---
kind: "section"
citation: "42 U.S.C. § 290bb–36"
title: "42"
title_heading: "The Public Health and Welfare"
number: "290bb–36"
heading: "Youth suicide early intervention and prevention strategies"
release: "119-102"
url: "https://uscodex.org/usc/42/290bb-36"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter III–A — Substance Abuse and Mental Health Services Administration"
  - "Part B — Centers and Programs"
  - "Subpart 3 — center for mental health services"
---

# §290bb–36. Youth suicide early intervention and prevention strategies

- (a) **In general—** The [Secretary](/usc/42/201.md?p=c), acting through the Assistant [Secretary](/usc/42/201.md?p=c) for Mental Health and Substance Use, shall award grants or cooperative [agreements](/usc/42/1320b–8.md?p=a-3-A) to [eligible entities](/usc/42/296.md?p=1) to—
  - (1) develop and implement [State](/usc/42/300gg–91.md?p=d-14)-sponsored statewide or Tribal [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) strategies in [schools](#l-2-C), [educational institutions](#l-2-A), juvenile justice systems, substance use disorder [programs](/usc/42/274l–1.md?p=4), mental health [programs](/usc/42/274l–1.md?p=4), foster care systems, pediatric health [programs](/usc/42/274l–1.md?p=4), and other [child](/usc/42/416.md?p=e) and [youth](#l-4) support organizations;
  - (2) support public organizations and private nonprofit organizations actively involved in [State](/usc/42/300gg–91.md?p=d-14)-sponsored statewide or Tribal [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) strategies and in the development and continuation of [State](/usc/42/300gg–91.md?p=d-14)-sponsored statewide [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) strategies;
  - (3) provide grants to institutions of higher education to coordinate the implementation of [State](/usc/42/300gg–91.md?p=d-14)-sponsored statewide or Tribal [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) strategies;
  - (4) collect and analyze data on [State](/usc/42/300gg–91.md?p=d-14)-sponsored statewide or Tribal [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) [services](/usc/42/201.md?p=a) that can be used to monitor the effectiveness of such [services](/usc/42/201.md?p=a) and for research, technical assistance, and policy development; and
  - (5) assist [eligible entities](/usc/42/296.md?p=1), through [State](/usc/42/300gg–91.md?p=d-14)-sponsored statewide or Tribal [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) strategies, in achieving targets for [youth](#l-4) suicide reductions under title V of the Social Security Act [[42 U.S.C. 701](/usc/42/701.md) et seq.].
- (b) **Eligible entity—**
  - (1) **Definition—** In this section, the term “eligible entity” means—
    - (A) a [State](/usc/42/300gg–91.md?p=d-14);
    - (B) a public organization or private nonprofit organization designated by a [State](/usc/42/300gg–91.md?p=d-14) or [Indian Tribe](/usc/42/300f.md?p=14) (as defined in [section 4](/usc/42/4.md) of the [Indian](/usc/42/6862.md?p=6) Self-Determination and Education Assistance Act [[25 U.S.C. 5304](/usc/25/5304.md)]) to develop or direct the [State](/usc/42/300gg–91.md?p=d-14)-sponsored statewide or Tribal [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) strategy; or
    - (C) a Federally recognized [Indian Tribe](/usc/42/300f.md?p=14) or [Tribal organization](/usc/42/629a.md?p=a-6) (as defined in the [Indian](/usc/42/6862.md?p=6) Self-Determination and Education Assistance Act [[25 U.S.C. 5301](/usc/25/5301.md) et seq.]) or an urban [Indian](/usc/42/6862.md?p=6) organization (as defined in the [Indian](/usc/42/6862.md?p=6) Health Care Improvement Act [[25 U.S.C. 1601](/usc/25/1601.md) et seq.]) that is actively involved in the development and continuation of a Tribal [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) strategy.
  - (2) **Limitation—** In carrying out this section, the [Secretary](/usc/42/201.md?p=c) shall ensure that a [State](/usc/42/300gg–91.md?p=d-14) does not receive more than 1 grant or cooperative [agreement](/usc/42/1320b–8.md?p=a-3-A) under this section at any 1 time. For purposes of the preceding sentence, a [State](/usc/42/300gg–91.md?p=d-14) shall be considered to have received a grant or cooperative [agreement](/usc/42/1320b–8.md?p=a-3-A) if the [eligible entity](#b-1) involved is the [State](/usc/42/300gg–91.md?p=d-14) or an entity designated by the [State](/usc/42/300gg–91.md?p=d-14) under [paragraph (1)(B)](#b-1-B). Nothing in this paragraph shall be construed to apply to entities described in [paragraph (1)(C)](#b-1-C).
  - (3) **Consideration—** In awarding grants under this section, the [Secretary](/usc/42/201.md?p=c) shall take into consideration the extent of the need of the applicant, including the incidence and prevalence of suicide in the [State](/usc/42/300gg–91.md?p=d-14) and among the populations of focus, including rates of suicide determined by the Centers for Disease Control and [Prevention](#l-3) for the [State](/usc/42/300gg–91.md?p=d-14) or population of focus.
  - (4) **Consultation—** An entity described in paragraph [(1)(A)](#b-1-A) or [(1)(B)](#b-1-B) that applies for a grant or cooperative [agreement](/usc/42/1320b–8.md?p=a-3-A) under this section shall agree to consult or confer with entities described in [paragraph (1)(C)](#b-1-C) and Native Hawaiian Health Care Systems, as applicable, in the applicable [State](/usc/42/300gg–91.md?p=d-14) with respect to the development and implementation of a statewide [early intervention](#l-1) strategy.
- (c) **Preference—** In providing assistance under a grant or cooperative [agreement](/usc/42/1320b–8.md?p=a-3-A) under this section, an [eligible entity](#b-1) shall give preference to public organizations, private nonprofit organizations, political subdivisions, institutions of higher education, and [Tribal organizations](/usc/42/629a.md?p=a-6) actively involved with the [State](/usc/42/300gg–91.md?p=d-14)-sponsored statewide or Tribal [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) strategy that—
  - (1) provide [early intervention](#l-1) and assessment [services](/usc/42/201.md?p=a), including screening [programs](/usc/42/274l–1.md?p=4), to [youth](#l-4) who are at risk for mental or emotional disorders that may lead to a suicide attempt, and that are integrated with [school](#l-2-C) systems, [educational institutions](#l-2-A), juvenile justice systems, substance use disorder [programs](/usc/42/274l–1.md?p=4), mental health [programs](/usc/42/274l–1.md?p=4), foster care systems, pediatric health [programs](/usc/42/274l–1.md?p=4), and other [child](/usc/42/416.md?p=e) and [youth](#l-4) support organizations;
  - (2) demonstrate collaboration among [early intervention](#l-1) and [prevention](#l-3) [services](/usc/42/201.md?p=a) or certify that entities will engage in future collaboration;
  - (3) employ or include in their applications a commitment to evaluate [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) [practices](/usc/42/17061.md?p=19) and strategies adapted to the local community;
  - (4) provide timely referrals for appropriate community-based mental health care and [treatment](/usc/42/11851.md?p=11) of [youth](#l-4) who are at risk for suicide in [child](/usc/42/416.md?p=e)-serving settings and agencies;
  - (5) provide immediate support and information resources to [families](/usc/42/12704.md?p=11) of [youth](#l-4) who are at risk for suicide;
  - (6) offer access to [services](/usc/42/201.md?p=a) and care to [youth](#l-4) with diverse linguistic and cultural backgrounds;
  - (7) offer appropriate postsuicide intervention [services](/usc/42/201.md?p=a), care, and information to [families](/usc/42/12704.md?p=11), friends, [schools](#l-2-C), [educational institutions](#l-2-A), juvenile justice systems, substance use disorder [programs](/usc/42/274l–1.md?p=4), mental health [programs](/usc/42/274l–1.md?p=4), foster care systems, pediatric health [programs](/usc/42/274l–1.md?p=4), and other [child](/usc/42/416.md?p=e) and [youth](#l-4) support organizations of [youth](#l-4) who recently completed suicide;
  - (8) offer continuous and up-to-date information and awareness campaigns that target [parents](/usc/42/1396a.md?p=k-3), [family members](/usc/42/300gg–91.md?p=d-15), [child](/usc/42/416.md?p=e) care professionals, community care providers, and the general public and highlight the risk factors associated with [youth](#l-4) suicide and the life-saving help and care available from [early intervention](#l-1) and [prevention](#l-3) [services](/usc/42/201.md?p=a);
  - (9) ensure that information and awareness campaigns on [youth](#l-4) suicide risk factors, and [early intervention](#l-1) and [prevention](#l-3) [services](/usc/42/201.md?p=a), use effective communication mechanisms that are targeted to and reach [youth](#l-4), [families](/usc/42/12704.md?p=11), [schools](#l-2-C), [educational institutions](#l-2-A), pediatric health [programs](/usc/42/274l–1.md?p=4), and [youth](#l-4) organizations;
  - (10) provide a timely response system to ensure that [child](/usc/42/416.md?p=e)-serving professionals and providers are properly trained in [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) strategies and that [child](/usc/42/416.md?p=e)-serving professionals and providers involved in [early intervention](#l-1) and [prevention](#l-3) [services](/usc/42/201.md?p=a) are properly trained in effectively identifying [youth](#l-4) who are at risk for suicide;
  - (11) provide continuous [training](/usc/42/285e–2.md?p=b-2) activities for [child](/usc/42/416.md?p=e) care professionals and community care providers on the latest [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) [services](/usc/42/201.md?p=a) [practices](/usc/42/17061.md?p=19) and strategies;
  - (12) conduct annual self-evaluations of outcomes and activities, including consulting with interested [families](/usc/42/12704.md?p=11) and advocacy organizations;
  - (13) provide [services](/usc/42/201.md?p=a) in areas or regions with rates of [youth](#l-4) suicide that exceed the national average as determined by the Centers for Disease Control and [Prevention](#l-3);
  - (14) obtain informed written consent from a [parent](/usc/42/1396a.md?p=k-3) or legal guardian of an at-risk [child](/usc/42/416.md?p=e) before involving the [child](/usc/42/416.md?p=e) in a [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) [program](/usc/42/274l–1.md?p=4); and
  - (15) provide to [parents](/usc/42/1396a.md?p=k-3), legal guardians, and [family members](/usc/42/300gg–91.md?p=d-15) of [youth](#l-4), supplies to securely store means commonly used in suicide, if applicable, within the household.
- (d) **Requirement for suicide prevention activities—** Not less than 85 percent of [grant funds](/usc/42/5106a.md?p=f-1-B) received under this section shall be used to provide suicide [prevention activities](/usc/42/300x–34.md?p=3).
- (e) **Coordination and collaboration—**
  - (1) **In general—** In carrying out this section, the [Secretary](/usc/42/201.md?p=c) shall collaborate with relevant [Federal agencies](/usc/42/300j–6.md?p=d-2) and suicide working groups responsible for [early intervention](#l-1) and [prevention](#l-3) [services](/usc/42/201.md?p=a) relating to [youth](#l-4) suicide.
  - (2) **Consultation—** In carrying out this section, the [Secretary](/usc/42/201.md?p=c) shall consult with—
    - (A) [State](/usc/42/300gg–91.md?p=d-14) and local agencies, including agencies responsible for [early intervention](#l-1) and [prevention](#l-3) [services](/usc/42/201.md?p=a) under title XIX of the Social Security Act [[42 U.S.C. 1396](/usc/42/1396.md) et seq.], the [State](/usc/42/300gg–91.md?p=d-14) [Children](/usc/42/256e.md?p=g-2)’s Health Insurance [Program](/usc/42/274l–1.md?p=4) under title XXI of the Social Security Act [[42 U.S.C. 1397aa](/usc/42/1397aa.md) et seq.], and [programs](/usc/42/274l–1.md?p=4) funded by grants under title V of the Social Security Act [[42 U.S.C. 701](/usc/42/701.md) et seq.];
    - (B) local and national organizations that serve [youth](#l-4) at risk for suicide and their [families](/usc/42/12704.md?p=11);
    - (C) relevant national medical and other health and education specialty organizations;
    - (D) [youth](#l-4) who are at risk for suicide, who have survived suicide attempts, or who are currently receiving care from [early intervention](#l-1) [services](/usc/42/201.md?p=a);
    - (E) [families](/usc/42/12704.md?p=11) and friends of [youth](#l-4) who are at risk for suicide, who have survived suicide attempts, who are currently receiving care from [early intervention](#l-1) and [prevention](#l-3) [services](/usc/42/201.md?p=a), or who have completed suicide;
    - (F) qualified professionals who possess the specialized knowledge, skills, experience, and relevant attributes needed to serve [youth](#l-4) at risk for suicide and their [families](/usc/42/12704.md?p=11); and
    - (G) third-party payers, managed care organizations, and related commercial industries.
  - (3) **Policy development—** In carrying out this section, the [Secretary](/usc/42/201.md?p=c) shall—
    - (A) coordinate and collaborate on policy development at the Federal level with the relevant Department of Health and Human [Services](/usc/42/201.md?p=a) agencies and suicide working groups and the Department of Education, as appropriate; and
    - (B) consult on policy development at the Federal level with the private sector, including consumer, medical, suicide [prevention](#l-3) advocacy groups, and other health and education professional-based organizations, with respect to [State](/usc/42/300gg–91.md?p=d-14)-sponsored statewide or Tribal [youth](#l-4) suicide [early intervention](#l-1) and [prevention](#l-3) strategies.
- (f) **Rule of construction; religious and moral accommodation—** Nothing in this section shall be construed to require suicide assessment, [early intervention](#l-1), or [treatment services](/usc/42/300x–34.md?p=7) for [youth](#l-4) whose [parents](/usc/42/1396a.md?p=k-3) or legal guardians object based on the [parents](/usc/42/1396a.md?p=k-3)’ or legal guardians’ religious beliefs or moral objections.
- (g) **Evaluations and report—**
  - (1) **Evaluations by eligible entities—** Not later than 24 months after receiving a grant or cooperative [agreement](/usc/42/1320b–8.md?p=a-3-A) under this section, an [eligible entity](#b-1) shall submit to the [Secretary](/usc/42/201.md?p=c) the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or [agreement](/usc/42/1320b–8.md?p=a-3-A).
  - (2) **Report—** Not later than December 31, 2025, the [Secretary](/usc/42/201.md?p=c) shall submit to the appropriate committees of Congress a report concerning the results of—
    - (A) the evaluations conducted under [paragraph (1)](#g-1); and
    - (B) an evaluation conducted by the [Secretary](/usc/42/201.md?p=c) to analyze the effectiveness and efficacy of the activities conducted with grants, collaborations, and consultations under this section.
- (h) **Rule of construction; student medication—** Nothing in this section or [section 290bb–36a of this title](/usc/42/290bb–36a.md) shall be construed to allow [school](#l-2-C) personnel to require that a student obtain any medication as a condition of attending [school](#l-2-C) or receiving [services](/usc/42/201.md?p=a).
- (i) **Prohibition—** [Funds](/usc/42/12854.md?p=3) appropriated to carry out this section, [section 290bb–34 of this title](/usc/42/290bb–34.md), [section 290bb–36a of this title](/usc/42/290bb–36a.md), or [section 290bb–36b of this title](/usc/42/290bb–36b.md) shall not be used to pay for or refer for abortion.
- (j) **Parental consent—** [States](/usc/42/300gg–91.md?p=d-14) and entities receiving funding under this section and [section 290bb–36a of this title](/usc/42/290bb–36a.md) shall obtain prior written, informed consent from the [child](/usc/42/416.md?p=e)’s [parent](/usc/42/1396a.md?p=k-3) or legal guardian for assessment [services](/usc/42/201.md?p=a), [school](#l-2-C)-sponsored [programs](/usc/42/274l–1.md?p=4), and [treatment](/usc/42/11851.md?p=11) involving medication related to [youth](#l-4) suicide conducted in elementary and secondary [schools](#l-2-C). The requirement of the preceding sentence does not apply in the following cases:
  - (1) In an emergency, where it is necessary to protect the immediate health and safety of the student or other students.
  - (2) Other instances, as defined by the [State](/usc/42/300gg–91.md?p=d-14), where parental consent cannot reasonably be obtained.
- (k) **Relation to education provisions—** Nothing in this section or [section 290bb–36a of this title](/usc/42/290bb–36a.md) shall be construed to supersede [section 1232g of title 20](/usc/20/1232g.md), including the requirement of prior parental consent for the disclosure of any education records. Nothing in this section or [section 290bb–36a of this title](/usc/42/290bb–36a.md) shall be construed to modify or affect parental notification requirements for [programs](/usc/42/274l–1.md?p=4) authorized under the Elementary and Secondary Education Act of 1965 [[20 U.S.C. 6301](/usc/20/6301.md) et seq.] (as amended by the No [Child](/usc/42/416.md?p=e) Left Behind Act of 2001; Public Law 107–110).
- (l) **Definitions—** In this section:
  - (1) **Early intervention—** The term “early intervention” means a strategy or approach that is intended to prevent an outcome or to alter the course of an existing condition.
  - (2) **Educational institution; institution of higher education; school—** The term—
    - (A) “educational institution” means a [school](#l-2-C) or [institution of higher education](#l-2-B);
    - (B) “institution of higher education” has the meaning given such term in [section 1001 of title 20](/usc/20/1001.md); and
    - (C) “school” means an elementary school or secondary school (as such terms are defined in [section 8101](/usc/42/8101.md) of the Elementary and Secondary Education Act of 1965 [[20 U.S.C. 7801](/usc/20/7801.md)]).
  - (3) **Prevention—** The term “prevention” means a strategy or approach that reduces the likelihood or risk of onset, or delays the onset, of adverse health problems that have been known to lead to suicide.
  - (4) **Youth—** The term “youth” means individuals who are up to 24 years of age.
- (m) **Authorization of appropriations—** For the purpose of carrying out this section, there are authorized to be appropriated $40,000,000 for each of fiscal years 2023 through 2027.

## Source credit

(July 1, 1944, ch. 373, title V, § 520E, as added Pub. L. 108–355, § 3(c), Oct. 21, 2004, 118 Stat. 1409; amended Pub. L. 114–95, title IX, § 9215(kkk)(3), Dec. 10, 2015, 129 Stat. 2187; Pub. L. 114–255, div. B, title VI, § 6001(c)(1), title IX, § 9008(b), Dec. 13, 2016, 130 Stat. 1203, 1242; Pub. L. 116–260, div. BB, title III, § 315, Dec. 27, 2020, 134 Stat. 2932; Pub. L. 117–328, div. FF, title I, § 1422, Dec. 29, 2022, 136 Stat. 5702.)

## Notes

### Editorial Notes

### References in Text

The Social Security Act, referred to in subsecs. (a)(5) and (e)(2)(A), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Titles V, XIX, and XXI of the Act are classified generally to subchapters V (§ 701 et seq.), XIX (§ 1396 et seq.), and XXI (§ 1397aa et seq.), respectively, of chapter 7 of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables.

The Indian Self-Determination and Education Assistance Act, referred to in subsec. (b)(1)(C), is Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2203, which is classified principally to chapter 46 (§ 5301 et seq.) of Title 25, Indians. For complete classification of this Act to the Code, see Short Title note set out under section 5301 of Title 25 and Tables.

The Indian Health Care Improvement Act, referred to in subsec. (b)(1)(C), is Pub. L. 94–437, Sept. 30, 1976, 90 Stat. 1400, which is classified principally to chapter 18 (§ 1601 et seq.) of Title 25, Indians. For complete classification of this Act to the Code, see Short Title note set out under section 1601 of Title 25 and Tables.

The Elementary and Secondary Education Act of 1965, referred to in subsec. (k), is Pub. L. 89–10, Apr. 11, 1965, 79 Stat. 27, which is classified generally to chapter 70 (§ 6301 et seq.) of Title 20, Education. For complete classification of this Act to the Code, see Short Title note set out under section 6301 of Title 20 and Tables.

The No Child Left Behind Act of 2001, referred to in subsec. (k), is Pub. L. 107–110, Jan. 8, 2002, 115 Stat. 1425. For complete classification of this Act to the Code, see Short Title of 2002 Amendment note set out under section 6301 of Title 20, Education, and Tables.

### Prior Provisions

A prior section 290bb–36, act July 1, 1944, ch. 373, title V, § 520E, as added Pub. L. 106–310, div. B, title XXXI, § 3111, Oct. 17, 2000, 114 Stat. 1186, and amended, which related to suicide prevention for children and adolescents, was renumbered section 520E–1 of act July 1, 1944, by Pub. L. 108–355, § 3(b)(2), Oct. 21, 2004, 118 Stat. 1409, and transferred to section 290bb–36a of this title.

### Amendments

2022—Pub. L. 117–328, § 1422(2), substituted “Tribal” for “tribal” wherever appearing.

Subsec. (a)(1). Pub. L. 117–328, § 1422(3), inserted “pediatric health programs,” after “foster care systems,”.

Subsec. (b)(1)(B). Pub. L. 117–328, § 1422(4), amended subpar. (B) generally. Prior to amendment, subpar. (B) read as follows: “a public organization or private nonprofit organization designated by a State to develop or direct the State-sponsored statewide youth suicide early intervention and prevention strategy; or”.

Subsec. (b)(1)(C). Pub. L. 117–328, § 1422(1), substituted “Tribe” for “tribe”.

Subsec. (c)(1). Pub. L. 117–328, § 1422(5)(A), inserted “pediatric health programs,” after “foster care systems,”.

Subsec. (c)(7). Pub. L. 117–328, § 1422(5)(B), inserted “pediatric health programs,” after “foster care systems,”.

Subsec. (c)(9). Pub. L. 117–328, § 1422(5)(C), inserted “pediatric health programs,” after “educational institutions,”.

Subsec. (c)(15). Pub. L. 117–328, § 1422(5)(D)–(F), added par. (15).

Subsec. (d). Pub. L. 117–328, § 1422(6), substituted “suicide prevention activities” for “direct services” in heading and “suicide prevention activities” for “direct services, of which not less than 5 percent shall be used for activities authorized under subsection (a)(3)” in text.

Subsec. (e)(3)(A). Pub. L. 117–328, § 1422(7), inserted “and the Department of Education, as appropriate” after “agencies and suicide working groups”.

Subsec. (g)(1). Pub. L. 117–328, § 1422(8)(A), substituted “24” for “18”.

Subsec. (g)(2). Pub. L. 117–328, § 1422(8)(B), substituted “December 31, 2025” for “2 years after December 13, 2016”.

Subsec. (l)(4). Pub. L. 117–328, § 1422(9), substituted “up to 24 years of age” for “between 10 and 24 years of age”.

Subsec. (m). Pub. L. 117–328, § 1422(10), substituted “$40,000,000 for each of fiscal years 2023 through 2027” for “$30,000,000 for each of fiscal years 2018 through 2022”.

2020—Subsec. (b)(4). Pub. L. 116–260 added par. (4).

2016—Subsec. (a). Pub. L. 114–255, § 6001(c)(1), substituted “Assistant Secretary for Mental Health and Substance Use” for “Administrator of the Substance Abuse and Mental Health Services Administration” in introductory provisions.

Subsec. (a)(1). Pub. L. 114–255, § 9008(b)(1), substituted “substance use disorder” for “substance abuse”.

Subsec. (b)(2). Pub. L. 114–255, § 9008(b)(2)(A), substituted “ensure that a State does not receive more than 1 grant or cooperative agreement under this section at any 1 time” for “ensure that each State is awarded only 1 grant or cooperative agreement under this section” and “received” for “been awarded”.

Subsec. (b)(3). Pub. L. 114–255, § 9008(b)(2)(B), added par. (3).

Subsec. (c)(1), (7). Pub. L. 114–255, § 9008(b)(1), substituted “substance use disorder” for “substance abuse”.

Subsec. (g)(2). Pub. L. 114–255, § 9008(b)(3), substituted “2 years after December 13, 2016,” for “2 years after October 21, 2004,”.

Subsec. (m). Pub. L. 114–255, § 9008(b)(4), added subsec. (m) and struck out former subsec. (m) which authorized appropriations for fiscal years 2005 to 2007 and provided that the Secretary should give preference to certain States if less than $3,500,000 was appropriated for any fiscal year.

2015—Subsec. (l)(2)(C). Pub. L. 114–95 substituted “elementary school or secondary school (as such terms are defined in section 8101 of the Elementary and Secondary Education Act of 1965)” for “elementary or secondary school (as such terms are defined in section 9101 of the Elementary and Secondary Education Act of 1965)”.

### Statutory Notes and Related Subsidiaries

### Effective Date of 2015 Amendment

Amendment by Pub. L. 114–95 effective Dec. 10, 2015, except with respect to certain noncompetitive programs and competitive programs, see section 5 of Pub. L. 114–95, set out as a note under section 6301 of Title 20, Education.

### Congressional Findings

Pub. L. 108–355, § 2, Oct. 21, 2004, 118 Stat. 1404, provided that: “Congress makes the following findings: More children and young adults die from suicide each year than from cancer, heart disease, AIDS, birth defects, stroke, and chronic lung disease combined. Over 4,000 children and young adults tragically take their lives every year, making suicide the third overall cause of death between the ages of 10 and 24. According to the Centers for Disease Control and Prevention, suicide is the third overall cause of death among college-age students. According to the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention, children and young adults accounted for 15 percent of all suicides completed in 2000. From 1952 to 1995, the rate of suicide in children and young adults tripled. From 1980 to 1997, the rate of suicide among young adults ages 15 to 19 increased 11 percent. From 1980 to 1997, the rate of suicide among children ages 10 to 14 increased 109 percent. According to the National Center of Health Statistics, suicide rates among Native Americans range from 1.5 to 3 times the national average for other groups, with young people ages 15 to 34 making up 64 percent of all suicides. Congress has recognized that youth suicide is a public health tragedy linked to underlying mental health problems and that youth suicide early intervention and prevention activities are national priorities. Youth suicide early intervention and prevention have been listed as urgent public health priorities by the President’s New Freedom Commission in [probably should be “on”] Mental Health (2002), the Institute of Medicine’s Reducing Suicide: A National Imperative (2002), the National Strategy for Suicide Prevention: Goals and Objectives for Action (2001), and the Surgeon General’s Call to Action To Prevent Suicide (1999). Many States have already developed comprehensive statewide youth suicide early intervention and prevention strategies that seek to provide effective early intervention and prevention services. In a recent report, a startling 85 percent of college counseling centers revealed an increase in the number of students they see with psychological problems. Furthermore, the American College Health Association found that 61 percent of college students reported feeling hopeless, 45 percent said they felt so depressed they could barely function, and 9 percent felt suicidal. There is clear evidence of an increased incidence of depression among college students. According to a survey described in the Chronicle of Higher Education (February 1, 2002), depression among freshmen has nearly doubled (from 8.2 percent to 16.3 percent). Without treatment, researchers recently noted that ‘depressed adolescents are at risk for school failure, social isolation, promiscuity, self-medication with drugs and alcohol, and suicide—now the third leading cause of death among 10–24 year olds.’. Researchers who conducted the study ‘Changes in Counseling Center Client Problems Across 13 Years’ (1989–2001) at Kansas State University stated that ‘students are experiencing more stress, more anxiety, more depression than they were a decade ago.’ (The Chronicle of Higher Education, February 14, 2003). According to the 2001 National Household Survey on Drug Abuse, 20 percent of full-time undergraduate college students use illicit drugs. The 2001 National Household Survey on Drug Abuse also reported that 18.4 percent of adults aged 18 to 24 are dependent on or abusing illicit drugs or alcohol. In addition, the study found that ‘serious mental illness is highly correlated with substance dependence or abuse. Among adults with serious mental illness in 2001, 20.3 percent were dependent on or abused alcohol or illicit drugs, while the rate among adults without serious mental illness was only 6.3 percent.’. A 2003 Gallagher’s Survey of Counseling Center Directors found that 81 percent were concerned about the increasing number of students with more serious psychological problems, 67 percent reported a need for more psychiatric services, and 63 percent reported problems with growing demand for services without an appropriate increase in resources. The International Association of Counseling Services accreditation standards recommend 1 counselor per 1,000 to 1,500 students. According to the 2003 Gallagher’s Survey of Counseling Center Directors, the ratio of counselors to students is as high as 1 counselor per 2,400 students at institutions of higher education with more than 15,000 students.”