Texans Have the Lowest Access to Mental Health Professionals but There is a Path Forward

This article was written by Bill Smith and Meadows Institute CEO Andy Keller and was originally published by Dallas Morning News on November 5, 2021.

The exacerbation of mental health needs during the COVID-19 pandemic has put even more strain on already overburdened health systems and laid bare the inadequacies of a more structurally flawed system. Rates of depression and anxiety continue at more than three times their pre-pandemic levels, and research suggests that these problems will only get worse as more people feel the effects of continued isolation and disruption of social support.

Texas is in dire need of mental health professionals. According to Mental Health America’s 2020 Access to Care Data report, Texas has 1 mental health worker for every 960 residents, a staggering ratio that is among the worst in the country. Pre-pandemic, nearly 7 million Texans lived with a mental illness, and over half received no care.

This latest crisis is hitting children especially hard, with emergency room visits for suicide among youth and young adults doubling and 6 out of every 7 youths with major depression nationwide not receiving treatment for their needs, according to reporting by The Texas Tribune.

Sen. John Cornyn, R-Texas, has long been focused on the consequences of failing to provide timely care for mental health and substance use disorders. He recently co-authored a white paper with Sen. Michael Bennet, D-Colorado, calling for a complete overhaul of America’s treatment of mental health. As leaders in data-driven and unbiased policy advocacy, Inseparable and the Meadows Mental Health Policy Institute strongly support Cornyn’s position and agree that our fundamental systemic approaches to delivering and paying for care must change.

Without early detection and treatment, there is far higher potential for mental health crises, which are usually responded to by police by default instead of trained medical professionals or social workers who can provide people with the support they actually need. This results in unnecessary criminalization, wasted resources and, too often, tragedy.

People with mental illness are 16 times more likely to die in an encounter with law enforcement, per the Treatment Advocacy Center. In fact, Texas’ Harris County Jail serves as “the largest mental health facility in the state,” according to Sheriff Ed Gonzalez, with 77% of inmates experiencing a mental health challenge. We should not ask law enforcement officers to serve as mental health professionals; we must have a better, medically informed, driven response to mental health crises.

Despite these grim realities, there is a better path that Cornyn supports. Recently, he introduced a bipartisan bill with Sen. Catherine Cortez Masto, D-Nevada. That bill, Senate Bill 1902, would revolutionize the way mental health crises are handled in America, establishing federal standards for crisis response, including universal, around-the-clock access to designated crisis hotlines, urgent care facilities, stabilization and observation beds, and walk-in urgent care. It would also support grants to establish crisis service capacity and technical assistance to train mental health professionals to de-escalate crisis situations and stabilize individuals experiencing mental health emergencies.

Perhaps most important, the bill provides coverage of mobile crisis teams and crisis stabilization services by Medicare, Medicaid, Affordable Care Act health plans, employer-sponsored coverage, the Federal Employee Health Benefits Program, and by the VA and TRICARE. Currently, these vital crisis services are often ineligible for insurance reimbursement. So establishing and supporting these services have been piecemeal and costly.

The reforms that Cornyn’s bill envisions have already proved to work in Texas. Starting in 2018, Dallas launched the Rapid Integrated Group Healthcare Team (RIGHT Care) program, which provides comprehensive emergency response to calls involving mental health emergencies. This system allows for specially trained and equipped paramedics, mental health professionals and police officers to respond as a single coordinated team. In Abilene, we see a similar system where a Community Response Team works to redirect mental health emergencies away from hospital emergency departments and jails into more helpful care.

Dallas and Abilene were among the first cities in America to institute this kind of system, and the results are enormously promising. Cornyn’s bill would bring this gold standard of care within the reach of exponentially more people.

As leaders of nonpartisan organizations that advocate for better mental health care policy on the national and state levels, we commend this legislation and are mobilizing to help enact it.

Cornyn’s financing and crisis reforms provide a solid start, not only for Texans, but for all Americans in desperate need of better mental health care options. And the time is now.

The full article is available online here.