I 

113TH CONGRESS 

1ST SESSION H. R. 1100 

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

health services on college campuses. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 12, 2013 

Ms. SCHAKOWSKY (for herself, Mr. RUSH, Mr. POLIS, Mr. CICILLINE, Mr. 

GRIJALVA, Mr. GARAMENDI, Mr. MCGOVERN, Ms. ROYBAL-ALLARD, Mr. 

ELLISON, Mr. TONKO, Ms. LEE of California, and Mr. HOLT) 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 2011 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 1,879 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 2012 American College Health Associa4 tion (ACHA) survey of more than 98,000 college 

5 and university students revealed that, within the last 

6 12 months, 51 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. The ACHA survey found that 7.5 percent of 

10 students have seriously considered suicide in the 

11 past 12 months. 

12 (7) The National Research Consortium of 

13 Counseling Centers in Higher Education found that 

14 6 percent of students have seriously considered sui15 cide in the past 12 months. The Research Consor16 tium found that of those who have seriously consid17 ered suicide in the past 12 months, 52 percent 

18 sought no preferred help and only 54 percent told 

19 anyone that they were considering suicide. 

20 (8) Research conducted between 1997 and 

21 2009, and presented at the 118th annual convention 

22 of the American Psychological Association found 

23 that more students are grappling with depression 

24 and anxiety disorders than did a decade ago. The 

25 study found that of students who sought college 


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1 counseling, 41 percent had moderate to severe de2 pression in 2009, that number was 34 percent in 

3 1997. 

4 (9) A survey conducted by the University of 

5 Idaho Student Counseling Center in 2000 found 

6 that 77 percent of students who responded reported 

7 that they were more likely to stay in school because 

8 of counseling and that their school performance 

9 would have declined without counseling. 

10 (10) Students with psychological issues often 

11 struggle academically and are at risk for dropping 

12 out of school. Counseling has been shown to address 

13 these issues while having a positive impact on stu14 dents remaining in school. A 6-year longitudinal 

15 study found college students receiving counseling to 

16 have an 11.4 percent higher retention rate than the 

17 general university population (Turner & Berry, 

18 2000). 

19 (11) A national survey of college students living 

20 with mental health conditions, conducted by the Na21 tional Alliance on Mental Health, found that 64 per22 cent of students who experience mental health prob23 lems in college and withdraw from school do so be24 cause of their mental health issues. The survey also 


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1 found that 50 percent of that group never accessed 

2 mental health services and supports. 

3 SEC. 3. IMPROVING MENTAL AND BEHAVIORAL HEALTH ON 

4 COLLEGE CAMPUSES. 

5 Title V of the Public Health Service Act is amended 

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

7 the following: 

8 ‘‘SEC. 520E–3. GRANTS TO IMPROVE MENTAL AND BEHAV9 IORAL HEALTH ON COLLEGE CAMPUSES. 

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

11 with respect to college and university settings, to— 

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

13 health services; 

14 ‘‘(2) foster and improve the prevention of men15 tal and behavioral health disorders, and the pro16 motion of mental health; 

17 ‘‘(3) improve the identification and treatment 

18 for students at risk; 

19 ‘‘(4) improve collaboration and the development 

20 of appropriate levels of mental and behavioral health 

21 care; 

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

23 health disorders and enhance their access to mental 

24 health services; and 

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


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

2 Administrator and in consultation with the Secretary of 

3 Education, shall award competitive grants to eligible enti4 ties to improve mental and behavioral health services and 

5 outreach on college and university campuses. 

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

7 under subsection (b), an entity shall— 

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

9 defined in section 101 of the Higher Education Act 

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

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

12 such time, in such manner, and containing such in13 formation as the Secretary may require, including 

14 the information required under subsection (d). 

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

16 under this section shall include— 

17 ‘‘(1) a description of the population to be tar18 geted by the program carried out under the grant, 

19 the particular mental and behavioral health needs of 

20 the students involved; 

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

22 private, and institutional resources available for 

23 meeting the needs of such students at the time the 

24 application is submitted; 


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

2 carried out under the grant; 

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

4 training to be provided under the program, including 

5 planned outreach strategies to reach students not 

6 currently seeking services; 

7 ‘‘(5) a plan to seek input from community men8 tal health providers, when available, community 

9 groups, and other public and private entities in car10 rying out the program; 

11 ‘‘(6) a plan, when applicable, to meet the spe12 cific mental and behavioral health needs of veterans 

13 attending institutions of higher education; 

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

15 evaluate the outcomes and effectiveness of the pro16 gram; and 

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

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

19 State, or local funds available to carry out activities 

20 of the type carried out under the grant. 

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

22 grants under this section, the Secretary shall give special 

23 consideration to applications that describe programs to be 

24 carried out under the grant that— 


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

2 additional mental and behavioral health services, in 

3 part by providing information on current ratios of 

4 students to mental and behavioral health profes5 sionals; 

6 ‘‘(2) propose effective approaches for initiating 

7 or expanding campus services and supports using 

8 evidence-based practices; 

9 ‘‘(3) target traditionally underserved popu10 lations and populations most at risk; 

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

12 of, and a willingness to, coordinate with a commu13 nity mental health center or other mental health re14 source in the community, to support screening and 

15 referral of students requiring intensive services; 

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

17 address psychiatric emergencies, including how in18 formation will be communicated with families or 

19 other appropriate parties; and 

20 ‘‘(6) demonstrate the greatest potential for rep21 lication and dissemination. 

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

23 grant under this section may be used to— 

24 ‘‘(1) provide mental and behavioral health serv25 ices to students, including prevention, promotion of 


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1 mental health, voluntary screening, early interven2 tion, voluntary assessment, treatment, management, 

3 and education services relating to the mental and be4 havioral health of students; 

5 ‘‘(2) provide outreach services to notify stu6 dents about the existence of mental and behavioral 

7 health services; 

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

9 and communities to increase awareness of mental 

10 health issues; 

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

12 engage in activities to educate students, including 

13 activities to reduce stigma surrounding mental and 

14 behavioral disorders, and promote mental health 

15 wellness; 

16 ‘‘(5) employ appropriately trained staff; 

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

18 staff to respond effectively to students with mental 

19 and behavioral health issues; 

20 ‘‘(7) expand mental health training through in21 ternship, post-doctorate, and residency programs; 

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

23 emerging best practices, including a focus on cul24 turally and linguistically appropriate best practices; 

25 and 


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

2 other colleges and universities. 

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

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

5 ‘‘(h) EVALUATION AND REPORTING.— 

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

7 after the date on which a grant is received under 

8 this section, the eligible entity involved shall submit 

9 to the Secretary the results of an evaluation to be 

10 conducted by the entity concerning the effectiveness 

11 of the activities carried out under the grant and 

12 plans for the sustainability of such efforts. 

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

14 date of enactment of this section, the Secretary shall 

15 submit to the appropriate committees of Congress a 

16 report concerning the results of— 

17 ‘‘(A) the evaluations conducted under 

18 paragraph (1); and 

19 ‘‘(B) an evaluation conducted by the Sec20 retary to analyze the effectiveness and efficacy 

21 of the activities conducted with grants under 

22 this section. 

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

24 provide technical assistance to grantees in carrying out 

25 this section. 


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

2 are authorized to be appropriated such sums as may be 

3 necessary to carry out this section. 

4 ‘‘SEC. 520E–4. MENTAL AND BEHAVIORAL HEALTH OUT5 REACH AND EDUCATION ON COLLEGE CAM6 PUSES. 

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

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

9 mental health services so as to ensure that college students 

10 have the support necessary to successfully complete their 

11 studies. 

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

13 The Secretary, acting through the Administrator and in 

14 collaboration with the Director of the Centers for Disease 

15 Control and Prevention, shall convene an interagency, 

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

17 begin coordinating and evaluating a targeted public edu18 cation campaign that is designed to focus on mental and 

19 behavioral health on college campuses. Such campaign 

20 shall be designed to— 

21 ‘‘(1) improve the general understanding of men22 tal health and mental health disorders; 

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

24 to the promotion of mental health, prevention of 


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1 mental health disorders, and treatment of such dis2 orders; 

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

4 behavioral health and academic success; and 

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

6 early warning signs and reducing the stigma of men7 tal illness. 

8 ‘‘(c) COMPOSITION.—The working group under sub9 section (b) shall include— 

10 ‘‘(1) mental health consumers, including stu11 dents and family members; 

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

13 ‘‘(3) representatives of national mental and be14 havioral health and college associations; 

15 ‘‘(4) representatives of college health promotion 

16 and prevention organizations; 

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

18 including community mental health centers; and 

19 ‘‘(6) representatives of private- and public-sec20 tor groups with experience in the development of ef21 fective public health education campaigns. 

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

23 shall develop a plan that shall— 

24 ‘‘(1) target promotional and educational efforts 

25 to the college age population and individuals who are 


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1 employed in college and university settings, including 

2 the use of roundtables; 

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

4 research-based public health messages and activities; 

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

6 stigma by using the National Mental Health Infor7 mation Center as a primary point of contact for in8 formation, publications, and service program refer9 rals; and 

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

11 a social marketing campaign that is targeted at the 

12 college population and individuals who are employed 

13 in college and university settings. 

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

15 are authorized to be appropriated such sums as may be 

16 necessary to carry out this section.’’. 

17 SEC. 4. INTERAGENCY WORKING GROUP ON COLLEGE MEN18 TAL HEALTH. 

19 (a) PURPOSE.—It is the purpose of this section, pur20 suant to Executive Order 13263 (and the recommenda21 tions issued under section 6(b) of such Order), to provide 

22 for the establishment of a College Campus Task Force 

23 under the Federal Executive Steering Committee on Men24 tal Health, to discuss mental and behavioral health con25 cerns on college and university campuses. 


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

2 Human Services (referred to in this section as the ‘‘Sec3 retary’’) shall establish a College Campus Task Force (re4 ferred to in this section as the ‘‘Task Force’’), under the 

5 Federal Executive Steering Committee on Mental Health, 

6 to discuss mental and behavioral health concerns on col7 lege and university campuses. 

8 (c) MEMBERSHIP.—The Task Force shall be com9 posed of a representative from each Federal agency (as 

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

11 over, or is affected by, mental health and education poli12 cies and projects, including— 

13 (1) the Department of Education; 

14 (2) the Department of Health and Human 

15 Services; 

16 (3) the Department of Veterans Affairs; and 

17 (4) such other Federal agencies as the Adminis18 trator of the Substance Abuse and Mental Health 

19 Services Administration and the Secretary jointly de20 termine to be appropriate. 

21 (d) DUTIES.—The Task Force shall— 

22 (1) serve as a centralized mechanism to coordi23 nate a national effort— 

24 (A) to discuss and evaluate evidence and 

25 knowledge on mental and behavioral health 


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1 services available to, and the prevalence of men2 tal health illness among, the college age popu3 lation of the United States; 

4 (B) to determine the range of effective, 

5 feasible, and comprehensive actions to improve 

6 mental and behavioral health on college and 

7 university campuses; 

8 (C) to examine and better address the 

9 needs of the college age population dealing with 

10 mental illness; 

11 (D) to survey Federal agencies to deter12 mine which policies are effective in encouraging, 

13 and how best to facilitate outreach without du14 plicating, efforts relating to mental and behav15 ioral health promotion; 

16 (E) to establish specific goals within and 

17 across Federal agencies for mental health pro18 motion, including determinations of account19 ability for reaching those goals; 

20 (F) to develop a strategy for allocating re21 sponsibilities and ensuring participation in men22 tal and behavioral health promotions, particu23 larly in the case of competing agency priorities; 

24 (G) to coordinate plans to communicate re25 search results relating to mental and behavioral 


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1 health amongst the college age population to 

2 enable reporting and outreach activities to 

3 produce more useful and timely information; 

4 (H) to provide a description of evidence5 based best practices, model programs, effective 

6 guidelines, and other strategies for promoting 

7 mental and behavioral health on college and 

8 university campuses; 

9 (I) to make recommendations to improve 

10 Federal efforts relating to mental and behav11 ioral health promotion on college campuses and 

12 to ensure Federal efforts are consistent with 

13 available standards and evidence and other pro14 grams in existence as of the date of enactment 

15 of this Act; and 

16 (J) to monitor Federal progress in meeting 

17 specific mental and behavioral health promotion 

18 goals as they relate to college and university 

19 settings; 

20 (2) consult with national organizations with ex21 pertise in mental and behavioral health, especially 

22 those organizations working with the college age 

23 population; and 


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1 (3) consult with and seek input from mental 

2 health professionals working on college and univer3 sity campuses as appropriate. 

4 (e) MEETINGS.— 

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

6 at least 3 times each year. 

7 (2) ANNUAL CONFERENCE.—The Secretary 

8 shall sponsor an annual conference on mental and 

9 behavioral health in college and university settings 

10 to enhance coordination, build partnerships, and 

11 share best practices in mental and behavioral health 

12 promotion, data collection, analysis, and services. 

13 (f) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated such sums as may be 

15 necessary to carry out this section. 

Æ 


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