assistance Act) or an urban Indian organization (as 
     defined in the Indian Health Care Improvement Act) that is 
     actively involved in the development and continuation of a 
     tribal youth suicide early intervention and prevention 
     strategy.
       ``(2) Limitation.--In carrying out this section, the 
     Secretary shall ensure that each State is awarded only 1 
     grant or cooperative agreement under this section. For 
     purposes of the preceding sentence, a State shall be 
     considered to have been awarded a grant or cooperative 
     agreement if the eligible entity involved is the State or an 
     entity designated by the State under paragraph (1)(B). 
     Nothing in this paragraph shall be construed to apply to 
     entities described in paragraph (1)(C).
       ``(c) Preference.--In providing assistance under a grant or 
     cooperative agreement under this section, an eligible entity 
     shall give preference to public organizations, private 
     nonprofit organizations, political subdivisions, institutions 
     of higher education, and tribal organizations actively 
     involved with the State-sponsored statewide or tribal youth 
     suicide early intervention and prevention strategy that--
       ``(1) provide early intervention and assessment services, 
     including screening programs, to youth who are at risk for 
     mental or emotional disorders that may lead to a suicide 
     attempt, and that are integrated with school systems, 
     educational institutions, juvenile justice systems, substance 
     abuse programs, mental health programs, foster care systems, 
     and other child and youth support organizations;
       ``(2) demonstrate collaboration among early intervention 
     and prevention services or certify that entities will engage 
     in future collaboration;
       ``(3) employ or include in their applications a commitment 
     to evaluate youth suicide early intervention and prevention 
     practices and strategies adapted to the local community;
       ``(4) provide timely referrals for appropriate community-
     based mental health care and treatment of youth who are at 
     risk for suicide in child-serving settings and agencies;
       ``(5) provide immediate support and information resources 
     to families of youth who are at risk for suicide;
       ``(6) offer access to services and care to youth with 
     diverse linguistic and cultural backgrounds;
       ``(7) offer appropriate postsuicide intervention services, 
     care, and information to families, friends, schools, 
     educational institutions, juvenile justice systems, substance 
     abuse programs, mental health programs, foster care systems, 
     and other child and youth support organizations of youth who 
     recently completed suicide;
       ``(8) offer continuous and up-to-date information and 
     awareness campaigns that target parents, family members, 
     child care professionals, community care providers, and the 
     general public and highlight the risk factors associated with 
     youth suicide and the life-saving help and care available 
     from early intervention and prevention services;
       ``(9) ensure that information and awareness campaigns on 
     youth suicide risk factors, and early intervention and 
     prevention services, use effective communication mechanisms 
     that are targeted to and reach youth, families, schools, 
     educational institutions, and youth organizations;
       ``(10) provide a timely response system to ensure that 
     child-serving professionals and providers are properly 
     trained in youth suicide early intervention and prevention 
     strategies and that child-serving professionals and providers 
     involved in early intervention and prevention services are 
     properly trained in effectively identifying youth who are at 
     risk for suicide;
       ``(11) provide continuous training activities for child 
     care professionals and community care providers on the latest 
     youth suicide early intervention and prevention services 
     practices and strategies;
       ``(12) conduct annual self-evaluations of outcomes and 
     activities, including consulting with interested families and 
     advocacy organizations;
       ``(13) provide services in areas or regions with rates of 
     youth suicide that exceed the national average as determined 
     by the Centers for Disease Control and Prevention; and
       ``(14) obtain informed written consent from a parent or 
     legal guardian of an at-risk child before involving the child 
     in a youth suicide early intervention and prevention program.
       ``(d) Requirement for Direct Services.--Not less than 85 
     percent of grant funds received under this section shall be 
     used to provide direct services, of which not less than 5 
     percent shall be used for activities authorized under 
     subsection (a)(3).
       ``(e) Coordination and Collaboration.--
       ``(1) In general.--In carrying out this section, the 
     Secretary shall collaborate with relevant Federal agencies 
     and suicide working groups responsible for early intervention 
     and prevention services relating to youth suicide.
       ``(2) Consultation.--In carrying out this section, the 
     Secretary shall consult with--
       ``(A) State and local agencies, including agencies 
     responsible for early intervention and prevention services 
     under title XIX of the Social Security Act, the State 
     Children's Health Insurance Program under title XXI of the 
     Social Security Act, and programs funded by grants under 
     title V of the Social Security Act;
       ``(B) local and national organizations that serve youth at 
     risk for suicide and their families;
       ``(C) relevant national medical and other health and 
     education specialty organizations;
       ``(D) youth who are at risk for suicide, who have survived 
     suicide attempts, or who are currently receiving care from 
     early intervention services;
       ``(E) families and friends of youth who are at risk for 
     suicide, who have survived suicide attempts, who are 
     currently receiving care from early intervention and 
     prevention services, or who have completed suicide;
       ``(F) qualified professionals who possess the specialized 
     knowledge, skills, experience, and relevant attributes needed 
     to serve youth at risk for suicide and their families; and
       ``(G) third-party payers, managed care organizations, and 
     related commercial industries.
       ``(3) Policy development.--In carrying out this section, 
     the Secretary shall--
       ``(A) coordinate and collaborate on policy development at 
     the Federal level with the relevant Department of Health and 
     Human

[[Page 17748]]

     Services agencies and suicide working groups; and
       ``(B) consult on policy development at the Federal level 
     with the private sector, including consumer, medical, suicide 
     prevention advocacy groups, and other health and education 
     professional-based organizations, with respect to State-
     sponsored statewide or tribal youth suicide early 
     intervention and prevention strategies.
       ``(f) Rule of Construction; Religious and Moral 
     Accommodation.--Nothing in this section shall be construed to 
     require suicide assessment, early intervention, or treatment 
     services for youth whose parents or legal guardians object 
     based on the parents' or legal guardians' religious beliefs 
     or moral objections.
       ``(g) Evaluations and Report.--
       ``(1) Evaluations by eligible entities.--Not later than 18 
     months after receiving a grant or cooperative agreement under 
     this section, an eligible entity shall submit to the 
     Secretary the results of an evaluation to be conducted by the 
     entity concerning the effectiveness of the activities carried 
     out under the grant or agreement.
       ``(2) Report.--Not later than 2 years after the date of 
     enactment of this section, the Secretary shall submit to the 
     appropriate committees of Congress a report concerning the 
     results of--
       ``(A) the evaluations conducted under paragraph (1); and
       ``(B) an evaluation conducted by the Secretary to analyze 
     the effectiveness and efficacy of the activities conducted 
     with grants, collaborations, and consultations under this 
     section.
       ``(h) Rule of Construction; Student Medication.--Nothing in 
     this section or section 520E-1 shall be construed to allow 
     school personnel to require that a student obtain any 
     medication as a condition of attending school or receiving 
     services.
       ``(i) Prohibition.--Funds appropriated to carry out this 
     section, section 520C, section 520E-1, or section 520E-2 
     shall not be used to pay for or refer for abortion.
       ``(j) Parental Consent.--States and entities receiving 
     funding under this section and section 520E-1 shall obtain 
     prior written, informed consent from the child's parent or 
     legal guardian for assessment services, school-sponsored 
     programs, and treatment involving medication related to youth 
     suicide conducted in elementary and secondary schools. The 
     requirement of the preceding sentence does not apply in the 
     following cases:
       ``(1) In an emergency, where it is necessary to protect the 
     immediate health and safety of the student or other students.
       ``(2) Other instances, as defined by the State, where 
     parental consent cannot reasonably be obtained.
       ``(k) Relation to Education Provisions.--Nothing in this 
     section or section 520E-1 shall be construed to supersede 
     section 444 of the General Education Provisions Act, 
     including the requirement of prior parental consent for the 
     disclosure of any education records. Nothing in this section 
     or section 520E-1 shall be construed to modify or affect 
     parental notification requirements for programs authorized 
     under the Elementary and Secondary Education Act of 1965 (as 
     amended by the No Child Left Behind Act of 2001; Public Law 
     107-110).
       ``(l) Definitions.--In this section:
       ``(1) Early intervention.--The term `early intervention' 
     means a strategy or approach that is intended to prevent an 
     outcome or to alter the course of an existing condition.
       ``(2) Educational institution; institution of higher 
     education; school.--The term--
       ``(A) `educational institution' means a school or 
     institution of higher education;
       ``(B) `institution of higher education' has the meaning 
     given such term in section 101 of the Higher Education Act of 
     1965; and
       ``(C) `school' means an elementary or secondary school (as 
     such terms are defined in section 9101 of the Elementary and 
     Secondary Education Act of 1965).
       ``(3) Prevention.--The term `prevention' means a strategy 
     or approach that reduces the likelihood or risk of onset, or 
     delays the onset, of adverse health problems that have been 
     known to lead to suicide.
       ``(4) Youth.--The term `youth' means individuals who are 
     between 10 and 24 years of age.
       ``(m) Authorization of Appropriations.--
       ``(1) In general.--For the purpose of carrying out this 
     section, there are authorized to be appropriated $7,000,000 
     for fiscal year 2005, $18,000,000 for fiscal year 2006, and 
     $30,000,000 for fiscal year 2007.
       ``(2) Preference.--If less than $3,500,000 is appropriated 
     for any fiscal year to carry out this section, in awarding 
     grants and cooperative agreements under this section during 
     the fiscal year, the Secretary shall give preference to 
     States that have rates of suicide that significantly exceed 
     the national average as determined by the Centers for Disease 
     Control and Prevention.''.
       (d) Mental and Behavioral Health Services on Campus.--Title 
     V of the Public Health Service Act (42 U.S.C. 290aa et seq.) 
     is amended by inserting after section 520E-1 (as redesignated 
     by subsection (b)) the following:

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

       ``(a) In General.--The Secretary, acting through the 
     Director of the Center for Mental Health Services, in 
     consultation with the Secretary of Education, may award 
     grants on a competitive basis to institutions of higher 
     education to enhance services for students with mental and 
     behavioral health problems that can lead to school failure, 
     such as depression, substance abuse, and suicide attempts, so 
     that students will successfully complete their studies.
       ``(b) Use of Funds.--The Secretary may not make a grant to 
     an institution of higher education under this section unless 
     the institution agrees to use the grant only for--
       ``(1) educational seminars;
       ``(2) the operation of hot lines;
       ``(3) preparation of informational material;
       ``(4) preparation of educational materials for families of 
     students to increase awareness of potential mental and 
     behavioral health issues of students enrolled at the 
     institution of higher education;
       ``(5) training programs for students and campus personnel 
     to respond effectively to students with mental and behavioral 
     health problems that can lead to school failure, such as 
     depression, substance abuse, and suicide attempts; or
       ``(6) the creation of a networking infrastructure to link 
     colleges and universities that do not have mental health 
     services with health care providers who can treat mental and 
     behavioral health problems.
       ``(c) Eligible Grant Recipients.--Any institution of higher 
     education receiving a grant under this section may carry out 
     activities under the grant through--
       ``(1) college counseling centers;
       ``(2) college and university psychological service centers;
       ``(3) mental health centers;
       ``(4) psychology training clinics; or
       ``(5) institution of higher education supported, evidence-
     based, mental health and substance abuse programs.
       ``(d) Application.--An institution of higher education 
     desiring a grant under this section shall prepare and submit 
     an application to the Secretary at such time and in such 
     manner as the Secretary may require. At a minimum, the 
     application shall include the following:
       ``(1) A description of identified mental and behavioral 
     health needs of students at the institution of higher 
     education.
       ``(2) A description of Federal, State, local, private, and 
     institutional resources currently available to address the 
     needs described in paragraph (1) at the institution of higher 
     education.
       ``(3) A description of the outreach strategies of the 
     institution of higher education for promoting access to 
     services, including a proposed plan for reaching those 
     students most in need of mental health services.
       ``(4) A plan to evaluate program outcomes, including a 
     description of the proposed use of funds, the program 
     objectives, and how the objectives will be met.
       ``(5) An assurance that the institution will submit a 
     report to the Secretary each fiscal year on the activities 
     carried out with the grant and the results achieved through 
     those activities.
       ``(e) Requirement of Matching Funds.--
       ``(1) In general.--The Secretary may make a grant under 
     this section to an institution of higher education only if 
     the institution agrees to make available (directly or through 
     donations from public or private entities) non-Federal 
     contributions in an amount that is not less than $1 for each 
     $1 of Federal funds provided in the grant, toward the costs 
     of activities carried out with the grant (as described in 
     subsection (b)) and other activities by the institution to 
     reduce student mental and behavioral health problems.
       ``(2) Determination of amount contributed.--Non-Federal 
     contributions required under paragraph (1) may be in cash or 
     in kind. Amounts provided by the Federal Government, or 
     services assisted or subsidized to any significant extent by 
     the Federal Government, may not be included in determining 
     the amount of such non-Federal contributions.
       ``(3) Waiver.--The Secretary may waive the requirement 
     established in paragraph (1) with respect to an institution 
     of higher education if the Secretary determines that 
     extraordinary need at the institution justifies the waiver.
       ``(f) Reports.--For each fiscal year that grants are 
     awarded under this section, the Secretary shall conduct a 
     study on the results of the grants and submit to the Congress 
     a report on such results that includes the following:
       ``(1) An evaluation of the grant program outcomes, 
     including a summary of activities carried out with the grant 
     and the results achieved through those activities.
       ``(2) Recommendations on how to improve access to mental 
     and behavioral health services at institutions of higher 
     education, including efforts to reduce the incidence of 
     suicide and substance abuse.
       ``(g) Definition.--In this section, the term `institution 
     of higher education' has the meaning given such term in 
     section 101 of the Higher Education Act of 1965.
       ``(h) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated

[[Page 17749]]

     $5,000,000 for fiscal year 2005, $5,000,000 for fiscal year 
     2006, and $5,000,000 for fiscal year 2007.''.

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


                             General Leave

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

                              {time}  1930

  Last year, over 4,000 young men and women in our great country 
resorted to the ultimate act of denial by committing suicide. Senator 
Gordon Smith of the other body has been the lead advocate for this 
legislation, and the bill is named in his son's honor, who, 
unfortunately, committed suicide last year, I think on this date. So we 
are here under the leadership of Senator Gordon Smith to try to do 
something legislatively to prevent future young Americans from 
resorting to suicide.
  I have had a young staff member on my staff last spring also commit 
suicide; so while I have not had the sacrifice or the tragedy that 
Senator Smith has had, I have been touched by suicide on my 
congressional staff down in Texas. I can tell you, as one would expect, 
that it is a very devastating experience. It is incredibly painful. It 
is a pain that is exacerbated when you see how your family and friends 
are burdened with grief because of an action like this. It is my 
sincere hope that the legislation the House is considering this 
evening, which the other body has already passed, will indeed help 
those who are troubled and are thinking about committing suicide in the 
future.
  This bill is a 3-year authorization bill that provides educational 
and support programs for children at risk of suicide. These suicide 
programs would be administered through a grant program through the 
States. It reflects a balanced and reasonable compromise that allows 
parents to have a direct role in determining whether their children 
participate in these long-range programs. At the same time, when there 
is a young man or woman in our country who is actively contemplating 
suicide, the bill would allow that emergency intervention could be done 
without any consent so that we stabilize that individual and prevent 
them from actually committing the suicide act at the time they are 
contemplating it.
  The compromise before us this evening does not modify in any way or 
affect any existing requirement under the No Child Left Behind Act. It 
is my hope that in the next Congress the House Committee on Energy and 
Commerce, which I have the privilege to chair, will systematically 
reauthorize many of the expired programs and even expired agencies at 
the Department of Health and Human Services.
  One of those agencies that we intend to look at very closely is the 
Substance Abuse and Mental Health Services Administration, or SAMSHA, 
which has primary responsibility to improve mental health services 
across this country. I am strongly inclined to rework several of the 
mental health service programs currently in effect at SAMSHA so that we 
are sure that the funding programs actually produce measurable results 
and the kind of results we intend those programs to produce. Without a 
doubt, as a part of our review of the SAMSHA program, I will pay close 
attention to SAMSHA's work in the area of suicide prevention.
  Mr. Speaker, I want to thank the subcommittee chairman, the gentleman 
from Florida (Mr. Bilirakis); the ranking member of the full committee, 
the gentleman from Michigan (Mr. Dingell); and the subcommittee ranking 
member, the gentleman from Ohio (Mr. Brown), for their cooperation in 
this legislation. I would also like to commend the gentleman from 
Tennessee (Mr. Gordon) and the gentleman from Oregon (Mr. Walden) for 
their help on the House side in improving this legislation. And, 
finally, I would like to thank the Speaker of the House and the 
majority leader for their assistance in expediting this bill as it 
comes to the floor today.
  Mr. Speaker, I would encourage my colleagues to support the 
legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. GARRETT of New Jersey. Mr. Speaker, I yield myself such time as I 
may consume.
  There is probably no more serious topic that we could be discussing 
this evening than we are right now when we are discussing suicide, 
especially when we are discussing suicide of young people. It is a 
serious topic, and it is an emotional topic.
  Earlier today, Mr. Speaker, I heard someone say in the Chamber that 
this House, as we move along and make changes, we do not always make 
large changes or great changes at one time; we may only be making 
changes incrementally. And my response to that was I am all in favor of 
incrementally moving the agenda along, just so long as we are moving it 
in the right direction and not in the wrong direction, a harmful 
direction, or a hurtful direction. I want to be moving the agenda along 
in a direction that is guided by facts and thought and planning and not 
by emotion.
  We just heard that this bill is moving along in an expedited fashion, 
and that is true. We are here tonight on a bill, on a piece of 
legislation, spending $82 million that would create two new Federal 
programs that never existed before, a new technical center that will 
deal with this issue as well; and yet there has never been an 
opportunity for input, discussion, a vote, or consideration in a 
committee. This bill has never gone in this House to a committee for a 
hearing, for a complete markup in a formal manner.
  If you are a parent and you have thoughts on this topic, you are 
concerned about your children or other children in your community, you 
have not had the opportunity to have your say, to have your feelings, 
to have your thoughts heard in a committee on this subject. If you are 
an expert in this field, a psychologist, psychiatrist, mental health 
association or the like, and you have thoughts about what would be best 
for our children or what would be harmful to our children, you too have 
not had the opportunity to have your thoughts or your opinions heard in 
a formal committee manner.
  So it is correct when we hear that this legislation is moving in an 
expedited format, without the committee process and already to the 
floor.
  Now, before this bill came up, we were talking about another topic, 
and I heard a lot of talk about the deficit and what grave financial 
straits we are in. I hope they continue with those feelings when we 
consider a bill that is $82 million in the making for the first

[[Page 17750]]

3 years, and how much after that no one knows.
  There was an article today in National Review that addresses this 
piece of legislation. It says, ``Occasionally a bill hits Capitol Hill 
over which there is remarkably little debate. This bill is an extreme 
example of that. Actually, according to news reports, there is no 
debating the bill, which provides additional Federal funding for 
suicide prevention programs in U.S. schools.'' It goes on, ``Well, of 
course if you are against suicide, you are for the bill; right?''
  Well, we really do not know. I am certainly against suicide. Everyone 
in this House is against suicide. But are we all for the bill? Are 
parents all for the bill? Are the experts all for the bill? The article 
goes on to point out that, ``No, the experts are not all for the 
bill.'' The Journal of the American Medical Association, the American 
Academy of Child and Adolescent Psychiatry have reported on this topic 
of suicide prevention programs, such as this bill addresses, and they 
reported, ``Suicide awareness programs in schools have not been shown 
to be effective either in reducing suicidal behavior or in increasing 
help-seeking behavior. Most kids who take their own lives are mentally 
ill. They need help, help that a school suicide prevention program is 
not going to provide them.''
  ``For some of the children, these new federally funded programs,'' as 
it says in the article, ``would reach awareness, putting ideas in their 
already normally confused adolescent heads.'' Conclusion: ``Such 
programs,'' as we are talking about tonight, ``could actually be 
harmful.''
  Let me go back to the issue of family and the like. We have to ask: 
Is this yet again another encroachment on the family, on the parent-
child relationship, one in which the Federal Government should at least 
ask for input and thought before we start creating new Federal programs 
on this level?
  In the end, are these programs, we should be asking ourselves, more 
harmful than helpful? The experts seem to indicate more harmful. 
Another expert, David Shaffer, M.D., Columbia College of Physicians and 
Surgeons, talking on the subject and doing research at Columbia 
University supported by grants for the Centers for Disease Control, 
suggests that ``case findings that involve giving lessons or lectures 
about suicide either to encourage suicidal students to identify 
themselves or to teach other students or teachers how to identify the 
suicidal teenager is not effective, and in some instances may undermine 
protective attitudes about suicide.''
  Furthermore, from Dr. Shaffer and others, ``self-identified 
attempters were less likely to approve of these programs, and there was 
little evidence that the programs were successful in influencing their 
views. There was some evidence that previous attempters were more upset 
by the programs than nonattempters were.''
  Again, the experts are showing that these programs that we are now 
spending money on may be more harmful than good.
  There was a case several years ago in Michigan where a second grade 
boy killed himself in the spring of the year, the day after watching a 
film in a suicide prevention class such as what we are talking about 
today. People who knew the young boy said that he was a happy child who 
had just been accepted into the school's gifted and talented program, 
and he was not depressed at all at the time of his death. Many think 
that he was merely mimicking what he saw in the movie in the suicide 
prevention program and had no intention to die. In the movie, the boy 
who tries to hang himself to commit suicide is rescued by his friends. 
In real life, that did not occur, and the 8-year-old boy, having 
attended a suicide prevention program, killed himself.
  As a parent, one also has to ask, where does the time come to do all 
these things in our schools? We already ask of our teachers so much, to 
teach all the curriculum already. Now we are adding an additional 
burden on the schools as well. I have talked to parents who have had 
their kids in public schools and have taken them out and either put 
them into private schools, Catholic schools, parochial schools, or home 
schooling. When I ask them why they do it, they say, because they 
realize the public schools are no longer focused on what they are 
supposed to be focusing on, and that is educating their kids. Instead, 
they are involved in so much other social programming, such as this.
  So we have to ask ourselves this question as well: Does this program 
address the needs of our schools as being able to fulfill their 
obligation to teach our kids?
  Next, we have to ask the question: Is this enough money, $82 million? 
Now, to me, that sounds like a lot of money; but if we are talking 
across the entire country for a 3-year period of time, I hazard a guess 
that next year and the year after that that people will be coming back 
and saying this was just a drop in the bucket and that we will have to 
spend even more.
  I figured it out just briefly in my head sitting over there earlier. 
This would provide my county in New Jersey maybe one new counselor, if 
it was spread evenly across the country. One counselor for my entire 
county. What about all the schools in that county? Will they not be 
looking for assistance as well, all the other services in the county? 
$82 million is not going to go that far.
  Now, it is set up as a 3-year program. In actuality, the bill that I 
am looking at talks about how much money we spend for the first 3 
years; but if we look at the fine print, it details $7 million one 
year, $16 million the next year, and $25 million the next year. That is 
3 years. But thereafter it says ``and such sums as may be necessary for 
each of the fiscal years 2008 and 2009.'' So, in reality, it is saying 
we know how much it is going to cost for the first 3 years, but after 
that it is anybody's question, as people come back asking for more.
  In the end, suicide is an emotional topic. The legislation we are 
dealing with today is an emotional topic. It is one that deserves our 
thoughtful time, it is one that deserves input from parents and experts 
alike, and so, therefore, Mr. Speaker, I would recommend to vote 
against this bill, or, better yet, to allow this bill to go back to 
committee for further consideration.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself 1 minute.
  Mr. Speaker, I want to thank my colleagues, the gentleman from 
Tennessee (Mr. Gordon), the gentleman from Texas (Mr. Barton), the 
gentleman from Florida (Mr. Bilirakis), and the gentleman from Michigan 
(Mr. Dingell), for their dedication to this bill. I also want to 
commend Cheryl Jaeger and John Ford of the staff of the Committee on 
Energy and Commerce for their good work.
  Youth suicide is an issue that strikes a deeply personal chord for 
all too many Americans. An intern in my office lost five classmates to 
suicide, the most in her school's history. This legislation recognizes 
that the causes of youth suicide are complex and individual; but every 
one of these tragedies is, in fact, preventable. It reflects the fact 
that preventing suicide requires an approach that is both comprehensive 
in its scope and targeted toward the populations most at risk.
  We will continue to work with the Department of Health and Human 
Services and mental health advocates to address one outstanding issue 
concerning parental consent; however, it makes sense to move forward 
and ensure that the good ideas in this bill are implemented as soon as 
possible.
  This legislation honors the courage of the families both within this 
Congress and across the country who have endured the tragedy of youth 
suicide and who seek to stop this crisis in its tracks. I am pleased to 
support this important legislation.
  Mr. BARTON of Texas. Mr. Speaker, I yield 3 minutes to the gentleman 
from Oregon (Mr. Walden).

                              {time}  1945

  Mr. WALDEN of Oregon. Mr. Speaker, I rise today in support of the 
Garrett Lee Smith Memorial Act. I extend sincere condolences to my 
colleague,

[[Page 17751]]

friend, constituent and fellow Oregonian, Senator Gordon Smith, sponsor 
of this act, and his family.
  It was exactly 1 year ago today that the Smith family was changed 
forever when Garrett Lee Smith took his life. As the father of a son 
myself, my heart aches for Gordon and Sharon, and the Smith family 
remains in our prayers. After Garrett's death, the Smith family's 
selfless dedication to shining the public spotlight on the tragedy of 
youth suicide and saving other families from the devastation of suicide 
is truly inspiring.
  Upon realizing that suicide is the third leading cause of death for 
15- to 24-year-olds, Senator Smith identified gaps in our public health 
infrastructure and crafted a bill to assist States, localities, tribal 
communities and college campuses in establishing youth suicide 
prevention programs. These programs will include prevention screening, 
early intervention, management and education activities.
  Suicide is an unspeakable tragedy. However, the provisions of the 
Garrett Lee Smith Memorial Act encourage young people to speak up about 
suicide, importantly to seek assistance when they are feeling hopeless 
or depressed, and to make sure they have access to trained specialists 
to help them make sense of the emotions that are overwhelming them. It 
also provides families and friends of at-risk youth with information 
and resources to support these very fragile people.
  There may be a misconception about this useful bill by some of my 
colleagues here in the House. Under no circumstances will this bill 
force parents to medicate their children as a condition of attending 
public school. In fact, it explicitly prohibits funds to be spent in 
such a way. Additionally, it does not allow schools to force children 
to attend school assemblies, undergo screenings for depression or 
receive treatment for depression without the written consent of a 
parent or guardian. It requires parental consent and involvement.
  The bill requires that States and entities receiving funding under 
this grant program shall obtain prior written informed consent from the 
child's parent or legal guardian for assessment services, school-
sponsored programs, and treatment involving medication related to the 
youth suicide conducted in elementary and secondary schools. So there 
is a very important provision for parents to be involved. Prior 
requirements do not apply if it is an emergency, as the chairman talked 
about.
  This bill comes to the House floor as a result of delicate 
negotiation at the Member level and hard work at the staff level. I 
want to thank especially the gentleman from Texas (Chairman Barton) and 
the subcommittee chairman, the gentleman from Florida (Mr. Bilirakis), 
and the gentleman from Ohio (Mr. Brown) and others for facilitating 
this bill's swift movement to the floor. All of these gentlemen were 
gracious and worked closely with Senator Smith to ensure that the 
Garrett Lee Smith Memorial Act would be considered by the House on this 
very day.
  I encourage my colleagues to support the Garrett Lee Smith Memorial 
Act. In closing, I echo the words of Senator Smith, my constituent. 
``Suicide and attempts do not simply leave an impression on the 
individual's life, it leaves a deep impact on everyone who knows the 
person or a family member of that person. No family should experience 
the pain we have suffered and no child should suffer the challenges of 
mental illness alone.''
  Mr. GARRETT of New Jersey. Mr. Speaker, I yield such time as he may 
consume to the gentleman from Iowa (Mr. King).
  Mr. KING of Iowa. Mr. Speaker, I thank the gentleman for yielding me 
this time.
  Mr. Speaker, I believe every life is a precious creation and that 
suicide is a tragic and terrible way to lose a family member or friend. 
One would automatically assume if you are against suicide, you will 
vote in favor of this bill; however, nothing could be further from the 
truth. We all want to stop suicide. Some of our most precious resources 
are our young people, and that resource must be preserved and promoted.
  Our children and teenagers are too valuable to be used as guinea pigs 
on this issue. The gentleman from New Jersey spoke of the movie 
Nobody's Useless, and I will not reiterate that here now, but that will 
not be the only case across this country where exposure to suicide 
discussion has actually brought on suicide. While this legislation does 
not fund suicide education for children under the age of 10, it did 
start out younger than the age of 10. I do not think we need to take 
chances with our young people. Awareness could put ideas into the heads 
of children and teenagers that are already at an awkward time in their 
lives.
  I would point out what happens when we do sex education and antidrug 
education. It is hard to find a program that resulted in less drug use 
or less sexual activity on the part of young people because they are 
made aware of something they may be afraid of. The more they talk about 
something, the more comfortable they get with it, the more likely they 
are to experiment.
  Research at Columbia University has suggested that encouraging 
suicidal students to identify themselves or to teach other students or 
teachers how to identify the suicidal teenager is not effective and in 
some instances may even undermine protective attitudes about suicide. 
In other words, the creation of this program can actually be harmful to 
our youth.
  In addition, we should also be asking ourselves is this really the 
role of the Federal Government. Federal money usually has strings 
attached to it. We do not know enough about how the grants will be 
distributed to know what these strings will be, but this legislation is 
just one more way that the government is encroaching on the lives and 
health care of private citizens and the parental role. Suicide 
prevention is best done through private counseling, faith-based groups, 
and within the nucleus of the family unit.
  I know of no successful suicide prevention programs. We should be 
able to find at least one successful model program somewhere in this 
world before we invest $82 million in a new, untried program.
  In conclusion, while I believe this bill is offered with good will 
and absolutely with the best intentions, and with broken hearts as 
well, we need to take a step back and realize that suicide is based on 
emotion, and it was from emotion that this bill was created.
  My heart goes out to those who have lost loved ones to suicide, and 
for that reason I ask my colleagues to vote no on this bill.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 4 minutes to the gentleman 
from Tennessee (Mr. Gordon), the sponsor of the bill, who has been a 
leader on this issue.
  Mr. GORDON. Mr. Speaker, I thank the gentleman from Ohio for helping 
bring this bill forward.
  Mr. Speaker, let me first follow up on the comments of the gentleman 
from Texas (Mr. Barton) that this bill really originated from a tragedy 
in Senator Gordon Smith's family. We all respect him for his courage in 
bringing this up, and our condolences go out to the Smith family on the 
first anniversary of that tragedy.
  I also thank the gentleman from Texas (Chairman Barton) for his hard 
work in expediting this bill. When this was taken to him earlier, he 
said he would do his best to bring it up. And as he always does, he not 
only did his best, he accomplished it, and I thank him for that.
  Unfortunately, it is certainly no fault of the chairman that this 
Garrett Lee Smith Memorial Act which started out as a bipartisan 
agreement is now mired in political extremism and really bizarre 
anecdotes. Let me be clear. I support the Senate version of this bill. 
The bill passed that body unanimously with the support of the White 
House. I sponsored the companion bill in the House. Unfortunately, a 
small group in the House have insisted on inserting language that 
undermines the very programs we are seeking to encourage.
  The language would require schools to treat suicide prevention 
programs differently from all other school-sponsored programs, 
requiring prior written parental permission for a child to even

[[Page 17752]]

attend a suicide prevention and awareness event. This would make 
suicide-prevention programs the only type of school-sponsored program 
with such a requirement.
  Suicide is a silent epidemic in this country. There are about 600,000 
teen suicide attempts each year that require emergency room care and 
hundreds of thousands more that are never reported. It is the third 
leading cause of death for older teens and the fourth leading cause of 
death for ages 10 to 14. Making it harder for schools to sponsor 
suicide-prevention programs undermines the goals of this legislation, 
and it perpetuates the very stigma that we are trying to overcome, and 
that is it is not okay to talk about youth suicide.
  Groups which have advised on this bill, including the National Mental 
Health Association, the Suicide Prevention Action Network, and the 
American Academy of Child and Adolescent Psychiatry, oppose this 
language. It puts passage in the Senate in question, and it puts hope 
of seeing this measure quickly reach the President in jeopardy.
  Mr. Speaker, while in Congress I have witnessed some frustrating 
moments, and this one ranks right up there at the top. Regrettably, it 
is increasingly rare these days for Members of Congress to set aside 
partisan politics, but we tried to do so on this bill because it was in 
the best interest of our Nation.
  However, in memory of our constituents and my colleagues' children 
who have lost their lives to suicide, I will reluctantly vote for this 
bill to keep this critically important legislation from dying in the 
House. I hope that this problematic language will be modified in the 
Senate.
  Mr. BARTON of Texas. Mr. Speaker, I yield 2 minutes to the gentleman 
from Nebraska (Mr. Osborne) who has been directly involved in these 
programs.
  Mr. OSBORNE. Mr. Speaker, I would like to thank the gentleman from 
Texas for his help on this bill. I am going to suspend my otherwise 
prepared remarks and try to address some of the concerns that we have 
heard here this evening about this bill.
  Mr. Speaker, 4,000 young people die per year from suicide, and I 
guess what we are being told here is we do not know of anything that 
will work, and this bill really may make things worse, and we may 
actually cause some people to take their lives. I would just like to 
mention what the bill is all about.
  Part 1 provides grant funding to States for development of a youth 
suicide prevention and intervention strategy. That does not necessarily 
mean that you go in and show films to kids of other kids killing 
themselves. It does not mean that you go out and hire a bunch of 
counselors to go into schools and tell kids do not kill yourselves. It 
may mean that you work with coaches and teachers to identify the signs, 
because there are very, very few suicides which occur where there are 
not some indications. It may be a term paper, a theme, it may be a 
comment in the locker room. So we can build awareness with those people 
who work with young people, and that is important.
  Some young people do not know that steroids are a leading cause of 
suicide. This is an education issue. Steroid precursors can be bought 
over the counter and cause untold number of suicides each year. People 
are not aware of that.
  This bill provides for screening programs that can identify mental 
health and behavioral conditions. There are certain medical conditions 
out there that make people more subject to suicide. It may be a 
personal tragedy that has occurred; it may be a friend who has 
committed suicide. These people can be watched more closely. There may 
be things which could be done. You do not have to go tell them, do not 
kill yourself.
  Lastly, the bill establishes the Federal Suicide Prevention Technical 
Assistance Center. People have said here, we do not know what works. 
That is what this center is for, to find out what strategies do work. 
That is the whole thing about it.
  Mr. GARRETT of New Jersey. Mr. Speaker, I yield myself 1 minute to 
respond.
  Many times in this House we do things for symbolic purposes, and I am 
not suggesting that this legislation is being done for symbolic 
purposes, but I do have to raise the question, as I did earlier, as to 
just what extent this bill may be successful if everything goes right.
  As I indicated before, we are spending at $82 million. That 
translates into around the addition of one new guidance counselor in 
every county in my State. So we have to question really are we 
providing any new services to the majority of kids, or are we just 
lifting up hopes and also the expectations of future calls for greater 
spending on these programs?
  As to the aspect of additional harm that may come from this, that is 
the very nature of the question that I raise here. We have yet to hear 
of any testimony in this body as to what is the nature of the benefits 
of this, from academic institutions, parents or otherwise, how this may 
benefit the students. Anecdotally we may have some, but I would think 
before we get into such a critical area as dealing with the mental 
state of our kids that we would want to have that information on hand.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman 
from Illinois (Mr. Davis).
  Mr. DAVIS of Illinois. Mr. Speaker, I rise in support of S. 2634 and 
commend Senator Gordon Smith and his family for helping to put the 
spotlight on this problem. I am happy to be the original sponsor, along 
with the gentleman from Nebraska (Mr. Osborne), for the second part of 
this legislation dealing with the mental and behavioral health of young 
people on our college campuses.

                              {time}  2000

  I was pleased to have our bill, H.R. 3593, the Campus Care and 
Counseling Act, combined with the gentleman from Tennessee's suicide 
bill to produce the Garrett Lee Smith Memorial Act. According to a 
survey described in the Chronicle of Higher Education in 2002, 
depression among college freshmen has nearly doubled, from 8.2 percent 
to 16.3. Along with depression, the number of suicidal students tripled 
and the number of students seen after a sexual assault quadrupled. 
Without treatment, researchers noted that depressed adolescents are at 
risk for school failure, social isolation, promiscuity, self-medication 
with drugs and alcohol, and suicide.
  I agree with the gentleman from Tennessee relative to some of the 
parental consent language. However, it is a good bill that leads us in 
the direction of dealing with a major health problem. Again I thank the 
gentleman from Ohio for yielding me this time.
  Mr. BARTON of Texas. Mr. Speaker, I reserve the balance of my time.
  Mr. GARRETT of New Jersey. Mr. Speaker, I yield myself such time as I 
may consume.
  Again I have to say it, the topic that we are dealing with is an 
extremely emotional one; and I take nothing away from what the sponsors 
are attempting to do with this legislation. And I take nothing away 
from the families that have suffered from the pains and arrows of going 
through this. All I say is that the best method of addressing this 
issue was perhaps, not perhaps, absolutely not followed in this 
procedure, that the parents in our communities have the right to have 
their say to make sure that we have the best system of taking care of 
their kids; that the experts, the doctors, the academies, have the 
right to have their say as to what are the best procedures as far as 
addressing the issue of suicide in schools. Finally, it ultimately 
falls upon our families and our parents to make sure that we are 
bringing our kids up in the correct manner.
  This legislation does not address that at all. This legislation 
simply expands once again the size and the scope of the Federal 
Government into an area where we have not heard any testimony tonight 
and never had the opportunity to hear testimony in the past to say 
whether this system will do more harm than good.
  Therefore, Mr. Speaker, I would suggest a ``no'' on this bill.

[[Page 17753]]

  Mr. Speaker, I yield the balance of my time to the gentleman from 
Texas (Mr. Barton).
  The SPEAKER pro tempore (Mr. Pearce). Without objection, the 
gentleman from Texas will control the balance of the time.
  There was no objection.
  Mr. BARTON of Texas. Mr. Speaker, could I ask since the distinguished 
gentleman from New Jersey has yielded to me the balance of his time, 
how much time that means I now have.
  The SPEAKER pro tempore. The gentleman from Texas has 6\1/2\ minutes, 
and the gentleman from Ohio (Mr. Brown) has 4 minutes.
  Mr. BROWN of Ohio. Mr. Speaker, I yield the balance of my time to the 
gentleman from Oregon (Mr. Blumenauer).
  The SPEAKER pro tempore. The gentleman from Oregon is recognized for 
4 minutes.
  Mr. BLUMENAUER. Mr. Speaker, I appreciate the gentleman's courtesy, 
and I appreciate the way that we are reallocating time a little bit to 
permit serious discussion of a serious topic. I deeply appreciate the 
expeditious way that the Committee on Energy and Commerce has moved 
forward with this. As my friend and colleague from Oregon pointed out, 
we have sort of a special sense in our State, but I must take exception 
with our colleagues who are rising in opposition of the philosophy 
somehow if we do not talk about this with our young people, if we do 
not establish programs, that it is going to go away.
  I would suggest that one of the reasons we have an epidemic of 
teenage suicide, especially among young men in this country, is because 
too few people do focus on the big picture, what it really means. 
Perhaps because it is so horrible, we do not really allow the reality 
to penetrate. But in a typical week in our State, there is more than 
one teenager who will take their life and about three in a typical day 
will be treated in an emergency room because of a failed attempt.
  Somebody who has worked to bring this out of the shadows and to put a 
face on these serious tragedies, to spare other families, not to tuck 
it away and assume that everything is going to be all right but to see 
what we can do to craft a solution that will spare people is our friend 
and colleague Senator Gordon Smith. As has been noted on the floor, 
Gordon and his wife, Sharon, lost their son who is memorialized in this 
act. This is a tremendously positive response that has grown out of a 
personal family tragedy.
  Frankly, I was disappointed in the changes that were added to this 
legislation, but I would take this for what it is, a positive start; 
and I appreciate what the committee has done. We are authorizing $82 
million over the next 3 fiscal years. In our great country of almost 
300 million people, this is truly a very small and modest beginning, 
but it is important.
  I am pleased that it speaks to the establishment of a national 
center, so perhaps we will have more compelling evidence for people to 
step forward and join in this effort. I am pleased that it will provide 
resources for statewide programs and especially programs run by Native 
American tribes where that need is especially acute. It is encouraging 
that we would establish new grants for mental and behavioral health 
services at colleges and universities. This is an important start, to 
let these young people who sadly have wrestled with these demons, let 
them know that they are not alone, let them know that there are 
services, that people do care and for us to experiment in ways to do a 
better job.
  In Oregon, we have a special interest not only in the courageous way 
that the Smith family has responded to trying to help other families 
but ours is a State with a suicide rate that is 40 percent higher than 
the national average. We all have an incentive to do our part. There is 
not a Member in this Chamber that has not either been touched directly 
in their family or by people close to them that they know and love. We 
have had cases on the floor of our colleagues just in the short time 
that I have been in Congress.
  I am hopeful that we can seize on the opportunity to approve and then 
improve this legislation, build upon it and to share in carrying this 
message to Congress and through Congress back to our communities. By 
our action, we can join the Smith family to help spare others this pain 
in the future. I appreciate the work of my colleagues on the committee.
  Mr. BARTON of Texas. Mr. Speaker, I yield 2 minutes to the 
distinguished gentleman from Nebraska (Mr. Osborne), who has been 
involved in programs to prevent suicide in Nebraska for a number of 
years.
  Mr. OSBORNE. Mr. Speaker, I thank the chairman for yielding me this 
time. I am sorry I had to be rushed earlier, and I thank him for giving 
me this extra time.
  In regard to the expeditious manner in which this bill has 
progressed, it actually started back in July. I know that there has 
been a tremendous amount of interplay and work over the last 6, 7, 8 
weeks. There has been a lot of give-and-take and a lot of valuable 
discussion. The thing that I did not get to talk about that I wanted to 
mention is that from 1952 to 1995, we have three times the number, the 
rate of suicides, in this country as we did in 1952. This is a national 
epidemic. So to say that we really should not do anything or we should 
really go slow for some reason rubs me the wrong way.
  The other aspect of the program that I wanted to mention today is the 
college mental health services. A survey regarding college students 
indicated that 60 percent of college students feel hopeless. More than 
40 percent report being depressed. And 9 percent are suicidal. On the 
college campus, we have tremendous problems with this issue. You do not 
have to again go to these students and say, do not kill yourself. We do 
not have to show them films, but we do have to persuade them that it is 
not unmanly or it is not weak on the part of a woman to express your 
problems, to go to a mental health service, to talk things out, to be 
open with what is bothering you. These are the kinds of things that 
need to happen.
  Part of this funding will simply go to enhance the mental health 
services on the college campus. This is not money that will be badly 
spent. This is something that is desperately needed. Again, Mr. 
Speaker, I thank the gentleman from Texas for his work.
  Mr. BARTON of Texas. Mr. Speaker, I yield myself the balance of my 
time.
  First of all, I want to comment on the procedural aspects of the 
consideration of this legislation. I think the gentleman from Tennessee 
(Mr. Gordon) pointed out a bill similar to this passed the other body 
100 to zero. That is a phenomenal accomplishment considering that the 
other body this year many days has not even agreed on whether the Sun 
rises in the east or the west. But on this particular piece of 
legislation, they passed it 100 to zero.
  The President of the United States, President Bush, and his 
legislative aides contacted my office immediately and asked us to 
expedite consideration of this legislation on the floor of the House. 
We took the bill that passed the other body, we looked at it and we 
felt like, as well-meaning as it was, that in many cases it was 
duplicative and it could be improved if we made some changes.
  To his credit, when we called Senator Smith, he agreed to work with 
us on that process. We attempted to bring the bill up the last day 
before we adjourned for the August work period. There were still some 
concerns that could not be worked out. That bill could only come up 
under unanimous consent. The minority leader, the gentlewoman from 
California, agreed to it, the majority leader the gentleman from Texas 
agreed to the unanimous consent, but there were some Members on the 
Republican side that still had concerns, so we pulled the bill that 
night. We spent the August work period working at the staff level to 
try to iron out the differences. I submit with no apology that the bill 
that is before us today as a result of those extra days and hours of 
consultation is a better bill.
  It requires that 85 percent of the funds expended have to be spent on 
direct services. So this is not an overhead bill. This is a direct-
services bill.

[[Page 17754]]

It requires that when grants are awarded to institutions that have 
existing programs, there be a dollar-for-dollar match, that the 
institution that already has a program has to match through services or 
in-kind contribution or direct dollars, dollar for dollar, the amount 
of the grant that they are receiving. There is a requirement in the 
legislation before us that there is an outcome-based assessment each 
year, so that as we begin to implement some of these programs, we 
actually go in and make sure that in future years we only award grants 
to programs that actually do have results in a positive way. I am very 
proud of that.
  In terms of the parental consent section of the bill, which was the 
most difficult to find a compromise, we agreed that if there is an 
emergency situation where direct intervention needs to be conducted to 
prevent an individual from committing suicide, that that can be done 
immediately and to whatever extent is necessary so that we stabilize 
that individual and prevent him from taking his life. But once that 
occurs, before there is any entry into a long-term program, the parents 
have to be notified and they have to consent in writing that their 
child can be involved in that long-term program. I personally think 
that is a very, very reasonable compromise.
  One can argue that the Federal Government should not be involved in 
early intervention and suicide prevention. That is a reasonable 
position to take. But given the fact that 4,000 of our young people 
killed themselves last year and that, as the gentleman from Nebraska 
has pointed out, suicide rates among our young people have tripled in 
the last 40 years, I think it is wise for the Federal Government to be 
involved. Every life that we save is a future productive citizen who is 
going to contribute to our society and to our country. I strongly agree 
that we should be involved with a Federal program that helps in that 
area.
  I would point out that this bill is a 3-year authorization bill. It 
is not a permanent expansion of any program. It is a 3-year 
authorization. As I said earlier, as we go through each year, the 
programs that are granted have to be evaluated on an outcomes basis. I 
think Members on both sides of the aisle, whether they are 
conservatives or liberals or moderates, regardless of whatever region 
of the country they come from, can sincerely and enthusiastically 
support this bill tomorrow when it comes to a vote. It is a good bill. 
I am proud that we have helped Senator Smith memorialize his son, the 
late Garrett Lee Smith; and I would hope that we get a unanimous vote 
tomorrow on this important piece of legislation.
  Mr. Speaker, I yield back the balance of my time.
  Mr. DINGELL. Mr. Speaker, I rise in support of S. 2634, the ``Garrett 
Lee Smith Memorial Act.'' This bill contains a variety of programs 
aimed at youth suicide early intervention and prevention, including 
campus mental and behavioral health service centers.
  Mr. Speaker, I urge my colleagues to read the findings in this bill. 
They contain alarming statistics on the incidence of youth suicide in 
this country. For example, according to the CDC, suicide is the third 
overall cause of death among college age students. More than 4,000 
children and young adults take their life each year, and the rate of 
youth suicides in increasing. The American College Health Association 
reports that 9 percent of college students have felt suicidal.
  While this bill contains many find provisions, it does contain 
language on parental consent that has drawn expressions of concern from 
a variety of mental health advocates. I hope that as this bill moves 
further along in the legislative process we can modify it further so 
that these concerns are reduced or eliminated. I also note that the 
bill before us contains an important rule of construction that makes 
clear that this legislation does not modify or affect current law on 
parental consent applicable to elementary and secondary education 
programs, including the law popularly known as No Child Left Behind.
  Mr. Speaker, I want to compliment my colleagues for the fine work 
they have done on this bill and I want to take particular note of the 
outstanding work of my good friend, Representative Bart Gordon and our 
Chairman, Representative Barton.
  Mr. WU. Mr. Speaker, I rise in strong support of the Garrett Lee 
Smith Memorial Act.
  I wish this bill were not necessary. Unfortunately, it is. Youth 
suicide is a growing problem that knows no geographic, cultural, 
racial, or socioeconomic bounds. More children and young adults die 
each year from suicide than from cancer, heart disease, AIDS, birth 
defects, stroke and chronic lung disease combined.
  More troubling, the rate of youth suicide has tripled in the last 50 
years. A recent study by the American College Health Association found 
that 61 percent of college students report feeding hopeless, 45 percent 
said they feel so depressed they could barely function, and 9 percent 
felt they were suicidal.
  The Garrett Lee Smith Memorial Act would provide critically important 
resources to help families, educators, and medical professionals better 
understand the warnings signs of a child in danger and foster better 
coordination and communication to come up with the best ways to prevent 
another painful loss.
  Specifically, the bill would authorize $82 million over 3 years to 
support efforts at the community, state, and Federal levels to enhance 
early intervention and prevention services. Federal funds would provide 
mental health services (e.g., screening, assessment, mentoring, 
counseling etc.) to children and young adults in a variety of youth-
oriented settings such as schools, juvenile justice systems, foster 
care, substantive abuse and mental programs. It would also help 
establish, and coordinate evaluation of the efficacy of early 
intervention and prevention programs specifically related to youth 
suicide.
  Mr. Speaker, this bill is named in memory and in honor of Senator 
Gordon Smith's son who tragically took his life after struggling with 
bipolar disorder. I admire Senator Smith and his wife, Sharon, who 
returned their family tragedy into something that will benefit other 
families. By sharing their story with others, they are raising 
awareness of this growing problem that I know will help prevent other 
youth suicides.

                              {time}  2015

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

                          ____________________