II 

★(Star Print)

110TH CONGRESS 

1ST SESSION S. 1196 

To improve mental health care for wounded members of the Armed Forces, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 24, 2007 

Mr. LIEBERMAN (for himself, Mrs. BOXER, Mr. KENNEDY, Mr. KERRY, Mr. 

HARKIN, and Mr. CHAMBLISS) introduced the following bill; which was 

read twice and referred to the Committee on Armed Services 

A BILL 

To improve mental health care for wounded members of 

the Armed Forces, and for other purposes. 

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 Care 

5 for Our Wounded Warriors Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) An estimated one in six members of the 

9 Armed Forces returning from service in Iraq or AfVerDate Aug 31 2005 21:16 May 04, 2007 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1196.IS S1196

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1 ghanistan has a diagnosable condition of post-trau2 matic stress disorder (PTSD). 

3 (2) One in ten members of the Armed Forces 

4 who have served in Iraq or Afghanistan may suffer 

5 from a traumatic brain injury (TBI). 

6 (3) Since 2001, approximately 1,500,000 mem7 bers of the Armed Forces have been deployed in sup8 port of the conflicts in Iraq and Afghanistan, of 

9 whom approximately one-third have served at least 

10 two tours of duty, 70,000 have served three tours of 

11 duty, and 20,000 have served at least five tours of 

12 duty. 

13 (4) Currently, there are 700,000 children in the 

14 United States with at least one parent deployed to 

15 support ongoing military operations in Iraq and Af16 ghanistan. 

17 (5) The Department of Defense is facing a 

18 shortage of mental health professionals. The Depart19 ment has had as many as 450 psychologists on ac20 tive duty in the Armed Forces in past years. How21 ever, the Department currently has only 350 psy22 chologists on active duty in the Armed Forces in 

23 support of combat operations. 

24 (6) The demands placed on the Department of 

25 Defense mental health system exceed its capacity to 


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1 provide services in a timely manner to all those in 

2 need. 

3 (7) The long-term costs of treating members of 

4 the Armed Forces returning from Iraq and Afghani5 stan could ultimately reach $700,000,000,000, with 

6 post-traumatic stress disorder projected to be one of 

7 the most expensive conditions to treat. 

8 (8) Women now constitute 16 percent of the 

9 members of the Armed Forces and are assigned to 

10 90 percent all military occupations. As a result, 

11 there is a need for research on whether or not 

12 women in combat roles have unique mental health 

13 needs that should be addressed by the mental health 

14 system of the Department of Defense. 

15 (9) More than 25 percent of the members of 

16 the Armed Forces deployed in support combat oper17 ations in Iraq and Afghanistan are ethnic minorities. 

18 There is a need for research on whether or not mi19 norities have unique mental health needs that should 

20 be addressed by the mental health system of the De21 partment of Defense. 

22 (10) Three out of every five deployed members 

23 of the Armed Forces have a spouse, child, or both. 

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1 tal health needs of members of the Armed Forces 

2 and their families. 

3 (11) Approximately 40 percent of the billets for 

4 licensed clinical psychologists in the Army are va5 cant, and there are shortages in other mental health 

6 professions, including psychiatry and clinical social 

7 work. 

8 (12) The long-term needs associated with men9 tal health conditions and brain injuries will require 

10 a robust mental health professional workforce. 

11 SEC. 3. SENSE OF CONGRESS ON MENTAL HEALTH OF THE 

12 MEMBERS OF THE ARMED FORCES. 

13 It is the sense of Congress that— 

14 (1) members of the Armed Forces deserve the 

15 best possible treatment for injuries sustained while 

16 in service to the United States; 

17 (2) injuries sustained by members of the Armed 

18 Forces in combat produce both physical and mental 

19 illnesses; 

20 (3) members of the Armed Forces should have 

21 access to mental health providers to facilitate their 

22 treatment for mental illness sustained during com23 bat; 

24 (4) mental health disorders, such as post-trau25 matic stress disorder (PTSD), incurred by members 


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1 of the Armed Forces in combat should be treated 

2 with an urgency similar to physical ailments in3 curred by such members in combat; 

4 (5) there is a need to train, recruit, and retain 

5 more psychologists, social workers, psychiatrists, 

6 neurologists, and other health care professionals to 

7 diagnose and provide short-term and long-term care 

8 for members of the Armed Forces with mental 

9 health conditions, including traumatic brain injuries 

10 (TBIs), sustained in combat; and 

11 (6) there is a continued need for— 

12 (A) basic science research on post-trau13 matic stress disorder, traumatic brain injury, 

14 and other combat-related conditions; 

15 (B) the development of new treatments for 

16 post-traumatic stress disorder, traumatic brain 

17 injury, and other combat-related conditions; 

18 (C) the dissemination of best practices for 

19 treating and managing post-traumatic stress 

20 disorder, traumatic brain injury, and other 

21 combat-related conditions; and 

22 (D) a long-term strategy for education, 

23 training, recruitment, and retention for the 

24 mental health workforce of the Department of 


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1 Defense in order to expand and improve that 

2 workforce. 

3 SEC. 4. CENTERS OF EXCELLENCE IN MILITARY MENTAL 

4 HEALTH. 

5 (a) ESTABLISHMENT.— 

6 (1) IN GENERAL.—Chapter 55 of title 10, 

7 United States Code, is amended by inserting after 

8 section 1105 the following new section: 

9 ‘‘§ 1105a. Centers of Excellence in Military Mental 

10 Health 

11 ‘‘(a) IN GENERAL.—The Secretary of Defense shall 

12 establish within the Department of Defense at least two 

13 centers of excellence in military mental health to carry out 

14 the responsibilities specified in subsection (c). Each such 

15 center shall be known as a ‘Center of Excellence in Mili16 tary Mental Health’. 

17 ‘‘(b) PARTNERSHIPS.—The Secretary shall authorize 

18 each Center of Excellence in Military Mental Health to 

19 enter into such partnerships, agreements, or other ar20 rangements as the Secretary considers appropriate with 

21 institutions of higher education and other appropriate 

22 public and private entities to carry out the responsibilities 

23 specified in subsection (c). 


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1 ‘‘(c) RESPONSIBILITIES.—Each Center of Excellence 

2 in Military Mental Health shall have responsibilities as fol3 lows: 

4 ‘‘(1) To direct and oversee, based on expert re5 search, the development and implementation of a 

6 long-term, comprehensive plan and strategy for the 

7 Department of Defense for the prevention, identi8 fication, and treatment of combat-related mental 

9 health conditions and brain injuries, with an empha10 sis on post-traumatic stress disorder (PTSD) and 

11 traumatic brain injury (TBI). 

12 ‘‘(2) To provide for the development, testing, 

13 and dissemination within the Department of best 

14 practices for the treatment of combat-related mental 

15 health conditions and brain injuries, including post16 traumatic stress disorder, traumatic brain injury, 

17 acute depression, and substance abuse. 

18 ‘‘(3) To provide guidance for the mental health 

19 system of the Department in determining the mental 

20 health and neurological health personnel required to 

21 provide quality mental health care for members of 

22 the armed forces. 

23 ‘‘(4) To establish, implement, and oversee a 

24 comprehensive program to train mental health and 

25 neurological health professionals of the Department 


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1 in the treatment of combat-related mental health 

2 conditions and brain injuries. 

3 ‘‘(5) To facilitate advancements in the study of 

4 the short-term and long-term psychological effects of 

5 traumatic brain injury. 

6 ‘‘(6) To disseminate within the military medical 

7 treatment facilities of the Department best practices 

8 for training mental health professionals, including 

9 neurological health professionals. 

10 ‘‘(7) To develop a strategic plan to reduce the 

11 stigma among members of the armed forces regard12 ing the presence of mental illness or other mental 

13 health conditions in such members. 

14 ‘‘(8) To conduct basic science and translational 

15 research on combat-related mental health conditions 

16 and brain injuries for the purposes of understanding 

17 the etiology of such conditions and injuries and de18 veloping preventive interventions and new treat19 ments. 

20 ‘‘(9) To develop outreach strategies and treat21 ments for families of members of the armed forces 

22 with combat-related mental health conditions or 

23 brain injuries in order to mitigate the negative im24 pacts of such conditions and injuries on such family 


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1 members and to support the recovery of such mem2 bers from such conditions and injuries. 

3 ‘‘(10) To conduct research on the unique men4 tal health needs of women members of the armed 

5 forces who serve in combat zones and develop treat6 ments to meet any needs identified through such re7 search. 

8 ‘‘(11) To conduct research on the unique men9 tal health needs of ethnic minority members of the 

10 armed forces who serve in combat and develop treat11 ments to meet any needs identified through such re12 search. 

13 ‘‘(12) To conduct research on the mental health 

14 needs of families of members of the armed forces 

15 who are deployed to combat zones and develop treat16 ments to meet any needs identified through such re17 search. 

18 ‘‘(13) To develop and oversee a long-term plan 

19 to increase the number of mental health and neuro20 logical health professionals within the Department in 

21 order to facilitate the meeting by the Department of 

22 the long-term needs of members of the armed forces 

23 with combat-related mental health conditions or 

24 brain injuries. 


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1 ‘‘(14) Such other responsibilities as the Sec2 retary shall specify.’’. 

3 (2) CLERICAL AMENDMENT.—The table of sec4 tions at the beginning of chapter 55 of such title is 

5 amended by inserting after the item relating to sec6 tion 1105 the following new item: 

‘‘1105a. Centers of Excellence in Military Mental Health.’’. 

7 (3) REPORT ON ESTABLISHMENT.—Not later 

8 than 180 days after the date of the enactment of 

9 this Act, the Secretary of Defense shall submit to 

10 Congress a report on the establishment of Centers of 

11 Excellence in Military Mental Health under section 

12 1105a of title 10, United States Code (as added by 

13 paragraph (1)). The report shall— 

14 (A) set forth the number and location of 

15 the Centers of Excellence in Military Mental 

16 Health so established; 

17 (B) for each Center so established, de18 scribe in detail the activities and proposed ac19 tivities of such Center; and 

20 (C) assess the general progress of the Cen21 ters in discharging the responsibilities set forth 

22 in that section. 

23 (b) OVERSIGHT.— 

24 (1) BOARD OF OVERSIGHT.—The Secretary of 

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1 ties of the Centers of Excellence in Military Mental 

2 Health of the Department of Defense established 

3 under section 1105a of title 10, United States Code 

4 (as added by subsection (a)). The board shall be 

5 known as the ‘‘Board of Oversight of Excellence in 

6 Military Mental Health’’ (in this subsection referred 

7 to as the ‘‘Board’’). 

8 (2) MEMBERSHIP.— 

9 (A) REQUIRED MEMBERS.—The members 

10 of the Board shall include the following: 

11 (i) The director of each Center of Ex12 cellence in Military Mental Health. 

13 (ii) The commanding officer of Walter 

14 Reed Army Medical Center, District of Co15 lumbia. 

16 (iii) The Surgeon General of the 

17 Army, the Surgeon General of the Navy, 

18 and the Surgeon General of the Air Force. 

19 (iv) The Assistant Secretary of De20 fense for Health Affairs. 

21 (B) AUTHORIZED MEMBERS.—With the 

22 joint approval of the Secretary of Defense and 

23 the Secretary of Veterans Affairs, the members 

24 of the Board may include any of the following: 


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1 (i) The Under Secretary of Veterans 

2 Affairs for Health. 

3 (ii) Any director of a polytrauma cen4 ter of the Department of Veterans Affairs. 

5 (3) MEETINGS.—The Board shall meet not less 

6 often than four times each year. 

7 (4) RESPONSIBILITIES.—The responsibilities of 

8 the Board shall include the following: 

9 (A) To consider and evaluate proposals of 

10 the Centers of Excellence in Military Mental 

11 Health in the discharge of the responsibilities of 

12 such Centers. 

13 (B) To develop mechanisms for the dis14 semination and implementation of recommenda15 tions and best practices on military mental 

16 health developed by the Centers of Excellence in 

17 Military Mental Health. 

18 (C) Such other responsibilities as the Sec19 retary shall establish for purposes of this sec20 tion. 

21 SEC. 5. PERSONNEL SHORTAGES IN MENTAL HEALTH 

22 WORKFORCE OF THE DEPARTMENT OF DE23 FENSE. 

24 (a) RECOMMENDATIONS ON MEANS OF ADDRESSING

25 SHORTAGES.— 


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1 (1) REPORT.—Not later than 45 days after the 

2 date of the enactment of this Act, the Secretary of 

3 Defense shall submit to the Committees on Armed 

4 Services of the Senate and the House of Representa5 tives a report setting forth the recommendations of 

6 the Secretary for such legislative or administrative 

7 actions as the Secretary considers appropriate to ad8 dress current personnel shortages in the mental 

9 health workforce of the Department of Defense. 

10 (2) ELEMENTS.—The report required by para11 graph (1) may include recommendations on the fol12 lowing: 

13 (A) Enhancements or improvements of fi14 nancial incentives for personnel in the mental 

15 health workforce of the Department of Defense 

16 in order to enhance the recruitment and reten17 tion of such personnel, including recruitment, 

18 accession, or retention bonuses and scholarship, 

19 tuition, and other financial assistance. 

20 (B) Modifications of service obligations of 

21 personnel in the mental health workforce. 

22 (C) Such other matters as the Secretary 

23 considers appropriate. 

24 (b) RECRUITMENT.—Commencing not later than 180 

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1 retary of Defense shall implement programs to recruit 

2 qualified individuals in mental health fields to service in 

3 the Armed Forces as mental health personnel of the 

4 Armed Forces. 

Æ 


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