SEC. 2. STUDY ON THE COSTS OF SERIOUS MENTAL ILL-
NESS. 
(a) IN GENERAL.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services, in consultation with the Assistant 
Secretary for Planning and Evaluation, the Attorney Gen-
eral of the United States, the Secretary of Labor, and the 
Secretary of Housing and Urban Development, shall con-
duct a study on the direct and indirect costs of serious 
mental illness with respect to— 
(1) nongovernmental entities; and 
(2) the Federal Government and State, local, 
and Tribal governments. 
(b) CONTENT.—The study under subsection (a) shall 
consider each of the following: 
(1) The costs of the health care system for all 
facilities and health services, including— 
(A) public and private inpatient hospitals, 
outpatient health care, and home health care; 
(B) office-based physician visits; 
(C) prescription drugs and digital thera-
peutics; 
(D) emergency room visits; 
(E) substance use treatment; 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
(F) skilled nursing and long-term care fa-
cilities for residential, custodial, and general 
health care; 
(G) with respect to the costs described in 
subparagraphs (A) through (F), out-of-pocket 
costs and costs for different types of behavioral 
health and psychiatric illness; and 
(H) other professional health services. 
(2) The costs of homelessness, including— 
(A) homeless shelters; 
(B) street outreach activities; 
(C) crisis response center visits; and 
(D) other supportive services. 
(3) The costs of structured residential facilities 
and other supportive housing for residential and cus-
todial care services. 
(4) The costs of law enforcement encounters 
and encounters with the criminal justice system, in-
cluding— 
(A) encounters that do and do not result 
in an arrest; 
(B) investigating a crime and judicial pro-
ceedings, including the process of sentencing; 
(C) services provided by police officers, 
sheriff deputies, police departments and sheriff 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
offices, and judicial staff (including public de-
fenders, prosecutors, and private attorneys); 
(D) services provided by public institutions 
(including local and county jails, State prisons, 
and paid legal guardians); 
(E) public safety costs to transport an in-
dividual with a serious mental illness to receive 
mental health or substance use treatment serv-
ices or be incarcerated (including vehicle miles 
and personnel expenses); 
(F) with respect to inmates with a serious 
mental illness, incarceration costs in Federal 
prison, State prison, and local jails (including 
residential, custodial, and on-site and off-site 
health care); and 
(G) solitary confinement, security, and 
other similar costs. 
(5) The costs of addressing serious mental ill-
ness as a disability in the workplace, including— 
(A) reduced wages for individuals with a 
serious mental illness who are employed; and 
(B) the estimated costs attributable to— 
(i) the nationwide unemployment rate 
for individuals with a serious mental ill-
ness; 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
(ii) benefits payable on the basis of 
disability to individuals with a serious 
mental illness— 
(I) under title II or XVI of the 
Social Security Act (42 U.S.C. 401 et 
seq., 1381 et seq.); or 
(II) from a State or other gov-
ernmental entity; or 
(iii) to the extent feasible, lost lifetime 
productivity due to disability. 
(6) With respect to family members and care-
givers, the costs of caring for an individual with a 
serious mental illness, including— 
(A) the cost of unpaid labor; 
(B) additional health care costs associated 
with providing ongoing care for an individual 
with a serious mental illness, including higher 
health care costs resulting from stress and anx-
iety; 
(C) taking leave from work; and 
(D) out-of-pocket costs incurred while car-
ing for such individual. 
(7) Costs with respect to funding for grants or 
cooperative agreements for programs or services for 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
basic, translational, and applied research for individ-
uals with a serious mental illness. 
(8) The costs of workforce development and 
training for personnel that interact with individuals 
with a serious mental illness, and insurance for such 
development and training, including health care 
workers, social service employees, law enforcement, 
and first responders. 
(9) Other costs for programs and services ad-
ministered by the Federal Government or State, 
Tribal, or local governments. 
(c) DATA
DISAGGREGATION.—In conducting the 
study under subsection (a), the Secretary shall (to the ex-
tent feasible)— 
(1) disaggregate data by— 
(A) costs to nongovernmental entities, the 
Federal Government, and State, local, and 
Tribal governments; 
(B) types of serious mental illnesses and 
medical chronic diseases common in patients 
with a serious mental illness; and 
(C) demographic characteristics, including 
race, ethnicity, sex, age (including pediatric 
subgroups), and other characteristics deter-
mined by the Secretary; and 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
(2) include an estimate of— 
(A) the total number of individuals with a 
serious mental illness in the United States, in-
cluding in traditional and nontraditional hous-
ing; and 
(B) taking into account the information 
collected pursuant to section 3(b)(3), the per-
centage of such individuals in— 
(i) homeless shelters; 
(ii) penal facilities, including Federal 
prisons, State prisons, and county and mu-
nicipal jails; and 
(iii) nursing facilities. 
(d) REPORT.—Not later than 2 years after the date 
of the enactment of this Act, the Secretary shall— 
(1) submit to the Congress a report containing 
the results of the study conducted under this sec-
tion; and 
(2) make such report publicly available. 
(e) DEFINITIONS.—In this section: 
(1) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(2) SERIOUS MENTAL ILLNESS.—The term ‘‘se-
rious mental illness’’ means a mental, behavioral, or 
emotional disorder resulting in a serious functional 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
impairment that substantially interferes with or lim-
its one or more major life activities, including the 
following: 
(A) Schizophrenia, including schizoaffective 
disorder and other related psychosis. 
(B) Schizoaffective disorder. 
(C) Persistent mood disorder, including bi-
polar disorder I and II. 
(D) Major depressive disorder. 
(E) Any other such mental, behavioral, or 
emotional disorder, as determined by the Sec-
retary. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to the Secretary to carry 
out this section $3,500,000 for each of fiscal years 2023 
and 2024. 
SEC. 3. SCHIZOPHRENIA SURVEILLANCE SURVEY. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’), acting through the Assistant Secretary for Men-
tal Health and Substance Use, and in coordination with 
the Director of the Centers for Disease Control and Pre-
vention and the Director of the National Institute of Men-
tal Health, shall— 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
(1) conduct a surveillance survey to collect the 
information described in subsection (b) about indi-
viduals with schizophrenia in the United States; and 
(2) not less than every 5 years, update such 
survey. 
(b) CONTENT.—In carrying out subsection (a), the 
Secretary shall collect— 
(1) to the extent practicable, information relat-
ing to individuals with schizophrenia, such as— 
(A) demographics, such as age, race, eth-
nicity, sex, geographic location, family history, 
and other information as appropriate; 
(B) risk factors that may be associated 
with schizophrenia such as environmental risk 
factors and other information as appropriate; 
and 
(C) average age at the time of initial diag-
nosis and time lapses, if any, between the initial 
diagnosis and the initiation of mental health 
care; 
(2) to the extent practicable, information on the 
health status of individuals with schizophrenia, in-
cluding— 
(A) mortality and morbidity rates; 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
(B) incidences of comorbid chronic dis-
eases, including diabetes, cardiac conditions, 
emphysema, cirrhosis, HIV/AIDS, and hepatitis 
C; and 
(C) the frequency of hospital emergency 
department utilization; and 
(3) the percentage of individuals with schizo-
phrenia in— 
(A) homeless shelters; 
(B) penal facilities, including Federal pris-
ons, State prisons, and county and municipal 
jails; 
(C) nursing facilities; and 
(D) inpatient hospitals. 
(c) CONSULTATION.—In carrying out this section, the 
Secretary shall consult with individuals with appropriate 
expertise, which may include— 
(1) epidemiologists with experience in mental 
health conditions surveillance; and 
(2) representatives of national voluntary health 
association and nonprofit citizens organizations 
that— 
(A) focus on schizophrenia and related 
psychotic conditions; and 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
(B) have experience in research, care, and 
patient services. 
(d) COORDINATION.—In carrying out this section, the 
Secretary shall— 
(1) coordinate with the National Neurological 
Conditions Surveillance System under section 399S– 
1 of the Public Health Service Act (42 U.S.C. 280g– 
7a) to determine any overlap between— 
(A) individuals with schizophrenia counted 
for purposes of the survey under this section; 
and 
(B) individuals with neurological conditions 
identified by the Director of the Centers for 
Disease Control and Prevention for purposes of 
the National Neurological Conditions Surveil-
lance System; and 
(2) coordinate with other Federal agencies, in-
cluding the Social Security Administration, the De-
partment of the Treasury, and the Department of 
Labor, to use administrative data, to the extent fea-
sible, to provide information for the survey author-
ized by subsection (a). 
(e) GRANTS.—The Secretary may award grants to, 
or enter into contracts or cooperative agreements with, 
public or private nonprofit entities to carry out activities 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
in furtherance of the surveillance survey under this sec-
tion, including the convening of stakeholder meetings. 
(f) REPORTING.— 
(1) IN GENERAL.—The Secretary shall submit 
to the Committee on Energy and Commerce of the 
House of Representatives and the Committee on 
Health, Education, Labor, and Pensions of the Sen-
ate— 
(A) not later than 2 years after the date 
of enactment of this Act, a report containing 
findings of the surveillance survey under this 
section, including aggregate information col-
lected and epidemiological analyses, as appro-
priate; and 
(B) not less than every 5 years when an 
updated survey is conducted pursuant to sub-
section (a)(2), an updated report. 
(2) POSTING.—The Secretary shall post the re-
port under paragraph (1) and each update under 
paragraph (2) on the public website of the Depart-
ment of Health and Human Services. 
(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS
$50,000,000 for the period of fiscal years 2023 through 
2027. 
Æ 
VerDate Sep 11 2014 
00:06 Apr 14, 2022
Jkt 029200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6301
E:\BILLS\H7483.IH
H7483
kjohnson on DSK79L0C42PROD with BILLS