Campus Care and Counseling Act

Mr. Speaker, I yield myself such time as I may consume.

There is probably no more serious topic that we could be discussing this evening than we are right now when we are discussing suicide, especially when we are discussing suicide of young people. It is a serious topic, and it is an emotional topic.

Earlier today, Mr. Speaker, I heard someone say in the Chamber that this House, as we move along and make changes, we do not always make large changes or great changes at one time; we may only be making changes incrementally. And my response to that was I am all in favor of incrementally moving the agenda along, just so long as we are moving it in the right direction and not in the wrong direction, a harmful direction, or a hurtful direction. I want to be moving the agenda along in a direction that is guided by facts and thought and planning and not by emotion.

We just heard that this bill is moving along in an expedited fashion, and that is true. We are here tonight on a bill, on a piece of legislation, spending $82 million that would create two new Federal programs that never existed before, a new technical center that will deal with this issue as well; and yet there has never been an opportunity for input, discussion, a vote, or consideration in a committee. This bill has never gone in this House to a committee for a hearing, for a complete markup in a formal manner.

If you are a parent and you have thoughts on this topic, you are concerned about your children or other children in your community, you have not had the opportunity to have your say, to have your feelings, to have your thoughts heard in a committee on this subject. If you are an expert in this field, a psychologist, psychiatrist, mental health association or the like, and you have thoughts about what would be best for our children or what would be harmful to our children, you too have not had the opportunity to have your thoughts or your opinions heard in a formal committee manner.

So it is correct when we hear that this legislation is moving in an expedited format, without the committee process and already to the floor.

Now, before this bill came up, we were talking about another topic, and I heard a lot of talk about the deficit and what grave financial straits we are in. I hope they continue with those feelings when we consider a bill that is $82 million in the making for the first 3 years, and how much after that no one knows.

There was an article today in National Review that addresses this piece of legislation. It says, ``Occasionally a bill hits Capitol Hill over which there is remarkably little debate. This bill is an extreme example of that. Actually, according to news reports, there is no debating the bill, which provides additional Federal funding for suicide prevention programs in U.S. schools.'' It goes on, ``Well, of course if you are against suicide, you are for the bill; right?''

Well, we really do not know. I am certainly against suicide. Everyone in this House is against suicide. But are we all for the bill? Are parents all for the bill? Are the experts all for the bill? The article goes on to point out that, ``No, the experts are not all for the bill.'' The Journal of the American Medical Association, the American Academy of Child and Adolescent Psychiatry have reported on this topic of suicide prevention programs, such as this bill addresses, and they reported, ``Suicide awareness programs in schools have not been shown to be effective either in reducing suicidal behavior or in increasing help-seeking behavior. Most kids who take their own lives are mentally ill. They need help, help that a school suicide prevention program is not going to provide them.''

``For some of the children, these new federally funded programs,'' as it says in the article, ``would reach awareness, putting ideas in their already normally confused adolescent heads.'' Conclusion: ``Such programs,'' as we are talking about tonight, ``could actually be harmful.''

Let me go back to the issue of family and the like. We have to ask: Is this yet again another encroachment on the family, on the parent- child relationship, one in which the Federal Government should at least ask for input and thought before we start creating new Federal programs on this level?

In the end, are these programs, we should be asking ourselves, more harmful than helpful? The experts seem to indicate more harmful. Another expert, David Shaffer, M.D., Columbia College of Physicians and Surgeons, talking on the subject and doing research at Columbia University supported by grants for the Centers for Disease Control, suggests that ``case findings that involve giving lessons or lectures about suicide either to encourage suicidal students to identify themselves or to teach other students or teachers how to identify the suicidal teenager is not effective, and in some instances may undermine protective attitudes about suicide.''

Furthermore, from Dr. Shaffer and others, ``self-identified attempters were less likely to approve of these programs, and there was little evidence that the programs were successful in influencing their views. There was some evidence that previous attempters were more upset by the programs than nonattempters were.''

Again, the experts are showing that these programs that we are now spending money on may be more harmful than good.

There was a case several years ago in Michigan where a second grade boy killed himself in the spring of the year, the day after watching a film in a suicide prevention class such as what we are talking about today. People who knew the young boy said that he was a happy child who had just been accepted into the school's gifted and talented program, and he was not depressed at all at the time of his death. Many think that he was merely mimicking what he saw in the movie in the suicide prevention program and had no intention to die. In the movie, the boy who tries to hang himself to commit suicide is rescued by his friends. In real life, that did not occur, and the 8-year-old boy, having attended a suicide prevention program, killed himself.

As a parent, one also has to ask, where does the time come to do all these things in our schools? We already ask of our teachers so much, to teach all the curriculum already. Now we are adding an additional burden on the schools as well. I have talked to parents who have had their kids in public schools and have taken them out and either put them into private schools, Catholic schools, parochial schools, or home schooling. When I ask them why they do it, they say, because they realize the public schools are no longer focused on what they are supposed to be focusing on, and that is educating their kids. Instead, they are involved in so much other social programming, such as this.

So we have to ask ourselves this question as well: Does this program address the needs of our schools as being able to fulfill their obligation to teach our kids?

Next, we have to ask the question: Is this enough money, $82 million? Now, to me, that sounds like a lot of money; but if we are talking across the entire country for a 3-year period of time, I hazard a guess that next year and the year after that that people will be coming back and saying this was just a drop in the bucket and that we will have to spend even more.

I figured it out just briefly in my head sitting over there earlier. This would provide my county in New Jersey maybe one new counselor, if it was spread evenly across the country. One counselor for my entire county. What about all the schools in that county? Will they not be looking for assistance as well, all the other services in the county? $82 million is not going to go that far.

Now, it is set up as a 3-year program. In actuality, the bill that I am looking at talks about how much money we spend for the first 3 years; but if we look at the fine print, it details $7 million one year, $16 million the next year, and $25 million the next year. That is 3 years. But thereafter it says ``and such sums as may be necessary for each of the fiscal years 2008 and 2009.'' So, in reality, it is saying we know how much it is going to cost for the first 3 years, but after that it is anybody's question, as people come back asking for more.

In the end, suicide is an emotional topic. The legislation we are dealing with today is an emotional topic. It is one that deserves our thoughtful time, it is one that deserves input from parents and experts alike, and so, therefore, Mr. Speaker, I would recommend to vote against this bill, or, better yet, to allow this bill to go back to committee for further consideration.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield such time as he may consume to the gentleman from Iowa (Mr. King).

Mr. Speaker, I yield myself 1 minute to respond.

Many times in this House we do things for symbolic purposes, and I am not suggesting that this legislation is being done for symbolic purposes, but I do have to raise the question, as I did earlier, as to just what extent this bill may be successful if everything goes right.

As I indicated before, we are spending at $82 million. That translates into around the addition of one new guidance counselor in every county in my State. So we have to question really are we providing any new services to the majority of kids, or are we just lifting up hopes and also the expectations of future calls for greater spending on these programs?

As to the aspect of additional harm that may come from this, that is the very nature of the question that I raise here. We have yet to hear of any testimony in this body as to what is the nature of the benefits of this, from academic institutions, parents or otherwise, how this may benefit the students. Anecdotally we may have some, but I would think before we get into such a critical area as dealing with the mental state of our kids that we would want to have that information on hand.

Mr. Speaker, I yield myself such time as I may consume.

Again I have to say it, the topic that we are dealing with is an extremely emotional one; and I take nothing away from what the sponsors are attempting to do with this legislation. And I take nothing away from the families that have suffered from the pains and arrows of going through this. All I say is that the best method of addressing this issue was perhaps, not perhaps, absolutely not followed in this procedure, that the parents in our communities have the right to have their say to make sure that we have the best system of taking care of their kids; that the experts, the doctors, the academies, have the right to have their say as to what are the best procedures as far as addressing the issue of suicide in schools. Finally, it ultimately falls upon our families and our parents to make sure that we are bringing our kids up in the correct manner.

This legislation does not address that at all. This legislation simply expands once again the size and the scope of the Federal Government into an area where we have not heard any testimony tonight and never had the opportunity to hear testimony in the past to say whether this system will do more harm than good.

Therefore, Mr. Speaker, I would suggest a ``no'' on this bill.

Mr. Speaker, I yield the balance of my time to the gentleman from Texas (Mr. Barton).

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, I move to suspend the rules and pass the Senate bill (S. 2634) 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, as amended.

Mr. Speaker, I ask unanimous consent that of the 20 minutes that I control, the gentleman from Ohio (Mr. Brown) have the right to control 10 minutes of that time.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on this bill.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise in support of S. 2634, as amended. I am pleased that the House is considering this legislation which is authored with the intent to improve access to quality health care to individuals suffering from mental and behavioral health problems that can lead to suicide.

Last year, over 4,000 young men and women in our great country resorted to the ultimate act of denial by committing suicide. Senator Gordon Smith of the other body has been the lead advocate for this legislation, and the bill is named in his son's honor, who, unfortunately, committed suicide last year, I think on this date. So we are here under the leadership of Senator Gordon Smith to try to do something legislatively to prevent future young Americans from resorting to suicide.

I have had a young staff member on my staff last spring also commit suicide; so while I have not had the sacrifice or the tragedy that Senator

Smith has had, I have been touched by suicide on my congressional staff down in Texas. I can tell you, as one would expect, that it is a very devastating experience. It is incredibly painful. It is a pain that is exacerbated when you see how your family and friends are burdened with grief because of an action like this. It is my sincere hope that the legislation the House is considering this evening, which the other body has already passed, will indeed help those who are troubled and are thinking about committing suicide in the future.

This bill is a 3-year authorization bill that provides educational and support programs for children at risk of suicide. These suicide programs would be administered through a grant program through the States. It reflects a balanced and reasonable compromise that allows parents to have a direct role in determining whether their children participate in these long-range programs. At the same time, when there is a young man or woman in our country who is actively contemplating suicide, the bill would allow that emergency intervention could be done without any consent so that we stabilize that individual and prevent them from actually committing the suicide act at the time they are contemplating it.

The compromise before us this evening does not modify in any way or affect any existing requirement under the No Child Left Behind Act. It is my hope that in the next Congress the House Committee on Energy and Commerce, which I have the privilege to chair, will systematically reauthorize many of the expired programs and even expired agencies at the Department of Health and Human Services.

One of those agencies that we intend to look at very closely is the Substance Abuse and Mental Health Services Administration, or SAMSHA, which has primary responsibility to improve mental health services across this country. I am strongly inclined to rework several of the mental health service programs currently in effect at SAMSHA so that we are sure that the funding programs actually produce measurable results and the kind of results we intend those programs to produce. Without a doubt, as a part of our review of the SAMSHA program, I will pay close attention to SAMSHA's work in the area of suicide prevention.

Mr. Speaker, I want to thank the subcommittee chairman, the gentleman from Florida (Mr. Bilirakis); the ranking member of the full committee, the gentleman from Michigan (Mr. Dingell); and the subcommittee ranking member, the gentleman from Ohio (Mr. Brown), for their cooperation in this legislation. I would also like to commend the gentleman from Tennessee (Mr. Gordon) and the gentleman from Oregon (Mr. Walden) for their help on the House side in improving this legislation. And, finally, I would like to thank the Speaker of the House and the majority leader for their assistance in expediting this bill as it comes to the floor today.

Mr. Speaker, I would encourage my colleagues to support the legislation.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to the gentleman from Oregon (Mr. Walden).

Mr. Speaker, I yield 2 minutes to the gentleman from Nebraska (Mr. Osborne) who has been directly involved in these programs.

Mr. Speaker, could I ask since the distinguished gentleman from New Jersey has yielded to me the balance of his time, how much time that means I now have.

Mr. Speaker, I yield 2 minutes to the distinguished gentleman from Nebraska (Mr. Osborne), who has been involved in programs to prevent suicide in Nebraska for a number of years.

Mr. Speaker, I yield myself the balance of my time.

First of all, I want to comment on the procedural aspects of the consideration of this legislation. I think the gentleman from Tennessee (Mr. Gordon) pointed out a bill similar to this passed the other body 100 to zero. That is a phenomenal accomplishment considering that the other body this year many days has not even agreed on whether the Sun rises in the east or the west. But on this particular piece of legislation, they passed it 100 to zero.

The President of the United States, President Bush, and his legislative aides contacted my office immediately and asked us to expedite consideration of this legislation on the floor of the House. We took the bill that passed the other body, we looked at it and we felt like, as well-meaning as it was, that in many cases it was duplicative and it could be improved if we made some changes.

To his credit, when we called Senator Smith, he agreed to work with us on that process. We attempted to bring the bill up the last day before we adjourned for the August work period. There were still some concerns that could not be worked out. That bill could only come up under unanimous consent. The minority leader, the gentlewoman from California, agreed to it, the majority leader the gentleman from Texas agreed to the unanimous consent, but there were some Members on the Republican side that still had concerns, so we pulled the bill that night. We spent the August work period working at the staff level to try to iron out the differences. I submit with no apology that the bill that is before us today as a result of those extra days and hours of consultation is a better bill.

It requires that 85 percent of the funds expended have to be spent on direct services. So this is not an overhead bill. This is a direct- services bill. It requires that when grants are awarded to institutions that have existing programs, there be a dollar-for-dollar match, that the institution that already has a program has to match through services or in-kind contribution or direct dollars, dollar for dollar, the amount of the grant that they are receiving. There is a requirement in the legislation before us that there is an outcome-based assessment each year, so that as we begin to implement some of these programs, we actually go in and make sure that in future years we only award grants to programs that actually do have results in a positive way. I am very proud of that.

In terms of the parental consent section of the bill, which was the most difficult to find a compromise, we agreed that if there is an emergency situation where direct intervention needs to be conducted to prevent an individual from committing suicide, that that can be done immediately and to whatever extent is necessary so that we stabilize that individual and prevent him from taking his life. But once that occurs, before there is any entry into a long-term program, the parents have to be notified and they have to consent in writing that their child can be involved in that long-term program. I personally think that is a very, very reasonable compromise.

One can argue that the Federal Government should not be involved in early intervention and suicide prevention. That is a reasonable position to take. But given the fact that 4,000 of our young people killed themselves last year and that, as the gentleman from Nebraska has pointed out, suicide rates among our young people have tripled in the last 40 years, I think it is wise for the Federal Government to be involved. Every life that we save is a future productive citizen who is going to contribute to our society and to our country. I strongly agree that we should be involved with a Federal program that helps in that area.

I would point out that this bill is a 3-year authorization bill. It is not a permanent expansion of any program. It is a 3-year authorization. As I said earlier, as we go through each year, the programs that are granted have to be evaluated on an outcomes basis. I think Members on both sides of the aisle, whether they are conservatives or liberals or moderates, regardless of whatever region of the country they come from, can sincerely and enthusiastically support this bill tomorrow when it comes to a vote. It is a good bill. I am proud that we have helped Senator Smith memorialize his son, the late Garrett Lee Smith; and I would hope that we get a unanimous vote tomorrow on this important piece of legislation.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I would like to thank the gentleman from Texas for his help on this bill. I am going to suspend my otherwise prepared remarks and try to address some of the concerns that we have heard here this evening about this bill.

Mr. Speaker, 4,000 young people die per year from suicide, and I guess what we are being told here is we do not know of anything that will work, and this bill really may make things worse, and we may actually cause some people to take their lives. I would just like to mention what the bill is all about.

Part 1 provides grant funding to States for development of a youth suicide prevention and intervention strategy. That does not necessarily mean that you go in and show films to kids of other kids killing themselves. It does not mean that you go out and hire a bunch of counselors to go into schools and tell kids do not kill yourselves. It may mean that you work with coaches and teachers to identify the signs, because there are very, very few suicides which occur where there are not some indications. It may be a term paper, a theme, it may be a comment in the locker room. So we can build awareness with those people who work with young people, and that is important.

Some young people do not know that steroids are a leading cause of suicide. This is an education issue. Steroid precursors can be bought over the counter and cause untold number of suicides each year. People are not aware of that.

This bill provides for screening programs that can identify mental health and behavioral conditions. There are certain medical conditions out there that make people more subject to suicide. It may be a personal tragedy that has occurred; it may be a friend who has committed suicide. These people can be watched more closely. There

may be things which could be done. You do not have to go tell them, do not kill yourself.

Lastly, the bill establishes the Federal Suicide Prevention Technical Assistance Center. People have said here, we do not know what works. That is what this center is for, to find out what strategies do work. That is the whole thing about it.

Mr. Speaker, I thank the chairman for yielding me this time. I am sorry I had to be rushed earlier, and I thank him for giving me this extra time.

In regard to the expeditious manner in which this bill has progressed, it actually started back in July. I know that there has been a tremendous amount of interplay and work over the last 6, 7, 8 weeks. There has been a lot of give-and-take and a lot of valuable discussion. The thing that I did not get to talk about that I wanted to mention is that from 1952 to 1995, we have three times the number, the rate of suicides, in this country as we did in 1952. This is a national epidemic. So to say that we really should not do anything or we should really go slow for some reason rubs me the wrong way.

The other aspect of the program that I wanted to mention today is the college mental health services. A survey regarding college students indicated that 60 percent of college students feel hopeless. More than 40 percent report being depressed. And 9 percent are suicidal. On the college campus, we have tremendous problems with this issue. You do not have to again go to these students and say, do not kill yourself. We do not have to show them films, but we do have to persuade them that it is not unmanly or it is not weak on the part of a woman to express your problems, to go to a mental health service, to talk things out, to be open with what is bothering you. These are the kinds of things that need to happen.

Part of this funding will simply go to enhance the mental health services on the college campus. This is not money that will be badly spent. This is something that is desperately needed. Again, Mr. Speaker, I thank the gentleman from Texas for his work.

Mr. Speaker, I rise today in support of the Garrett Lee Smith Memorial Act. I extend sincere condolences to my colleague, friend, constituent and fellow Oregonian, Senator Gordon Smith, sponsor of this act, and his family.

It was exactly 1 year ago today that the Smith family was changed forever when Garrett Lee Smith took his life. As the father of a son myself, my heart aches for Gordon and Sharon, and the Smith family remains in our prayers. After Garrett's death, the Smith family's selfless dedication to shining the public spotlight on the tragedy of youth suicide and saving other families from the devastation of suicide is truly inspiring.

Upon realizing that suicide is the third leading cause of death for 15- to 24-year-olds, Senator Smith identified gaps in our public health infrastructure and crafted a bill to assist States, localities, tribal communities and college campuses in establishing youth suicide prevention programs. These programs will include prevention screening, early intervention, management and education activities.

Suicide is an unspeakable tragedy. However, the provisions of the Garrett Lee Smith Memorial Act encourage young people to speak up about suicide, importantly to seek assistance when they are feeling hopeless or depressed, and to make sure they have access to trained specialists to help them make sense of the emotions that are overwhelming them. It also provides families and friends of at-risk youth with information and resources to support these very fragile people.

There may be a misconception about this useful bill by some of my colleagues here in the House. Under no circumstances will this bill force parents to medicate their children as a condition of attending public school. In fact, it explicitly prohibits funds to be spent in such a way. Additionally, it does not allow schools to force children to attend school assemblies, undergo screenings for depression or receive treatment for depression without the written consent of a parent or guardian. It requires parental consent and involvement.

The bill requires that States and entities receiving funding under this grant program shall obtain prior written informed consent from the child's parent or legal guardian for assessment services, school- sponsored programs, and treatment involving medication related to the youth suicide conducted in elementary and secondary schools. So there is a very important provision for parents to be involved. Prior requirements do not apply if it is an emergency, as the chairman talked about.

This bill comes to the House floor as a result of delicate negotiation at the Member level and hard work at the staff level. I want to thank especially the gentleman from Texas (Chairman Barton) and the subcommittee chairman, the gentleman from Florida (Mr. Bilirakis), and the gentleman from Ohio (Mr. Brown) and others for facilitating this bill's swift movement to the floor. All of these gentlemen were gracious and worked closely with Senator Smith to ensure that the Garrett Lee Smith Memorial Act would be considered by the House on this very day.

I encourage my colleagues to support the Garrett Lee Smith Memorial Act. In closing, I echo the words of Senator Smith, my constituent. ``Suicide and attempts do not simply leave an impression on the individual's life, it leaves a deep impact on everyone who knows the person or a family member of that person. No family should experience the pain we have suffered and no

child should suffer the challenges of mental illness alone.''

Mr. Speaker, I appreciate the gentleman's courtesy, and I appreciate the way that we are reallocating time a little bit to permit serious discussion of a serious topic. I deeply appreciate the expeditious way that the Committee on Energy and Commerce has moved forward with this. As my friend and colleague from Oregon pointed out, we have sort of a special sense in our State, but I must take exception with our colleagues who are rising in opposition of the philosophy somehow if we do not talk about this with our young people, if we do not establish programs, that it is going to go away.

I would suggest that one of the reasons we have an epidemic of teenage suicide, especially among young men in this country, is because too few people do focus on the big picture, what it really means. Perhaps because it is so horrible, we do not really allow the reality to penetrate. But in a typical week in our State, there is more than one teenager who will take their life and about three in a typical day will be treated in an emergency room because of a failed attempt.

Somebody who has worked to bring this out of the shadows and to put a face on these serious tragedies, to spare other families, not to tuck it away and assume that everything is going to be all right but to see what we can do to craft a solution that will spare people is our friend and colleague Senator Gordon Smith. As has been noted on the floor, Gordon and his wife, Sharon, lost their son who is memorialized in this act. This is a tremendously positive response that has grown out of a personal family tragedy.

Frankly, I was disappointed in the changes that were added to this legislation, but I would take this for what it is, a positive start; and I appreciate what the committee has done. We are authorizing $82 million over the next 3 fiscal years. In our great country of almost 300 million people, this is truly a very small and modest beginning, but it is important.

I am pleased that it speaks to the establishment of a national center, so perhaps we will have more compelling evidence for people to step forward and join in this effort. I am pleased that it will provide resources for statewide programs and especially programs run by Native American tribes where that need is especially acute. It is encouraging that we would establish new grants for mental and behavioral health services at colleges and universities. This is an important start, to let these young people who sadly have wrestled with these demons, let them know that they are not alone, let them know that there are services, that people do care and for us to experiment in ways to do a better job.

In Oregon, we have a special interest not only in the courageous way that the Smith family has responded to trying to help other families but ours is a State with a suicide rate that is 40 percent higher than the national average. We all have an incentive to do our part. There is not a Member in this Chamber that has not either been touched directly in their family or by people

close to them that they know and love. We have had cases on the floor of our colleagues just in the short time that I have been in Congress.

I am hopeful that we can seize on the opportunity to approve and then improve this legislation, build upon it and to share in carrying this message to Congress and through Congress back to our communities. By our action, we can join the Smith family to help spare others this pain in the future. I appreciate the work of my colleagues on the committee.