US Codex
Pub. L.
Notes

Title III — Programs, Studies, and Guidelines on Mental Health

116th Congress · Approved Oct 17, 2020 · 134 Stat. 778

TITLE III Programs, Studies, and Guidelines on Mental Health

SEC. 301. Study on Connection Between Living at High Altitude and Suicide Risk Factors Among Veterans.

(a)
In General.— Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with Rural Health Resource Centers of the Office of Rural Health of the Department of Veterans Affairs, shall commence the conduct of a study on the connection between living at high altitude and the risk of developing depression or dying by suicide among veterans.
(b)
Completion of Study.— The study conducted under subsection (a) shall be completed not later than three years after the date of the commencement of the study.
(c)
Individual Impact.— The study conducted under subsection (a) shall be conducted so as to determine the effect of high altitude on suicide risk at the individual level, not at the State or county level.
(d)
Report.— Not later than 150 days after the completion of the study conducted under subsection (a), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the results of the study.
(e)
Follow-up Study.—
(1)
In general.— If the Secretary determines through the study conducted under subsection (a) that living at high altitude is a risk factor for developing depression or dying by suicide, the Secretary shall conduct an additional study to identify the following:
(A)
The most likely biological mechanism that makes living at high altitude a risk factor for developing depression or dying by suicide.
(B)
The most effective treatment or intervention for reducing the risk of developing depression or dying by suicide associated with living at high altitude.
(2)
Report.— Not later than 150 days after completing the study conducted under paragraph (1), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the results of the study.

SEC. 302. Establishment by Department of Veterans Affairs and Department of Defense of a Clinical Provider Treatment Toolkit and Accompanying Training Materials for Comorbidities.

(a)
In General.— Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with the Secretary of Defense, shall develop a clinical provider treatment toolkit and accompanying training materials for the evidence-based management of comorbid mental health conditions, comorbid mental health and substance use disorders, and a comorbid mental health condition and chronic pain.
(b)
Matters Included.— In developing the clinical provider treatment toolkit and accompanying training materials under subsection (a), the Secretary of Veterans Affairs and the Secretary of Defense shall ensure that the toolkit and training materials include guidance with respect to the following:
(1)
The treatment of patients with post-traumatic stress disorder who are also experiencing an additional mental health condition, a substance use disorder, or chronic pain.
(2)
The treatment of patients experiencing a mental health condition, including anxiety, depression, or bipolar disorder, who are also experiencing a substance use disorder or chronic pain.
(3)
The treatment of patients with traumatic brain injury who are also experiencing—
(A)
a mental health condition, including post-traumatic stress disorder, anxiety, depression, or bipolar disorder;
(B)
a substance use disorder; or
(C)
chronic pain.

SEC. 303. Update of Clinical Practice Guidelines for Assessment and Management of Patients at Risk for Suicide.

(a)
In General.— In the first publication of the Department of Veterans Affairs and Department of Defense Clinical Practice Guideline for Assessment and Management of Patients at Risk for Suicide published after the date of the enactment of this Act, the Secretary of Veterans Affairs and the Secretary of Defense, through the Assessment and Management of Patients at Risk for Suicide Work Group (in this section referred to as the “Work Group”), shall ensure the publication includes the following:
(1)
Enhanced guidance with respect to gender-specific—
(A)
risk factors for suicide and suicidal ideation;
(B)
treatment efficacy for depression and suicide prevention;
(C)
pharmacotherapy efficacy; and
(D)
psychotherapy efficacy.
(2)
Guidance with respect to the efficacy of alternative therapies, other than psychotherapy and pharmacotherapy, including the following:
(A)
Yoga therapy.
(B)
Meditation therapy.
(C)
Equine therapy.
(D)
Other animal therapy.
(E)
Training and caring for service dogs.
(F)
Agritherapy.
(G)
Art therapy.
(H)
Outdoor sports therapy.
(I)
Music therapy.
(J)
Any other alternative therapy that the Work Group considers appropriate.
(3)
Guidance with respect to the findings of the Creating Options for Veterans’ Expedited Recovery Commission (commonly referred to as the “COVER Commission”) established under section 931 of the Jason Simcakoski Memorial and Promise Act (title IX of Public Law 114–198; 38 U.S.C. 1701 note).
(b)
Rule of Construction.— Nothing in this section shall be construed to prevent the Secretary of Veterans Affairs and the Secretary of Defense from considering all relevant evidence, as appropriate, in updating the Department of Veterans Affairs and Department of Defense Clinical Practice Guideline for Assessment and Management of Patients at Risk for Suicide, as required under subsection (a), or from ensuring that the final clinical practice guidelines updated under such subsection remain applicable to the patient populations of the Department of Veterans Affairs and the Department of Defense.

SEC. 304. Establishment by Department of Veterans Affairs and Department of Defense of Clinical Practice Guidelines for the Treatment of Serious Mental Illness.

(a)
In General.— Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with the Secretary of Defense and the Secretary of Health and Human Services, shall complete the development of a clinical practice guideline or guidelines for the treatment of serious mental illness, to include the following conditions:
(1)
Schizophrenia.
(2)
Schizoaffective disorder.
(3)
Persistent mood disorder, including bipolar disorder I and II.
(4)
Any other mental, behavioral, or emotional disorder resulting in serious functional impairment that substantially interferes with major life activities as the Secretary of Veterans Affairs, in consultation with the Secretary of Defense and the Secretary of Health and Human Services, considers appropriate.
(b)
Matters Included in Guidelines.— The clinical practice guideline or guidelines developed under subsection (a) shall include the following:
(1)
Guidance contained in the 2016 Clinical Practice Guidelines for the Management of Major Depressive Disorders of the Department of Veterans Affairs and the Department of Defense.
(2)
Guidance with respect to the treatment of patients with a condition described in subsection (a).
(3)
A list of evidence-based therapies for the treatment of conditions described in subsection (a).
(4)
An appropriate guideline for the administration of pharmacological therapy, psychological or behavioral therapy, or other therapy for the management of conditions described in subsection (a).
(c)
Assessment of Existing Guidelines.— Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with the Secretary of Defense and the Secretary of Health and Human Services, shall complete an assessment of the 2016 Clinical Practice Guidelines for the Management of Major Depressive Disorders to determine whether an update to such guidelines is necessary.
(d)
Work Group.—
(1)
Establishment.— The Secretary of Veterans Affairs, the Secretary of Defense, and the Secretary of Health and Human Services shall create a work group to develop the clinical practice guideline or guidelines under subsection (a) to be known as the “Serious Mental Illness Work Group” (in this subsection referred to as the “Work Group”).
(2)
Membership.— The Work Group created under paragraph (1) shall be comprised of individuals that represent Federal Government entities and non-Federal Government entities with expertise in the areas covered by the Work Group, including the following entities:
(A)
Academic institutions that specialize in research for the treatment of conditions described in subsection (a).
(B)
The Health Services Research and Development Service of the Department of Veterans Affairs.
(C)
The Office of the Assistant Secretary for Mental Health and Substance Use of the Department of Health and Human Services.
(D)
The National Institute of Mental Health.
(E)
The Indian Health Service.
(F)
Relevant organizations with expertise in researching, diagnosing, or treating conditions described in subsection (a).
(3)
Relation to other work groups.— The Work Group shall be created and conducted in the same manner as other work groups for the development of clinical practice guidelines for the Department of Veterans Affairs and the Department of Defense.
(e)
Rule of Construction.— Nothing in this section shall be construed to prevent the Secretary of Veterans Affairs and the Secretary of Defense from considering all relevant evidence, as appropriate, in creating the clinical practice guideline or guidelines required under subsection (a) or from ensuring that the final clinical practice guideline or guidelines developed under such subsection and subsequently updated, as appropriate, remain applicable to the patient populations of the Department of Veterans Affairs and the Department of Defense.

SEC. 305. Precision Medicine Initiative of Department of Veterans Affairs to Identify and Validate Brain and Mental Health Biomarkers.

(a)
In General.— Beginning not later than 18 months after the date of the enactment of this Act, the Secretary of Veterans Affairs shall develop and implement an initiative of the Department of Veterans Affairs to identify and validate brain and mental health biomarkers among veterans, with specific consideration for depression, anxiety, post-traumatic stress disorder, bipolar disorder, traumatic brain injury, and such other mental health conditions as the Secretary considers appropriate. Such initiative may be referred to as the “Precision Medicine for Veterans Initiative”.
(b)
Model of Initiative.— The initiative under subsection (a) shall be modeled on the All of Us Precision Medicine Initiative administered by the National Institutes of Health with respect to large-scale collection of standardized data and open data sharing.
(c)
Methods.— The initiative under subsection (a) shall include brain structure and function measurements, such as functional magnetic resonance imaging and electroencephalogram, and shall coordinate with additional biological methods of analysis utilized in the Million Veterans Program of the Department of Veterans Affairs.
(d)
Use of Data.—
(1)
Privacy and security.— In carrying out the initiative under subsection (a), the Secretary shall develop robust data privacy and security measures, consistent with section 552a of title 5, United States Code (commonly known as the “Privacy Act of 1974”), and regulations promulgated pursuant to the Health Insurance Portability and Accountability Act of 1996 (parts 160, 162, and 164 of title 45, Code of Federal Regulations, or successor regulations) to ensure that information of veterans participating in the initiative is kept private and secure.
(2)
Consultation with the national institutes of science and technology.— The Secretary may consult with the National Institute of Science and Technology in developing the data privacy and security measures described in paragraph (1).
(3)
Access standards.— The Secretary shall provide access to information under the initiative consistent with the standards described in section 552a(d)(1) of title 5, United States Code, and section 164.524 of title 45, Code of Federal Regulations, or successor regulations.
(4)
Open platform.—
(A)
Availability of data.— The Secretary shall make de-identified data collected under the initiative available for research purposes to Federal agencies.
(B)
Contract.— The Secretary shall contract with nongovernment entities that comply with requisite data security measures to make available for research purposes de-identified data collected under the initiative.
(C)
Assistance.— The Secretary shall provide assistance to a Federal agency conducting research using data collected under the initiative at the request of that agency.
(D)
Prohibition on transfer of data.— Federal agencies may not disclose, transmit, share, sell, license, or otherwise transfer data collected under the initiative to any nongovernment entity other than as allowed under subparagraph (B).
(5)
Standardization.—
(A)
In general.— The Secretary shall ensure that data collected under the initiative is standardized.
(B)
Consultation.— The Secretary shall consult with the National Institutes of Health and the Food and Drug Administration to determine the most effective, efficient, and cost-effective way of standardizing data collected under the initiative.
(C)
Manner of standardization.— In consultation with the National Institute for Science and Technology, data collected under the initiative shall be standardized in the manner in which it is collected, entered into the database, extracted, and recorded.
(6)
Measures of brain function or structure.— Any measures of brain function or structure collected under the initiative shall be collected with a device that is approved by the Food and Drug Administration.
(7)
De-identified data defined.— In this subsection, the term “de-identified data” means, with respect to data held by the Department of Veterans Affairs, that the Department—
(A)
alters, anonymizes, or aggregates the data so that there is a reasonable basis for expecting that the data could not be linked as a practical matter to a specific individual;
(B)
publicly commits to refrain from attempting to re-identify the data with a specific individual, and adopts controls to prevent such identification; and
(C)
causes the data to be covered by a contractual or other legally enforceable prohibition on each entity to which the Department discloses the data from attempting to use the data to identify a specific individual and requires the same of all onward disclosures.
(e)
Inclusion of Initiative in Program.— The Secretary shall coordinate efforts of the initiative under subsection (a) with the Million Veterans Program of the Department.

SEC. 306. Statistical Analyses and Data Evaluation by Department of Veterans Affairs.

(a)
In General.— Chapter 1 of title 38, United States Code, is amended by adding at the end the following new section:

Ҥ 119. Contracting for statistical analyses and data evaluation

“(a) In General.—The Secretary may enter into a contract or other agreement with an academic institution or other qualified entity, as determined by the Secretary, to carry out statistical analyses and data evaluation as required of the Secretary by law.”

“(b) Rule of Construction.—Nothing in this section may be construed to limit the authority of the Secretary to enter into contracts or other agreements for statistical analyses and data evaluation under any other provision of law.”

(b)
Clerical Amendment.— The table of sections at the beginning of chapter 1 of such title is amended by adding at the end the following new item:

“119. Contracting for statistical analyses and data evaluation.”.