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108th CONGRESS
2d Session
H. R. 4799
To amend the Public Health Service Act to support the planning,
implementation, and evaluation of organized activities involving
statewide youth suicide early intervention and prevention strategies,
to provide funds for campus mental and behavioral health service
centers, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 9, 2004
Mr. Gordon (for himself, Mr. Davis of Illinois, Mr. Osborne, Mr. Walden
of Oregon, Mr. Duncan, and Mr. Stupak) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to support the planning,
implementation, and evaluation of organized activities involving
statewide youth suicide early intervention and prevention strategies,
to provide funds for campus mental and behavioral health service
centers, 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 the ``Garrett Lee Smith Memorial Act''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) More children and young adults die from suicide each
year than from cancer, heart disease, AIDS, birth defects,
stroke, and chronic lung disease combined.
(2) Over 4,000 children and young adults tragically take
their lives every year, making suicide the third overall cause
of death between the ages of 10 and 24. According to the
Centers for Disease Control and Prevention suicide is the third
overall cause of death among college-age students.
(3) According to the National Center for Injury Prevention
and Control of the Centers for Disease Control and Prevention,
children and young adults accounted for 15 percent of all
suicides completed in 2000.
(4) From 1952 to 1995, the rate of suicide in children and
young adults has tripled.
(5) From 1980 to 1997, the rate of suicide among young
adults ages 15 to 19 increased 11 percent.
(6) From 1980 to 1997, the rate of suicide among children
ages 10 to 14 increased 109 percent.
(7) According to the National Center of Health Statistics,
suicide rates among Native Americans range from 1.5 to 3 times
the national average for other groups, with young people ages
15 to 34 making up 64 percent of all suicides.
(8) Congress has recognized that youth suicide is a public
health tragedy linked to underlying mental health problems and
that youth suicide early intervention and prevention activities
are national priorities.
(9) Youth suicide early intervention and prevention have
been listed as urgent public health priorities by the
President's New Freedom Commission in Mental Health (2002), the
Institute of Medicine's Reducing Suicide: A National Imperative
(2002), the National Strategy for Suicide Prevention: Goals and
Objectives for Action (2001), and the Surgeon General's Call to
Action To Prevent Suicide (1999).
(10) Many States have already developed comprehensive
Statewide youth suicide early intervention and prevention
strategies that seek to provide effective early intervention
and prevention services.
(11) In a recent report, a startling 85 percent of college
counseling centers revealed an increase in the number of
students they see with psychological problems. Furthermore, the
American College Health Association found that 61 percent of
college students reported feeling hopeless, 45 percent said
they felt so depressed they could barely function, and 9
percent felt suicidal.
(12) There is clear evidence of an increased incidence of
depression among college students. According to a survey
described in the Chronicle of Higher Education (February 1,
2002), depression among freshmen has nearly doubled (from 8.2
percent to 16.3 percent). Without treatment, researchers
recently noted that ``depressed adolescents are at risk for
school failure, social isolation, promiscuity, self medication
with drugs and alcohol, and suicide--now the third leading
cause of death among 10-24 year olds.''.
(13) Researchers who conducted the study ``Changes in
Counseling Center Client Problems Across 13 Years'' (1989-2001)
at Kansas State University stated that ``students are
experiencing more stress, more anxiety, more depression than
they were a decade ago.'' (The Chronicle of Higher Education,
February 14, 2003).
(14) According to the 2001 National Household Survey on
Drug Abuse, 20 percent of full-time undergraduate college
students use illicit drugs.
(15) The 2001 National Household Survey on Drug Abuse also
reported that 18.4 percent of adults aged 18 to 24 are
dependent on or abusing illicit drugs or alcohol. In addition,
the study found that ``serious mental illness is highly
correlated with substance dependence or abuse. Among adults
with serious mental illness in 2001, 20.3 percent were
dependent on or abused alcohol or illicit drugs, while the rate
among adults without serious mental illness was only 6.3
percent.''.
(16) A 2003 Gallagher's Survey of Counseling Center
Directors found that 81 percent were concerned about the
increasing number of students with more serious psychological
problems, 67 percent reported a need for more psychiatric
services, and 63 percent reported problems with growing demand
for services without an appropriate increase in resources.
(17) The International Association of Counseling Services
accreditation standards recommend 1 counselor per 1,000 to
1,500 students. According to the 2003 Gallagher's Survey of
Counseling Center Directors, the ratio of counselors to
students is as high as 1 counselor per 2,400 students at
institutions of higher education with more than 15,000
students.
SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICES ACT.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq)
is amended--
(1) in section 520E (42 U.S.C. 290bb-36)--
(A) in the section heading by striking ``children
and adolescents'' and inserting ``youth'' ;
(B) by striking subsection (a) and inserting the
following:
``(a) In General.--The Secretary shall award grants or cooperative
agreements to public organizations, private nonprofit organizations,
political subdivisions, and Federally recognized Indian tribes or
tribal organizations to implement the State-sponsored statewide or
tribal youth suicide early intervention and prevention strategy as
developed under section 596A.'';
(C) in subsection (b), by striking all after
``coordinated'' and inserting ``with the Strategy for
Suicide Prevention Federal Steering Group and the
suicide prevention resource center provided for under
section 596B.'';
(D) in subsection (c)--
(i) in the matter preceding paragraph (1),
by striking ``A State'' and all that follows
through ``desiring'' and inserting ``A public
organization, private nonprofit organization,
political subdivision, and Federally recognized
Indian tribes or tribal organization
desiring'';
(ii) by redesignating paragraphs (1)
through (9) as paragraphs (2) through (10),
respectively;
(iii) by inserting before paragraph (2) (as
so redesignated), the following:
``(1) comply with the State-sponsored statewide early
intervention and prevention strategy as developed under section
596A;'';
(iv) in paragraph (2) (as so redesignated),
by striking ``children and adolescents'' and
inserting ``youth'';
(v) in paragraph (3) (as so redesignated),
by striking ``best evidence-based,'';
(vi) in paragraph (4) (as so redesignated),
by striking ``primary'' and all that follows
and inserting ``general, mental, and behavioral
health services, and substance abuse
services;'';
(vii) in paragraph (5) (as so
redesignated), by striking ``children and'' and
all that follows and inserting ``youth
including the school systems, educational
institutions, juvenile justice system,
substance abuse programs, mental health
programs, foster care systems, and community
child and youth support organizations;'';
(viii) by striking paragraph (8) (as so
redesignated), and inserting the following:
``(8) offer access to services and care to youth with
diverse linguistic and cultural backgrounds;''; and
(ix) by striking paragraph (9) (as so
redesignated), and inserting the following:
``(9) conduct annual self-evaluations of outcomes and
activities, including consulting with interested families and
advocacy organizations;'';
(E) by striking subsection (d) and inserting the
following:
``(d) Use of Funds.--Amounts provided under a grant or cooperative
agreement under this section shall be used to supplement, and not
supplant, Federal and non-Federal funds available for carrying out the
activities described in this section. Applicants shall provide
financial information to demonstrate compliance with this section.'';
(F) in subsection (e)--
(i) by striking ``contract,''; and
(ii) by inserting after ``Secretary that
the'' the following: ``application complies
with the State-sponsored statewide early
intervention and prevention strategy as
developed under section 596A and'';
(G) in subsection (f), by striking ``contracts,'';
(H) in subsection (g)--
(i) by striking ``A State'' and all that
follows through ``organization receiving'' and
inserting ``A public organization, private
nonprofit organization, political subdivision,
and Federally recognized Indian tribes or
tribal organization receiving''; and
(ii) by striking ``contract,'' each place
that such appears;
(I) in subsection (h), by striking ``contracts,'';
(J) in subsection (i)--
(i) by striking ``A State'' and all that
follows through ``organization receiving'' and
inserting ``A public organization, private
nonprofit organization, political subdivision,
and Federally recognized Indian tribes or
tribal organization receiving''; and
(ii) by striking ``contract,'';
(K) in subsection (k), by striking ``5 years'' and
inserting ``3 years'';
(L) in subsection (l)(2), by striking ``21'' and
inserting ``24''; and
(M) in subsection (m)--
(i) by striking ``Appropriation.--'' and
all that follows through ``For'' in paragraph
(1) and inserting ``Appropriation.--For''; and
(ii) by striking paragraph (2);
(2) by inserting after part I (42 U.S.C. 290jj et seq), the
following:
``PART J--SUICIDE EARLY INTERVENTION AND PREVENTION'';
(3) by redesignating section 520E (42 U.S.C. 290bb-36), as
amended by paragraph (1), as section 596 and transferring such
section to part J (as added by paragraph (2)); and
(4) by adding at the end of part J (as added by paragraph
(2) and amended by paragraph (3)), the following:
``SEC. 596A. YOUTH SUICIDE EARLY INTERVENTION AND PREVENTION
STRATEGIES, TRAINING, AND TECHNICAL ASSISTANCE.
``(a) Youth Suicide Early Intervention and Prevention Strategies.--
``(1) In general.--The Secretary acting through the
Administrator of the Substance Abuse and Mental Health Services
Administration, shall award grants or cooperative agreements to
eligible entities to--
``(A) develop and implement State-sponsored
statewide or tribal youth suicide early intervention
and prevention strategies in schools, educational
institutions, juvenile justice systems, substance abuse
programs, mental health programs, foster care systems,
and other child and youth support organizations;
``(B) support public organizations and private
nonprofit organizations actively involved in State-
sponsored statewide or tribal youth suicide early
intervention and prevention strategies and in the
development and continuation of State-sponsored
statewide youth suicide early intervention and
prevention strategies;
``(C) collect and analyze data on State-sponsored
statewide or tribal youth suicide early intervention
and prevention services that can be used to monitor the
effectiveness of such services and for research,
technical assistance, and policy development; and
``(D) assist eligible entities, through State-
sponsored statewide or tribal youth suicide early
intervention and prevention strategies, in achieving
targets for youth suicide reductions under title V of
the Social Security Act (42 U.S.C. 701 et seq.).
``(2) Eligible entity.--
``(A) Definition.--In this subsection, the term
`eligible entity' means--
``(i) a State;
``(ii) a public organization or private
nonprofit organization designated by a State to
develop or direct the State-sponsored statewide
youth suicide early intervention and prevention
strategy; and
``(iii) a Federally-recognized Indian tribe
or tribal organization (as defined in the
Indian Self-Determination and Education
Assistance Act) or an urban Indian organization
(as defined in the Indian Health Care
Improvement Act) that is actively involved in
the development and continuation of a tribal
youth suicide early intervention and prevention
strategy.
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