Let Me Be Brief: Addressing The Texas Mental Health Crisis

A series of briefs by Texas Medical Students

By: Jasmine Liu-Zarzuela, Isreal Munoz, Rozena Shirvani

Background

Addressing the Texas mental health crisis is a multifaceted challenge that requires the coordination of various entities and an approach that addresses the underlying causes. Some of the most important aspects of addressing the national mental health crisis is increasing access to mental health care services, improving mental health literacy among the general public, and promoting a collaborative effort between various sectors of society, including government agencies, healthcare providers, schools, employers, and community organizations.¹ Collaboration can help ensure that mental health resources are accessible, that policies and regulations support mental health, and that individuals receive the care and support they need to maintain appropriate mental health.

In accordance with the mental health of minors, The American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP) and the Children’s Hospital Association (CHA) declared a National State of Emergency
in Children’s Mental Health in 2021.² It is estimated that 16.5% of children under 18 have at least one mental health disorder, but about 49% did not receive treatment or counseling from a professional.³ To combat this, the 86th Texas Legislature created the Texas Child Mental Health Care Consortium that funded the Texas Child Health Access Through Telemedicine (TCHATT) initiative, which provides telehealth services at no cost to the school or students, such as mental health evaluations, short term therapy, psychiatric care, and referrals to long term treatment to students of participating districts.⁴ It is important to support funding for these initiatives as they aim to have resources in every school district in Texas; however, only about a third are estimated to be involved.⁴

TMA Policy

In June 2022, The TMA submitted written testimony that emphasizes the increasing need for mental health resources in Texas, particularly with the aftermath of the COVID-19 pandemic and incidences of gun violence, such as the Uvalde incident.^5-8 In fact, Texas has had more school shootings than any other state since 2012 with 43 incidents.⁹ In this testimony, TMA strongly encourages the importance of firearm safety promotion, mental health investments, and adolescent, family, and community interventions that foster resilience in the midst of childhood adversity. A key issue for the TMA agenda at the 2023 legislative session is preventing suicide and supporting Texans’ mental health. The TMA also has many policies aimed at increasing funding and coverage for services including:

• 55.033 Children’s Mental and Behavioral Health- supports improved
  access to mental health services and payment systems that fully integrate mental health care services in primary care¹⁰
• 145.019 Mental Health Equitable Treatment and Parity- supports lobbying state and federal government to increase scope of limited parity laws to include all mental health disorders and supports state funding for pilots to improve treatment ¹¹
• 215.019 Public Mental Health Care Funding & 215.020 Improved Funding for Mental Illness and Substance Use Disorder(s) – supports increasing funding from Texas Legislature for the mental health care system ^12,13
• 100.022 Emergency Psychiatric Services- supports funding to sustain and expand state investments to redesign mental health crisis services ¹⁴

Fast Facts

1. 198 (out of 254) Texas counties are considered Health Professional Shortage Areas for mental health.¹⁵
2. An additional 23 Texas counties are considered a mental health Health Professional Shortage Area for low-income populations. ¹⁵
3. 221 of 254 (87%) of Texas counties lack adequate mental health resources. ¹⁵
4. Among adults with serious mental illness, only 64.8% received mental health services in the past year. ¹⁶
5. The economic burden of mental illness in the United States is estimated to be $193.2 billion in lost earnings per year. ¹⁷

 Current Bills

Senate Bill 672 is a current bill that advises Texas Medicaid to construct a mental health collaborative care model.

Call to Action

It is imperative that medical professionals and students acknowledge the rising national mental health crisis and further promote awareness and create policy to ultimately improve health outcomes.

Resources

1. https://www.apa.org/news/press/releases/2022/11/mental-health-care-strains
2. https://www.texmed.org/uploadedFiles/Current/2016_Advocacy/Texas_Legislatur
   e/TMA-written-testimony-mental-health.pdf

References

1. Saxena, S., Funk, M., & Chisholm, D. (2020). World Health Assembly adopts resolution on mental health. The Lancet Psychiatry, 7(8), 655-656. https://doi.org/10.1016/S2215-0366(20)30306-5
2. AAP-AACAP-CHA declaration of a national emergency in child and adolescent mental health. (n.d.). Aap.org. Retrieved March 17, 2023, from https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in-child-and-adolescent-mental-health/
3. Spotlight 1: Prevalence of mental health services provided by public schools and limitations in schools’ efforts to provide mental health services. (n.d.). Bing. Retrieved March 17, 2023, from
   https://nces.ed.gov/programs/crimeindicators/ind_s01.asp
4. Texas child health access through telemedicine (TCHATT). (2021, July 27). MMHPI – Meadows Mental Health Policy Institute; Meadows Mental Health Policy Institute. https://mmhpi.org/project/texas-child-health-access-through-
   telemedicine-tchatt/
5. Kathirvel, N. (2020). Post COVID-19 pandemic mental health challenges. Asian journal of psychiatry, 53, 102430.
6. Vadivel, R., Shoib, S., El Halabi, S., El Hayek, S., Essam, L., Bytyçi, D. G., … & Kundadak, G. K. (2021). Mental health in the post-COVID-19 era: challenges and the way forward. General psychiatry, 34(1).
7. Shanbehzadeh, S., Tavahomi, M., Zanjari, N., Ebrahimi-Takamjani, I., & Amiri-Arimi, S. (2021). Physical and mental health complications post-COVID-19: Scoping review. Journal of psychosomatic research, 147, 110525.
8. Ren, F. F., & Guo, R. J. (2020). Public mental health in post-COVID-19 era. Psychiatria danubina, 32(2), 251-255.
9. States With the Most School Shootings. (2022, May 27). Usnews.com. Retrieved March 17, 2023, from https://www.usnews.com/news/best-states/articles/2022-
   05-27/states-with-the-most-school-shootings
10. 55.033 Childrens Mental and Behavioral Health. TMA Policy . (2022, June 14). Retrieved March 16, 2023, from
    https://www.texmed.org/Template.aspx?id=42554&terms=children+mental+
    health
11. 145.019 Mental Health Equitable Treatment Parity . TMA Policy. (2022, June 14). Retrieved March 16, 2023, from https://www.texmed.org/Template.aspx?id=42846&terms=mental+health+equitable+treatment
12. 215.019 Public Mental Health Care Funding. TMA Policy. (2021, July 21). Retrieved March 16, 2023, from https://www.texmed.org/Template.aspxid=43155&terms=public+mental+health+care+funding
13. 215.020 Improved Funding for Mental Illness and Substance Use Disorders.TMA Policy . (2020, October 29). Retrieved March 16, 2023, fromhttps://www.texmed.org/Template.aspx?id=43156&terms=improved+funding+for+mental+illness
14. 100.022 Emergency Psychiatric Services. TMA Policy. (2018, August 20). Retrieved March 16, 2023, from https://www.texmed.org/Template.aspx?id=42696&terms=psychiatric+services
15. Special committee to protect all Texans. (2022). Texmed.org. https://www.texmed.org/uploadedFiles/Current/2016_Advocacy/Texas_Legislature/TMA-written-testimony-mental-health.pdf
16. Mental illness. (n.d.). National Institute of Mental Health (NIMH). Retrieved March17, 2023, from https://www.nimh.nih.gov/health/statistics/mental-illness
17. Mental disorders cost society billions in unearned income. (2015, September 19).National Institutes of Health (NIH). https://www.nih.gov/news-events/news-releases/mental-disorders-cost-society-billions-unearned-income