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Safe Communities, Safe Schools Act of 2013--Motion to Proceed--Continued

Floor Speech

Location: Washington, DC


Mr. HARKIN. I ask unanimous consent the reading of the amendment be dispensed with.

The PRESIDING OFFICER. Without objection, it is so ordered.

(The text of the amendment is printed in today's Record under ``Text of Amendments.'')

Today, I offer this bipartisan amendment with my colleague Senator Alexander and several other members from the Health, Education, Labor, and Pensions Committee to reauthorize and improve programs administered by both the Departments of Education and Health and Human Services related to awareness, prevention, and early identification of mental health conditions, and the promotion of linkages to appropriate services for children and youth.

The tragic shooting in Newtown, CT, in December 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 across the country. I was pleased to have the opportunity to start that dialogue with my colleagues on the HELP Committee in January when we held a hearing to examine the state of our Nation's mental health care system.

A starting point of any conversation about mental health is recognizing that one of the most insidious stereotypes about people with mental illness is that they are inherently violent. It is deeply regrettable that some of the discussion in the wake of the Newtown tragedy has sadly reinforced this stereotype. As my colleagues in the Senate know and as the President has emphasized, people with mental illness are much more likely to be victims of violent crimes than they are to be perpetrators of acts of violence.

However, for too long, mental health care has not been at the forefront of public dialogue, despite the fact that mental illness affects one in four Americans every year, and serious mental illness affects 1 in 17. Unfortunately, there is still a stigma associated with mental illness, and that stigma results in too many people suffering in silence without access to the care that could significantly improve their lives.

Unlike many other chronic diseases, mental health problems often begin at a young age. Half of all mental illnesses manifest by age 14, with another quarter appearing by the age of 24. However, less than half of the children with an identified mental health illness receive treatment, and the average lag time from the first onset of symptoms to receiving treatment is almost a decade.

This lack of treatment has huge consequences. Some 30,000 Americans die by suicide each year, and it is a shocking fact that people with serious mental illness die 25 years earlier than Americans overall, often from treatable causes like diabetes and smoking-related chronic conditions.

The shame in this is that with access to the right treatments and supports, most people with mental illnesses can recover and lead productive, healthy lives. But we need to make the critical investments that will enable this to happen, and this amendment is about making those investments.

In the past several years, we have made two important steps forward in mental health care. First, in 2008 Congress passed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act. This long-overdue law put an end to the absurd practice of treating mental and physical illness as two different things under health insurance. We followed this up with another important step forward in the Affordable Care Act, by requiring coverage for mental health and substance use disorders as an essential benefit in health insurance plans and extending Federal parity protections to 62 million Americans.

Building on these important insurance reforms, we started working in the HELP Committee a few months ago to put together a targeted package to address some of the most pressing mental health care challenges in schools and communities. And last week, the HELP Committee unanimously passed and reported out the Mental Health Awareness and Improvement Act, which is this amendment.

The first title of this amendment provides a number of strategies to make sure we are addressing the concerns of students with mental health needs, starting with prevention and early detection. According to the National Institutes of Mental Health, 20 percent of America's 75 million school-aged children have some mental health needs. This means that 15 million students in our K-12 schools have some sort of mental health need. A RAND Foundation study found that only a quarter of those students needing mental health support received any type of services to address their needs. That means over 11 million school-aged children may be struggling with mental health concerns and not receiving the support that will help them in school, in their home and in their communities.

I worked with Senators Bennet, Alexander, and Murphy on language in our amendment that encourages schools to develop and implement schoolwide prevention and early intervention programs such as Positive Behavior Interventions and Supports, PBIS. Such schoolwide programs reach every single student in a school; every grade; every classroom. And the programs provide students with both clear information about what the expectations are for positive behavior and interactions, and the support they need to be successful to meet those expectations.

Schoolwide programs such as Positive Behavior Interventions and Supports are important, but we also know that schools often lack sufficient mental health services for students who need more comprehensive services. We also need to help schools link to mental health services. An NIH study found that most mental health services for school-aged children were provided in schools. But schools do not always have the expertise to provide those services. I worked with Senator Franken to direct the Department of Education to allow for grants that would link local schools to community-based mental health services, thereby expanding a school's ability to support children who have more complex mental health needs and allowing for the training of school personnel to meet students' mental health needs.

Finally, this title allows for the use of Elementary and Secondary Education Act title I funds to create or update school crisis management plans. These plans are key to ensuring the safety of all students and school personnel.

Because these programs are schoolwide and reach every student, this means students receive the support they need early--often before problems develop. It also means that students who need more comprehensive and complex services are identified early and can be linked to those services as soon as possible so that problems don't become worse.

This combination of prevention and early detection of needs, as well as expanding the services and supports available to schools, will help address the wide gap in mental health supports for school-age children.

The second title of this amendment focuses on programs at the Department of Health and Human Services. I worked with my colleagues Senator Reed and Murkowski to reauthorize the Garrett Lee Smith Memorial Act, which focuses on suicide prevention on college campuses and through grants to States. The bill authorizes ``Mental Health Awareness Training Grants,'' a commonsense idea introduced by Senators Begich, Blumenthal, and Ayotte to train school and emergency personnel, as well as other individuals, to recognize the signs and symptoms of mental illness, to become familiar with mental health resources in the community, and to safely de-escalate crisis situations.

I worked with Senator Murray to reauthorize and strengthen the National Child Traumatic Stress Initiative, which supports a national network of child trauma centers in order to coordinate the collection, analysis, and reporting of data concerning evidence-based treatments, interventions, and practices for children and their families who have experienced trauma.

I also worked with Senator Sanders to authorize and improve the National Violent Death Reporting System at CDC which provides valuable information about violent deaths so we can look for ways to prevent them.

Finally, the amendment calls for additional information to be gathered on mental health services for children, integrating mental health and substance use disorder treatments with primary care and the implementation of recommendations made after the Virginia Tech tragedy in 2007.

Before I yield the floor, I wish to join my colleagues in expressing my appreciation to Senator Manchin and Senator Toomey. They have provided great leadership in bringing this legislation forward so that we can have background checks. We will be voting on that legislation later this afternoon.

I think it is another example around here--and maybe people will learn this too late--of how we can sit down and talk. We won't know what kind of agreement can be reached until we sit down and talk to people. A person may think he or she is miles apart on an issue, and in the beginning maybe they are, but by talking and working things out, we can reach good agreements. This is a good example of that.

The one element I would add to that is that the amendment I just called up is an important part of this bill in that it deals with mental health services both to children in school and out of school. Again, I believe this is a very important part of what we ought to be doing to reduce violence and respond to the mental health care needs of our young people.

Again, I thank Senator Manchin and Senator Toomey for their tremendous leadership on this important issue.

I yield the floor.


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