25 U.S.C. § 1667 — Findings and purpose

Page 332 TITLE 25—INDIANS § 1665n (2) Report Not later than 2 years after March 23, 2010, the Secretary shall submit to the Committee on Indian Affairs of the Senate and the Com- mittee on Natural Resources of the House of Representatives a report that describes, with respect to the matters described in paragraph (1), the improvements made and needed, prob- lems or obstacles identified, and costs nec- essary to address the problems or obstacles, and any other recommendations that the Sec- retary determines to be appropriate. (Pub. L. 94–437, title VII, § 714, as added Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes CODIFICATION Section 714 of Pub. L. 94–437 is based on section 181 of title I of S. 1790, One Hundred Eleventh Congress, as re- ported by the Committee on Indian Affairs of the Sen- ate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148. PRIOR PROVISIONS A prior section 1665m, Pub. L. 94–437, title VII, § 714, as added Pub. L. 102–573, title VII, § 702(a), Oct. 29, 1992, 106 Stat. 4581, authorized appropriations through fiscal year 2000 to carry out this subchapter, prior to the gen- eral amendment of this subchapter by Pub. L. 111–148. § 1665n. Behavioral health research (a) In general The Secretary, in consultation with appro- priate Federal agencies, shall make grants to, or enter into contracts with, Indian tribes, tribal organizations, and urban Indian organizations or enter into contracts with, or make grants to ap- propriate institutions for, the conduct of re- search on the incidence and prevalence of behav- ioral health problems among Indians served by the Service, Indian tribes, or tribal organiza- tions and among Indians in urban areas. Re- search priorities under this section shall in- clude— (1) the multifactorial causes of Indian youth suicide, including— (A) protective and risk factors and sci- entific data that identifies those factors; and (B) the effects of loss of cultural identity and the development of scientific data on those effects; (2) the interrelationship and interdepend- ence of behavioral health problems with alco- holism and other substance abuse, suicide, homicides, other injuries, and the incidence of family violence; and (3) the development of models of prevention techniques. (b) Emphasis The effect of the interrelationships and inter- dependencies referred to in subsection (a)(2) on children, and the development of prevention techniques under subsection (a)(3) applicable to children, shall be emphasized. (Pub. L. 94–437, title VII, § 715, as added Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes CODIFICATION Section 715 of Pub. L. 94–437 is based on section 181 of title I of S. 1790, One Hundred Eleventh Congress, as re- ported by the Committee on Indian Affairs of the Sen- ate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148. PART B—INDIAN YOUTH SUICIDE PREVENTION § 1667. Findings and purpose (a) Findings Congress finds that— (1)(A) the rate of suicide of American Indi- ans and Alaska Natives is 1.9 times higher than the national average rate; and (B) the rate of suicide of Indian and Alaska Native youth aged 15 through 24 is— (i) 3.5 times the national average rate; and (ii) the highest rate of any population group in the United States; (2) many risk behaviors and contributing factors for suicide are more prevalent in In- dian country than in other areas, including— (A) history of previous suicide attempts; (B) family history of suicide; (C) history of depression or other mental illness; (D) alcohol or drug abuse; (E) health disparities; (F) stressful life events and losses; (G) easy access to lethal methods; (H) exposure to the suicidal behavior of others; (I) isolation; and (J) incarceration; (3) according to national data for 2005, sui- cide was the second-leading cause of death for Indians and Alaska Natives of both sexes aged 10 through 34; (4)(A) the suicide rates of Indian and Alaska Native males aged 15 through 24 are— (i) as compared to suicide rates of males of any other racial group, up to 4 times great- er; and (ii) as compared to suicide rates of females of any other racial group, up to 11 times greater; and (B) data demonstrates that, over their life- times, females attempt suicide 2 to 3 times more often than males; (5)(A) Indian tribes, especially Indian tribes located in the Great Plains, have experienced epidemic levels of suicide, up to 10 times the national average; and (B) suicide clustering in Indian country af- fects entire tribal communities; (6) death rates for Indians and Alaska Na- tives are statistically underestimated because many areas of Indian country lack the proper resources to identify and monitor the presence of disease; (7)(A) the Indian Health Service experiences health professional shortages, with physician vacancy rates of approximately 17 percent, and nursing vacancy rates of approximately 18 percent, in 2007; (B) 90 percent of all teens who die by suicide suffer from a diagnosable mental illness at time of death; Page 333 TITLE 25—INDIANS § 1667b (C) more than 1⁄2 of teens who die by suicide have never been seen by a mental health pro- vider; and (D) 1⁄3 of health needs in Indian country re- late to mental health; (8) often, the lack of resources of Indian tribes and the remote nature of Indian res- ervations make it difficult to meet the re- quirements necessary to access Federal assist- ance, including grants; (9) the Substance Abuse and Mental Health Services Administration and the Service have established specific initiatives to combat youth suicide in Indian country and among In- dians and Alaska Natives throughout the United States, including the National Suicide Prevention Initiative of the Service, which has worked with Service, tribal, and urban Indian health programs since 2003; (10) the National Strategy for Suicide Pre- vention was established in 2001 through a De- partment of Health and Human Services col- laboration among— (A) the Substance Abuse and Mental Health Services Administration; (B) the Service; (C) the Centers for Disease Control and Prevention; (D) the National Institutes of Health; and (E) the Health Resources and Services Ad- ministration; and (11) the Service and other agencies of the De- partment of Health and Human Services use information technology and other programs to address the suicide prevention and mental health needs of Indians and Alaska Natives. (b) Purposes The purposes of this part are— (1) to authorize the Secretary to carry out a demonstration project to test the use of tele- mental health services in suicide prevention, intervention, and treatment of Indian youth, including through— (A) the use of psychotherapy, psychiatric assessments, diagnostic interviews, thera- pies for mental health conditions predis- posing to suicide, and alcohol and substance abuse treatment; (B) the provision of clinical expertise to, consultation services with, and medical ad- vice and training for frontline health care providers working with Indian youth; (C) training and related support for com- munity leaders, family members, and health and education workers who work with In- dian youth; (D) the development of culturally relevant educational materials on suicide; and (E) data collection and reporting; (2) to encourage Indian tribes, tribal organi- zations, and other mental health care pro- viders serving residents of Indian country to obtain the services of predoctoral psychology and psychiatry interns; and (3) to enhance the provision of mental health care services to Indian youth through existing grant programs of the Substance Abuse and Mental Health Services Administration. (Pub. L. 94–437, title VII, § 721, as added Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes CODIFICATION Section 721 of Pub. L. 94–437 is based on section 181 of title I of S. 1790, One Hundred Eleventh Congress, as re- ported by the Committee on Indian Affairs of the Sen- ate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148. § 1667a. Definitions In this part: (1) Administration The term ‘‘Administration’’ means the Sub- stance Abuse and Mental Health Services Ad- ministration. (2) Demonstration project The term ‘‘demonstration project’’ means the Indian youth telemental health dem- onstration project authorized under section 1667b(a) of this title. (3) Telemental health The term ‘‘telemental health’’ means the use of electronic information and tele- communications technologies to support long- distance mental health care, patient and pro- fessional-related education, public health, and health administration. (Pub. L. 94–437, title VII, § 722, as added Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes CODIFICATION Section 722 of Pub. L. 94–437 is based on section 181 of title I of S. 1790, One Hundred Eleventh Congress, as re- ported by the Committee on Indian Affairs of the Sen- ate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148. § 1667b. Indian youth telemental health dem- onstration project (a) Authorization (1) In general The Secretary, acting through the Service, is authorized to carry out a demonstration project to award grants for the provision of telemental health services to Indian youth who— (A) have expressed suicidal ideas; (B) have attempted suicide; or (C) have behavioral health conditions that increase or could increase the risk of sui- cide. (2) Eligibility for grants Grants under paragraph (1) shall be awarded to Indian tribes and tribal organizations that operate 1 or more facilities— (A) located in an area with documented disproportionately high rates of suicide; (B) reporting active clinical telehealth ca- pabilities; or (C) offering school-based telemental health services to Indian youth. (3) Grant period The Secretary shall award grants under this section for a period of up to 4 years.