I 

112TH CONGRESS 

1ST SESSION H. R. 1833 

To amend the Public Health Service Act to improve mental and behavioral 

health services on college campuses. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 11, 2011 

Ms. SCHAKOWSKY (for herself, Mr. RYAN of Ohio, Mr. WU, and Mr. STARK) 

introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and 

the Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend the Public Health Service Act to improve mental 

and behavioral health services on college campuses. 

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 TITLE. 

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

5 Campus Improvement Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 


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1 (1) The 2010 Association of University and 

2 College Counseling Center Directors Survey found 

3 that the average ratio of counselors to students on 

4 campus is nearly 1 to 1,940 and is often far higher 

5 on large campuses. The International Association of 

6 Counseling Services accreditation standards rec7 ommends 1 counselor per 1,000 to 1,500 students. 

8 (2) College Counselors report that 10.8 percent 

9 of enrolled students sought counseling in the past 

10 year, totaling an estimated 2,000,000 students. 

11 (3) Over 90 percent of counseling directors be12 lieve there is an increase in the number of students 

13 coming to campus with severe psychological prob14 lems; today, 44 percent of the students who visit 

15 campus counseling centers are dealing with severe 

16 mental illness, up from 16 percent in 2000, and 24 

17 percent are on psychiatric medication, up from 17 

18 percent in 2000. 

19 (4) The majority of campus counseling directors 

20 report that the demand for services and the severity 

21 of student needs are growing without an increase in 

22 resources. 

23 (5) Many students who need help never receive 

24 it. Only 15 percent of college students who commit 

25 suicide received campus counseling. Of students who 


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1 seriously consider suicide each year, only 52% of 

2 them seek any professional help at all. 

3 (6) A 2010 American College Health Associa4 tion survey of more than 95,000 college and univer5 sity students revealed that, within the last 12 

6 months, 48 percent of students report having felt 

7 overwhelming anxiety, 31 percent felt so depressed it 

8 was difficult to function, and 46 percent felt hope9 less. Both the ACHA survey as well as the National 

10 Research Consortium of Counseling Centers in 

11 Higher Education found that 6 percent of students 

12 have seriously considered suicide in the past 12 

13 months. 

14 (7) Research conducted between 1997 and 

15 2009, and presented at the 118th annual convention 

16 of the American Psychological Association found 

17 that more students are grappling with depression 

18 and anxiety disorders than did a decade ago. The 

19 study found that of students who sought college 

20 counseling, 41 percent had moderate to severe de21 pression in 2009, that number was 34 percent in 

22 1997. 

23 (8) A survey conducted by the University of 

24 Idaho Student Counseling Center in 2000 found 

25 that 77 percent of students who responded reported 


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1 that they were more likely to stay in school because 

2 of counseling and that their school performance 

3 would have declined without counseling. 

4 (9) Students with psychological issues often 

5 struggle academically and are at risk for dropping 

6 out of school. Counseling has been shown to address 

7 these issues while having a positive impact on stu8 dents remaining in school. A 6-year longitudinal 

9 study found college students receiving counseling to 

10 have an 11.4 percent higher retention rate than the 

11 general university population (Turner & Berry, 

12 2000). 

13 SEC. 3. IMPROVING MENTAL AND BEHAVIORAL HEALTH ON 

14 COLLEGE CAMPUSES. 

15 Title V of the Public Health Service Act is amended 

16 by inserting after section 520E–2 (42 U.S.C. 290bb–36b) 

17 the following: 

18 ‘‘SEC. 520E–3. GRANTS TO IMPROVE MENTAL AND BEHAV19 IORAL HEALTH ON COLLEGE CAMPUSES. 

20 ‘‘(a) PURPOSE.—It is the purpose of this section, 

21 with respect to college and university settings, to— 

22 ‘‘(1) increase access to mental and behavioral 

23 health services; 


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1 ‘‘(2) foster and improve the prevention of men2 tal and behavioral health disorders, and the pro3 motion of mental health; 

4 ‘‘(3) improve the identification and treatment 

5 for students at risk; 

6 ‘‘(4) improve collaboration and the development 

7 of appropriate levels of mental and behavioral health 

8 care; 

9 ‘‘(5) reduce the stigma for students with mental 

10 health disorders and enhance their access to mental 

11 health services; and 

12 ‘‘(6) improve the efficacy of outreach efforts. 

13 ‘‘(b) GRANTS.—The Secretary, acting through the 

14 Administrator and in consultation with the Secretary of 

15 Education, shall award competitive grants to eligible enti16 ties to improve mental and behavioral health services and 

17 outreach on college and university campuses. 

18 ‘‘(c) ELIGIBILITY.—To be eligible to receive a grant 

19 under subsection (b), an entity shall— 

20 ‘‘(1) be an institution of higher education (as 

21 defined in section 101 of the Higher Education Act 

22 of 1965 (20 U.S.C. 1001)); and 

23 ‘‘(2) submit to the Secretary an application at 

24 such time, in such manner, and containing such inVerDate Mar 15 2010 04:29 May 18, 2011 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1833.IH H1833

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1 formation as the Secretary may require, including 

2 the information required under subsection (d). 

3 ‘‘(d) APPLICATION.—An application for a grant 

4 under this section shall include— 

5 ‘‘(1) a description of the population to be tar6 geted by the program carried out under the grant, 

7 the particular mental and behavioral health needs of 

8 the students involved; 

9 ‘‘(2) a description of the Federal, State, local, 

10 private, and institutional resources available for 

11 meeting the needs of such students at the time the 

12 application is submitted; 

13 ‘‘(3) an outline of the objectives of the program 

14 carried out under the grant; 

15 ‘‘(4) a description of activities, services, and 

16 training to be provided under the program, including 

17 planned outreach strategies to reach students not 

18 currently seeking services; 

19 ‘‘(5) a plan to seek input from community men20 tal health providers, when available, community 

21 groups, and other public and private entities in car22 rying out the program; 

23 ‘‘(6) a plan, when applicable, to meet the spe24 cific mental and behavioral health needs of veterans 

25 attending institutions of higher education; 


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1 ‘‘(7) a description of the methods to be used to 

2 evaluate the outcomes and effectiveness of the pro3 gram; and 

4 ‘‘(8) an assurance that grant funds will be used 

5 to supplement, and not supplant, any other Federal, 

6 State, or local funds available to carry out activities 

7 of the type carried out under the grant. 

8 ‘‘(e) SPECIAL CONSIDERATIONS.—In awarding 

9 grants under this section, the Secretary shall give special 

10 consideration to applications that describe programs to be 

11 carried out under the grant that— 

12 ‘‘(1) demonstrate the greatest need for new or 

13 additional mental and behavioral health services, in 

14 part by providing information on current ratios of 

15 students to mental and behavioral health profes16 sionals; 

17 ‘‘(2) propose effective approaches for initiating 

18 or expanding campus services and supports using 

19 evidence-based practices; 

20 ‘‘(3) target traditionally underserved popu21 lations and populations most at risk; 

22 ‘‘(4) where possible, demonstrate an awareness 

23 of, and a willingness to, coordinate with a commu24 nity mental health center or other mental health reVerDate Mar 15 2010 04:29 May 18, 2011 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1833.IH H1833

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1 source in the community, to support screening and 

2 referral of students requiring intensive services; 

3 ‘‘(5) identify how the college or university will 

4 address psychiatric emergencies, including how in5 formation will be communicated with families or 

6 other appropriate parties; and 

7 ‘‘(6) demonstrate the greatest potential for rep8 lication and dissemination. 

9 ‘‘(f) USE OF FUNDS.—Amounts received under a 

10 grant under this section may be used to— 

11 ‘‘(1) provide mental and behavioral health serv12 ices to students, including prevention, promotion of 

13 mental health, voluntary screening, early interven14 tion, voluntary assessment, treatment, management, 

15 and education services relating to the mental and be16 havioral health of students; 

17 ‘‘(2) provide outreach services to notify stu18 dents about the existence of mental and behavioral 

19 health services; 

20 ‘‘(3) educate students, families, faculty, staff, 

21 and communities to increase awareness of mental 

22 health issues; 

23 ‘‘(4) support student groups on campus that 

24 engage in activities to educate students, including 

25 activities to reduce stigma surrounding mental and 


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1 behavioral disorders, and promote mental health 

2 wellness; 

3 ‘‘(5) employ appropriately trained staff; 

4 ‘‘(6) provide training to students, faculty, and 

5 staff to respond effectively to students with mental 

6 and behavioral health issues; 

7 ‘‘(7) expand mental health training through in8 ternship, post-doctorate, and residency programs; 

9 ‘‘(8) develop and support evidence-based and 

10 emerging best practices, including a focus on cul11 turally and linguistically appropriate best practices; 

12 and 

13 ‘‘(9) evaluate and disseminate best practices to 

14 other colleges and universities. 

15 ‘‘(g) DURATION OF GRANTS.—A grant under this 

16 section shall be awarded for a period not to exceed 3 years. 

17 ‘‘(h) EVALUATION AND REPORTING.— 

18 ‘‘(1) EVALUATION.—Not later than 18 months 

19 after the date on which a grant is received under 

20 this section, the eligible entity involved shall submit 

21 to the Secretary the results of an evaluation to be 

22 conducted by the entity concerning the effectiveness 

23 of the activities carried out under the grant and 

24 plans for the sustainability of such efforts. 


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1 ‘‘(2) REPORT.—Not later than 2 years after the 

2 date of enactment of this section, the Secretary shall 

3 submit to the appropriate committees of Congress a 

4 report concerning the results of— 

5 ‘‘(A) the evaluations conducted under 

6 paragraph (1); and 

7 ‘‘(B) an evaluation conducted by the Sec8 retary to analyze the effectiveness and efficacy 

9 of the activities conducted with grants under 

10 this section. 

11 ‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may 

12 provide technical assistance to grantees in carrying out 

13 this section. 

14 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 

15 are authorized to be appropriated such sums as may be 

16 necessary to carry out this section. 

17 ‘‘SEC. 520E–4. MENTAL AND BEHAVIORAL HEALTH OUT18 REACH AND EDUCATION ON COLLEGE CAM19 PUSES. 

20 ‘‘(a) PURPOSE.—It is the purpose of this section to 

21 increase access to, and reduce the stigma associated with, 

22 mental health services so as to ensure that college students 

23 have the support necessary to successfully complete their 

24 studies. 


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1 ‘‘(b) NATIONAL PUBLIC EDUCATION CAMPAIGN.— 

2 The Secretary, acting through the Administrator and in 

3 collaboration with the Director of the Centers for Disease 

4 Control and Prevention, shall convene an interagency, 

5 public-private sector working group to plan, establish, and 

6 begin coordinating and evaluating a targeted public edu7 cation campaign that is designed to focus on mental and 

8 behavioral health on college campuses. Such campaign 

9 shall be designed to— 

10 ‘‘(1) improve the general understanding of men11 tal health and mental health disorders; 

12 ‘‘(2) encourage help-seeking behaviors relating 

13 to the promotion of mental health, prevention of 

14 mental health disorders, and treatment of such dis15 orders; 

16 ‘‘(3) make the connection between mental and 

17 behavioral health and academic success; and 

18 ‘‘(4) assist the general public in identifying the 

19 early warning signs and reducing the stigma of men20 tal illness. 

21 ‘‘(c) COMPOSITION.—The working group under sub22 section (b) shall include— 

23 ‘‘(1) mental health consumers, including stu24 dents and family members; 

25 ‘‘(2) representatives of colleges and universities; 


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1 ‘‘(3) representatives of national mental and be2 havioral health and college associations; 

3 ‘‘(4) representatives of college health promotion 

4 and prevention organizations; 

5 ‘‘(5) representatives of mental health providers, 

6 including community mental health centers; and 

7 ‘‘(6) representatives of private- and public-sec8 tor groups with experience in the development of ef9 fective public health education campaigns. 

10 ‘‘(d) PLAN.—The working group under subsection (b) 

11 shall develop a plan that shall— 

12 ‘‘(1) target promotional and educational efforts 

13 to the college age population and individuals who are 

14 employed in college and university settings, including 

15 the use of roundtables; 

16 ‘‘(2) develop and propose the implementation of 

17 research-based public health messages and activities; 

18 ‘‘(3) provide support for local efforts to reduce 

19 stigma by using the National Mental Health Infor20 mation Center as a primary point of contact for in21 formation, publications, and service program refer22 rals; and 

23 ‘‘(4) develop and propose the implementation of 

24 a social marketing campaign that is targeted at the 


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1 college population and individuals who are employed 

2 in college and university settings. 

3 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated such sums as may be 

5 necessary to carry out this section.’’. 

6 SEC. 4. INTERAGENCY WORKING GROUP ON COLLEGE MEN7 TAL HEALTH. 

8 (a) PURPOSE.—It is the purpose of this section, pur9 suant to Executive Order 13263 (and the recommenda10 tions issued under section 6(b) of such Order), to provide 

11 for the establishment of a College Campus Task Force 

12 under the Federal Executive Steering Committee on Men13 tal Health, to discuss mental and behavioral health con14 cerns on college and university campuses. 

15 (b) ESTABLISHMENT.—The Secretary of Health and 

16 Human Services (referred to in this section as the ‘‘Sec17 retary’’) shall establish a College Campus Task Force (re18 ferred to in this section as the ‘‘Task Force’’), under the 

19 Federal Executive Steering Committee on Mental Health, 

20 to discuss mental and behavioral health concerns on col21 lege and university campuses. 

22 (c) MEMBERSHIP.—The Task Force shall be com23 posed of a representative from each Federal agency (as 

24 appointed by the head of the agency) that has jurisdiction 


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1 over, or is affected by, mental health and education poli2 cies and projects, including— 

3 (1) the Department of Education; 

4 (2) the Department of Health and Human 

5 Services; 

6 (3) the Department of Veterans Affairs; and 

7 (4) such other Federal agencies as the Adminis8 trator of the Substance Abuse and Mental Health 

9 Services Administration and the Secretary jointly de10 termine to be appropriate. 

11 (d) DUTIES.—The Task Force shall— 

12 (1) serve as a centralized mechanism to coordi13 nate a national effort— 

14 (A) to discuss and evaluate evidence and 

15 knowledge on mental and behavioral health 

16 services available to, and the prevalence of men17 tal health illness among, the college age popu18 lation of the United States; 

19 (B) to determine the range of effective, 

20 feasible, and comprehensive actions to improve 

21 mental and behavioral health on college and 

22 university campuses; 

23 (C) to examine and better address the 

24 needs of the college age population dealing with 

25 mental illness; 


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1 (D) to survey Federal agencies to deter2 mine which policies are effective in encouraging, 

3 and how best to facilitate outreach without du4 plicating, efforts relating to mental and behav5 ioral health promotion; 

6 (E) to establish specific goals within and 

7 across Federal agencies for mental health pro8 motion, including determinations of account9 ability for reaching those goals; 

10 (F) to develop a strategy for allocating re11 sponsibilities and ensuring participation in men12 tal and behavioral health promotions, particu13 larly in the case of competing agency priorities; 

14 (G) to coordinate plans to communicate re15 search results relating to mental and behavioral 

16 health amongst the college age population to 

17 enable reporting and outreach activities to 

18 produce more useful and timely information; 

19 (H) to provide a description of evidence20 based best practices, model programs, effective 

21 guidelines, and other strategies for promoting 

22 mental and behavioral health on college and 

23 university campuses; 

24 (I) to make recommendations to improve 

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1 ioral health promotion on college campuses and 

2 to ensure Federal efforts are consistent with 

3 available standards and evidence and other pro4 grams in existence as of the date of enactment 

5 of this Act; and 

6 (J) to monitor Federal progress in meeting 

7 specific mental and behavioral health promotion 

8 goals as they relate to college and university 

9 settings; 

10 (2) consult with national organizations with ex11 pertise in mental and behavioral health, especially 

12 those organizations working with the college age 

13 population; and 

14 (3) consult with and seek input from mental 

15 health professionals working on college and univer16 sity campuses as appropriate. 

17 (e) MEETINGS.— 

18 (1) IN GENERAL.—The Task Force shall meet 

19 at least 3 times each year. 

20 (2) ANNUAL CONFERENCE.—The Secretary 

21 shall sponsor an annual conference on mental and 

22 behavioral health in college and university settings 

23 to enhance coordination, build partnerships, and 

24 share best practices in mental and behavioral health 

25 promotion, data collection, analysis, and services. 


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1 (f) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated such sums as may be 

3 necessary to carry out this section. 

Æ 


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