What This Bill Does
This bill directs the United States government to add mental health and counseling support to development and humanitarian assistance programs overseas. The bill creates a new coordinator position to oversee these mental health efforts and requires reporting on how much funding goes toward mental health programs globally.
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Who It Affects
- The Administrator of USAID (United States Agency for International Development)
- The Secretary of State
- USAID regional offices and missions worldwide
- Department of State offices
- Congressional committees overseeing foreign affairs
- Children, families and populations affected by conflict, displacement or crisis in countries receiving U.S. assistance
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Key Provisions
- The USAID Administrator must appoint a Mental Health and Psychosocial Support Coordinator to oversee mental health efforts across development and humanitarian programs (Sec. 4)
- The coordinator must establish a working group with senior representatives from USAID, the State Department and other federal agencies to coordinate mental health support across U.S. assistance programs (Sec. 5)
- USAID and the State Department must require all their regional offices and missions to advance mental health integration in their development and humanitarian work, including building local capacity (Sec. 6)
- All mental health programs must be evidence-based, culturally competent and trauma-informed when appropriate (Sec. 6)
- Within one year and annually for five years thereafter, the USAID Administrator and Secretary of State must report to Congress on mental health program funding, implementation progress and barriers to integration (Sec. 7)
##
What Changes
If enacted, this law creates a new coordinating position within USAID dedicated to mental health and psychosocial support. U.S. development and humanitarian assistance programs must now include mental health components in their planning and implementation. The government must begin tracking and reporting how much money goes toward mental health programming overseas. Regional USAID and State Department missions will be required to integrate mental health support into existing programs in health, education, nutrition and child protection sectors.
##
Important Definitions
- **Administrator**: The head of USAID (Sec. 3)
- **USAID**: The United States Agency for International Development (Sec. 3)
- **Psychosocial support**: Not explicitly defined in the bill text
- **Trauma-informed approach**: Not explicitly defined in the bill text
##
Effective Date
Not specified in bill text. The bill states it will end five years after it becomes law (Sec. 8).
II
118TH CONGRESS
1ST SESSION
S. 767
To enhance mental health and psychosocial support within United States
development and humanitarian assistance programs.
IN THE SENATE OF THE UNITED STATES
MARCH 9, 2023
Mr. CASEY (for himself, Ms. STABENOW, Mr. BOOKER, Mrs. SHAHEEN, Mrs.
MURRAY, Mr. MERKLEY, and Mr. FETTERMAN) introduced the following
bill; which was read twice and referred to the Committee on Foreign Re-
lations
A BILL
To enhance mental health and psychosocial support within
United States development and humanitarian assistance
programs.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLES.
3
This Act may be cited as the ‘‘Mental Health in
4
International Development and Humanitarian Settings
5
Act’’ or the ‘‘MINDS Act’’.
6
SEC. 2. FINDINGS; SENSE OF CONGRESS.
7
(a) FINDINGS.—Congress finds the following:
8
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(1) According to the World Health Organiza-
1
tion (referred to in this section as ‘‘WHO’’), an esti-
2
mated 1,000,000,000 individuals worldwide have a
3
mental health or substance use disorder.
4
(2) The Lancet Commission estimates that
5
nearly 130,000,000 additional cases of major depres-
6
sive and anxiety disorders globally in 2020 resulted
7
from the COVID–19 pandemic.
8
(3) According to WHO—
9
(A) depression is among the primary
10
causes of illness and disability in adolescents;
11
(B) 50 percent of mental health disorders
12
emerge by the time an adolescent reaches 14
13
years of age; and
14
(C) 14 percent of children and adolescents
15
worldwide experience mental health conditions,
16
the majority of whom do not seek care, receive
17
care, or have access to care.
18
(4) According to a report commissioned by the
19
United Nations—
20
(A) more than 1 out of every 5 individuals
21
living in a conflict-affected area has a mental
22
health disorder;
23
(B) approximately 1,500,000,000 (or 2 out
24
of every 3) of the world’s children younger than
25
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18 years of age live in countries affected by
1
conflict;
2
(C) more than 1 out of every 6 children
3
live in conflict zones;
4
(D) a greater number of children live in
5
areas affected by armed conflict and war now
6
than at any other time during this century; and
7
(E) the mental health burden in conflict-
8
affected contexts is twice the global average.
9
(5) According to the WHO—
10
(A) risk factors that increase susceptibility
11
to mental health disorders include—
12
(i) poverty and hunger;
13
(ii) chronic health conditions;
14
(iii) trauma or maltreatment;
15
(iv) social exclusion;
16
(v) discrimination; and
17
(vi) exposure to, and displacement by,
18
war or conflict;
19
(B) these risk factors, along with demo-
20
graphic risk factors, manifest at all stages in
21
life;
22
(C) preliminary research illustrates that
23
the COVID–19 pandemic—
24
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(i) has increased the risk factors af-
1
fecting communities, families, and individ-
2
uals for multiple types of adversity; and
3
(ii) compounded preexisting conditions
4
and vulnerabilities.
5
(6) According to a Lancet Commission report—
6
(A) allocations for mental health have
7
never risen above 1 percent of health-related
8
global development assistance; and
9
(B) child and adolescent mental health
10
services receive an estimated 0.1 percent of
11
health-related global development assistance.
12
(b) SENSE OF CONGRESS.—It is the sense of Con-
13
gress that—
14
(1) helping to ensure that individuals have the
15
opportunity to thrive and reach their fullest poten-
16
tial is a critical component of effective and sustain-
17
able international development efforts;
18
(2) mental health is integral and essential to
19
overall health outcomes and other development ob-
20
jectives;
21
(3) mental health is an issue of critical and
22
growing importance for United States development
23
and humanitarian assistance programs that requires
24
coordinated efforts to ensure that programming
25
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funded by the United States Government is evi-
1
dence-based, culturally competent, and trauma-in-
2
formed;
3
(4) the relevant United States Government de-
4
velopment and humanitarian assistance strategies
5
should include a mental health and psychosocial sup-
6
port component;
7
(5) the redesign of USAID—
8
(A) reflects the nexus between humani-
9
tarian and development interventions; and
10
(B) should be applied to all mental health
11
and psychosocial support efforts of United
12
States development and humanitarian assist-
13
ance programs; and
14
(6) ongoing efforts to improve social service
15
workforce development and local capacity building
16
are essential to expanding mental health and psycho-
17
social support activities across all United States de-
18
velopment and humanitarian assistance programs.
19
SEC. 3. DEFINITIONS.
20
In this Act:
21
(1) ADMINISTRATOR.—The term ‘‘Adminis-
22
trator’’ means the Administrator of USAID.
23
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(2) USAID.—The term ‘‘USAID’’ means the
1
United States Agency for International Develop-
2
ment.
3
SEC. 4. COORDINATOR FOR MENTAL HEALTH AND PSYCHO-
4
SOCIAL SUPPORT.
5
Section 135 of the Foreign Assistance Act of 1961
6
(22 U.S.C. 2152f) is amended—
7
(1) by redesignating subsection (f) as sub-
8
section (g); and
9
(2) by inserting after subsection (e) the fol-
10
lowing:
11
‘‘(f) COORDINATOR FOR MENTAL HEALTH AND PSY-
12
CHOSOCIAL SUPPORT.—
13
‘‘(1) APPOINTMENT.—The Administrator of the
14
United States Agency for International Develop-
15
ment, in consultation with the Secretary of State, is
16
authorized to appoint a Mental Health and Psycho-
17
social Support Coordinator (referred to in this sec-
18
tion as the ‘MHPSS Coordinator’).
19
‘‘(2) SPECIFIC DUTIES.—The MHPSS Coordi-
20
nator shall—
21
‘‘(A) establish and chair the Mental Health
22
and Psychosocial Support Working Group au-
23
thorized under section 4 of the MINDS Act;
24
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‘‘(B) guide, oversee, and direct mental
1
health and psychosocial support programming
2
and integration across United States foreign as-
3
sistance programming;
4
‘‘(C) serve as the main point of contact on
5
mental health and psychosocial support in the
6
Bureau for Global Health, the Bureau for Hu-
7
manitarian Assistance, regional bureaus, the
8
Center for Education and the Inclusive Devel-
9
opment Hub in the Bureau for Development,
10
Democracy, and Innovation, other bureaus, the
11
Office of the Global AIDS Coordinator and
12
Global Health Diplomacy, and other inter-
13
agency or presidential initiatives;
14
‘‘(D) promote best practices, coordination
15
and reporting in mental health and psychosocial
16
support programming across United States de-
17
velopment and humanitarian assistance pro-
18
grams;
19
‘‘(E) provide direction, guidance, and over-
20
sight on the integration of mental health and
21
psychosocial support in United States develop-
22
ment and humanitarian assistance programs;
23
and
24
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‘‘(F) participate in the Advancing Protec-
1
tion and Care for Children in Adversity Inter-
2
agency Working Group.
3
‘‘(3) FOCUS POPULATIONS.—The MHPSS Co-
4
ordinator, as appropriate, should prioritize popu-
5
lations with increased risk factors for developing
6
mental health disorders, including—
7
‘‘(A) adult caretakers and children, includ-
8
ing families and adults who are long-term care-
9
takers;
10
‘‘(B) children and others who are sepa-
11
rated from a family unit; and
12
‘‘(C) other specific populations in need of
13
mental health and psychosocial support, such as
14
crisis affected communities, displaced popu-
15
lations, gender-based violence survivors, and in-
16
dividuals and households coping with the con-
17
sequences of diseases, such as Ebola, HIV/
18
AIDS, and COVID–19.’’.
19
SEC. 5. MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT
20
WORKING GROUP.
21
The Administrator, in cooperation with the Mental
22
Health and Psychosocial Support Coordinator appointed
23
pursuant to section 135(f) of the Foreign Assistance Act
24
of 1961, as added by section 4, shall establish the Mental
25
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Health and Psychosocial Support Working Group, which
1
shall include senior representatives from relevant USAID
2
bureaus, the Department of State, and other Federal de-
3
partments and agencies, as appropriate, to ensure con-
4
tinuity and integration of mental health and psychosocial
5
support across United States development and humani-
6
tarian assistance programs.
7
SEC. 6. INTEGRATION OF MENTAL HEALTH AND PSYCHO-
8
SOCIAL SUPPORT.
9
(a) STATEMENT OF POLICY.—It is the policy of the
10
United States to integrate mental health and psychosocial
11
support across all relevant United States development and
12
humanitarian assistance programs.
13
(b) IMPLEMENTATION
OF POLICY.—The Adminis-
14
trator and the Secretary of State should—
15
(1) require all USAID and Department of State
16
regional bureaus and missions to advance the policy
17
described in subsection (a) through relevant develop-
18
ment and humanitarian assistance efforts, including
19
by building local capacity to inform, design, and im-
20
plement mental health and psychosocial support pro-
21
gramming;
22
(2) ensure that all USAID and Department of
23
State mental health and psychosocial support pro-
24
gramming—
25
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(A) is evidence-based and culturally com-
1
petent;
2
(B) responds to all types of childhood ad-
3
versity; and
4
(C) includes trauma-specific interventions
5
in accordance with the recognized principles of
6
a trauma-informed approach, whenever applica-
7
ble; and
8
(3) integrate the principles of the Advancing
9
Protection and Care for Children in Adversity Strat-
10
egy.
11
SEC. 7. CONSULTATION AND REPORTING REQUIREMENTS.
12
(a) CONSULTATION.—Not later than 180 days after
13
the date of the enactment of this Act, the Administrator,
14
in coordination with the Secretary of State, shall consult
15
with the Committee on Foreign Relations of the Senate
16
and the Committee on Foreign Affairs of the House of
17
Representatives regarding—
18
(1) the progress made in carrying out section
19
6(b); and
20
(2) any barriers preventing the full integration
21
of the strategy referred to in section 6(b)(3).
22
(b) REPORT.—Not later than 1 year after the date
23
of the enactment of this Act, and annually thereafter for
24
the following 5 fiscal years, the Administrator and the
25
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Secretary of State, in consultation with the Mental Health
1
and Psychosocial Support Coordinator appointed pursuant
2
to section 135(f) of the Foreign Assistance Act of 1961,
3
as added by section 4, and the Director of the Office of
4
Management and Budget, as necessary and appropriate,
5
shall submit a report to the Committee on Foreign Rela-
6
tions of the Senate and the Committee on Foreign Affairs
7
of the House of Representatives that describes—
8
(1) the amount of United States development
9
and humanitarian assistance program funding that
10
was obligated and expended during the most recently
11
concluded fiscal year on mental health and psycho-
12
social support programming;
13
(2) how USAID and the Department of State
14
are working to integrate mental health and psycho-
15
social programming, including child-specific pro-
16
gramming, into their development and humanitarian
17
assistance programs across relevant sectors, includ-
18
ing health, education, nutrition, and protection;
19
(3) the metrics of success of the Advancing
20
Protection and Care for Children in Adversity Strat-
21
egy and the progress made towards achieving broad-
22
er mental health outcomes;
23
(4) the programs in which trauma-specific
24
strategies are being implemented, and how best
25
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practices for trauma-informed programming are
1
being shared across programs;
2
(5) any barriers preventing full integration of
3
child mental health and psychosocial support into
4
programs for children and youth, and recommenda-
5
tions for modifications or expansion of such pro-
6
grams;
7
(6) any barriers to the expansion of mental
8
health and psychosocial support programming in
9
conflict and humanitarian settings, and how such
10
barriers are being addressed;
11
(7) the impact of the COVID–19 pandemic on
12
mental health and psychosocial support program-
13
ming; and
14
(8) funding data, including a list of programs
15
to which USAID and the Department of State have
16
obligated funds during the most recently concluded
17
fiscal year to improve access to, and the quality of,
18
mental health and psychosocial support program-
19
ming in development and humanitarian contexts.
20
SEC. 8. SUNSET.
21
This Act, and the amendments made by this Act,
22
shall terminate on the date that is 5 years after the date
23
of the enactment of this Act.
24
Æ
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