II 

118TH CONGRESS 

1ST SESSION S. 767 

To enhance mental health and psychosocial support within United States 

development and humanitarian assistance programs. 

IN THE SENATE OF THE UNITED STATES 

MARCH 9, 2023 

Mr. CASEY (for himself, Ms. STABENOW, Mr. BOOKER, Mrs. SHAHEEN, Mrs. 

MURRAY, Mr. MERKLEY, and Mr. FETTERMAN) introduced the following 

bill; which was read twice and referred to the Committee on Foreign Relations 

A BILL 

To enhance mental health and psychosocial support within 

United States development and humanitarian assistance 

programs. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLES. 

4 This Act may be cited as the ‘‘Mental Health in 

5 International Development and Humanitarian Settings 

6 Act’’ or the ‘‘MINDS Act’’. 

7 SEC. 2. FINDINGS; SENSE OF CONGRESS. 

8 (a) FINDINGS.—Congress finds the following: 


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1 (1) According to the World Health Organiza2 tion (referred to in this section as ‘‘WHO’’), an esti3 mated 1,000,000,000 individuals worldwide have a 

4 mental health or substance use disorder. 

5 (2) The Lancet Commission estimates that 

6 nearly 130,000,000 additional cases of major depres7 sive and anxiety disorders globally in 2020 resulted 

8 from the COVID–19 pandemic. 

9 (3) According to WHO— 

10 (A) depression is among the primary 

11 causes of illness and disability in adolescents; 

12 (B) 50 percent of mental health disorders 

13 emerge by the time an adolescent reaches 14 

14 years of age; and 

15 (C) 14 percent of children and adolescents 

16 worldwide experience mental health conditions, 

17 the majority of whom do not seek care, receive 

18 care, or have access to care. 

19 (4) According to a report commissioned by the 

20 United Nations— 

21 (A) more than 1 out of every 5 individuals 

22 living in a conflict-affected area has a mental 

23 health disorder; 

24 (B) approximately 1,500,000,000 (or 2 out 

25 of every 3) of the world’s children younger than 


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1 18 years of age live in countries affected by 

2 conflict; 

3 (C) more than 1 out of every 6 children 

4 live in conflict zones; 

5 (D) a greater number of children live in 

6 areas affected by armed conflict and war now 

7 than at any other time during this century; and 

8 (E) the mental health burden in conflict9 affected contexts is twice the global average. 

10 (5) According to the WHO— 

11 (A) risk factors that increase susceptibility 

12 to mental health disorders include— 

13 (i) poverty and hunger; 

14 (ii) chronic health conditions; 

15 (iii) trauma or maltreatment; 

16 (iv) social exclusion; 

17 (v) discrimination; and 

18 (vi) exposure to, and displacement by, 

19 war or conflict; 

20 (B) these risk factors, along with demo21 graphic risk factors, manifest at all stages in 

22 life; 

23 (C) preliminary research illustrates that 

24 the COVID–19 pandemic— 


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1 (i) has increased the risk factors af2 fecting communities, families, and individ3 uals for multiple types of adversity; and 

4 (ii) compounded preexisting conditions 

5 and vulnerabilities. 

6 (6) According to a Lancet Commission report— 

7 (A) allocations for mental health have 

8 never risen above 1 percent of health-related 

9 global development assistance; and 

10 (B) child and adolescent mental health 

11 services receive an estimated 0.1 percent of 

12 health-related global development assistance. 

13 (b) SENSE OF CONGRESS.—It is the sense of Con14 gress that— 

15 (1) helping to ensure that individuals have the 

16 opportunity to thrive and reach their fullest poten17 tial is a critical component of effective and sustain18 able international development efforts; 

19 (2) mental health is integral and essential to 

20 overall health outcomes and other development ob21 jectives; 

22 (3) mental health is an issue of critical and 

23 growing importance for United States development 

24 and humanitarian assistance programs that requires 

25 coordinated efforts to ensure that programming 


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1 funded by the United States Government is evi2 dence-based, culturally competent, and trauma-in3 formed; 

4 (4) the relevant United States Government de5 velopment and humanitarian assistance strategies 

6 should include a mental health and psychosocial sup7 port component; 

8 (5) the redesign of USAID— 

9 (A) reflects the nexus between humani10 tarian and development interventions; and 

11 (B) should be applied to all mental health 

12 and psychosocial support efforts of United 

13 States development and humanitarian assist14 ance programs; and 

15 (6) ongoing efforts to improve social service 

16 workforce development and local capacity building 

17 are essential to expanding mental health and psycho18 social support activities across all United States de19 velopment and humanitarian assistance programs. 

20 SEC. 3. DEFINITIONS. 

21 In this Act: 

22 (1) ADMINISTRATOR.—The term ‘‘Adminis23 trator’’ means the Administrator of USAID. 


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1 (2) USAID.—The term ‘‘USAID’’ means the 

2 United States Agency for International Develop3 ment. 

4 SEC. 4. COORDINATOR FOR MENTAL HEALTH AND PSYCHO5 SOCIAL SUPPORT. 

6 Section 135 of the Foreign Assistance Act of 1961 

7 (22 U.S.C. 2152f) is amended— 

8 (1) by redesignating subsection (f) as sub9 section (g); and 

10 (2) by inserting after subsection (e) the fol11 lowing: 

12 ‘‘(f) COORDINATOR FOR MENTAL HEALTH AND PSY13 CHOSOCIAL SUPPORT.— 

14 ‘‘(1) APPOINTMENT.—The Administrator of the 

15 United States Agency for International Develop16 ment, in consultation with the Secretary of State, is 

17 authorized to appoint a Mental Health and Psycho18 social Support Coordinator (referred to in this sec19 tion as the ‘MHPSS Coordinator’). 

20 ‘‘(2) SPECIFIC DUTIES.—The MHPSS Coordi21 nator shall— 

22 ‘‘(A) establish and chair the Mental Health 

23 and Psychosocial Support Working Group au24 thorized under section 4 of the MINDS Act; 


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1 ‘‘(B) guide, oversee, and direct mental 

2 health and psychosocial support programming 

3 and integration across United States foreign as4 sistance programming; 

5 ‘‘(C) serve as the main point of contact on 

6 mental health and psychosocial support in the 

7 Bureau for Global Health, the Bureau for Hu8 manitarian Assistance, regional bureaus, the 

9 Center for Education and the Inclusive Devel10 opment Hub in the Bureau for Development, 

11 Democracy, and Innovation, other bureaus, the 

12 Office of the Global AIDS Coordinator and 

13 Global Health Diplomacy, and other inter14 agency or presidential initiatives; 

15 ‘‘(D) promote best practices, coordination 

16 and reporting in mental health and psychosocial 

17 support programming across United States de18 velopment and humanitarian assistance pro19 grams; 

20 ‘‘(E) provide direction, guidance, and over21 sight on the integration of mental health and 

22 psychosocial support in United States develop23 ment and humanitarian assistance programs; 

24 and 


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1 ‘‘(F) participate in the Advancing Protec2 tion and Care for Children in Adversity Inter3 agency Working Group. 

4 ‘‘(3) FOCUS POPULATIONS.—The MHPSS Co5 ordinator, as appropriate, should prioritize popu6 lations with increased risk factors for developing 

7 mental health disorders, including— 

8 ‘‘(A) adult caretakers and children, includ9 ing families and adults who are long-term care10 takers; 

11 ‘‘(B) children and others who are sepa12 rated from a family unit; and 

13 ‘‘(C) other specific populations in need of 

14 mental health and psychosocial support, such as 

15 crisis affected communities, displaced popu16 lations, gender-based violence survivors, and in17 dividuals and households coping with the con18 sequences of diseases, such as Ebola, HIV/ 

19 AIDS, and COVID–19.’’. 

20 SEC. 5. MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT 

21 WORKING GROUP. 

22 The Administrator, in cooperation with the Mental 

23 Health and Psychosocial Support Coordinator appointed 

24 pursuant to section 135(f) of the Foreign Assistance Act 

25 of 1961, as added by section 4, shall establish the Mental 


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1 Health and Psychosocial Support Working Group, which 

2 shall include senior representatives from relevant USAID 

3 bureaus, the Department of State, and other Federal de4 partments and agencies, as appropriate, to ensure con5 tinuity and integration of mental health and psychosocial 

6 support across United States development and humani7 tarian assistance programs. 

8 SEC. 6. INTEGRATION OF MENTAL HEALTH AND PSYCHO9 SOCIAL SUPPORT. 

10 (a) STATEMENT OF POLICY.—It is the policy of the 

11 United States to integrate mental health and psychosocial 

12 support across all relevant United States development and 

13 humanitarian assistance programs. 

14 (b) IMPLEMENTATION OF POLICY.—The Adminis15 trator and the Secretary of State should— 

16 (1) require all USAID and Department of State 

17 regional bureaus and missions to advance the policy 

18 described in subsection (a) through relevant develop19 ment and humanitarian assistance efforts, including 

20 by building local capacity to inform, design, and im21 plement mental health and psychosocial support pro22 gramming; 

23 (2) ensure that all USAID and Department of 

24 State mental health and psychosocial support pro25 gramming— 


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1 (A) is evidence-based and culturally com2 petent; 

3 (B) responds to all types of childhood ad4 versity; and 

5 (C) includes trauma-specific interventions 

6 in accordance with the recognized principles of 

7 a trauma-informed approach, whenever applica8 ble; and 

9 (3) integrate the principles of the Advancing 

10 Protection and Care for Children in Adversity Strat11 egy. 

12 SEC. 7. CONSULTATION AND REPORTING REQUIREMENTS. 

13 (a) CONSULTATION.—Not later than 180 days after 

14 the date of the enactment of this Act, the Administrator, 

15 in coordination with the Secretary of State, shall consult 

16 with the Committee on Foreign Relations of the Senate 

17 and the Committee on Foreign Affairs of the House of 

18 Representatives regarding— 

19 (1) the progress made in carrying out section 

20 6(b); and 

21 (2) any barriers preventing the full integration 

22 of the strategy referred to in section 6(b)(3). 

23 (b) REPORT.—Not later than 1 year after the date 

24 of the enactment of this Act, and annually thereafter for 

25 the following 5 fiscal years, the Administrator and the 


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1 Secretary of State, in consultation with the Mental Health 

2 and Psychosocial Support Coordinator appointed pursuant 

3 to section 135(f) of the Foreign Assistance Act of 1961, 

4 as added by section 4, and the Director of the Office of 

5 Management and Budget, as necessary and appropriate, 

6 shall submit a report to the Committee on Foreign Rela7 tions of the Senate and the Committee on Foreign Affairs 

8 of the House of Representatives that describes— 

9 (1) the amount of United States development 

10 and humanitarian assistance program funding that 

11 was obligated and expended during the most recently 

12 concluded fiscal year on mental health and psycho13 social support programming; 

14 (2) how USAID and the Department of State 

15 are working to integrate mental health and psycho16 social programming, including child-specific pro17 gramming, into their development and humanitarian 

18 assistance programs across relevant sectors, includ19 ing health, education, nutrition, and protection; 

20 (3) the metrics of success of the Advancing 

21 Protection and Care for Children in Adversity Strat22 egy and the progress made towards achieving broad23 er mental health outcomes; 

24 (4) the programs in which trauma-specific 

25 strategies are being implemented, and how best 


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1 practices for trauma-informed programming are 

2 being shared across programs; 

3 (5) any barriers preventing full integration of 

4 child mental health and psychosocial support into 

5 programs for children and youth, and recommenda6 tions for modifications or expansion of such pro7 grams; 

8 (6) any barriers to the expansion of mental 

9 health and psychosocial support programming in 

10 conflict and humanitarian settings, and how such 

11 barriers are being addressed; 

12 (7) the impact of the COVID–19 pandemic on 

13 mental health and psychosocial support program14 ming; and 

15 (8) funding data, including a list of programs 

16 to which USAID and the Department of State have 

17 obligated funds during the most recently concluded 

18 fiscal year to improve access to, and the quality of, 

19 mental health and psychosocial support program20 ming in development and humanitarian contexts. 

21 SEC. 8. SUNSET. 

22 This Act, and the amendments made by this Act, 

23 shall terminate on the date that is 5 years after the date 

24 of the enactment of this Act. 

Æ 


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