Harkin Statement on Adoption of Mental Health Amendment

WASHINGTON, D.C.—U.S. Senator Tom Harkin (D-IA), Chairman of the Senate Committee on Health, Education, Labor, and Pensions (HELP) Committee, released the following statement on the adoption of the Mental Health Awareness and Improvement Act as an amendment to S.649, the Safe Communities, Safe Schools Act of 2013.

The mental health legislation, which reauthorizes and improves programs administered by both the Departments of Education and Health and Human Services related to awareness, prevention, and early identification of mental health conditions, was unanimously approved by the Senate HELP Committee last week. Earlier this year, the Committee held a hearing to assess the state of America’s mental health care system and to discuss ways to improve access to services for those who need assistance.

“Last year’s tragic shooting in Newtown, Connecticut brought the issue of mental health care to the forefront of public dialogue.  Many people across the nation, including the President, have said that we need to take a long, hard look at access to mental health services around the country—and I agree,” Harkin said. “Mental health conditions are a ‘silent epidemic,’ affecting one in four Americans every year—with one in 17 affected by serious mental illness. There is consensus among Democrats and Republicans alike that we must do more to ensure that Americans are getting the care that they need to live long and healthy lives.

“Last week, the HELP Committee unanimously approved a bipartisan measure to ensure that more Americans with mental illness can get access to the care and supports they need to live healthy and productive lives. Prevention and early intervention are key parts of this legislation.

“Despite its prevalence, there is still a stigma associated with mental illness, and that stigma results in too many people suffering without access to care that could significantly improve their lives. That is why it is so important that Congress move forward with this vital piece of mental health legislation, which will improve and strengthen the mental health care system in our communities and in our schools,” Harkin continued.

Title I of the legislation focuses on school settings, by promoting school-wide prevention through the development of positive behavioral interventions and supports, and encourages school-based mental health partnerships, while Title II of the bill focuses on suicide prevention, helping children recover from traumatic events, mental health awareness for teachers and other individuals, and assessing barriers to integrating behavioral health and primary care. This bipartisan legislation makes targeted improvements designed to improve federal efforts to assist state and local communities in addressing the mental health needs of its citizens.

A section-by-section of the legislation follows.

Title I- Education Programs

Sec. 101. Short Title- Establishes that Title I may be cited as the “Achievement through Prevention Act”.
Sec. 102. Purpose- Sets forth the purpose of the title to expand the use of positive behavioral interventions and supports, as well as early intervening services in schools to improve student academic achievement, reduce over-identification of individuals with disabilities, and reduce disciplinary problems in schools.
Sec. 103. Amendments to the Elementary and Secondary Education Act of 1965 (ESEA)

• Encourages the development of school-wide prevention programs, such as positive behavioral interventions and supports (PBIS) to promote positive behaviors in students, create positive conditions for learning in schools, and identify students in need of supports and link them with appropriate services.  
• Encourages states to provide technical assistance to Local Educational Agencies and school personnel on the implementation of school-based mental health programs and other approaches designed to improve learning environments in schools.
• Modifies the use of funds for grants under section 4121 to include the promotion of school-based mental health partnerships designed to help schools link students with the clinical mental health services they need.
• Clarifies that Title I funds from ESEA can be used for school-wide intervention services and can also be used to create or update school emergency management plans.

Title II- Health Programs

Sec. 201. Garrett Lee Smith Memorial Act Reauthorization

• Codifies the suicide prevention technical assistance center to provide information and training for suicide prevention, surveillance, and intervention strategies for all ages, particularly among groups at high risk for suicide.
• Reauthorizes the Youth Suicide Early Intervention and Prevention Strategies grants to states and tribes and clarifies that states may receive continuation grants after the first grant is awarded.
• Reauthorizes the Mental Health and Substance Use Disorder Services on Campuses grant program and updates the use of funds to allow for the education of students, families, faculty, and staff to increase awareness and training to respond effectively to students with mental health and substance use disorders, to provide outreach to administer voluntary screenings and assessments to students, and to enhance networks with health care providers who treat mental health and substance use disorders. Incorporates consideration of the needs of veterans enrolled as students on campus.

Sec. 202. Mental Health Awareness Training

• Reauthorizes grants to states, political subdivisions of states, Indian tribes, tribal organizations, and nonprofit private entities to train teachers, appropriate school personnel, emergency services personnel, and others, as appropriate, to recognize the signs and symptoms of mental illness, to become familiar with resources in the community for individuals with mental illnesses, and for the purpose of the safe de-escalation of crisis situations involving individuals with mental illness.

Sec. 203. Children’s Recovery from Trauma

• Reauthorizes the National Child Traumatic Stress Initiative (NCTSI), which supports a national network of child trauma centers, including university, hospital, and community-based centers and affiliate (formerly funded) members.
• Supports the coordinating center’s collection, analysis, and reporting of child outcome and other data to inform evidence-based treatments and services. Also supports the continuum of training initiatives related to such evidence-based treatments, interventions, and practices offered to providers.
• Encourages the collaboration between NCTSI and HHS to disseminate evidence-based and trauma-informed interventions, treatments, and other resources to appropriate stakeholders.

Sec. 204. Assessing Barriers to Behavioral Health Integration

• Requires a GAO report on the federal requirements impacting access to mental health and substance use disorder treatment related to integration with primary care, administrative and regulatory issues, quality measurement and accountability, and data sharing.

Sec. 205. Improving Education and Awareness of Treatments for Opioid Use Disorders

• Directs the Substance Abuse and Mental Health Services Administration (SAMHSA) to advance, through its current programs, the education and awareness of providers, patients, and other stakeholders regarding FDA-approved products to treat opioid use disorders.
• Calls for a report on such activities, including the role of adherence in the treatment of opioid use disorders, and recommendations on priorities and strategies to address co-occurring substance use disorders and mental illness.

Sec. 206. Examining Mental Health Care for Children

• Requires a GAO report on the utilization of mental health services for children, including information about how children access care and referrals; the tools and assessments available for children; and the usage of psychotropic medications.

Sec. 207. Evidence-Based Practices for Older Adults

• Encourages the Secretary to disseminate information and provide technical assistance on evidence-based practices for mental health and substance use disorders in older adults.  

Sec. 208. National Violent Death Reporting System    

• Encourages the Director of the Centers for Disease Control and Prevention to improve, particularly through the inclusion of other states, the existing National Violent Death Reporting System.
• The reporting system was created in 2002 and currently collects surveillance data from 18 states.

Sec. 209. GAO Study on Virginia Tech Recommendations

• Recommendations were outlined in a report to President Bush in 2007 by the Secretaries of Health and Human Services and Education and the Attorney General of the United States after the Virginia Tech tragedy.  
• This provision requires a GAO study on the status of implementation of the recommendations, as well as identification of any barriers to implementation and identification of additional actions the Federal government can take to support states and local communities to ensure the Federal government and laws are not obstacles at the community level.
• The report will only address those recommendations that require participation by the Department of Health and Human Services.

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