II 

112TH CONGRESS 

1ST SESSION S. 40 

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

health services for underserved populations. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 25 (legislative day, JANUARY 5), 2011 

Mr. INOUYE introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to promote mental 

and behavioral health services for underserved populations. 

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 ‘‘Graduate Psychology 

5 Education Act of 2011’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds that— 

8 (1) the Institute of Medicine issued a 2006 re9 port entitled ‘‘Improving the Quality of Health Care 

10 for Mental and Substance Abuse Conditions’’, which 


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1 called for efforts to increase the mental and behav2 ioral health care workforce in the United States, and 

3 to assure competency of that workforce; 

4 (2) the ‘‘Action Plan for Behavioral Health 

5 Workforce Development’’, commissioned in 2007 by 

6 the Substance Abuse and Mental Health Services 

7 Administration, reported an insufficient supply of 

8 trained professionals available to provide mental and 

9 behavioral health services to older adults, and pre10 dicted that such shortage would become more dire as 

11 the aging population grows and the demand for spe12 cialized mental and behavioral health services in13 creases; 

14 (3) the Bureau of Labor Statistics projects a 

15 need for approximately 70,000 more doctoral level 

16 health service psychologists, including clinical psy17 chologists, counselors, and school psychologists, in 

18 the United States by 2016; 

19 (4) the Department of Defense Task Force on 

20 Mental Health reported in 2007 that— 

21 (A) the Nation faces a great need for ade22 quately trained mental health professionals, 

23 both civilian and in the Armed Forces; 

24 (B) nearly 40 percent of soldiers and half 

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1 logical ‘‘symptoms’’ and these problems are 

2 ‘‘daunting and growing’’; and 

3 (C) increasingly, National Guard members, 

4 reservists, and even active duty members of the 

5 Armed Forces who are stationed far from 

6 health care installations of the Armed Forces, 

7 as well as the families of such individuals, are 

8 more likely to seek care in civilian settings, thus 

9 increasing the demand for mental health serv10 ices in those communities; 

11 (5) according to a report of the Health Re12 sources and Services Administration in September 

13 2008, there are 3,059 mental health professional 

14 shortage areas in rural and urban areas of the 

15 United States, in which 77,000,000 people live, and, 

16 based on the Administration’s population to practi17 tioner ratio of 10,000:1, an additional 5,145 mental 

18 health providers are required to meet the immediate 

19 needs of the mental health professional shortage 

20 areas; 

21 (6) the Annapolis Coalition Report, commis22 sioned in 2007 by the Substance Abuse and Mental 

23 Health Services Administration— 

24 (A) found substantial needs to increase the 

25 mental and behavioral health workforce of the 


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1 future and to broaden the racial and cultural 

2 diversity of that workforce; and 

3 (B) identified a pending retirement of 

4 more than half of the clinically trained mental 

5 and behavioral health professionals in the 

6 United States, along with a serious shortage of 

7 providers in rural areas, and urged a national 

8 focus on— 

9 (i) addressing the needs of under10 served persons dealing with chronic ill11 nesses; 

12 (ii) treating young people with mental 

13 disorders; and 

14 (iii) working with young people to 

15 help prevent risk-taking behaviors, includ16 ing smoking, substance abuse, violence, un17 safe sex, and actions that might cause ve18 hicular accidents; 

19 (7) according to multiple reports of the Surgeon 

20 General on the mental health of children and older 

21 adults— 

22 (A) there is an urgent need for a well23 trained mental and behavioral health workforce 

24 to treat the increase in depression and suicide; 


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1 (B) 2 out of every 100 children and adoles2 cents have major depression, and 20 percent of 

3 older adults suffer from depression; 

4 (C) depression is a condition commonly as5 sociated with suicide and older adults are dis6 proportionately likely to die by suicide; and 

7 (D) in general, suicide rates for adults and 

8 children are higher in rural communities than 

9 in urban communities; 

10 (8) in 2007, the President’s Commission on 

11 Care For America’s Returning Wounded Warriors 

12 (the ‘‘Dole-Shalala Commission’’)— 

13 (A) recommended that the Department of 

14 Defense aggressively address the acute shortage 

15 of mental health clinicians in the Armed 

16 Forces; 

17 (B) recognized that the health care system 

18 in the United States is certain to experience in19 creased strain for years to come as active duty 

20 service members re-enter civilian society in local 

21 communities and turn to mental health care 

22 professionals skilled in treating such combat 

23 stress disorders and their effects on families, 

24 which is especially significant due to the ex25 pected long-term demand that may arise from 


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1 chronic or delayed-onset symptoms of post-trau2 matic stress disorder; 

3 (C) reported that the Armed Forces’s new 

4 efforts to prevent mental health problems and 

5 identify symptoms more quickly have severely 

6 stretched the already thin mental health pro7 gram staff; and 

8 (D) reported that hospitals located in geo9 graphically isolated or less desirable areas re10 port great difficulty recruiting civilian staff; 

11 and 

12 (9) the determinants of human health include a 

13 complex array of biological, environmental, and so14 cial factors, an individual’s behavior and coping re15 sources, and an individual’s access to health care; al16 though biologic interventions, including medications 

17 and immunizations, often are considered the hall18 mark of medical practice, the role of behavior and 

19 psychosocial components has received increasing at20 tention, and, because approximately half of mortality 

21 in the United States is linked to behavior, behavioral 

22 science and practice are fundamental to addressing 

23 societal needs. 


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1 SEC. 3. PROMOTING EDUCATION AND TRAINING OF PSY2 CHOLOGISTS TO PROVIDE MENTAL AND BE3 HAVIORAL HEALTH SERVICES TO UNDER4 SERVED POPULATIONS. 

5 Part E of title VII of the Public Health Service Act 

6 (42 U.S.C. 294n et seq.) is amended by adding at the end 

7 the following: 

8 ‘‘Subpart 4—Mental and Behavioral Health Care 

9 Workforce 

10 ‘‘SEC. 781. PROGRAM FOR GRADUATE EDUCATION AND 

11 TRAINING IN PSYCHOLOGY. 

12 ‘‘(a) IN GENERAL.—The Secretary may award 

13 grants, cooperative agreements, and contracts to accred14 ited doctoral, internship, and residency programs in psy15 chology for the development and implementation of pro16 grams to provide interdisciplinary training in integrated 

17 health care settings to students in doctoral psychology 

18 programs, including interns and residents in such pro19 grams. Any training funded by such grants, cooperative 

20 agreements, or contracts shall focus on the needs of under21 served populations. 

22 ‘‘(b) ELIGIBILITY.—To be eligible to receive an award 

23 under this section an entity shall— 

24 ‘‘(1) provide training at or through an accred25 ited doctoral program in psychology, including an in26 ternship or residency program; and 


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1 ‘‘(2) prepare and submit to the Secretary an 

2 application at such time, in such manner, and con3 taining such information as the Secretary may re4 quire. 

5 ‘‘(c) EVALUATION OF PROGRAMS.—The Secretary 

6 shall evaluate any program implemented through an 

7 award under this section in order to determine the effect 

8 of such program on increasing the number of psychologists 

9 who provide mental and behavioral health services to un10 derserved populations. 

11 ‘‘(d) DEFINITIONS.—For purposes of this section— 

12 ‘‘(1) the term ‘underserved population’ means 

13 individuals, especially older adults, children, chron14 ically ill individuals, victims of abuse or trauma, and 

15 victims of combat- or war-related stress disorders, 

16 including post-traumatic stress disorder and trau17 matic brain injury, and their families, living in an 

18 urban or rural area that has a shortage of mental 

19 or behavioral health services; and 

20 ‘‘(2) the term ‘interdisciplinary training’ means 

21 training for graduate psychology students with 1 or 

22 more of the other health professions, including medi23 cine, nursing, dentistry, and pharmacy. 

24 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

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1 priated $10,000,000 for fiscal year 2012, $12,000,000 for 

2 fiscal year 2013, $14,000,000 for fiscal year 2014, 

3 $16,000,000 for fiscal year 2015, and $18,000,000 for fis4 cal year 2016.’’. 

Æ 


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