I 
114TH CONGRESS 
2D SESSION 
H. R. 4374 
To amend the Public Health Service Act to improve mental and behavioral 
health services on college and university campuses. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 12, 2016 
Ms. SCHAKOWSKY (for herself and Mr. TONKO) 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 consider-
ation 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 and university 
campuses. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Mental Health on 
Campus Improvement Act’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
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(1) The 2011 Association of University and 
College Counseling Center Directors Survey found 
that the average ratio of counselors to students on 
campus is nearly 1 to 1,879 and is often far higher 
on large campuses. The International Association of 
Counseling Services accreditation standards rec-
ommends 1 counselor per 1,000 to 1,500 students. 
(2) College Counselors report that 10.8 percent 
of enrolled students sought counseling in the past 
year, totaling an estimated 2,000,000 students. 
(3) Over 90 percent of counseling directors be-
lieve there is an increase in the number of students 
coming to campus with severe psychological prob-
lems; today, 44 percent of the students who visit 
campus counseling centers are dealing with severe 
mental illness, up from 16 percent in 2000, and 24 
percent are on psychiatric medication, up from 17 
percent in 2000. 
(4) The majority of campus counseling directors 
report that the demand for services and the severity 
of student needs are growing without an increase in 
resources. 
(5) Many students who need help never receive 
it. Only 15 percent of college and university students 
who commit suicide received campus counseling. Of 
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students who seriously consider suicide each year, 
only 52 percent of them seek any professional help 
at all. 
(6) A 2012 American College Health Associa-
tion (ACHA) survey of more than 98,000 college 
and university students revealed that, within the last 
12 months, 51 percent of students report having felt 
overwhelming anxiety, 31 percent felt so depressed it 
was difficult to function, and 46 percent felt hope-
less. The ACHA survey found that 7.5 percent of 
students have seriously considered suicide in the 
past 12 months. 
(7) The National Research Consortium of 
Counseling Centers in Higher Education found that 
6 percent of students have seriously considered sui-
cide in the past 12 months. The Research Consor-
tium found that of those who have seriously consid-
ered suicide in the past 12 months, 52 percent 
sought no preferred help and only 54 percent told 
anyone that they were considering suicide. 
(8) Research conducted between 1997 and 
2009, and presented at the 118th Annual Conven-
tion of the American Psychological Association 
found that more students are grappling with depres-
sion and anxiety disorders than did a decade ago. 
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The study found that of students who sought college 
or university counseling, 41 percent had moderate to 
severe depression in 2009, that number was 34 per-
cent in 1997. 
(9) A survey conducted by the University of 
Idaho Student Counseling Center in 2000 found 
that 77 percent of students who responded reported 
that they were more likely to stay in school because 
of counseling and that their school performance 
would have declined without counseling. 
(10) Students with psychological issues often 
struggle academically and are at risk for dropping 
out of school. Counseling has been shown to address 
these issues while having a positive impact on stu-
dents remaining in school. A 6-year longitudinal 
study found college and university students receiving 
counseling to have an 11.4 percent higher retention 
rate than the general college and university popu-
lation (Turner & Berry, 2000). 
(11) A national survey of college and university 
students living with mental health conditions, con-
ducted by the National Alliance on Mental Health, 
found that 64 percent of students who experience 
mental health problems in college or university and 
withdraw from school do so because of their mental 
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health issues. The survey also found that 50 percent 
of that group never accessed mental health services 
and supports. 
SEC. 3. IMPROVING MENTAL AND BEHAVIORAL HEALTH ON 
COLLEGE CAMPUSES. 
Title V of the Public Health Service Act is amended 
by inserting after section 520E–2 (42 U.S.C. 290bb–36b) 
the following: 
‘‘SEC. 520E–3. GRANTS TO IMPROVE MENTAL AND BEHAV-
IORAL HEALTH ON COLLEGE CAMPUSES. 
‘‘(a) PURPOSE.—It is the purpose of this section, 
with respect to college and university settings, to— 
‘‘(1) increase access to mental and behavioral 
health services; 
‘‘(2) foster and improve the prevention of men-
tal and behavioral health disorders, and the pro-
motion of mental health; 
‘‘(3) improve the identification and treatment 
for students at risk; 
‘‘(4) improve collaboration and the development 
of appropriate levels of mental and behavioral health 
care; 
‘‘(5) reduce the stigma for students with mental 
health disorders and enhance their access to mental 
health services; and 
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‘‘(6) improve the efficacy of outreach efforts. 
‘‘(b) GRANTS.—The Secretary, acting through the 
Administrator and in consultation with the Secretary of 
Education, shall award competitive grants to eligible enti-
ties to improve mental and behavioral health services and 
outreach on college and university campuses. 
‘‘(c) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (b), an entity shall— 
‘‘(1) be an institution of higher education (as 
defined in section 101 of the Higher Education Act 
of 1965 (20 U.S.C. 1001)); and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require, including 
the information required under subsection (d). 
‘‘(d) APPLICATION.—An application for a grant 
under this section shall include— 
‘‘(1) a description of the population to be tar-
geted by the program carried out under the grant, 
the particular mental and behavioral health needs of 
the students involved; 
‘‘(2) a description of the Federal, State, local, 
private, and institutional resources available for 
meeting the needs of such students at the time the 
application is submitted; 
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‘‘(3) an outline of the objectives of the program 
carried out under the grant; 
‘‘(4) a description of activities, services, and 
training to be provided under the program, including 
planned outreach strategies to reach students not 
currently seeking services; 
‘‘(5) a plan to seek input from community men-
tal health providers, when available, community 
groups, and other public and private entities in car-
rying out the program; 
‘‘(6) a plan, when applicable, to meet the spe-
cific mental and behavioral health needs of veterans 
attending institutions of higher education; 
‘‘(7) a description of the methods to be used to 
evaluate the outcomes and effectiveness of the pro-
gram; and 
‘‘(8) an assurance that grant funds will be used 
to supplement, and not supplant, any other Federal, 
State, or local funds available to carry out activities 
of the type carried out under the grant. 
‘‘(e) 
SPECIAL
CONSIDERATIONS.—In 
awarding 
grants under this section, the Secretary shall give special 
consideration to applications that describe programs to be 
carried out under the grant that— 
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‘‘(1) demonstrate the greatest need for new or 
additional mental and behavioral health services, in 
part by providing information on current ratios of 
students to mental and behavioral health profes-
sionals; 
‘‘(2) propose effective approaches for initiating 
or expanding campus services and supports using 
evidence-based practices; 
‘‘(3) target traditionally underserved popu-
lations and populations most at risk; 
‘‘(4) where possible, demonstrate an awareness 
of, and a willingness to, coordinate with a commu-
nity mental health center or other mental health re-
source in the community, to support screening and 
referral of students requiring intensive services; 
‘‘(5) identify how the college or university will 
address psychiatric emergencies, including how in-
formation will be communicated with families or 
other appropriate parties; 
‘‘(6) propose innovative practices that will im-
prove efficiencies in clinical care, broaden collabora-
tions with primary care, or improve prevention pro-
grams; and 
‘‘(7) demonstrate the greatest potential for rep-
lication and dissemination. 
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‘‘(f) USE OF FUNDS.—Amounts received under a 
grant under this section may be used to— 
‘‘(1) provide mental and behavioral health serv-
ices to students, including prevention, promotion of 
mental health, voluntary screening, early interven-
tion, voluntary assessment, treatment, management, 
and education services relating to the mental and be-
havioral health of students; 
‘‘(2) conduct research through a counseling or 
health center at the institution of higher education 
involved regarding improving the mental and behav-
ioral health of college and university students 
through clinical services, outreach, prevention, or 
academic success; 
‘‘(3) provide outreach services to notify stu-
dents about the existence of mental and behavioral 
health services; 
‘‘(4) educate students, families, faculty, staff, 
and communities to increase awareness of mental 
health issues; 
‘‘(5) support student groups on campus that 
engage in activities to educate students, including 
activities to reduce stigma surrounding mental and 
behavioral disorders, and promote mental health 
wellness; 
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‘‘(6) employ appropriately trained staff; 
‘‘(7) provide training to students, faculty, and 
staff to respond effectively to students with mental 
and behavioral health issues; 
‘‘(8) expand mental health training through in-
ternship, post-doctorate, and residency programs; 
‘‘(9) develop and support evidence-based and 
emerging best practices, including a focus on cul-
turally and linguistically appropriate best practices; 
and 
‘‘(10) evaluate and disseminate best practices to 
other colleges and universities. 
‘‘(g) DURATION OF GRANTS.—A grant under this 
section shall be awarded for a period not to exceed 3 years. 
‘‘(h) EVALUATION AND REPORTING.— 
‘‘(1) EVALUATION.—Not later than 18 months 
after the date on which a grant is received under 
this section, the eligible entity involved shall submit 
to the Secretary the results of an evaluation to be 
conducted by the entity (or by another party under 
contract with the entity) concerning the effectiveness 
of the activities carried out under the grant and 
plans for the sustainability of such efforts. 
‘‘(2) REPORT.—Not later than 2 years after the 
date of enactment of this section, the Secretary shall 
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submit to the appropriate committees of Congress a 
report concerning the results of— 
‘‘(A) the evaluations conducted under 
paragraph (1); and 
‘‘(B) an evaluation conducted by the Sec-
retary to analyze the effectiveness and efficacy 
of the activities conducted with grants under 
this section. 
‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to grantees in carrying out 
this section. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this section. 
‘‘SEC. 520E–4. MENTAL AND BEHAVIORAL HEALTH OUT-
REACH AND EDUCATION ON COLLEGE CAM-
PUSES. 
‘‘(a) PURPOSE.—It is the purpose of this section to 
increase access to, and reduce the stigma associated with, 
mental health services so as to ensure that college and 
university students have the support necessary to success-
fully complete their studies. 
‘‘(b) NATIONAL PUBLIC EDUCATION CAMPAIGN.— 
The Secretary, acting through the Administrator and in 
collaboration with the Director of the Centers for Disease 
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Control and Prevention, shall convene an interagency, 
public-private sector working group to plan, establish, and 
begin coordinating and evaluating a targeted public edu-
cation campaign that is designed to focus on mental and 
behavioral health on college and university campuses. 
Such campaign shall be designed to— 
‘‘(1) improve the general understanding of men-
tal health and mental health disorders; 
‘‘(2) encourage help-seeking behaviors relating 
to the promotion of mental health, prevention of 
mental health disorders, and treatment of such dis-
orders; 
‘‘(3) make the connection between mental and 
behavioral health and academic success; and 
‘‘(4) assist the general public in identifying the 
early warning signs and reducing the stigma of men-
tal illness. 
‘‘(c) COMPOSITION.—The working group under sub-
section (b) shall include— 
‘‘(1) mental health consumers, including stu-
dents and family members; 
‘‘(2) representatives of colleges and universities; 
‘‘(3) representatives of national mental and be-
havioral health and college and university associa-
tions; 
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‘‘(4) representatives of college and university 
health promotion and prevention organizations; 
‘‘(5) representatives of mental health providers, 
including community mental health centers; and 
‘‘(6) representatives of private- and public-sec-
tor groups with experience in the development of ef-
fective public health education campaigns. 
‘‘(d) PLAN.—The working group under subsection (b) 
shall develop a plan that shall— 
‘‘(1) target promotional and educational efforts 
to the college- and university-age population and in-
dividuals who are employed in college and university 
settings, including the use of roundtables; 
‘‘(2) develop and propose the implementation of 
research-based public health messages and activities; 
‘‘(3) provide support for local efforts to reduce 
stigma by using the National Mental Health Infor-
mation Center as a primary point of contact for in-
formation, publications, and service program refer-
rals; and 
‘‘(4) develop and propose the implementation of 
a social marketing campaign that is targeted at the 
college or university population and individuals who 
are employed in college and university settings. 
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‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this section.’’. 
SEC. 4. INTERAGENCY WORKING GROUP ON COLLEGE MEN-
TAL HEALTH. 
(a) PURPOSE.—It is the purpose of this section, pur-
suant to Executive Order 13263 (and the recommenda-
tions issued under section 6(b) of such Order), to provide 
for the establishment of a College Campus Task Force 
under the Federal Executive Steering Committee on Men-
tal Health, to discuss mental and behavioral health con-
cerns on college and university campuses. 
(b) ESTABLISHMENT.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’) shall establish a College Campus Task Force (re-
ferred to in this section as the ‘‘Task Force’’), under the 
Federal Executive Steering Committee on Mental Health, 
to discuss mental and behavioral health concerns on col-
lege and university campuses. 
(c) MEMBERSHIP.—The Task Force shall be com-
posed of a representative from each Federal agency (as 
appointed by the head of the agency) that has jurisdiction 
over, or is affected by, mental health and education poli-
cies and projects, including— 
(1) the Department of Education; 
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(2) the Department of Health and Human 
Services; 
(3) the Department of Veterans Affairs; and 
(4) such other Federal agencies as the Adminis-
trator of the Substance Abuse and Mental Health 
Services Administration and the Secretary jointly de-
termine to be appropriate. 
(d) DUTIES.—The Task Force shall— 
(1) serve as a centralized mechanism to coordi-
nate a national effort— 
(A) to discuss and evaluate evidence and 
knowledge on mental and behavioral health 
services available to, and the prevalence of men-
tal health illness among, the college- and uni-
versity-age population of the United States; 
(B) to determine the range of effective, 
feasible, and comprehensive actions to improve 
mental and behavioral health on college and 
university campuses; 
(C) to examine and better address the 
needs of the college- and university-age popu-
lation dealing with mental illness; 
(D) to survey Federal agencies to deter-
mine which policies are effective in encouraging 
and how best to facilitate outreach without du-
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plicating efforts relating to mental and behav-
ioral health promotion; 
(E) to establish specific goals within and 
across Federal agencies for mental health pro-
motion, including determinations of account-
ability for reaching those goals; 
(F) to develop a strategy for allocating re-
sponsibilities and ensuring participation in men-
tal and behavioral health promotions, particu-
larly in the case of competing agency priorities; 
(G) to coordinate plans to communicate re-
search results relating to mental and behavioral 
health amongst the college- and university-age 
population to enable reporting and outreach ac-
tivities to produce more useful and timely infor-
mation; 
(H) to provide a description of evidence- 
based best practices, model programs, effective 
guidelines, and other strategies for promoting 
mental and behavioral health on college and 
university campuses; 
(I) to make recommendations to improve 
Federal efforts relating to mental and behav-
ioral health promotion on college and university 
campuses and to ensure Federal efforts are 
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consistent with available standards and evidence 
and other programs in existence as of the date 
of enactment of this Act; and 
(J) to monitor Federal progress in meeting 
specific mental and behavioral health promotion 
goals as they relate to college and university 
settings; 
(2) consult with national organizations with ex-
pertise in mental and behavioral health, especially 
those organizations working with the college- and 
university-age population; and 
(3) consult with and seek input from mental 
health professionals working on college and univer-
sity campuses as appropriate. 
(e) MEETINGS.— 
(1) IN GENERAL.—The Task Force shall meet 
at least 3 times each year. 
(2) ANNUAL
CONFERENCE.—The Secretary 
shall sponsor an annual conference on mental and 
behavioral health in college and university settings 
to enhance coordination, build partnerships, and 
share best practices in mental and behavioral health 
promotion, data collection, analysis, and services. 
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(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this section. 
Æ 
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