Title: Cost of Mental Illness Act of 2022
Policy area: Health

Summary:
Cost of Mental Illness Act of 2022
This bill requires a study on the direct and indirect costs associated with serious mental illness (i.e., a mental, behavioral, or emotional disorder resulting in a serious, functional impairment that substantially interferes with major life activities). It also requires periodic surveillance surveys of individuals with schizophrenia.
Specifically, the Department of Health and Human Services (HHS) must study health care, housing, public safety, and other costs incurred by federal, state, tribal, and local governments and nongovernmental entities to address serious mental illness. HHS must consult with the Department of Justice, the Department of Labor, and the Department of Housing and Urban Development on the study.
Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA) must periodically conduct a surveillance survey to collect information about individuals with schizophrenia, such as their demographic characteristics and health status. SAMHSA must coordinate with the Centers for Disease Control and Prevention, the National Institute of Mental Health, and other federal agencies on the survey. SAMHSA may also award grants or other assistance to nonprofits for convening stakeholder meetings and other activities to support the survey.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7483 Introduced in House (IH)]

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117th CONGRESS
  2d Session
                                H. R. 7483

To direct the Secretary of Health and Human Services to conduct a study 
    on the direct and indirect costs of serious mental illness for 
nongovernmental entities, the Federal Government, and State, local, and 
              Tribal governments, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 7, 2022

Mr. Reschenthaler (for himself and Mr. Trone) introduced the following 
    bill; which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To direct the Secretary of Health and Human Services to conduct a study 
    on the direct and indirect costs of serious mental illness for 
nongovernmental entities, the Federal Government, and State, local, and 
              Tribal governments, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as ``Cost of Mental Illness Act of 2022''.

SEC. 2. STUDY ON THE COSTS OF SERIOUS MENTAL ILLNESS.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Health and Human Services, in 
consultation with the Assistant Secretary for Planning and Evaluation, 
the Attorney General of the United States, the Secretary of Labor, and 
the Secretary of Housing and Urban Development, shall conduct a study 
on the direct and indirect costs of serious mental illness with respect 
to--
            (1) nongovernmental entities; and
            (2) the Federal Government and State, local, and Tribal 
        governments.
    (b) Content.--The study under subsection (a) shall consider each of 
the following:
            (1) The costs of the health care system for all facilities 
        and health services, including--
                    (A) public and private inpatient hospitals, 
                outpatient health care, and home health care;
                    (B) office-based physician visits;
                    (C) prescription drugs and digital therapeutics;
                    (D) emergency room visits;
                    (E) substance use treatment;
                    (F) skilled nursing and long-term care facilities 
                for residential, custodial, and general health care;
                    (G) with respect to the costs described in 
                subparagraphs (A) through (F), out-of-pocket costs and 
                costs for different types of behavioral health and 
                psychiatric illness; and
                    (H) other professional health services.
            (2) The costs of homelessness, including--
                    (A) homeless shelters;
                    (B) street outreach activities;
                    (C) crisis response center visits; and
                    (D) other supportive services.
            (3) The costs of structured residential facilities and 
        other supportive housing for residential and custodial care 
        services.
            (4) The costs of law enforcement encounters and encounters 
        with the criminal justice system, including--
                    (A) encounters that do and do not result in an 
                arrest;
                    (B) investigating a crime and judicial proceedings, 
                including the process of sentencing;
                    (C) services provided by police officers, sheriff 
                deputies, police departments and sheriff offices, and 
                judicial staff (including public defenders, 
                prosecutors, and private attorneys);
                    (D) services provided by public institutions 
                (including local and county jails, State prisons, and 
                paid legal guardians);
                    (E) public safety costs to transport an individual 
                with a serious mental illness to receive mental health 
                or substance use treatment services or be incarcerated 
                (including vehicle miles and personnel expenses);
                    (F) with respect to inmates with a serious mental 
                illness, incarceration costs in Federal prison, State 
                prison, and local jails (including residential, 
                custodial, and on-site and off-site health care); and
                    (G) solitary confinement, security, and other 
                similar costs.
            (5) The costs of addressing serious mental illness as a 
        disability in the workplace, including--
                    (A) reduced wages for individuals with a serious 
                mental illness who are employed; and
                    (B) the estimated costs attributable to--
                            (i) the nationwide unemployment rate for 
                        individuals with a serious mental illness;
                            (ii) benefits payable on the basis of 
                        disability to individuals with a serious mental 
                        illness--
                                    (I) under title II or XVI of the 
                                Social Security Act (42 U.S.C. 401 et 
                                seq., 1381 et seq.); or
                                    (II) from a State or other 
                                governmental entity; or
                            (iii) to the extent feasible, lost lifetime 
                        productivity due to disability.
            (6) With respect to family members and caregivers, the 
        costs of caring for an individual with a serious mental 
        illness, including--
                    (A) the cost of unpaid labor;
                    (B) additional health care costs associated with 
                providing ongoing care for an individual with a serious 
                mental illness, including higher health care costs 
                resulting from stress and anxiety;
                    (C) taking leave from work; and
                    (D) out-of-pocket costs incurred while caring for 
                such individual.
            (7) Costs with respect to funding for grants or cooperative 
        agreements for programs or services for basic, translational, 
        and applied research for individuals with a serious mental 
        illness.
            (8) The costs of workforce development and training for 
        personnel that interact with individuals with a serious mental 
        illness, and insurance for such development and training, 
        including health care workers, social service employees, law 
        enforcement, and first responders.
            (9) Other costs for programs and services administered by 
        the Federal Government or State, Tribal, or local governments.
    (c) Data Disaggregation.--In conducting the study under subsection 
(a), the Secretary shall (to the extent feasible)--
            (1) disaggregate data by--
                    (A) costs to nongovernmental entities, the Federal 
                Government, and State, local, and Tribal governments;
                    (B) types of serious mental illnesses and medical 
                chronic diseases common in patients with a serious 
                mental illness; and
                    (C) demographic characteristics, including race, 
                ethnicity, sex, age (including pediatric subgroups), 
                and other characteristics determined by the Secretary; 
                and
            (2) include an estimate of--
                    (A) the total number of individuals with a serious 
                mental illness in the United States, including in 
                traditional and nontraditional housing; and
                    (B) taking into account the information collected 
                pursuant to section 3(b)(3), the percentage of such 
                individuals in--
                            (i) homeless shelters;
                            (ii) penal facilities, including Federal 
                        prisons, State prisons, and county and 
                        municipal jails; and
                            (iii) nursing facilities.
    (d) Report.--Not later than 2 years after the date of the enactment 
of this Act, the Secretary shall--
            (1) submit to the Congress a report containing the results 
        of the study conducted under this section; and
            (2) make such report publicly available.
    (e) Definitions.--In this section:
            (1) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (2) Serious mental illness.--The term ``serious mental 
        illness'' means a mental, behavioral, or emotional disorder 
        resulting in a serious functional impairment that substantially 
        interferes with or limits one or more major life activities, 
        including the following:
                    (A) Schizophrenia, including schizoaffective 
                disorder and other related psychosis.
                    (B) Schizoaffective disorder.
                    (C) Persistent mood disorder, including bipolar 
                disorder I and II.
                    (D) Major depressive disorder.
                    (E) Any other such mental, behavioral, or emotional 
                disorder, as determined by the Secretary.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary to carry out this section $3,500,000 for 
each of fiscal years 2023 and 2024.

SEC. 3. SCHIZOPHRENIA SURVEILLANCE SURVEY.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary''), acting through the 
Assistant Secretary for Mental Health and Substance Use, and in 
coordination with the Director of the Centers for Disease Control and 
Prevention and the Director of the National Institute of Mental Health, 
shall--
            (1) conduct a surveillance survey to collect the 
        information described in subsection (b) about individuals with 
        schizophrenia in the United States; and
            (2) not less than every 5 years, update such survey.
    (b) Content.--In carrying out subsection (a), the Secretary shall 
collect--
            (1) to the extent practicable, information relating to 
        individuals with schizophrenia, such as--
                    (A) demographics, such as age, race, ethnicity, 
                sex, geographic location, family history, and other 
                information as appropriate;
                    (B) risk factors that may be associated with 
                schizophrenia such as environmental risk factors and 
                other information as appropriate; and
                    (C) average age at the time of initial diagnosis 
                and time lapses, if any, between the initial diagnosis 
                and the initiation of mental health care;
            (2) to the extent practicable, information on the health 
        status of individuals with schizophrenia, including--
                    (A) mortality and morbidity rates;
                    (B) incidences of comorbid chronic diseases, 
                including diabetes, cardiac conditions, emphysema, 
                cirrhosis, HIV/AIDS, and hepatitis C; and
                    (C) the frequency of hospital emergency department 
                utilization; and
            (3) the percentage of individuals with schizophrenia in--
                    (A) homeless shelters;
                    (B) penal facilities, including Federal prisons, 
                State prisons, and county and municipal jails;
                    (C) nursing facilities; and
                    (D) inpatient hospitals.
    (c) Consultation.--In carrying out this section, the Secretary 
shall consult with individuals with appropriate expertise, which may 
include--
            (1) epidemiologists with experience in mental health 
        conditions surveillance; and
            (2) representatives of national voluntary health 
        association and nonprofit citizens organizations that--
                    (A) focus on schizophrenia and related psychotic 
                conditions; and
                    (B) have experience in research, care, and patient 
                services.
    (d) Coordination.--In carrying out this section, the Secretary 
shall--
            (1) coordinate with the National Neurological Conditions 
        Surveillance System under section 399S-1 of the Public Health 
        Service Act (42 U.S.C. 280g-7a) to determine any overlap 
        between--
                    (A) individuals with schizophrenia counted for 
                purposes of the survey under this section; and
                    (B) individuals with neurological conditions 
                identified by the Director of the Centers for Disease 
                Control and Prevention for purposes of the National 
                Neurological Conditions Surveillance System; and
            (2) coordinate with other Federal agencies, including the 
        Social Security Administration, the Department of the Treasury, 
        and the Department of Labor, to use administrative data, to the 
        extent feasible, to provide information for the survey 
        authorized by subsection (a).
    (e) Grants.--The Secretary may award grants to, or enter into 
contracts or cooperative agreements with, public or private nonprofit 
entities to carry out activities in furtherance of the surveillance 
survey under this section, including the convening of stakeholder 
meetings.
    (f) Reporting.--
            (1) In general.--The Secretary shall submit to the 
        Committee on Energy and Commerce of the House of 
        Representatives and the Committee on Health, Education, Labor, 
        and Pensions of the Senate--
                    (A) not later than 2 years after the date of 
                enactment of this Act, a report containing findings of 
                the surveillance survey under this section, including 
                aggregate information collected and epidemiological 
                analyses, as appropriate; and
                    (B) not less than every 5 years when an updated 
                survey is conducted pursuant to subsection (a)(2), an 
                updated report.
            (2) Posting.--The Secretary shall post the report under 
        paragraph (1) and each update under paragraph (2) on the public 
        website of the Department of Health and Human Services.
    (g) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $50,000,000 for the period of 
fiscal years 2023 through 2027.
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