PUBLIC LAW 108–355—OCT. 21, 2004

GARRETT LEE SMITH MEMORIAL ACT

118 STAT. 1404 PUBLIC LAW 108–355—OCT. 21, 2004

Public Law 108–355

108th Congress

An Act

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 authorize grants to institutions of higher

education to reduce student mental and behavioral health problems, and for

other purposes.

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

42 USC

290bb–36 note.

Garrett Lee

Smith

Memorial Act.

42 USC 201 note.

Oct. 21, 2004

[S. 2634]

PUBLIC LAW 108–355—OCT. 21, 2004 118 STAT. 1405

(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 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—

118 STAT. 1406 PUBLIC LAW 108–355—OCT. 21, 2004

(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;

Appropriation

authorization.

PUBLIC LAW 108–355—OCT. 21, 2004 118 STAT. 1407

‘‘(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;’’;

Contracts.

118 STAT. 1408 PUBLIC LAW 108–355—OCT. 21, 2004

(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

(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:

PUBLIC LAW 108–355—OCT. 21, 2004 118 STAT. 1409

‘‘(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 Statesponsored 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.

Contracts.

42 USC

290bb–36.

42 USC

290bb–36,

290bb–36a.

118 STAT. 1410 PUBLIC LAW 108–355—OCT. 21, 2004

‘‘(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 communitybased 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 childserving professionals and providers are properly trained in

youth suicide early intervention and prevention strategies and

that child-serving professionals and providers involved in early

PUBLIC LAW 108–355—OCT. 21, 2004 118 STAT. 1411

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 Services agencies and suicide working groups;

and

118 STAT. 1412 PUBLIC LAW 108–355—OCT. 21, 2004

‘‘(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 ACCOMMO- DATION.—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:

PUBLIC LAW 108–355—OCT. 21, 2004 118 STAT. 1413

‘‘(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;

42 USC

290bb–36b.

118 STAT. 1414 PUBLIC LAW 108–355—OCT. 21, 2004

‘‘(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, evidencebased, 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

Reports.

PUBLIC LAW 108–355—OCT. 21, 2004 118 STAT. 1415

LEGISLATIVE HISTORY—S. 2634:

CONGRESSIONAL RECORD, Vol. 150 (2004):

July 8, considered and passed Senate.

Sept. 8, considered in House.

Sept. 9, considered and passed House, amended. Senate concurred in House

amendment.

Æ

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

$5,000,000 for fiscal year 2005, $5,000,000 for fiscal year 2006,

and $5,000,000 for fiscal year 2007.’’.

Approved October 21, 2004.