Military Moms’ Mental Health Assessment Act

II 116TH CONGRESS 2D SESSION S. 3809 To require the Comptroller General of the United States to conduct a study on prenatal and postpartum mental health conditions among members of the Armed Forces and their dependents. IN THE SENATE OF THE UNITED STATES MAY 21, 2020 Mr. BLUMENTHAL (for himself and Mr. KAINE) introduced the following bill; which was read twice and referred to the Committee on Armed Services A BILL To require the Comptroller General of the United States to conduct a study on prenatal and postpartum mental health conditions among members of the Armed Forces and their dependents. 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 TITLE. 3 This Act may be cited as the ‘‘Military Moms’ Mental 4 Health Assessment Act’’. 5 VerDate Sep 11 2014 03:38 Jun 14, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3809.IS S3809 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 3809 IS SEC. 2. COMPTROLLER GENERAL STUDY ON PRENATAL 1 AND POSTPARTUM MENTAL HEALTH CONDI- 2 TIONS AMONG MEMBERS OF THE ARMED 3 FORCES AND THEIR DEPENDENTS. 4 (a) FINDINGS.—Congress makes the following find- 5 ings: 6 (1) In 2018, 52,535 members of the Armed 7 Forces and their dependents gave birth at military 8 medical treatment facilities or civilian hospitals 9 where the Department of Defense purchased care. 10 (2) Members of the Armed Forces and military 11 spouses often give birth alone due to deployments or 12 training exercises that prevent their birthing partner 13 from being present during childbirth. 14 (3) Members of the military community are 15 sometimes uniquely isolated from their support net- 16 works due to frequent permanent changes of station 17 or during deployments. 18 (4) Social isolation and frequent moves can im- 19 pact mental health outcomes of pregnant members 20 of the Armed Forces or military spouses, while also 21 interrupting the continuity of mental health care or 22 other medical care. 23 (5) Some studies have concluded that women 24 with deployed spouses show high stress levels and in- 25 creased risk for prenatal and postpartum mood dis- 26 VerDate Sep 11 2014 03:38 Jun 14, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3809.IS S3809 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 3809 IS orders, including depression, which may explain ad- 1 verse birth outcomes. 2 (6) According to the American College of Ob- 3 stetricians and Gynecologists, deployment status is 4 strongly associated with an increased risk of depres- 5 sion during pregnancy and the postpartum period. 6 (7) The Department of Defense determined 7 that pregnant members of the Armed Forces and 8 veterans more commonly experience mental health 9 issues than nonpregnant members of the Armed 10 Forces and veterans and pregnant women in the 11 general population. 12 (8) Some studies have indicated that minority 13 women in the civilian community are more likely to 14 experience prenatal and postpartum mood disorders, 15 but that minority women are less likely to seek or 16 receive treatment, and there are troubling racial and 17 ethnic disparities in the initiation and continuation 18 of prenatal and postpartum mental health care. 19 (9) Despite some studies regarding prenatal 20 care, postpartum health, and social support during 21 pregnancy and child birth among the military com- 22 munity, those studies have been limited in scope, 23 and there is little research related to prenatal and 24 postpartum mental health conditions and mental 25 VerDate Sep 11 2014 03:38 Jun 14, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3809.IS S3809 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 3809 IS health care among military spouses and active duty 1 members of the Armed Forces to support policy re- 2 forms. 3 (10) Members of the Armed Forces and mili- 4 tary spouses might refrain from seeking mental 5 health care due to stigma and fear of potential re- 6 percussions on employment or career progression. 7 (b) SENSE OF CONGRESS.—It is the sense of Con- 8 gress that— 9 (1) members of the military community, includ- 10 ing members of the Armed Forces and military 11 spouses, are vulnerable to prenatal and postpartum 12 mental health conditions given the unique challenges 13 those individuals face due to frequent deployments 14 and permanent changes of station; 15 (2) additional studies and research regarding 16 prenatal and postpartum mental health conditions 17 among members of the Armed Forces and military 18 spouses are necessary to identify gaps in, and bar- 19 riers to, mental health care provided to beneficiaries 20 under the TRICARE program, including an assess- 21 ment of issues such as stigma, negative career im- 22 pact, and discrimination or retaliation against mem- 23 bers of the Armed Forces and military spouses; 24 VerDate Sep 11 2014 03:38 Jun 14, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3809.IS S3809 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 3809 IS (3) additional studies and research are nec- 1 essary to determine whether minority women in the 2 Armed Forces and minority military spouses— 3 (A) experience prenatal and postpartum 4 mood disorders at a higher rate; 5 (B) are more likely to experience racial 6 and ethnic disparities in health care access; or 7 (C) are less likely to initiate or continue 8 prenatal or postpartum mental health care; and 9 (4) more information will enable the Depart- 10 ment of Defense to better address the prenatal and 11 postpartum mental health needs of members of the 12 Armed Forces and military spouses. 13 (c) STUDY.— 14 (1) IN GENERAL.—The Comptroller General of 15 the United States shall conduct a study on prenatal 16 and postpartum mental health conditions among 17 members of the Armed Forces and dependents of 18 such members. 19 (2) ELEMENTS.—The study required under 20 paragraph (1) shall include the following: 21 (A) An assessment of the extent to which 22 beneficiaries under the TRICARE program, in- 23 cluding members of the Armed Forces and de- 24 pendents of such members, are diagnosed with 25 VerDate Sep 11 2014 03:38 Jun 14, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3809.IS S3809 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 3809 IS prenatal or postpartum mental health condi- 1 tions, including— 2 (i) prenatal or postpartum depression; 3 (ii) prenatal or postpartum anxiety 4 disorder; 5 (iii) prenatal or postpartum obsessive 6 compulsive disorder; 7 (iv) prenatal or postpartum psychosis; 8 and 9 (v) other relevant mood disorders. 10 (B) A demographic assessment of the pop- 11 ulation included in the study with respect to 12 race, ethnicity, sex, age, relationship status, 13 military service, military occupation, and rank, 14 where applicable. 15 (C) An assessment of the status of pre- 16 natal and postpartum mental health care for 17 beneficiaries under the TRICARE program, in- 18 cluding those who seek care at military medical 19 treatment facilities and those who rely on civil- 20 ian providers. 21 (D) An assessment of the ease or delay for 22 beneficiaries under the TRICARE program in 23 obtaining treatment for prenatal and 24 VerDate Sep 11 2014 03:38 Jun 14, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3809.IS S3809 pbinns on DSKJLVW7X2PROD with BILLS 7 •S 3809 IS postpartum mental health conditions, includ- 1 ing— 2 (i) an assessment of wait times for 3 mental health treatment at each military 4 medical treatment facility; and 5 (ii) a description of the reasons such 6 beneficiaries may cease seeking such treat- 7 ment. 8 (E) A comparison of the rates of prenatal 9 or postpartum mental health conditions within 10 the military community to such rates in the ci- 11 vilian population, as reported by the Centers for 12 Disease Control and Prevention. 13 (F) An assessment of any effects of im- 14 plicit or explicit bias in prenatal and 15 postpartum mental health care under the 16 TRICARE program, or evidence of racial or so- 17 cioeconomic barriers to such care. 18 (3) REPORT.—Not later than one year after the 19 date of the enactment of this Act, the Comptroller 20 General shall submit to the congressional defense 21 committees a report on the findings of the study 22 conducted under paragraph (1), including— 23 (A) recommendations for actions to be 24 taken by the Secretary of Defense to improve 25 VerDate Sep 11 2014 03:38 Jun 14, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3809.IS S3809 pbinns on DSKJLVW7X2PROD with BILLS 8 •S 3809 IS prenatal and postpartum mental health among 1 members of the Armed Forces and dependents 2 of such members; and 3 (B) such other recommendations as the 4 Comptroller General determines appropriate. 5 (d) DEFINITIONS.—In this section: 6 (1) CONGRESSIONAL DEFENSE COMMITTEES.— 7 The term ‘‘congressional defense committees’’ has 8 the meaning given that term in section 101(a)(16) 9 of title 10, United States Code. 10 (2) DEPENDENT; TRICARE PROGRAM.—The 11 terms ‘‘dependent’’ and ‘‘TRICARE program’’ have 12 the meanings given those terms in section 1072 of 13 such title. 14 Æ VerDate Sep 11 2014 03:38 Jun 14, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\S3809.IS S3809 pbinns on DSKJLVW7X2PROD with BILLS