I 
112TH CONGRESS 
1ST SESSION H. R. 1833 
To amend the Public Health Service Act to improve mental and behavioral 
health services on college campuses. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 11, 2011 
Ms. SCHAKOWSKY (for herself, Mr. RYAN of Ohio, Mr. WU, and Mr. STARK) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committee on Education and 
the Workforce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction 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: 
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
(1) The 2010 Association of University and 
College Counseling Center Directors Survey found 
that the average ratio of counselors to students on 
campus is nearly 1 to 1,940 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 students who commit 
suicide received campus counseling. Of students who 
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
seriously consider suicide each year, only 52% of 
them seek any professional help at all. 
(6) A 2010 American College Health Associa-
tion survey of more than 95,000 college and univer-
sity students revealed that, within the last 12 
months, 48 percent of students report having felt 
overwhelming anxiety, 31 percent felt so depressed it 
was difficult to function, and 46 percent felt hope-
less. Both the ACHA survey as well as the National 
Research Consortium of Counseling Centers in 
Higher Education found that 6 percent of students 
have seriously considered suicide in the past 12 
months. 
(7) Research conducted between 1997 and 
2009, and presented at the 118th annual convention 
of the American Psychological Association found 
that more students are grappling with depression 
and anxiety disorders than did a decade ago. The 
study found that of students who sought college 
counseling, 41 percent had moderate to severe de-
pression in 2009, that number was 34 percent in 
1997. 
(8) A survey conducted by the University of 
Idaho Student Counseling Center in 2000 found 
that 77 percent of students who responded reported 
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
that they were more likely to stay in school because 
of counseling and that their school performance 
would have declined without counseling. 
(9) 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 students receiving counseling to 
have an 11.4 percent higher retention rate than the 
general university population (Turner & Berry, 
2000). 
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; 
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
‘‘(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— 
‘‘(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-
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
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; 
‘‘(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; 
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
‘‘(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— 
‘‘(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-
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
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, voluntary screening, early interven-
tion, voluntary assessment, treatment, management, 
and education services relating to the mental and be-
havioral health of students; 
‘‘(2) provide outreach services to notify stu-
dents about the existence of mental and behavioral 
health services; 
‘‘(3) educate students, families, faculty, staff, 
and communities to increase awareness of mental 
health issues; 
‘‘(4) support student groups on campus that 
engage in activities to educate students, including 
activities to reduce stigma surrounding mental and 
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
behavioral disorders, and promote mental health 
wellness; 
‘‘(5) employ appropriately trained staff; 
‘‘(6) provide training to students, faculty, and 
staff to respond effectively to students with mental 
and behavioral health issues; 
‘‘(7) expand mental health training through in-
ternship, post-doctorate, and residency programs; 
‘‘(8) develop and support evidence-based and 
emerging best practices, including a focus on cul-
turally and linguistically appropriate best practices; 
and 
‘‘(9) 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 
of the activities carried out under the grant and 
plans for the sustainability of such efforts. 
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
‘‘(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 
have the support necessary to successfully complete their 
studies. 
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
‘‘(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— 
‘‘(1) mental health consumers, including stu-
dents and family members; 
‘‘(2) representatives of colleges and universities; 
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS
‘‘(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 
‘‘(4) develop and propose the implementation of 
a social marketing campaign that is targeted at the 
VerDate Mar 15 2010 
04:29 May 18, 2011
Jkt 099200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H1833.IH
H1833
tjames on DSKG8SOYB1PROD with BILLS