I 
110TH CONGRESS 
2D SESSION 
H. R. 6948 
To amend the Public Health Service Act to improve mental and behavioral 
health services on college campuses. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 18, 2008 
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 
concern that the demand for services is growing 
without an increase in resources. 
(4) A 2006 American College Health Associa-
tion survey revealed that 44 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 from 1989 to 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 these students. 
(7) A survey conducted by the University of 
Idaho Student Counseling Center (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 level of mental and behavioral health 
care; and 
‘‘(5) 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); and 
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‘‘(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 
groups, and other public and private entities in car-
rying out the program; 
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‘‘(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; 
‘‘(3) target traditionally underserved popu-
lations and populations most at risk; 
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‘‘(4) where possible, demonstrate an awareness 
of and a willingness to coordinate with a community 
mental health center or other mental health resource 
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 shall 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; 
‘‘(3) educate families, peers, faculty, staff, and 
communities to increase awareness of mental health 
issues; 
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‘‘(4) employ appropriately trained staff; 
‘‘(5) expand mental health training through in-
ternship, post-doctorate, and residency programs; 
‘‘(6) develop and support evidence-based and 
emerging best practices; and 
‘‘(7) 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 of 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. 
‘‘(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 
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