Stop Mental Health Stigma in Our Communities Act

II 118TH CONGRESS 1ST SESSION S. 1773 To amend the Public Health Service Act to provide for a national outreach and education strategy and research to improve behavioral health among the Asian American, Native Hawaiian, and Pacific Islander population, while addressing stigma against behavioral health treatment among such population. IN THE SENATE OF THE UNITED STATES MAY 31 (legislative day, MAY 30), 2023 Ms. HIRONO (for herself, Ms. CORTEZ MASTO, and Mr. BOOKER) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Public Health Service Act to provide for a national outreach and education strategy and research to improve behavioral health among the Asian American, Native Hawaiian, and Pacific Islander population, while addressing stigma against behavioral health treatment among such population. 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 ‘‘Stop Mental Health 4 Stigma in Our Communities Act’’. 5 VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1773 IS SEC. 2. DEFINITIONS. 1 In this Act: 2 (1) AANHPI.—The term ‘‘AANHPI’’ means 3 Asian American, Native Hawaiian, and Pacific Is- 4 lander. 5 (2) SECRETARY.—Except as otherwise speci- 6 fied, the term ‘‘Secretary’’ means the Secretary of 7 Health and Human Services. 8 SEC. 3. FINDINGS. 9 Congress finds the following: 10 (1) The AANHPI community is among the 11 fastest growing population groups in the United 12 States. It is a diverse population representing over 13 30 countries, making up more than 50 distinct eth- 14 nic groups, and speaking more than 100 languages 15 and dialects. 16 (2) There is a growing mental health crisis in 17 the United States, particularly for AANHPI individ- 18 uals. AANHPI individuals with mental health chal- 19 lenges have the lowest rates of mental health service 20 utilization compared to other racial or ethnic popu- 21 lations. In 2021, only 25 percent of Asian adults 22 with a mental health challenge received treatment in 23 the past year. Although suicide is the eleventh lead- 24 ing cause of death, it is the leading cause of death 25 for AANHPI youth. From 2018 to 2020, AANHPI 26 VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1773 IS youth between the ages of 10 to 24 years were the 1 only racial or ethnic population in this age category 2 where suicide was the leading cause of death. 3 (3) Such mental health disparities within the 4 AANHPI community may be attributed to systemic 5 barriers to accessing mental health services, includ- 6 ing stigma attached to mental health, limited avail- 7 ability of and access to culturally and linguistically 8 appropriate services, and insufficient research. 9 (4) Insufficient research on AANHPI commu- 10 nities often leads to an inaccurate representation of 11 their experiences and needs. It is imperative to 12 disaggregate AANHPI population data to better un- 13 derstand the range of mental health issues for each 14 subpopulation so that specific culturally and linguis- 15 tically appropriate solutions can be developed. 16 (5) Critical investments are necessary to reduce 17 stigma and improve mental health within AANHPI 18 communities, including increasing culturally and lin- 19 guistically appropriate outreach education and men- 20 tal health services, improving representation of 21 AANHPI individuals among behavioral health pro- 22 viders, and strengthening disaggregated data collec- 23 tion in research. 24 VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1773 IS SEC. 4. NATIONAL AANHPI BEHAVIORAL HEALTH OUT- 1 REACH AND EDUCATION STRATEGY. 2 Part D of title V of the Public Health Service Act 3 (42 U.S.C. 290dd et seq.) is amended by adding at the 4 end the following new section: 5 ‘‘SEC. 553. NATIONAL AANHPI BEHAVIORAL HEALTH OUT- 6 REACH AND EDUCATION STRATEGY. 7 ‘‘(a) IN GENERAL.—The Secretary, acting through 8 the Assistant Secretary, shall, in coordination with the Di- 9 rector of the Office of Minority Health, the Director of 10 the National Institutes of Health, and the Director of the 11 Centers for Disease Control and Prevention, and in con- 12 sultation with advocacy and behavioral health organiza- 13 tions serving populations of Asian American, Native Ha- 14 waiian, and Pacific Islander individuals or communities, 15 develop and implement a national outreach and education 16 strategy to promote behavioral health and reduce stigma 17 associated with mental health and substance use disorders 18 within the Asian American, Native Hawaiian, and Pacific 19 Islander population. Such strategy shall— 20 ‘‘(1) be designed to meet the diverse cultural 21 and language needs of the various Asian American, 22 Native Hawaiian, and Pacific Islander populations; 23 ‘‘(2) be developmentally and age appropriate; 24 ‘‘(3) increase awareness of symptoms of mental 25 illnesses common within subgroups of such popu- 26 VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1773 IS lation, taking into account differences within sub- 1 groups, such as gender, gender identity, age, sexual 2 orientation, or ethnicity; 3 ‘‘(4) provide information on evidence-based, cul- 4 turally and linguistically appropriate, and adapted 5 interventions and treatments; 6 ‘‘(5) ensure full participation of, and engage, 7 both consumers and community members in the de- 8 velopment and implementation of materials; and 9 ‘‘(6) seek to broaden the perspective among 10 both individuals in Asian American, Native Hawai- 11 ian, and Pacific Islander communities and stake- 12 holders serving such communities to use a com- 13 prehensive public health approach to promoting be- 14 havioral health that addresses a holistic view of 15 health by focusing on the intersection between be- 16 havioral and physical health. 17 ‘‘(b) REPORTS.—Beginning not later than 1 year 18 after the date of the enactment of the Stop Mental Health 19 Stigma in Our Communities Act and annually thereafter, 20 the Secretary, acting through the Assistant Secretary, 21 shall submit to Congress, and make publicly available, a 22 report on the extent to which the strategy developed and 23 implemented under subsection (a) increased treatment uti- 24 lization among the Asian American, Native Hawaiian, and 25 VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1773 IS Pacific Islander population for mental health and sub- 1 stance use disorders. 2 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 3 is authorized to be appropriated to carry out this section 4 $3,000,000 for each of fiscal years 2024 through 2028.’’. 5 SEC. 5. STUDY AND REPORT ON THE AANHPI YOUTH MEN- 6 TAL HEALTH CRISIS. 7 (a) STUDY.— 8 (1) IN GENERAL.—The Secretary, acting 9 through the Assistant Secretary for Mental Health 10 and Substance Use, in coordination with the Direc- 11 tor of the National Institutes of Health, the Director 12 of the Centers for Disease Control and Prevention, 13 and the Director of the Office of Minority Health, 14 shall conduct a study on behavioral health among 15 AANHPI youth. 16 (2) ELEMENTS.—Such study required under 17 paragraph (1) shall include an assessment of— 18 (A) the prevalence, risk factors, and root 19 causes of mental health challenges, substance 20 misuse, and mental health and substance use 21 disorders among AANHPI youth; 22 (B) the prevalence among AANHPI youth 23 of attempted suicide, nonfatal substance use 24 VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1773 IS overdose, and death by suicide or substance use 1 overdose; and 2 (C) AANHPI youth that received treat- 3 ment for mental health and substance use dis- 4 orders. 5 (b) REPORT.—Not later than one year after the date 6 of the enactment of this Act, the Secretary shall submit 7 to the Committee on Health, Education, Labor, and Pen- 8 sions of the Senate and the Committee on Energy and 9 Commerce of the House of Representatives, and make 10 publicly available, a report on the findings of the study 11 conducted under subsection (a), including— 12 (1) identification of the barriers to accessing 13 behavioral health services for AANHPI youth; 14 (2) identification of root causes of mental 15 health challenges and substance misuse among 16 AANHPI youth; 17 (3) recommendations for actions to be taken by 18 the Secretary to improve behavioral health among 19 AANHPI youth; 20 (4) recommendations for legislative or adminis- 21 trative action to improve the behavioral health of 22 AANHPI youth experiencing depression, suicide, 23 and overdose, and to reduce the prevalence of de- 24 VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1773 IS pression, suicide, and overdose among AANHPI 1 youth; and 2 (5) such other recommendations as the Sec- 3 retary determines appropriate. 4 (c) DATA.—Any data included in the study or report 5 under this section shall be disaggregated by race, eth- 6 nicity, age, sex, gender identity, sexual orientation, geo- 7 graphic region, disability status, and other relevant fac- 8 tors, in a manner that protects personal privacy and that 9 is consistent with applicable Federal and State privacy 10 law. 11 (d) AUTHORIZATION OF APPROPRIATIONS.—For pur- 12 poses of carrying out this section, there is authorized to 13 be appropriated $1,500,000 for fiscal year 2024. 14 SEC. 6. STUDY AND REPORT ON STRATEGIES ON THE 15 AANHPI BEHAVIORAL HEALTH WORKFORCE 16 SHORTAGE. 17 (a) STUDY.— 18 (1) IN GENERAL.—The Secretary, acting 19 through the Assistant Secretary for Mental Health 20 and Substance Use, in coordination with the Admin- 21 istrator of the Health Resources and Services Ad- 22 ministration, the Secretary of Labor, and the Direc- 23 tor of the Office of Minority Health, shall conduct 24 a study on strategies for increasing the behavioral 25 VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1773 IS health professional workforce that identify as 1 AANHPI. 2 (2) ELEMENTS.—Such study required under 3 paragraph (1) shall consider— 4 (A) the total number of licensed behavioral 5 health providers in the United States who iden- 6 tify as AANHPI; 7 (B) with respect to each such provider, in- 8 formation regarding the current type of license, 9 geographic area of practice, and type of em- 10 ployer (such as hospital, Federally-qualified 11 health center, school, or private practice); 12 (C) information regarding the cultural and 13 linguistic capabilities of such providers, includ- 14 ing languages spoken proficiently; and 15 (D) the relevant barriers to enrollment in 16 behavioral health professional education pro- 17 grams and entering the behavioral workforce 18 for AANHPI individuals. 19 (b) REPORT.—Not later than one year after the date 20 of the enactment of this Act, the Secretary shall submit 21 to the Committee on Health, Education, Labor, and Pen- 22 sions of the Senate and the Committee on Energy and 23 Commerce of the House of Representatives, and make 24 VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 10 •S 1773 IS publicly available, a report on the findings of the study 1 conducted under subsection (a), including— 2 (1) identification of AANHPI licensed behav- 3 ioral health providers’ knowledge and awareness of 4 the barriers to quality behavioral health care services 5 faced by AANHPI individuals, including stigma, lim- 6 ited English proficiency, and lack of health insur- 7 ance coverage; 8 (2) recommendations for actions to be taken by 9 the Secretary to increase the number of AANHPI li- 10 censed behavioral health professionals; 11 (3) recommendations for legislative or adminis- 12 trative action to improve the enrollment of AANHPI 13 individuals in behavioral health professional edu- 14 cation programs; and 15 (4) such other recommendations as the Sec- 16 retary determines appropriate. 17 (c) DATA.—Any data included in the study or report 18 under this section shall be disaggregated by race, eth- 19 nicity, age, sex, gender identity, sexual orientation, geo- 20 graphic region, disability status, and other relevant fac- 21 tors, in a manner that protects personal privacy and that 22 is consistent with applicable Federal and State privacy 23 law. 24 VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 11 •S 1773 IS (d) DEFINITION.—In this section the term ‘‘licensed 1 behavioral health provider’’ means any individual licensed 2 to provide mental health or substance use disorder serv- 3 ices, including in the professions of social work, psy- 4 chology, psychiatry, marriage and family therapy, mental 5 health counseling, and substance use disorder counseling. 6 (e) AUTHORIZATION OF APPROPRIATIONS.—For pur- 7 poses of carrying out this section, there is authorized to 8 be appropriated $1,500,000 for fiscal year 2024. 9 Æ VerDate Sep 11 2014 05:11 Jun 15, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS