Mental Health in International Development and Humanitarian Settings Act or the MINDS Act
This bill directs the U.S. Agency for International Development (USAID) and the Department of State to integrate mental health and psychosocial support activities across all U.S. foreign assistance programs, with a particular focus on children and other vulnerable populations.
To facilitate this integration, the bill makes organizational changes at the USAID. It authorizes the USAID to appoint a coordinator to oversee and direct mental health and psychosocial support activities. The coordinator must ensure that these activities focus on children, adult caretakers and families, displaced populations, and other vulnerable groups. In addition, the bill establishes a working group comprised of representatives from every USAID bureau and the Department of State to coordinate interagency efforts related to, promote best practices for, and ensure sustainability and continuity of mental health and psychosocial support activities.
The USAID and the State Department must brief Congress about the amount of foreign assistance spending on mental health and psychosocial support activities and related matters.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3988 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 3988
To enhance mental health and psychosocial support within United States
foreign assistance programs.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 17, 2021
Mr. Deutch (for himself, Mr. Wilson of South Carolina, Ms. Titus, Mr.
McGovern, Ms. Jacobs of California, Mr. Sires, Mr. Castro of Texas, Mr.
Moulton, Ms. Bass, and Mr. Fitzpatrick) introduced the following bill;
which was referred to the Committee on Foreign Affairs
_______________________________________________________________________
A BILL
To enhance mental health and psychosocial support within United States
foreign assistance programs.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Mental Health in International
Development and Humanitarian Settings Act'' or the ``MINDS Act''.
SEC. 2. FINDINGS; SENSE OF CONGRESS.
(a) Findings.--Congress finds the following:
(1) According to the 2016 Global Burden of Disease Study,
an estimated 1,000,000,000 individuals worldwide have a mental
health or substance use disorder. Mental disorders are major
contributors to the global burden of disease, and depression is
among the primary causes of illness and disability in
adolescents.
(2) An individual's mental health is a complex interaction
between genetic, neuropsychological, and environmental factors,
and environmental and social factors, from the early years
through childhood and adolescence, can have long-term impacts
on mental health.
(3) According to a Lancet Commission report, allocations
for mental health have never risen above 1 percent of health-
related global development assistance. Estimates indicate that
child and adolescent mental health receives just 0.1 percent of
health-related global development assistance.
(4) The National Alliance on Mental Illness estimates that
depression and anxiety disorders cost the global economy
$1,000,000,000,000 in lost productivity each year. According to
Lancet, mental health disorders are projected to cost the
global economy $16,000,000,000,000 between 2010 and 2030, in
part due to the early age of onset.
(5) According to the World Health Organization (WHO), half
of mental health disorders emerge by age 14, and 14 percent of
children and adolescents worldwide experience mental health
conditions, the majority of whom do not seek care, receive
care, or have access to care.
(6) Exposure to violence and early childhood adversity,
including trauma, has been linked to negative, lasting effects
on physical and mental health. Early childhood adversity can
impact brain development, nervous and immune system
functioning, the onset of mental health conditions, and future
behaviors. The United Nations asserts that widespread school
closures due to COVID-19, which have affected roughly
1,500,000,000 school-aged children, have placed many children
at higher risk of exposure to traumas, such as household
violence, abuse, neglect, and food insecurity.
(7) According to the United Nations, more than 1 out of
every 5 individuals in conflict-affected areas has a mental
health disorder. Roughly 1,500,000,000, or 2 out of every 3 of
the world's children under 18 years of age live in countries
affected by conflict, and more than 1 out of every 6 children
live in conflict zones. A greater number of children live in
areas affected by armed conflict and war now than at any other
point this century. The mental health burden in conflict-
affected contexts is twice the global average.
(8) Gender, age, disability status, race and ethnicity, and
other identity characteristics contribute to different risks
and needs for mental health and psychosocial support. Research
has shown that harmful gender norms contribute to higher
prevalence of depression and anxiety disorders in women and
girls, while socialization of boys and men contributes to
higher prevalence of substance use disorders.
(9) Risks and experiences of gender-based violence,
particularly sexual violence, are a key driver of mental health
and psychosocial support needs for children. Girls account for
98 percent of verified incidents of conflict-related sexual
violence. According to the World Health Organization, 35
percent of women globally ``face sexual and/or intimate partner
violence in their lifetime'' and these survivors can, according
to the Centers for Disease Control and Prevention, ``experience
mental health problems such as depression and posttraumatic
stress disorder (PTSD) symptoms'', signifying the urgent need
for age and gender-responsive mental health and psychosocial
support services.
(10) According to the World Health Organization, risk
factors that increase susceptibility to mental health disorders
include poverty and hunger, chronic health conditions, trauma
or maltreatment, social exclusion and discrimination, and
exposure to and displacement by war or conflict. These risk
factors, along with demographic risk factors, manifest at all
stages in life. Preliminary research already illustrates that
the COVID-19 pandemic has increased communities', families',
and individuals' risk factors for multiple types of adversity
and compounded preexisting conditions and vulnerabilities.
(11) Crisis situations put parents and caregivers under
mental and psychosocial duress, which can prevent them from
providing the protection, stability and nurturing care their
children need during and after an emergency. The Lancet
Commission estimates that between 15 and 23 percent of children
globally live with a parent with a mental disorder, and
parental ill health can impact the emotional and physical
development of children and predispose these children to mental
health problems. Numerous and compounding stressors and
uncertainty caused by COVID-19 have exacerbated distress and
further impede caregivers' ability to provide responsive care
to their children.
(12) Investments in the mental health, resilience, and
well-being of the children in a country to ensure that they
continue to thrive into adulthood and contribute to their
societies can help break cycles of poverty, violence, and
trauma and further the country's future potential.
(13) Investments in protecting and improving mental health
in a country across the life course must take into account the
need to target vulnerable populations and address social,
environmental, and other risk factors in conjunction with other
sectors and local partners.
(b) Sense of Congress.--It is the sense of Congress that--
(1) ensuring that individuals have the opportunity to
thrive and reach their fullest potential is a critical
component of sustainable international development, and the
global public good benefits from investment in child and
adolescent mental health;
(2) mental health is integral and essential to overall
health outcomes and other development objectives;
(3) mental health is an issue of critical and growing
importance for United States foreign assistance that requires a
coordinated strategy to ensure that programming funded by the
United States Government is evidence-based, culturally
competent, and trauma-informed;
(4) the United States Government foreign assistance
strategy should include a mental health and psychosocial
support component;
(5) the redesign of the United States Agency for
International Development (referred to in this Act as
``USAID'') reflects the nexus between humanitarian and
development interventions and should be applied to all mental
health and psychosocial support efforts of United States
foreign assistance programs; and
(6) ongoing efforts to improve social service workforce
development and local capacity building are essential to
expanding mental health and psychosocial support activities
across all United States foreign assistance programs.
SEC. 3. COORDINATOR FOR MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT.
Section 135 of the Foreign Assistance Act of 1961 (22 U.S.C. 2152f)
is amended--
(1) by redesignating subsection (f) as subsection (g); and
(2) by inserting after subsection (e) the following:
``(f) Coordinator for Mental Health and Psychosocial Support.--
``(1) Appointment.--The Administrator of the United States
Agency for International Development, in consultation with the
Secretary of State, is authorized to appoint a Mental Health
and Psychosocial Support Coordinator (referred to in this
section as the `MHPSS Coordinator').
``(2) Specific duties.--The duties of the MHPSS Coordinator
shall include--
``(A) establishing and chairing the Mental Health
and Psychosocial Support Working Group authorized under
section 4 of the Mental Health in International
Development and Humanitarian Settings Act;
``(B) guiding, overseeing, and directing mental
health and psychosocial support programming and
integration across United States foreign assistance
programming;
``(C) serving as the main point of contact on
mental health and psychosocial support in the Bureau
for Global Health, Bureau for Humanitarian Assistance,
regional bureaus, the Office of Education, the
Inclusive Development Hub in the Bureau of Development,
Democracy, and Innovation, the President's Emergency
Plan for AIDS Relief, and other interagency or
presidential initiatives;
``(D) promoting best practices, coordination and
reporting in mental health and psychosocial support
programming across both development and humanitarian
foreign assistance programs;
``(E) providing direction, guidance, and oversight
on the integration of mental health and psychosocial
support in both development and humanitarian foreign
assistance programs; and
``(F) participating in the Advancing Protection and
Care for Children in Adversity Interagency Working
Group.
``(3) Focus populations.--Along with a general focus on
mental health and psychosocial support, the MHPSS Coordinator
should pay special attention to mental health and psychosocial
support in the context of family and children, including--
``(A) meeting the needs of adult caretakers and
children, including families and adults who are long-
term caretakers;
``(B) children and others who are separated from a
family unit; and
``(C) other specific populations in need of mental
health and psychosocial support, such as crisis
affected communities, displaced populations, gender-
based violence survivors, and individuals and
households coping with the consequences of diseases,
such as Ebola, HIV/AIDS, and COVID-19.''.
SEC. 4. MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT WORKING GROUP.
(a) Establishment.--The Administrator of the United States Agency
for International Development (referred to in this Act as the ``USAID
Administrator''), in cooperation with the Mental Health and
Psychosocial Support Coordinator, shall establish the Mental Health and
Psychosocial Support Working Group, which shall include representatives
from every United States Agency for International Development bureau
and from the Department of State, to ensure continuity and
sustainability of mental health and psychosocial support across foreign
assistance programs.
(b) Requirements.--The Mental Health and Psychosocial Support
Working Group--
(1) should include representation at the Deputy Assistant
Administrator level from every United States Agency for
International Development bureau;
(2) shall promote and encourage dialogue across the
interagency on mental health and psychosocial support program
development and best practices; and
(3) shall coordinate the implementation and continuity of
mental health and psychosocial support programs--
(A) within USAID;
(B) between the USAID and the Bureau of Population,
Refugees, and Migration of the Department of State; and
(C) in consultation with the Centers for Disease
Control and Prevention and the National Institutes of
Mental Health, as appropriate.
SEC. 5. INTEGRATION OF MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT.
(a) Statement of Policy.--It is the policy of the United States to
integrate mental health and psychosocial support across all foreign
assistance programs funded by the United States Government.
(b) Implementation of Policy.--The USAID Administrator and the
Secretary of State shall--
(1) require all USAID and Department of State regional
bureaus and missions to utilize such policy for local capacity
building, as appropriate, for mental health and psychosocial
support programming;
(2) ensure that all USAID and Department of State mental
health and psychosocial support programming--
(A) is evidence-based and culturally competent;
(B) responds to all types of childhood adversity;
and
(C) includes trauma-specific interventions in
accordance with the recognized principles of a trauma-
informed approach, whenever applicable; and
(3) integrate the Advancing Protection and Care for
Children in Adversity Strategy into its official policy.
SEC. 6. BRIEFING REQUIREMENTS.
(a) USAID Briefing.--Not later than 180 days after the date of the
enactment of this Act, the USAID Administrator and the Secretary of
State shall brief the Committee on Foreign Relations of the Senate and
the Committee on Foreign Affairs of the House of Representatives
regarding--
(1) the progress made in carrying out section 5(b); and
(2) any barriers preventing the full integration of the
strategy referred to in section 5(b)(3).
(b) Briefing on Spending.--The USAID Administrator, in consultation
with the Director of the Office of Management and Budget, as necessary
and appropriate, shall annually brief the Committee on Appropriations
of the Senate and the Committee on Appropriations of the House of
Representatives during each of the fiscal years 2022 through 2026
regarding the amount of United States foreign assistance spent during
the most recently concluded fiscal year on child mental health and
psychosocial support programming.
(c) USAID and Department of State Briefings.--Not later than 180
days after the date of the enactment of this Act, annually thereafter
for the following 5 fiscal years, and subsequently, as requested, the
USAID Administrator and the Secretary of State, in consultation with
the Mental Health and Psychosocial Support Coordinator appointed
pursuant to section 135(f) of the Foreign Assistance Act of 1961, as
added by section 3, shall brief the Committee on Foreign Relations of
the Senate and the Committee on Foreign Affairs of the House of
Representatives regarding--
(1) how USAID and the Department of State have integrated
mental health and psychosocial programming, including child-
specific programming, into their development and humanitarian
assistance programs across health, education, nutrition, and
child protection sectors;
(2) the metrics of success of the Advancing Protection and
Care for Children in Adversity Strategy;
(3) the mental health outcomes pertaining to the evidence-
based strategic objectives upon which such strategy is built;
(4) where trauma-specific strategies are being implemented,
and how best practices for trauma-informed programming are
being shared across programs;
(5) barriers preventing full integration of child mental
health and psychosocial support into programs for children and
youth and recommendations for its expansion;
(6) any unique barriers to the expansion of mental health
and psychosocial support programming in conflict and
humanitarian settings and how such barriers are being
addressed;
(7) the impact of the COVID-19 pandemic on mental health
and psychosocial support programming; and
(8) funding data, including a list of programs to which
USAID and the Department of State have obligated funds during
the most recently concluded fiscal year to improve access to,
and the quality of, mental health and psychosocial support
programming in development and humanitarian contexts.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Foreign Affairs.
Ordered to be Reported (Amended) by Voice Vote.
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