students reported feeling hopeless, 45 percent said 
they felt so depressed they could barely function, 
and 9 percent felt suicidal. 
(12) There is clear evidence of an increased in-
cidence of depression among college students. Ac-
cording to a survey described in the Chronicle of 
Higher Education (February 1, 2002), depression 
among freshmen has nearly doubled (from 8.2 per-
cent to 16.3 percent). Without treatment, research-
ers recently noted that ‘‘depressed adolescents are at 
risk for school failure, social isolation, promiscuity, 
self medication with drugs and alcohol, and sui-
cide—now the third leading cause of death among 
10–24 year olds.’’. 
(13) Researchers who conducted the study 
‘‘Changes in Counseling Center Client Problems 
Across 13 Years’’ (1989–2001) at Kansas State 
University stated that ‘‘students are experiencing 
more stress, more anxiety, more depression than 
they were a decade ago.’’ (The Chronicle of Higher 
Education, February 14, 2003). 
(14) According to the 2001 National Household 
Survey on Drug Abuse, 20 percent of full-time un-
dergraduate college students use illicit drugs.
(15) The 2001 National Household Survey on 
Drug Abuse also reported that 18.4 percent of 
adults aged 18 to 24 are dependent on or abusing 
illicit drugs or alcohol. In addition, the study found 
that ‘‘serious mental illness is highly correlated with 
substance dependence or abuse. Among adults with 
serious mental illness in 2001, 20.3 percent were de-
pendent on or abused alcohol or illicit drugs, while 
the rate among adults without serious mental illness 
was only 6.3 percent.’’. 
(16) A 2003 Gallagher’s Survey of Counseling 
Center Directors found that 81 percent were con-
cerned about the increasing number of students with 
more serious psychological problems, 67 percent re-
ported a need for more psychiatric services, and 63 
percent reported problems with growing demand for 
services without an appropriate increase in re-
sources. 
(17) The International Association of Coun-
seling Services accreditation standards recommend 1 
counselor per 1,000 to 1,500 students. According to 
the 2003 Gallagher’s Survey of Counseling Center 
Directors, the ratio of counselors to students is as 
high as 1 counselor per 2,400 students at institu-
tions of higher education with more than 15,000 
students. 
SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICES 
ACT. 
Title V of the Public Health Service Act (42 U.S.C. 
290aa et seq) is amended— 
(1) in section 520E (42 U.S.C. 290bb–36)— 
(A) in the section heading by striking 
‘‘CHILDREN AND ADOLESCENTS’’ and insert-
ing ‘‘YOUTH’’ ; 
(B) by striking subsection (a) and insert-
ing the following: 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants or cooperative agreements to public organizations, 
private nonprofit organizations, political subdivisions, and 
Federally recognized Indian tribes or tribal organizations 
to implement the State-sponsored statewide or tribal youth 
suicide early intervention and prevention strategy as devel-
oped under section 596A.’’; 
(C) in subsection (b), by striking all after 
‘‘coordinated’’ and inserting ‘‘with the Strategy 
for Suicide Prevention Federal Steering Group 
and the suicide prevention resource center pro-
vided for under section 596B.’’; 
(D) in subsection (c)—