[House Report 116-516]
[From the U.S. Government Publishing Office]


116th Congress    }                                     {       Report
                        HOUSE OF REPRESENTATIVES
 2d Session       }                                     {      116-516

======================================================================



 
                    CAMPAIGN TO PREVENT SUICIDE ACT

                                _______
                                

 September 18, 2020.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Pallone, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 4585]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 4585) to require the Director of the Centers for 
Disease Control and Prevention to conduct a national suicide 
prevention media campaign, and for other purposes, having 
considered the same, reports favorably thereon with amendments 
and recommends that the bill as amended do pass.

                                CONTENTS

                                                                   Page
  I. Purpose and Summary..............................................3
 II. Background and Need for the Legislation..........................4
III. Committee Hearings...............................................5
 IV. Committee Consideration..........................................5
  V. Committee Votes..................................................5
 VI. Oversight Findings...............................................6
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures6
VIII.Federal Mandates Statement.......................................6

 IX. Statement of General Performance Goals and Objectives............6
  X. Duplication of Federal Programs..................................6
 XI. Committee Cost Estimate..........................................6
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......7
XIII.Advisory Committee Statement.....................................7

XIV. Applicability to Legislative Branch..............................7
 XV. Section-by-Section Analysis of the Legislation...................7
XVI. Changes in Existing Law Made by the Bill, as Reported............8

    The amendments are as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Campaign to Prevent Suicide Act''.

SEC. 2. NATIONAL SUICIDE PREVENTION LIFELINE.

  Section 520E-3(b)(2) of the Public Health Service Act (42 U.S.C. 
290bb-36c(b)(2)) is amended by inserting after ``suicide prevention 
hotline'' the following: ``, which, beginning not later than one year 
after the date of the enactment of the Campaign to Prevent Suicide Act, 
shall be a 3-digit nationwide toll-free telephone number,''.

SEC. 3. NATIONAL SUICIDE PREVENTION MEDIA CAMPAIGN.

  (a) National Suicide Prevention Media Campaign.--
          (1) In general.--Not later than the date that is three years 
        after the date of the enactment of this Act, the Secretary of 
        Health and Human Services (referred to in this section as the 
        ``Secretary''), in coordination with the Assistant Secretary 
        for Mental Health and Substance Use (referred to in this 
        section as the ``Assistant Secretary'') and the Director of the 
        Centers for Disease Control and Prevention (referred to in this 
        section as the ``Director''), shall conduct a national suicide 
        prevention media campaign (referred to in this section as the 
        ``national media campaign''), in accordance with the 
        requirements of this section, for purposes of--
                  (A) preventing suicide in the United States;
                  (B) educating families, friends, and communities on 
                how to address suicide and suicidal thoughts, including 
                when to encourage individuals with suicidal risk to 
                seek help; and
                  (C) increasing awareness of suicide prevention 
                resources of the Centers for Disease Control and 
                Prevention and the Substance Abuse and Mental Health 
                Services Administration (including the suicide 
                prevention hotline maintained under section 520E-3 of 
                the Public Health Service Act (42 U.S.C. 290bb-36c)), 
                any suicide prevention mobile application of the 
                Centers for Disease Control and Prevention or the 
                Substance Abuse Mental Health Services Administration, 
                and other support resources determined appropriate by 
                the Secretary.
          (2) Additional consultation.--In addition to coordinating 
        with the Assistant Secretary and the Director under this 
        section, the Secretary shall consult with, as appropriate, 
        State, local, Tribal, and territorial health departments, 
        primary health care providers, hospitals with emergency 
        departments, mental and behavioral health services providers, 
        crisis response services providers, first responders, suicide 
        prevention and mental health professionals, patient advocacy 
        groups, survivors of suicide attempts, and representatives of 
        television and social media platforms in planning the national 
        media campaign to be conducted under paragraph (1).
  (b) Target Audiences.--
          (1) Tailoring advertisements and other communications.--In 
        conducting the national media campaign under subsection (a)(1), 
        the Secretary may tailor culturally competent advertisements 
        and other communications of the campaign across all available 
        media for a target audience (such as a particular geographic 
        location or demographic) across the lifespan.
          (2) Targeting certain local areas.--The Secretary shall, to 
        the maximum extent practicable, use amounts made available 
        under subsection (f) for media that targets individuals in 
        local areas with higher suicide rates.
  (c) Use of Funds.--
          (1) Required uses.--
                  (A) In general.--The Secretary shall, to the extent 
                reasonably feasible with the funds made available under 
                subsection (f), carry out the following, with respect 
                to the national media campaign:
                          (i) The purchase of advertising time and 
                        space, including the strategic planning for, 
                        and accounting of, any such purchase.
                          (ii) Creative services and talent costs.
                          (iii) Advertising production costs.
                          (iv) Testing and evaluation of advertising.
                          (v) Evaluation of the effectiveness of the 
                        national media campaign.
                          (vi) Operational and management expenses.
                          (vii) The creation of an educational toolkit 
                        for television and social media platforms to 
                        use in discussing suicide and raising awareness 
                        about how to prevent suicide.
                  (B) Specific requirements.--
                          (i) Testing and evaluation of advertising.--
                        In testing and evaluating advertising under 
                        subparagraph (A)(iv), the Secretary shall test 
                        all advertisements after use in the national 
                        media campaign to evaluate the extent to which 
                        such advertisements have been effective in 
                        carrying out the purposes of the national media 
                        campaign.
                          (ii) Evaluation of effectiveness of national 
                        media campaign.--In evaluating the 
                        effectiveness of the national media campaign 
                        under subparagraph (A)(v), the Secretary shall 
                        take into account--
                                  (I) the number of unique calls that 
                                are made to the suicide prevention 
                                hotline maintained under section 520E-3 
                                of the Public Health Service Act (42 
                                U.S.C. 290bb-36c) and assess whether 
                                there are any State and regional 
                                variations with respect to the capacity 
                                to answer such calls;
                                  (II) the number of unique encounters 
                                with suicide prevention and support 
                                resources of the Centers for Disease 
                                Control and Prevention and the 
                                Substance Abuse and Mental Health 
                                Services Administration and assess 
                                engagement with such suicide prevention 
                                and support resources;
                                  (III) whether the national media 
                                campaign has contributed to increased 
                                awareness that suicidal individuals 
                                should be engaged, rather than ignored; 
                                and
                                  (IV) such other measures of 
                                evaluation as the Secretary determines 
                                are appropriate.
          (2) Optional uses.--The Secretary may use amounts made 
        available under subsection (f) for the following, with respect 
        to the national media campaign:
                  (A) Partnerships with professional and civic groups, 
                community-based organizations, including faith-based 
                organizations, and Government or Tribal organizations 
                that the Secretary determines have experience in 
                suicide prevention, including the Substance Abuse and 
                Mental Health Services Administration and the Centers 
                for Disease Control and Prevention.
                  (B) Entertainment industry outreach, interactive 
                outreach, media projects and activities, public 
                information, news media outreach, outreach through 
                television programs, and corporate sponsorship and 
                participation.
  (d) Prohibitions.--None of the amounts made available under 
subsection (f) may be obligated or expended for any of the following:
          (1) To supplant current suicide prevention campaigns.
          (2) For partisan political purposes, or to express advocacy 
        in support of or to defeat any clearly identified candidate, 
        clearly identified ballot initiative, or clearly identified 
        legislative or regulatory proposal.
  (e) Report to Congress.--Not later than 18 months after 
implementation of the national media campaign has begun, the Secretary, 
in coordination with the Assistant Secretary and the Director, shall, 
with respect to the first year of the national media campaign, submit 
to Congress a report that describes--
          (1) the strategy of the national media campaign and whether 
        specific objectives of such campaign were accomplished, 
        including whether such campaign impacted the number of calls 
        made to lifeline crisis centers and the capacity of such 
        centers to manage such calls;
          (2) steps taken to ensure that the national media campaign 
        operates in an effective and efficient manner consistent with 
        the overall strategy and focus of the national media campaign;
          (3) plans to purchase advertising time and space;
          (4) policies and practices implemented to ensure that Federal 
        funds are used responsibly to purchase advertising time and 
        space and eliminate the potential for waste, fraud, and abuse; 
        and
          (5) all contracts entered into with a corporation, a 
        partnership, or an individual working on behalf of the national 
        media campaign.
  (f) Authorization of Appropriations.--For purposes of carrying out 
this section, there is authorized to be appropriated $10,000,000 for 
each of fiscal years 2020 through 2024.

    Amend the title so as to read:
    A bill to require the Secretary of Health and Human 
Services to conduct a national suicide prevention media 
campaign, and for other purposes.

                         I. Purpose and Summary

    H.R. 4585, the ``Campaign to Prevent Suicide Act'', was 
introduced on October 1, 2019, by Representatives Donald S. 
Beyer, Jr. (D-VA) and Greg Gianforte (R-MT). H.R. 4585 would 
direct the Secretary of Health and Human Services (Secretary), 
in coordination with the Assistant Secretary for Mental Health 
and Substance Use (Assistant Secretary) and the Director of the 
Centers for Disease Control and Prevention (CDC), to carry out 
a national suicide prevention media campaign to advertise the 
new three-digit number for the National Suicide Prevention 
Lifeline, raise awareness for suicide prevention resources, and 
cultivate a more effective discourse on how to prevent suicide. 
The bill would also provide guidance to TV and social media 
companies on how to talk about suicide by creating a best 
practices toolkit.

                II. Background and Need for Legislation

    According to recent data, suicide is the tenth leading 
cause of death in the United States.\1\ In 2018, 10.7 million 
adults seriously contemplated suicide, 3.3 million of whom made 
suicide plans, and 1.4 million made a nonfatal suicide 
attempt.\2\ Although suicide rates vary by age group, it is the 
second leading cause of death in people between the ages of 10-
34 and the fourth leading cause of death among people aged 35-
54.\3\ Suicide rates among youth in Black communities are also 
on the rise.\4\
---------------------------------------------------------------------------
    \1\National Center for Health Statistics, Leading Causes of Death 
Reports, 1981-2018 (accessed September 10, 2020).
    \2\Substance Abuse and Mental Health Services Administration. Key 
substance use and mental health indicators in the United States: 
Results from the 2018 National Survey on Drug Use and Health (2019) 
(www.samhsa.gov/data/sites/default/files/cbhsqreports/
NSDUHNationalFindings Report2018/
NSDUHNationalFindingsReport2018.pdf).Ik
    \3\National Center for Health Statistics, Leading Causes of Death 
Reports, 1981-2018 (accessed September 10, 2020).
    \4\`We're losing our kids': Black youth suicide rate rising far 
faster than for whites; coronavirus, police violence deepen trauma, USA 
Today (June 7, 2020) (www.usatoday.com/story/news/health/2020/06/07/
coronavirus-police-violence-boost-risksrising-black-youth-suicide/
2300765001/).
---------------------------------------------------------------------------
    The coronavirus disease of 2019 (COVID-19) public health 
emergency has triggered distress for many Americans, such as 
experiencing the loss of family, friends, or community members, 
along with the loss of employment, insurance, and other 
supports. Research suggests that adverse effects of the 
pandemic on people with mental health conditions may be 
exacerbated by physical distancing, self-isolation, and 
fear.\5\ More broadly, close to half of Americans say that 
their mental health has been negatively affected due to worry 
and stress over the virus.\6\ Despite over 10 million Americans 
seriously considering suicide, many people do not know what 
resources exist or how to seek help.\7\
---------------------------------------------------------------------------
    \5\Kaiser Family Foundation, The Implications of COVID-19 for 
Mental Health and Substance Use (Apr. 21, 2020) (www.kff.org/
coronavirus-covid-19/issue-brief/the-implicationsof-covid-19-for-
mental-health-and-substance-use/).
    \6\Id.
    \7\As suicide, addiction death projections soar amid COVID-19, 
treatment centers struggle to stay alive too, USA Today (June 21, 2020) 
(www.usatoday.com/story/news/health/2020/06/21/covid-spurs-mental-
health-needs-treatmentcenters-go-underfunded/3191251001/).
---------------------------------------------------------------------------
    On July 17, 2020, the Federal Communications Commission 
(FCC) announced that it would move forward and establish 
``988'' as the new nationwide 3-digit number for the National 
Suicide Prevention Lifeline.\8\ This ``911 for the brain'' is 
aimed at making it easier for Americans to get help when in 
crisis. While this change to an easy-to-remember number is 
helpful, an FCC report identified the importance of an 
extensive public awareness campaign to publicize the new 
number.\9\ The North American Numbering Council, which is cited 
within the FCC report, says ``[a] national education plan would 
need to be created to alert consumers of the new 988 
abbreviated dialing code.''\10\ The Substance Abuse and Mental 
Health Services Administration (SAMHSA) also noted that ``a 
public education and awareness campaign to publicize the new 
number would be instrumental in encouraging the use of the new 
number.''\11\
---------------------------------------------------------------------------
    \8\Federal Communications Commission, Designating 988 for the 
National Suicide Prevention Lifeline (July 17, 2020).
    \9\Federal Communications Commission, Report on the National 
Suicide Hotline Improvement Act of 2018 (August 14, 2019).
    \10\Id.
    \11\Id.
---------------------------------------------------------------------------

                        III. Committee Hearings

    For the purposes of section 103(i) of H. Res. 6 of the 
116th Congress, the following hearing was used to develop or 
consider H.R. 4585:
    The Subcommittee on Health held a virtual legislative 
hearing on June 30, 2020, entitled, ``High Anxiety and Stress: 
Legislation to Improve Mental Health During Crisis.'' The 
hearing focused on H.R. 4585, the ``Campaign to Prevent Suicide 
Act'', and 21 other bills. The Subcommittee received testimony 
from the following witnesses:
           The Honorable Patrick J. Kennedy, Founder of 
        the Kennedy Forum and former Member of Congress
           Arthur C. Evans, Jr. Ph.D., Chief Executive 
        Officer, American Psychological Association;
           Jeffrey L. Geller, M.D., M.P.H., President, 
        American Psychiatric Association, Professor of 
        Psychiatry and Director of Public Sector Psychiatry at 
        the University of Massachusetts Medical School 
        Worcester Recovery Center and Hospital
           Ms. Arriana Gross, National Youth Advisory 
        Board Member, Sandy Hook Promise Students Against 
        Violence Everywhere (SAVE) Promise Club.

                      IV. Committee Consideration

    H.R. 4564, the ``Campaign to Prevent Suicide Act'', was 
introduced by Representatives Beyer (D-VA) and Gianforte (R-MT) 
on October 1, 2019, and the bill was referred to the Committee 
on Energy and Commerce. Subsequently, the bill was referred to 
the Subcommittee on Health on October 2, 2019. On June 30, 
2020, the Subcommittee held a legislative hearing on the bill.
    On July 15, 2020, the Subcommittee on Health was discharged 
from further consideration of H.R. 4564 because, pursuant to 
notice, the bill was called up for markup by the full Committee 
on Energy and Commerce. During Committee consideration of the 
bill, an amendment in the nature of a substitute, offered by 
Mr. Cardenas of California, was agreed to by a voice vote. At 
the conclusion of the bill's consideration, Mr. Pallone, 
Chairman of the committee, moved that H.R. 4585 be ordered 
reported favorably to the House, amended. The Pallone motion on 
final passage was agreed to by a voice vote by the full 
Committee, a quorum being present.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. The 
Committee advises that there were no record votes taken on H.R. 
4564, including the motion for final passage of the bill.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

 VII. New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.
    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.

                    VIII. Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

       IX. Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to require 
the Secretary of Health and Human Services to conduct a 
national suicide prevention media campaign, and for other 
purposes.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 4585 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

                      XI. Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

    XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 4585 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIII. Advisory Committee Statement

    No advisory committee within the meaning of section 5(b) of 
the Federal Advisory Committee Act was created by this 
legislation.

                XIV. Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

           XV. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the short title may be cited as 
the ``Campaign to Prevent Suicide Act''.

Sec. 2. National suicide prevention lifeline

    Section 2 amends the Public Health Service Act to specify 
that the suicide prevention hotline shall be a 3-digit 
nationwide toll-free telephone number not later than one year 
after the enactment of this Act.

Sec. 3. National suicide prevention media campaign

    Subsection (a) of section 3 directs the Secretary of Health 
and Human Services (the Secretary), with the Assistant 
Secretary for Mental Health and Substance Use and the CDC 
Director, to conduct a national suicide prevention media 
campaign for the purposes of preventing suicide in the United 
States; educating families, friends, and communities on how to 
address suicide and encourage individuals with suicidal risk to 
seek help; and increasing awareness of Federally supported 
suicide prevention resources, including the suicide prevention 
hotline, any suicide prevention mobile applications, and any 
other support resources determined appropriate by the 
Secretary. In planning the national campaign, the Secretary is 
directed to consult with State, local, Tribal, territorial 
health departments, primary health care providers, hospitals 
with emergency departments, mental and behavioral health 
services providers, crisis response services providers, first 
responders, suicide prevention and mental health professionals, 
patient advocacy groups, survivors of suicide attempts, and 
representatives of television and social media platforms.
    Subsection (b) of section 3 provides the Secretary with the 
authority to tailor culturally competent advertisements and 
other communications of the campaign across all available media 
for target audiences, such as those in a particular geographic 
location or demographic, across the lifespan. To the maximum 
extent practicable, the Secretary shall use funding provided 
under this Act for media that targets individuals in local 
areas with higher suicide rates.
    Subsection (c) of section 3 authorizes the use of funds to 
purchase advertising time and space, including planning costs; 
creative services and talent costs; advertising production 
costs; testing and evaluation; operational and management 
expenses; and costs associated with the creation of an 
educational toolkit for television and social media platforms 
for raising awareness about suicide and suicide prevention. In 
testing and evaluating advertisements, the Secretary shall test 
all national media campaign advertisements to evaluate the 
extent to which such advertisements were effective, taking into 
account the number of unique calls made to the suicide 
prevention hotline and State and regional capacity variations; 
the number of unique encounters and engagement with Federally 
supported suicide prevention and support resources; and whether 
the national media campaign contributed to increased awareness; 
in addition to any other relevant evaluation measures. 
Subsection (c) also permits funding to be used for partnerships 
with professional and civic groups, community-based 
organizations, including faith-based organizations, and 
Government or Tribal organizations that have experience in 
suicide prevention. Such partnerships can also include outreach 
to the entertainment industry, public information groups, 
television media, news media, and corporate sponsors.
    Subsection (d) of section 3 clarifies that funding 
authorized under this Act may not be used to supplant current 
suicide prevention campaigns, for partisan political purposes, 
or to express advocacy in support of or defeat of any 
identified candidate, ballot initiative, legislative or 
regulatory proposal.
    Subsection (e) of section 3 requires that no later than 18 
months after implementation of the national media campaign, the 
Secretary, in coordination with the Assistant Secretary and CDC 
Director, shall submit a report to Congress describing the 
strategy of the national media campaign and whether specific 
objectives of such campaign were accomplished, including 
whether such campaign affected the number of calls made to 
lifeline crisis centers and the capacity of such centers to 
manage calls; steps taken to ensure the effectiveness and 
efficiency of national media campaign; plans to purchase 
advertising time and space; policies and practices implemented 
to ensure that Federal funds are used responsibly to eliminate 
the potential for waste, fraud, and abuse; and all contracts 
entered into with a corporation, partnership, or an individual 
for purposes of the national media campaign.
    Subsection (f) of section 3 authorizes $10 million for each 
of fiscal years 2021 through 2025.

       XVI. Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italics and existing law in which no change is 
proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE V--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

           *       *       *       *       *       *       *



Part B--Centers and Programs

           *       *       *       *       *       *       *



Subpart 3--Center for Mental Health Services

           *       *       *       *       *       *       *



SEC. 520E-3. NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.

  (a) In General.--The Secretary, acting through the Assistant 
Secretary, shall maintain the National Suicide Prevention 
Lifeline program (referred to in this section as the 
``program''), authorized under section 520A and in effect prior 
to the date of enactment of the Helping Families in Mental 
Health Crisis Reform Act of 2016.
  (b) Activities.--In maintaining the program, the activities 
of the Secretary shall include--
          (1) coordinating a network of crisis centers across 
        the United States for providing suicide prevention and 
        crisis intervention services to individuals seeking 
        help at any time, day or night;
          (2) maintaining a suicide prevention hotline, which, 
        beginning not later than one year after the date of the 
        enactment of the Campaign to Prevent Suicide Act, shall 
        be a 3-digit nationwide toll-free telephone number, to 
        link callers to local emergency, mental health, and 
        social services resources; and
          (3) consulting with the Secretary of Veterans Affairs 
        to ensure that veterans calling the suicide prevention 
        hotline have access to a specialized veterans' suicide 
        prevention hotline.
  (c) Authorization of Appropriations.--To carry out this 
section, there are authorized to be appropriated $7,198,000 for 
each of fiscal years 2018 through 2022.

           *       *       *       *       *       *       *


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