IV 

116TH CONGRESS 

2D SESSION H. RES. 1057 

Expressing the sense of the House of Representatives that in order to effectively address the high prevalence of those suffering from mental health 

conditions and substance use disorders, the United States needs to make 

historic financial investments into mental health and substance use disorder care and finally acknowledge such care as a priority in health 

care equal to physical health, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 21, 2020 

Mr. KENNEDY (for himself, Ms. MATSUI, Mr. TONKO, Mr. CA ́RDENAS, and 

Mr. TRONE) submitted the following resolution; which was referred to the 

Committee on Energy and Commerce 

RESOLUTION 

Expressing the sense of the House of Representatives that 

in order to effectively address the high prevalence of 

those suffering from mental health conditions and substance use disorders, the United States needs to make 

historic financial investments into mental health and substance use disorder care and finally acknowledge such 

care as a priority in health care equal to physical health, 

and for other purposes. 

Whereas there is an urgent need to improve our health care 

system to better integrate mental health and substance 

use disorders so they are no longer seen separately; 


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Whereas according to the World Health Organization, mental 

illness is severely underdiagnosed, and less than half of 

those who meet diagnostic criteria are identified; 

Whereas there is a pressing need to provide a comprehensive 

solution to fix our health system that incorporates the 

needs and expertise of all its stakeholders, especially 

those who have expertise in mental health and substance 

use disorders; 

Whereas it is essential to remove the misguided association 

between mental illness and violence driven by fear and 

misunderstanding; 

Whereas mental illness and substance use disorders have 

been underresearched, undertreated, and overstigmatized; 

Whereas stigma, vilification, and dismissal of mental illness 

and substance use— 

(1) create a culture that— 

(A) discourages utilization of mental health and 

substance use disorder services; and 

(B) lacks acknowledgment that struggling with 

mental health conditions or substance use disorder is 

not something to be ashamed of; and 

(2) can vary in prominence in different cultures and 

communities, and are particularly high among communities of color and minority communities; 

Whereas men in particular face cultural and societal barriers 

to seeking treatment for mental health concerns and substance use disorders, which can contribute to concerning 

outcomes including suicide and aggressive behaviors; 

Whereas the bulk of our mental health and substance use disorder services are reactive instead of proactive, treating 

patients when they are in crisis instead of incorporating 


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services and screenings earlier in an attempt to prevent 

such crisis from occurring; 

Whereas there is a need to increase access to treatment, services, and social supports for everyone to proactively address root causes of mental illness and substance use disorders; 

Whereas it is necessary to address the root causes of mental 

health concerns and substance use disorders; 

Whereas it is necessary to address suicide in a holistic manner and recognize and address suicide ideation and not 

just the action in isolation; 

Whereas there is a need to address social determinants of 

health, which are conditions that directly and indirectly 

affect the health, health care, and wellness of individuals 

and communities, in order to effectively provide care for 

all individuals living with mental illness and substance 

use disorders; 

Whereas mental health impacts physical health, and physical 

health impacts mental health; 

Whereas the current health care system does not adequately 

incorporate mental health and substance use disorders 

into the assessment or delivery of care, as evidenced by 

the fact that all vital signs are currently for physical 

health alone and do not touch on mental health or substance use disorders; 

Whereas the lack of a united approach across the Federal 

Government to improve mental health and substance use 

disorders has left States and localities— 

(1) without adequate guidance or resources; 


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(2) without resources unable to provide the mental 

health and substance use disorder services needed to adequately meet the needs of their populations; and 

(3) with resources unable to effectively distribute 

services to adequately meet the needs of their populations; 

Whereas there is a need for greater collaboration across all 

Federal departments that touches various aspects of the 

health care system in order to fully incorporate the needs 

and concerns of everyone involved in the mental health 

and substance use disorder system; 

Whereas there is a need for greater collaboration between 

Federal, State, and local departments that touches on 

various aspects of the health care system; 

Whereas there is a need for one centralized location within 

the Federal Government for good, reliable information on 

mental health and substance use disorders for providers, 

patients, and caregivers; 

Whereas there is a need for standardized definitions, standards of care, and metrics for mental health and substance 

use disorders across disciplines; 

Whereas there is a need to change incentives for providers to 

better ensure everyone with mental health and substance 

use disorders needs gets access to the necessary care and 

treatment; 

Whereas the Mental Health Parity and Addiction Equality 

Act has been in effect since 2008, and 12 years later 

there is still a lack of compliance among insurers not 

adequately covering mental health and substance use disorder services; 


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Whereas Medicaid is the single largest payer of mental health 

and substance use disorder services, and reimbursement 

is far from adequate; 

Whereas there is a need to incentivize payers to adequately 

cover mental health and substance use disorder services 

in the same manner that all specialty services are covered; 

Whereas there is a need to increase the number of mental 

health and substance use disorder providers; 

Whereas 55 percent of counties in the United States do not 

have a single psychiatrist, psychologist, or social worker; 

Whereas only 10 percent of people suffering from a substance 

use disorder receive specialty treatment; 

Whereas there is a need to increase access and utilization to 

telemedicine for mental health and substance use disorder 

services both within States and across State lines; 

Whereas patient privacy needs to be protected, but there 

needs to be a better way to share information among providers to better serve the patient’s needs; 

Whereas safe housing needs to be recognized as a basic requirement for treatment to be successful and needs to be 

better addressed as people transition care; 

Whereas there is a need to improve social determinants of 

health, such as increased access to stable housing and 

jobs, for those suffering from mental illness and substance use disorders to have a sustained recovery; 

Whereas there is a need to provide care in more appropriate 

and integrated settings for all patients, such as treating 

geriatric patients in their homes as opposed to nursing 

homes, when appropriate and in compliance with the 


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Americans with Disabilities Act of 1990 (Public Law 

101–336) and the Supreme Court’s Olmstead v. L.C. decision; 

Whereas there is a need for greater focus on intensive outpatient, partial hospitalizations, residential programs, day 

programs, supported housing, assertive community treatment, mobile crisis services, peer support services, supported employment, and community-based services for 

adults with mental illness and substance use disorders; 

Whereas there is a need to ensure that services support individuals with mental health conditions and substance use 

disorders to participate fully in their communities and 

live and thrive independently 

Whereas there needs to be consistent care coordination and 

more effective transition services for those moving between hospitals and the community; 

Whereas there is a need to address isolation issues geriatric 

patients face which can negatively impact their mental 

health; 

Whereas depression, anxiety, post-traumatic stress, and psychosis are some of the most common conditions women 

experience pre- and postpartum; 

Whereas unmet parental mental health and substance use 

disorder treatment and service needs contribute to increased involvement with the child welfare system, which 

leads to preventable foster care placements, given that— 

(1) in 2018, 262,956 children entered foster care, 

with the leading reasons related to mental health and 

substance use disorder needs of the parents, with— 

(A) 36 percent of children entering care as a 

result of parental drug abuse; 


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(B) 14 percent of children entering care as a 

result of the caretaker’s inability to cope; and 

(C) 5 percent of children entering care as a result of parental alcohol abuse; 

(2) even when necessary to ensure a child’s safety, 

foster care itself creates additional trauma for both the 

child and family; and 

(3) longstanding racial inequities in child welfare 

services create disproportionate child welfare involvement 

for Black, Native, and Latinx children and families, 

which exacerbates those families’ experiences of trauma 

and contribute to health disparities while not resulting in 

needed access to quality mental health and substance use 

disorder services; 

Whereas children and adolescents have unique needs when it 

comes to mental health and substance use disorders and 

the services provided, given that— 

(1) 45 percent of children have experienced adverse 

childhood experiences which have the potential to significantly impact the mental health of children; 

(2) in the last 12 months, 49.4 percent of children 

who needed mental health services did not receive the 

necessary services, and there needs to be improved access 

to more appropriate treatment services, which must focus 

on community-based supports and services available near 

their home, in order to effectively prevent children from 

experiencing a mental health crisis; 

(3) many children suffering and struggling go 

undiagnosed and are not adequately supported, and there 

is a need to improve training and understanding of mental health and substance use disorder concerns for educators since often there are barriers to mental health and 

substance use disorder treatment in a school setting; 


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(4) 42 percent of school districts have reported using 

threat assessment and risk assessment teams, an approach created by the United States Secret Service that 

involves identifying, evaluating, and taking action on current or potential threats which— 

(A) can cause significant harm to the mental 

health and emotional well-being of children; 

(B) has compounded already existent stigma for 

groups of students; 

(C) has had a disproportionate impact on students of color by initiating justice involvement in 

lieu of more appropriate services; and 

(D) has had a disproportionate impact on students with disabilities; 

(5) families and caregivers need to be included when 

treating children suffering from mental illness and substance use disorders; and 

(6) when children turn 18 they are cut off from 

mental health and substance use disorder services which 

impacts continuity of care; 

Whereas there is a growing need for mental health and substance use disorder services amongst young adults and 

college-aged adults, and between 2007 and 2017, for 

those aged 18–34 there was a— 

(1) 108-percent increase in drug-related deaths; 

(2) 69-percent increase in alcohol-induced deaths; 

and 

(3) 35-percent increase in suicide deaths; 

Whereas despite the rising need for mental health and substance use disorder treatment by young adults, there continues to be disparities in accessing care experienced by 

young adults of color; 


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Whereas 5.5 million veterans and servicemembers rely on the 

Department of Veterans Affairs for health services, and 

1.5 million veterans have received a mental health diagnosis, and— 

(1) 1 in 4 active duty members shows signs of mental health conditions; 

(2) the rate of post-traumatic stress disorder 

(PTSD) is 15 times higher in servicemembers than compared to civilians due to military combat and military 

sexual assault and trauma; 

(3) the rate of depression is 5 times higher in 

servicemembers than compared to civilians; 

(4) every day, 22 veterans die by suicide; 

(5) there is a fear of disclosing mental health conditions and substance use disorders and seeking treatment 

due to negative career implications; and 

(6) less than 50 percent of veterans receive the mental health treatment and services they need; 

Whereas 11 percent of those entering the Veterans Affairs 

health system meet the criteria for a substance use disorder; 

Whereas veterans are more likely to have an alcohol use disorder than civilians; 

Whereas 2 in 10 veterans with PTSD have a comorbid substance use disorder, and 1 in 3 veterans seeking services 

for a substance use disorder also have PTSD, showing 

the interconnectedness between these conditions; 

Whereas there is a need to better educate all those in the 

criminal justice system on the impact and needs of those 

with mental health conditions and substance use disorders; 


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Whereas the United States justice system is the largest provider of mental health services, and it was not built, or 

intended to be used, for that purpose, and— 

(1) there are 550,000 people currently incarcerated 

with mental illness; 

(2) 1 in 5 people incarcerated has a serious mental 

illness; and 

(3) of those incarcerated, 75 percent with a serious 

mental illness suffer from a co-occurring substance use 

disorder; 

Whereas there is a need for incentives to reduce inappropriate incarceration and detention for those with mental 

health and substance use disorder needs; 

Whereas one-third of people incarcerated receive treatment 

for mental illness, and many times it is inconsistent and 

inadequate, and there is a need for improved access to 

services and treatments that are also trauma informed; 

Whereas there is a need to have mental health, substance use 

disorder, and diversion services available at all intercepts 

of the Sequential Intercept Model, a model developed to 

inform more appropriate community-based responses and 

divert those with mental illness and substance use disorder; 

Whereas there is a need to improve levels of coordination, 

care management, and insurance coverage before, during, 

and after incarceration; 

Whereas postrelease navigation is key to keeping people from 

reentering the justice system; 

Whereas there is insufficient understanding of the mental 

health effects of incarceration; 


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Whereas there is a need to redefine the juvenile justice system to include those who are 25 years of age or younger 

in order to reflect the most up-to-date scientific consensus on brain development and behavior; 

Whereas the juvenile justice system must fulfill its purpose 

of supporting, rehabilitating, and treating children in 

need rather than punishing them given that— 

(1) studies have shown that 70 percent of youth in 

detention have a diagnosed mental illness, and 60 percent 

of those may also meet the criteria for a substance use 

disorder; 

(2) 90 percent of those in the juvenile justice system 

have been exposed to trauma or violence which may increase the likelihood of juvenile justice involvement; 

(3) entry into the juvenile justice system may exacerbate the existing mental health and substance use disorder concerns of youths, particularly in the absence of 

consistent screening and treatment for these conditions; 

and 

(4) an estimated 33 percent of children in long-term 

juvenile justice facilities have intellectual, developmental, 

and other disabilities and were receiving special education 

services; therefore there is a need to have specific services 

and programs within the juvenile justice system with a 

focus on their needs; 

Whereas studies show that 41.2 percent of those who are diagnosed with a substance use disorder are also diagnosed 

with a mental illness, which is likely an underestimate in 

light of the current barriers to identifying and reporting 

mental health concerns; 

Whereas given the high co-occurrence with mental illness, 

comprehensive care for substance use should include acVerDate Sep 11 2014 01:52 Jul 22, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6300 E:\BILLS\HR1057.IH HR1057

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cess to psychopharmacology, psychotherapy, contingency 

management, recovery support, all evidence-based medication-assisted treatment, a multidisciplinary staff, and 

group therapy for adults, and— 

(1) addiction treatment centers should either offer 

or have available comprehensive care and support and 

have the ability to treat mental illness as well as substance use disorders; and 

(2) to allow for treatment flexibility to fit the needs 

of the patient, there is a need to increase access to all 

evidence-based medication-assisted treatment, in prisons, 

jails, and all addiction treatment centers; 

Whereas there are inequities in access, availability, and quality for mental health and substance use disorder services 

for minority communities, and— 

(1) there is greater stigma among racial and ethnic 

minority populations; 

(2) racial and ethnic minorities are disproportionately affected by disabilities that result from mental 

health conditions; and 

(3) only 31 percent of African Americans and Hispanics and 22 percent of Asians receive mental health 

care compared to 48 percent of Caucasians; 

Whereas LGBTQ individuals are more than twice as likely to 

suffer from mental health conditions and substance use 

disorders than heterosexual individuals, and— 

(1) 29 percent of LGBTQ youths attempt suicide, 

which is almost 5 times more likely than heterosexual 

youths; 

(2) approximately 31 percent of LGBTQ older 

adults report symptoms of depression, and 39 percent report seriously thinking about suicide; 


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(3) 30.8 percent of transgender individuals report 

considering suicide compared to 2.3 percent of heterosexual individuals; and 

(4) of the 4,890 transgender individuals incarcerated 

in State prisons, only 15 were confirmed of being housed 

according to their lived gender, which poses a significant 

threat to their mental health; 

Whereas the COVID–19 pandemic has highlighted the gaps 

in our health system when it comes to mental health and 

substance use disorder services and shown how sheltering 

in place and isolating can impact one’s mental health and 

substance use, specifically showing— 

(1) that 47 percent of people report that the pandemic has negatively impacted their mental health, with 

21 percent saying that it has had a major negative impact; 

(2) a significant increase in number of calls to suicide prevention hotlines; 

(3) a 1,000-percent increase in texts to SAMHSA’s 

mental health hotline to about 20,000 texts in April 

2020; 

(4) a 55-percent increase in number of alcohol sales; 

and 

(5) an 11.4-percent increase in overdose fatalities in 

the first quarter of 2020 driven by increased feelings of 

anxiety, depression, and use of substances; and 

Whereas there is a need for a population health approach 

that examines the distribution of health across populations and focuses attention on the need to provide access to the best evidence-based treatment for those with 

mental health conditions and substance use disorders who 

need clinical intervention in order to effectively reduce or 


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mitigate the impact of risk factors that lead to psychological distress among those in high-risk populations: 

Now, therefore, be it 

1 Resolved, That it is the sense of the House of Rep2 resentatives that in order to effectively address the high 

3 prevalence of those suffering from mental health condi4 tions and substance use disorders, the United States needs 

5 to make historic financial investments into mental health 

6 and substance use disorder care and finally acknowledge 

7 such care as a priority in health care, equal to physical 

8 health, and recognize that— 

9 (1) mental health and physical health need to 

10 be treated together to treat the whole patient; 

11 (2) patient care needs to be patient-focused; 

12 (3) mental health and substance use disorder 

13 care needs to be proactive and treat people before 

14 they are in crisis; 

15 (4) any stigma associated with mental health 

16 and substance use disorders is completely unwar17 ranted and serves as a barrier to care; 

18 (5) the Federal Government needs to create a 

19 comprehensive approach to improving the health 

20 care system that incorporates mental health and 

21 substance use disorders that includes system reform 

22 that— 


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1 (A) aims to break down silos across the 

2 Federal, State, local, and Tribal levels for im3 proved communication and care coordination; 

4 (B) provides a Federal framework to 

5 States, localities, and Tribes that connects 

6 agencies and services so they can have guidance 

7 when working to address the mental health and 

8 substance use disorder needs of their commu9 nities; 

10 (C) incentivizes providers to see both more 

11 complex and less complex patients and to see 

12 patients in rural and underserved areas; 

13 (D) expects insurers to comply with parity 

14 laws and holds them accountable for not pro15 viding parity of mental health and substance 

16 use disorder services and treatments; and 

17 (E) requires both public and private payers 

18 to have higher reimbursement rates for mental 

19 health and substance use disorder services that 

20 are on par with medical and surgical services; 

21 (6) the Federal Government needs to create a 

22 comprehensive approach to improving the health 

23 care system that incorporates mental health and 

24 substance use disorders that includes system im25 provements that— 


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1 (A) focuses on early screenings, diagnosis, 

2 and intervention across the care continuum to 

3 prevent those from experiencing a mental health 

4 crisis; 

5 (B) improves families’ ability to access 

6 timely, affordable, and high-quality treatment 

7 and services; 

8 (C) strengthens mental health and sub9 stance use disorder services in schools and en10 sures there is engagement from all stake11 holders; 

12 (D) improves and expands community13 based services so people have access to services 

14 locally; 

15 (E) improves care coordination across 

16 treatment settings so patients have the services 

17 they need when they need it and do not need 

18 to navigate the system themselves; 

19 (F) promotes a sustained recovery that in20 cludes social determinants of health, such as 

21 housing, jobs, and childcare; 

22 (G) can adjust to meet the needs of each 

23 individual to provide the best care for each per24 son; 


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1 (H) ensures seamless transitions in care 

2 when moving through steps or processes; 

3 (I) ends the criminalization of mental ill4 ness and substance use disorders and increases 

5 programs for diversion that connects individuals 

6 to treatment, social supports, and social serv7 ices; 

8 (J) provides access to high-quality and evi9 dence-based mental health and substance use 

10 disorder care for those who are incarcerated; 

11 (K) creates young adult services and pro12 grams within the justice system for those who 

13 are ages 18 to 25 to successfully reduce recidi14 vism and that are informed by neuropsycholog15 ical brain science; 

16 (L) incorporates apprenticeship or job 

17 training programs into the justice system, par18 ticularly for youth, to empower them and re19 duce recidivism; 

20 (M) ensures cultural congruence so every21 one in need of mental health and substance use 

22 disorder care has services that meet their needs; 

23 (N) adopts a population health approach 

24 as a tool to help address ongoing disparities in 


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1 access to mental health and substance use dis2 order care by youth and adults of color; 

3 (O) ensures that LGBTQ individuals, com4 munities of color, and immigrants have access 

5 to mental health and substance use disorder 

6 services that are culturally appropriate, are in 

7 the necessary language, and address any unique 

8 stigma from their communities; 

9 (P) enables veterans to access timely men10 tal health and substance use disorder care that 

11 ensures continuity and is free of any adminis12 trative burdens; 

13 (Q) includes training for educators, first 

14 responders, and clinicians to identify indicators 

15 of mental health conditions and substance use 

16 disorders and to reduce stigma and bias related 

17 to these conditions so they can respond in a 

18 more productive way and connect people with 

19 more appropriate services; 

20 (R) supports health care providers by ad21 dressing their mental health and substance use 

22 disorder needs to reduce burnout; 

23 (S) provides a process in which States can 

24 work with other States to reconcile licensure 

25 and certification for and reimbursement to 


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1 mental health and substance use disorder pro2 viders across State lines for the purpose of tele3 medicine; 

4 (T) leverages the current mental health 

5 and substance use disorder workforce by reduc6 ing administrative burdens to allow mental 

7 health and substance use disorder providers to 

8 perform to their highest level of licensure and 

9 certification; and 

10 (U) expands training opportunities and 

11 grows the workforce by partnering with schools 

12 and programs to provide free education to those 

13 who work in rural or underserved areas; 

14 (7) expanded access to mental health and sub15 stance use disorder care is essential to improving 

16 health and well-being; 

17 (8) all Americans deserve access to mental 

18 health and substance use disorder care without any 

19 barriers, such as cost or location of services; and 

20 (9) the United States needs to comprehensively 

21 break down all barriers to receiving access to mental 

22 health and substance use disorder care including fi23 nancial burdens and location hurdles. 

Æ 


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