[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\
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\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/).
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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\
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\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/).
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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\
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\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.
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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.
* * * * * * *
[all]