•HRES 1057 IH 
(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 re-
sult 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 signifi-
cantly 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 men-
tal health and substance use disorder concerns for edu-
cators 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 ap-
proach created by the United States Secret Service that 
involves identifying, evaluating, and taking action on cur-
rent 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 stu-
dents of color by initiating justice involvement in 
lieu of more appropriate services; and 
(D) has had a disproportionate impact on stu-
dents with disabilities; 
(5) families and caregivers need to be included when 
treating children suffering from mental illness and sub-
stance 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 sub-
stance 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 sub-
stance use disorder treatment by young adults, there con-
tinues to be disparities in accessing care experienced by 
young adults of color; 
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•HRES 1057 IH 
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 diag-
nosis, and— 
(1) 1 in 4 active duty members shows signs of men-
tal health conditions; 
(2) the rate of post-traumatic stress disorder 
(PTSD) is 15 times higher in servicemembers than com-
pared 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 condi-
tions and substance use disorders and seeking treatment 
due to negative career implications; and 
(6) less than 50 percent of veterans receive the men-
tal health treatment and services they need; 
Whereas 11 percent of those entering the Veterans Affairs 
health system meet the criteria for a substance use dis-
order; 
Whereas veterans are more likely to have an alcohol use dis-
order than civilians; 
Whereas 2 in 10 veterans with PTSD have a comorbid sub-
stance 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 dis-
orders; 
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Whereas the United States justice system is the largest pro-
vider 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 inappro-
priate 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 dis-
order; 
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 sys-
tem to include those who are 25 years of age or younger 
in order to reflect the most up-to-date scientific con-
sensus 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 in-
crease the likelihood of juvenile justice involvement; 
(3) entry into the juvenile justice system may exac-
erbate the existing mental health and substance use dis-
order 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 di-
agnosed 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 ac-
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cess to psychopharmacology, psychotherapy, contingency 
management, recovery support, all evidence-based medi-
cation-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 sub-
stance 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 qual-
ity 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 disproportion-
ately affected by disabilities that result from mental 
health conditions; and 
(3) only 31 percent of African Americans and His-
panics 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 re-
port seriously thinking about suicide; 
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(3) 30.8 percent of transgender individuals report 
considering suicide compared to 2.3 percent of hetero-
sexual 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 pan-
demic has negatively impacted their mental health, with 
21 percent saying that it has had a major negative im-
pact; 
(2) a significant increase in number of calls to sui-
cide 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 popu-
lations and focuses attention on the need to provide ac-
cess 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 psycho-
logical distress among those in high-risk populations: 
Now, therefore, be it 
Resolved, That it is the sense of the House of Rep-
resentatives that in order to effectively address the high 
prevalence of those suffering from mental health condi-
tions 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 recognize that— 
(1) mental health and physical health need to 
be treated together to treat the whole patient; 
(2) patient care needs to be patient-focused; 
(3) mental health and substance use disorder 
care needs to be proactive and treat people before 
they are in crisis; 
(4) any stigma associated with mental health 
and substance use disorders is completely unwar-
ranted and serves as a barrier to care; 
(5) the Federal Government needs to create a 
comprehensive approach to improving the health 
care system that incorporates mental health and 
substance use disorders that includes system reform 
that— 
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(A) aims to break down silos across the 
Federal, State, local, and Tribal levels for im-
proved communication and care coordination; 
(B) provides a Federal framework to 
States, localities, and Tribes that connects 
agencies and services so they can have guidance 
when working to address the mental health and 
substance use disorder needs of their commu-
nities; 
(C) incentivizes providers to see both more 
complex and less complex patients and to see 
patients in rural and underserved areas; 
(D) expects insurers to comply with parity 
laws and holds them accountable for not pro-
viding parity of mental health and substance 
use disorder services and treatments; and 
(E) requires both public and private payers 
to have higher reimbursement rates for mental 
health and substance use disorder services that 
are on par with medical and surgical services; 
(6) the Federal Government needs to create a 
comprehensive approach to improving the health 
care system that incorporates mental health and 
substance use disorders that includes system im-
provements that— 
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(A) focuses on early screenings, diagnosis, 
and intervention across the care continuum to 
prevent those from experiencing a mental health 
crisis; 
(B) improves families’ ability to access 
timely, affordable, and high-quality treatment 
and services; 
(C) strengthens mental health and sub-
stance use disorder services in schools and en-
sures there is engagement from all stake-
holders; 
(D) improves and expands community- 
based services so people have access to services 
locally; 
(E) improves care coordination across 
treatment settings so patients have the services 
they need when they need it and do not need 
to navigate the system themselves; 
(F) promotes a sustained recovery that in-
cludes social determinants of health, such as 
housing, jobs, and childcare; 
(G) can adjust to meet the needs of each 
individual to provide the best care for each per-
son; 
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(H) ensures seamless transitions in care 
when moving through steps or processes; 
(I) ends the criminalization of mental ill-
ness and substance use disorders and increases 
programs for diversion that connects individuals 
to treatment, social supports, and social serv-
ices; 
(J) provides access to high-quality and evi-
dence-based mental health and substance use 
disorder care for those who are incarcerated; 
(K) creates young adult services and pro-
grams within the justice system for those who 
are ages 18 to 25 to successfully reduce recidi-
vism and that are informed by neuropsycholog-
ical brain science; 
(L) incorporates apprenticeship or job 
training programs into the justice system, par-
ticularly for youth, to empower them and re-
duce recidivism; 
(M) ensures cultural congruence so every-
one in need of mental health and substance use 
disorder care has services that meet their needs; 
(N) adopts a population health approach 
as a tool to help address ongoing disparities in 
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access to mental health and substance use dis-
order care by youth and adults of color; 
(O) ensures that LGBTQ individuals, com-
munities of color, and immigrants have access 
to mental health and substance use disorder 
services that are culturally appropriate, are in 
the necessary language, and address any unique 
stigma from their communities; 
(P) enables veterans to access timely men-
tal health and substance use disorder care that 
ensures continuity and is free of any adminis-
trative burdens; 
(Q) includes training for educators, first 
responders, and clinicians to identify indicators 
of mental health conditions and substance use 
disorders and to reduce stigma and bias related 
to these conditions so they can respond in a 
more productive way and connect people with 
more appropriate services; 
(R) supports health care providers by ad-
dressing their mental health and substance use 
disorder needs to reduce burnout; 
(S) provides a process in which States can 
work with other States to reconcile licensure 
and certification for and reimbursement to 
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mental health and substance use disorder pro-
viders across State lines for the purpose of tele-
medicine; 
(T) leverages the current mental health 
and substance use disorder workforce by reduc-
ing administrative burdens to allow mental 
health and substance use disorder providers to 
perform to their highest level of licensure and 
certification; and 
(U) expands training opportunities and 
grows the workforce by partnering with schools 
and programs to provide free education to those 
who work in rural or underserved areas; 
(7) expanded access to mental health and sub-
stance use disorder care is essential to improving 
health and well-being; 
(8) all Americans deserve access to mental 
health and substance use disorder care without any 
barriers, such as cost or location of services; and 
(9) the United States needs to comprehensively 
break down all barriers to receiving access to mental 
health and substance use disorder care including fi-
nancial burdens and location hurdles. 
Æ 
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