(1) Increasing numbers of members of the 
Armed Forces serving in Afghanistan and Iraq are 
suffering from the significant injuries of the current 
conflict: post traumatic stress disorder and trau-
matic brain injury (hereafter in this Act referred to 
as ‘‘PTSD’’ and ‘‘TBI’’, respectively) . 
(2) A recent report by the RAND Corporation 
estimated that of the 1.64 million individuals who 
have been deployed to Afghanistan and Iraq, ap-
proximately 300,000 individuals currently suffer 
from PTSD or major depression and that 320,000 
report having a probable TBI during deployment. 
(3) The need for mental health services is likely 
to increase because deployment lengths have in-
creased in the last year, the number of troops who 
have served in multiple deployments is increasing, 
and the breaks between deployments have been in-
frequent. 
(4) Several experts have noted the difficulties 
faced by members of the Armed Forces in getting 
screened, diagnosed, and treated for PTSD and 
TBI. The RAND report found that, of those who 
met diagnostic criteria for PTSD or major depres-
sion, only 53 percent had seen a physician or mental 
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health provider to seek help for a mental health 
problem in the past 12 months. 
(5) Stigma remains a critical barrier to mem-
bers of the Armed Forces who may be in need of 
psychological care, especially fears that seeking men-
tal health care will lower the confidence of others in 
their abilities, threaten career advancement and se-
curity clearances, and possibly cause removal from 
their unit. 
(6) Stigma may be greatest among those indi-
viduals with the greatest need for mental health 
services. 
(7) To combat stigma, the Mental Health Task 
Force of the Department of Defense and others have 
noted the need for the Department to reexamine its 
policies, including those policies related to command 
notification or self-disclosure of psychological health 
issues that contribute to fears that seeking mental 
health care will negatively affect career opportunities 
or advancement. 
(8) The Mental Health Task Force stated that 
this ‘‘widespread perception that seeking psycho-
logical health services is costly to an individual’s ca-
reer . . . must be challenged through thoughtful re-
finements in command notification policies, including 
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redefining the balance between the need to encour-
age those in need to seek help and the need for com-
manders to know in order to maintain force readi-
ness’’. 
(9) Congress recognizes that much change is 
under way to implement numerous recommendations 
to address concerns that soldiers in need of mental 
health services for PTSD and other conditions are 
not receiving, including efforts led by the Depart-
ment of Defense and the Department of Veterans 
Affairs. 
(10) However, without addressing stigma at all 
levels, including structurally, these laudable efforts 
may not accomplish their goals. 
(11) In its July 2007 report, the Mental Health 
Task Force called for ending overly conservative 
policies that have the unintentional consequence of 
fueling erroneous beliefs that seeking psychological 
health care invariably results in permanent damage 
to one’s military career. For example, the Task 
Force called for allowing, in the case of alcohol use 
by a member of the Armed Forces, for the member 
to receive appropriate and non-prejudicial education 
and preventive services, without a requirement for 
command notification, when, in a clinician’s judg-
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ment, the alcohol use does not warrant a diagnosis 
of substance abuse or dependency or does not re-
quire entry into a formal treatment program. 
(12) In May, responding to some of these con-
cerns, Secretary of Defense Robert Gates reportedly 
approved a change in the Department’s security 
clearance process to help remove the stigma associ-
ated with seeking mental health care. Under the 
change, members of the Armed Forces and employ-
ees of the Department of Defense who have received 
mental health care will no longer have to acknowl-
edge that when they fill out standard security clear-
ance forms, unless the treatment was court-ordered 
or involved violence. 
(13) Congress encourages the Department to 
explore further changes to notification and other 
policies to further reduce stigma among members of 
the Armed Forces, especially as it relates to career 
opportunities. 
SEC. 3. MENTAL HEALTH SERVICES ACCESS DEMONSTRA-
TION PROJECT. 
(a) DEMONSTRATION
PROJECT
REQUIRED.—The 
Secretary of Defense shall conduct a demonstration 
project designed to develop and test options for the fol-
lowing: 
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(1) Increasing access of members of the Armed 
Forces returning from deployment abroad, and fam-
ily members of such members, to accessible, safe, 
and confidential mental health counseling. 
(2) Reducing stigma and perceived career re-
percussions associated with such members seeking 
such services. 
(3) Making high quality mental health services 
more user friendly and accessible for members of the 
Armed Forces and their family members, including 
making services available outside standard working 
hours. 
(b) PURPOSE.—The purpose of the demonstration 
project is to provide high-quality treatment, using (to the 
extent practicable) evidence-based treatment, for a broad 
range of mental health conditions, including post-trau-
matic stress disorder and depression, with the goal of early 
intervention to promote effective coping and resilience. 
(c) DURATION
OF PROJECT.—The demonstration 
project authorized by this section shall be implemented for 
a period of three years beginning not later than one year 
after the date of the enactment of this Act. 
SEC. 4. SPECIAL WORKING GROUP ON CONFIDENTIALITY. 
(a) ESTABLISHMENT.—The Secretary of Defense, 
acting through the Assistant Secretary of Defense for 
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Health Affairs, shall establish a Special Working Group, 
which shall be composed of mental health professionals 
from each of the Armed Forces, officials from the Surgeon 
General Offices at each Armed Force, members of the 
Armed Forces who have been deployed in support of Oper-
ation Enduring Freedom or Operation Iraqi Freedom, and 
other members as determined appropriated by the Assist-
ant Secretary. 
(b) APPOINTMENT.—The Secretary shall make every 
effort to appoint members of the working group not later 
than 60 days after the date of the enactment of this Act. 
(c) PURPOSE.—The Special Working Group shall de-
velop guidelines and make recommendations about regula-
tions to ensure that confidentiality is protected to the 
maximum extent possible for members of the Armed 
Forces participating in the demonstration project. 
(d) SPECIFIC DUTIES.—In addition to such other du-
ties as the Secretary may assign to the Working Group, 
the duties of the Working Group shall include the fol-
lowing: 
(1) REVIEW
OF
REQUIREMENTS
FOR
DOCU-
MENTATION OF HEALTH CARE VISITS.—The review 
of current policies, questionnaires, and other rel-
evant documents that require official documentation 
of health care visits by a member of the Armed 
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Forces seeking mental health services, including 
when access to such services must be documented in 
the personnel record of a member. 
(2) CRITERIA FOR CHANGES TO COMMAND NO-
TIFICATION.—The development of guidelines and 
criteria for the demonstration project to address any 
needed changes to military command notification re-
quirements to ensure that a visit to an off-base 
treatment site by a member of the Armed Forces for 
mental health services is not recorded on any mili-
tary medical or other record of the member, except 
in accordance with guidelines developed under para-
graph (3). 
(3) GUIDELINES FOR BREACH OF CONFIDEN-
TIALITY.—The development of guidelines for the 
demonstration project to address the circumstances 
under which the confidentiality protections afforded 
to a member of the Armed Forces participating in 
the demonstration project may be breached and noti-
fication to military commanders and documentation 
in personnel records may be made. Such guidelines 
shall provide, in general, that confidentiality may be 
broken only if a mental health professional deter-
mines that the member is a threat to the member 
or to another person. 
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(4) CRITERIA TO LIMIT ACCESS TO TREATMENT 
RECORDS.—The development of criteria for the dem-
onstration project for limiting access to the treat-
ment records of members of the Armed Forces treat-
ed at the demonstration locations, including when to 
allow, if appropriate, appropriate access and notifi-
cation to military commanders consistent with guide-
lines developed under paragraph (3). 
(5) CRITERIA FOR FITNESS FOR DUTY.—The 
development of criteria for determining fitness for 
duty and deployment for a member of the Armed 
Forces that does not depend solely on the number 
of visits to mental health providers by the member. 
(6) GUIDELINES FOR PAYMENT.—The develop-
ment of guidelines for ensuring that demonstration 
sites under the demonstration project receive pay-
ment from the Department of Defense for treating 
members of the Armed Forces notwithstanding any 
requirements of the Department that prohibit such 
payments without certain commander notification or 
personnel documentation requirements. 
(7) CHANGES
RELATED
TO
DISCLOSURE
OF 
SERVICES RECEIVED UNDER PROJECT.—The provi-
sion of changes as necessary to ensure that those re-
ceiving care at demonstration locations are not re-
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quired to reveal any services they receive at these lo-
cations on any military form or questionnaire, except 
to comply with any guidelines developed under para-
graph (3). 
(8) STANDARDS TO ASSESS EFFECTIVENESS OF 
PROJECT.—The development of evaluation standards 
and criteria to use to assess the effectiveness of the 
demonstration project in increasing access to care, 
decreasing stigma, and improving high quality men-
tal health care provided to members of the Armed 
Forces. As appropriate, the evaluation should be 
structured to include both pre- and post-demonstra-
tion assessments of changes in— 
(A) access and utilization of care; 
(B) costs of care; 
(C) outcomes of care; 
(D) member satisfaction with access to and 
quality of care; and 
(E) impact on the ability of military com-
manders to determine member fitness for duty 
and deployability. 
(e) SUBMISSION OF PLAN AND DEADLINE.— 
(1) PLAN.—The Special Working Group shall 
submit to the Secretary of Defense a plan with de-
tails on the implementation and evaluation of the 
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demonstration project. After approval of the plan by 
the Secretary, the Special Working Group shall sub-
mit to Congress the plan. 
(2) DEADLINE.—All duties of the Special 
Working group, including submission of the plan 
under paragraph (1), shall be completed before se-
lection of any site of the demonstration project 
under section 3 but in no case shall the date of com-
pletion of such duties be later than one year after 
the date of the enactment of this Act. 
(f) 
APPLICATION
OF
GUIDELINES
AND
REC-
OMMENDATIONS.—The guidelines and other recommenda-
tions, including changes and standards, developed by the 
Special Working Group under this section shall be applica-
ble only to the demonstration project unless the Secretary 
of Defense determines otherwise. 
SEC. 5. ADVISORY GROUP FOR OVERSIGHT OF DEM-
ONSTRATION PROGRAM. 
(a) ESTABLISHMENT.—The Secretary of Defense 
shall establish an advisory group of qualified individuals 
to oversee implementation of the demonstration project. 
(b) DUTIES.—The advisory group shall— 
(1) ensure that the demonstration project ad-
heres to the guidelines developed by the Special 
Working Group under section 4; 
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(2) ensure that plans for implementing the 
demonstration at selected sites are developed and in-
clude— 
(A) outreach strategies to ensure that par-
ticipants in the project are informed about the 
availability of the programs being provided 
under the project; and 
(B) a plan for training and certifying men-
tal health providers as well as the development 
of strategies and settings, including settings 
that are not located at military treatment facili-
ties, where care can be offered; 
(3) ensure that the demonstration project has 
detailed evaluation plans, using the criteria and 
standards developed by the Special Working Group; 
and 
(4) ensure that independent evaluations of the 
demonstration project are conducted in accordance 
with the guidelines developed by the Special Working 
Group, and that the results of those evaluations are 
provided to the Secretary of Defense. 
SEC. 6. REPORTS ON DEMONSTRATION PROJECT. 
(a) REPORTS REQUIRED.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall submit to the Committees on Armed Services 
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of the Senate and the House of Representatives two 
reports on the demonstration project. 
(2) FIRST REPORT.—The first report shall ex-
amine and assess the plan developed by the Special 
Working Group under section 4(e)(1) for implemen-
tation and evaluation of the demonstration project. 
(3) SECOND REPORT.—The second report shall 
include the following: 
(A) The results of the demonstration 
project, evaluated in accordance with the guide-
lines and other criteria, changes, and standards 
developed by the Special Working Group. 
(B) Recommendations on whether any of 
the policy changes tested in the demonstration 
project should be adopted throughout the De-
partment of Defense. 
(C) A plan to ensure that each member of 
the Armed Forces participating in the dem-
onstration project continues to have access to 
mental health services and providers after the 
conclusion of the demonstration project. 
(b) DEADLINES.—The first report under this section 
shall be submitted not later than one year after the date 
the demonstration project begins to be implemented. The 
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second report shall be submitted at the completion of the 
demonstration project. 
SEC. 7. STUDY AND REPORT ON RETENTION OF MILITARY 
MENTAL HEALTH PROFESSIONALS. 
(a) STUDY.—The Secretary of Defense, in consulta-
tion with the Surgeon General of each branch of the 
Armed Forces, shall conduct a study to determine the rea-
sons for attrition among military mental health profes-
sionals and to make recommendations to increase recruit-
ment and retention of military mental health profes-
sionals, such as through scholarships, loan forgiveness, or 
updates in current recruiting bonuses. 
(b) REPORT.—Not later than six months after the 
date of the enactment of this Act, the Secretary of Defense 
shall submit to Congress a report on the study conducted 
and recommendations made under subsection (a), includ-
ing— 
(1) the estimated cost of implementing each 
such recommendation; 
(2) with respect to each branch of the Armed 
Forces, an estimate of the existing number of mili-
tary mental health professionals and the estimated 
number of such professionals required to meet de-
mand, including for future years, for mental health 
services; and 
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(3) any recommendations for legislative changes 
necessary to implement the recommendations made 
under such study. 
(c) MILITARY MENTAL HEALTH PROFESSIONAL DE-
FINED.—For purposes of this section, the term ‘‘military 
mental health professional’’ means a mental health profes-
sional who provides mental health services to members of 
the Armed Forces, whether such professional is a member 
of the Armed Forces, an employee of the Department of 
Defense, or a contractor of the Department of Defense. 
Æ 
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