187 
‘‘(H) exposure to the suicidal behavior of 
others; 
‘‘(I) isolation; and 
‘‘(J) incarceration; 
‘‘(3) according to national data for 2005, sui-
cide was the second-leading cause of death for Indi-
ans and Alaska Natives of both sexes aged 10 
through 34; 
‘‘(4)(A) the suicide rates of Indian and Alaska 
Native males aged 15 through 24 are— 
‘‘(i) as compared to suicide rates of males 
of any other racial group, up to 4 times greater; 
and 
‘‘(ii) as compared to suicide rates of fe-
males of any other racial group, up to 11 times 
greater; and 
‘‘(B) data demonstrates that, over their life-
times, females attempt suicide 2 to 3 times more 
often than males; 
‘‘(5)(A) Indian tribes, especially Indian tribes 
located in the Great Plains, have experienced epi-
demic levels of suicide, up to 10 times the national 
average; and 
‘‘(B) suicide clustering in Indian country affects 
entire tribal communities; 
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188 
‘‘(6) death rates for Indians and Alaska Natives 
are statistically underestimated because many areas 
of Indian country lack the proper resources to iden-
tify and monitor the presence of disease; 
‘‘(7)(A) the Indian Health Service experiences 
health professional shortages, with physician vacancy 
rates of approximately 17 percent, and nursing va-
cancy rates of approximately 18 percent, in 2007; 
‘‘(B) 90 percent of all teens who die by suicide 
suffer from a diagnosable mental illness at time of 
death; 
‘‘(C) more than 1⁄2 of teens who die by suicide 
have never been seen by a mental health provider; 
and 
‘‘(D) 1⁄3 of health needs in Indian country re-
late to mental health; 
‘‘(8) often, the lack of resources of Indian 
tribes and the remote nature of Indian reservations 
make it difficult to meet the requirements necessary 
to access Federal assistance, including grants; 
‘‘(9) the Substance Abuse and Mental Health 
Services Administration and the Service have estab-
lished specific initiatives to combat youth suicide in 
Indian country and among Indians and Alaska Na-
tives throughout the United States, including the 
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189 
National Suicide Prevention Initiative of the Service, 
which has worked with Service, tribal, and urban In-
dian health programs since 2003; 
‘‘(10) the National Strategy for Suicide Preven-
tion was established in 2001 through a Department 
of Health and Human Services collaboration 
among— 
‘‘(A) the Substance Abuse and Mental 
Health Services Administration; 
‘‘(B) the Service; 
‘‘(C) the Centers for Disease Control and 
Prevention; 
‘‘(D) the National Institutes of Health; 
and 
‘‘(E) the Health Resources and Services 
Administration; and 
‘‘(11) the Service and other agencies of the De-
partment of Health and Human Services use infor-
mation technology and other programs to address 
the suicide prevention and mental health needs of 
Indians and Alaska Natives. 
‘‘(b) PURPOSES.—The purposes of this subtitle are— 
‘‘(1) to authorize the Secretary to carry out a 
demonstration project to test the use of telemental 
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190 
health services in suicide prevention, intervention, 
and treatment of Indian youth, including through— 
‘‘(A) the use of psychotherapy, psychiatric 
assessments, diagnostic interviews, therapies for 
mental health conditions predisposing to sui-
cide, and alcohol and substance abuse treat-
ment; 
‘‘(B) the provision of clinical expertise to, 
consultation services with, and medical advice 
and training for frontline health care providers 
working with Indian youth; 
‘‘(C) training and related support for com-
munity leaders, family members, and health 
and education workers who work with Indian 
youth; 
‘‘(D) the development of culturally relevant 
educational materials on suicide; and 
‘‘(E) data collection and reporting; 
‘‘(2) to encourage Indian tribes, tribal organiza-
tions, and other mental health care providers serving 
residents of Indian country to obtain the services of 
predoctoral psychology and psychiatry interns; and 
‘‘(3) to enhance the provision of mental health 
care services to Indian youth through existing grant 
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191 
programs of the Substance Abuse and Mental 
Health Services Administration. 
‘‘SEC. 722. DEFINITIONS. 
‘‘In this subtitle: 
‘‘(1) ADMINISTRATION.—The term ‘Administra-
tion’ means the Substance Abuse and Mental Health 
Services Administration. 
‘‘(2) DEMONSTRATION
PROJECT.—The term 
‘demonstration project’ means the Indian youth tele-
mental health demonstration project authorized 
under section 723(a). 
‘‘(3) TELEMENTAL HEALTH.—The term ‘tele-
mental health’ means the use of electronic informa-
tion and telecommunications technologies to support 
long-distance mental health care, patient and profes-
sional-related education, public health, and health 
administration. 
‘‘SEC. 723. INDIAN YOUTH TELEMENTAL HEALTH DEM-
ONSTRATION PROJECT. 
‘‘(a) AUTHORIZATION.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Service, is authorized to carry out a 
demonstration project to award grants for the provi-
sion of telemental health services to Indian youth 
who— 
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‘‘(A) have expressed suicidal ideas; 
‘‘(B) have attempted suicide; or 
‘‘(C) have behavioral health conditions that 
increase or could increase the risk of suicide. 
‘‘(2) ELIGIBILITY FOR GRANTS.—Grants under 
paragraph (1) shall be awarded to Indian tribes and 
tribal organizations that operate 1 or more facili-
ties— 
‘‘(A) located in an area with documented 
disproportionately high rates of suicide; 
‘‘(B) reporting active clinical telehealth ca-
pabilities; or 
‘‘(C) 
offering 
school-based 
telemental 
health services to Indian youth. 
‘‘(3) GRANT
PERIOD.—The Secretary shall 
award grants under this section for a period of up 
to 4 years. 
‘‘(4) MAXIMUM
NUMBER
OF
GRANTS.—Not 
more than 5 grants shall be provided under para-
graph (1), with priority consideration given to In-
dian tribes and tribal organizations that— 
‘‘(A) serve a particular community or geo-
graphic area in which there is a demonstrated 
need to address Indian youth suicide; 
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