I 
111TH CONGRESS 
1ST SESSION H. R. 1704 
To amend the Public Health Service Act to improve mental and behavioral 
health services on college campuses. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 25, 2009 
Ms. SCHAKOWSKY introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee 
on Education and Labor, for a period to be subsequently determined by 
the Speaker, in each case for consideration of such provisions as fall with-
in the jurisdiction of the committee concerned 
A BILL 
To amend the Public Health Service Act to improve mental 
and behavioral health services on college 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: 
(1) The 2007 National Survey of Counseling 
Center Directors found that the average ratio of 
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counselors to students on campus is nearly 1 to 
2,000 and is often far higher on large campuses. 
The International Association of Counseling Services 
accreditation standards recommend 1 counselor per 
1,000 to 1,500 students. 
(2) College counselors report that 8.5 percent of 
enrolled students sought counseling in the past year, 
totaling an estimated 1,600,000 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. The majority of counseling directors report 
concerns that the demand for services is growing 
without an increase in resources. 
(4) A 2008 American College Health Associa-
tion survey revealed that 43 percent of students at 
colleges and universities report having felt so de-
pressed it was difficult to function, and one out of 
every 11 students seriously considered suicide within 
the past year. 
(5) Research conducted between 1989 and 2002 
found that students seen for anxiety disorders dou-
bled, for depression tripled, and for serious suicidal 
intention tripled. 
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(6) Many students who need help never receive 
it. Counseling directors report that, of the students 
who committed suicide on their campuses, only 22 
percent were current or former counseling center cli-
ents. Directors did not know the previous psychiatric 
history of 60 percent of those students. 
(7) 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. 
(8) A 6-year longitudinal study of college stu-
dents found that personal and emotional adjustment 
was an important factor in retention and predicted 
attrition as well as, or better than, academic adjust-
ment (Gerdes & Mallinckrodt, 1994). 
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: 
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‘‘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 
‘‘(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— 
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‘‘(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, and the Federal, State, local, 
private, and institutional resources available for 
meeting the needs of such students at the time the 
application is submitted; 
‘‘(2) an outline of the objectives of the program 
carried out under the grant; 
‘‘(3) a description of activities, services, and 
training to be provided under the program, including 
planned outreach strategies to reach students not 
currently seeking services; 
‘‘(4) a plan to seek input from community men-
tal health providers, when available, community 
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groups, and other public and private entities in car-
rying out the program; 
‘‘(5) a plan, when applicable, to meet the spe-
cific mental and behavioral health needs of veterans 
attending institutions of higher education; 
‘‘(6) a description of the methods to be used to 
evaluate the outcomes and effectiveness of the pro-
gram; and 
‘‘(7) 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— 
‘‘(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; 
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‘‘(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; and 
‘‘(6) demonstrate the greatest potential for rep-
lication and dissemination. 
‘‘(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, screening, early intervention, assess-
ment, treatment, management, and education serv-
ices relating to the mental and behavioral health of 
students; 
‘‘(2) provide outreach services to notify stu-
dents about the existence of mental and behavioral 
health services; 
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‘‘(3) educate families, peers, faculty, staff, and 
communities to increase awareness of mental health 
issues; 
‘‘(4) support student groups on campus that 
engage in activities to educate students, reduce stig-
ma surrounding mental and behavioral disorders, 
and promote mental health wellness; 
‘‘(5) employ appropriately trained staff; 
‘‘(6) expand mental health training through in-
ternship, post-doctorate, and residency programs; 
‘‘(7) develop and support evidence-based and 
emerging best practices, including a focus on cul-
turally and linguistically appropriate best practices; 
and 
‘‘(8) 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 concerning the effectiveness 
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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 
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 students 
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have the support necessary to successfully 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 
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 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— 
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‘‘(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 associations; 
‘‘(4) representatives of college 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 age population and individuals 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 
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‘‘(4) develop and propose the implementation of 
a social marketing campaign that is targeted at the 
college population and individuals who are employed 
in college and university settings. 
‘‘(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 
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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; 
(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 age popu-
lation 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; 
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(C) to examine and better address the 
needs of the college age population 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-
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 age population to 
enable reporting and outreach activities to 
produce more useful and timely information; 
(H) to provide a description of evidence- 
based best practices, model programs, effective 
guidelines, and other strategies for promoting 
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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 campuses and 
to ensure Federal efforts are consistent with 
available standards and evidence and other pro-
grams 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 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 
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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. 
(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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