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Mental Health Makes a Comeback in Texas

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Getting needed treatment for anxiety, depression, bipolar disorder or a substance use problem has long been difficult in Texas. Almost two million adult and youth Texans need substance use treatment and about a million more need mental health treatment. Yet, only a fraction actually get the care they need.  

The severe shortage of behavioral health providers, long waitlists for services and insurance challenges are pervasive barriers to behavioral health treatment.

Historically underfunded, the state’s behavioral health care system is difficult to navigate and lacks sufficient number of providers to treat the rapidly growing population of vulnerable Texans. In 2015, 185 Texas counties did not have a single psychiatrist, which left more than 3 million Texans with­out access to a physician who can diagnose and prescribe medications for a given disorder.  The physical deterioration of the state’s psychiatric facilities has resulted in reduced inpatient care capacity. More than 350 inpatient beds in state psychiatric care facilities were unfit for use in 2016 because the facilities didn’t meet current patient safety and quality standards.

In recent years, the Texas Legislature has recognized the need to address these challenges and has begun to transform the behavioral health system. During the 2015 legislative session, lawmakers increased behavioral health funding by $1 billion from the previous biennium.

And in the interim leading up to the 2017 legislative session, Speaker of the Texas House of Representatives Joe Straus (R-San Antonio) and Lt. Gov. Dan Patrick (R) asked lawmakers to study several mental health issues, with Speaker Straus convening the Select Committee on Mental Health to take a comprehensive look at the state’s behavioral health system.

In the home stretch to the end of the 85th legislative session, lawmakers at the Texas Capitol are building on that momentum in a big way. They’re heeding recommendations from the Select Committee on Mental Health and focusing on ways to increase access to timely, medically necessary behavioral health treatment.

From the $63 million to reduce waiting lists for community mental health services and the significant investment to improve state psychiatric hospitals put forth by Senate Finance Committee chair, Sen. Jane Nelson (R-Flower Mound), to the numerous, bipartisan pro-mental health bills, lawmakers are demonstrating their commitment to improving behavioral health treatment in the Lone Star State.  

One, House Bill 10, will give the Texas Department of Insurance more authority to fully enforce the existing mental health parity law and prohibit health plans from disproportionately limiting treatment for mental health and substance use conditions than for physical health conditions. Texans with depression would be treated the same, in terms of benefits or provider access, as someone with a heart condition.

Another bill, House Bill 3083, would increase access to substance use treatment by growing the drug and alcohol provider workforce.  The legislation would address the 80 percent of Texas counties that have too few behavioral health providers to meet residents’ needs by incentivizing licensed chemical dependency counselors to serve low-income and uninsured populations in exchange for loan repayment assistance, which lawmakers created for behavioral health professionals last session.

While the obstacles to obtain behavioral health care are persistent, these measures taken with the state’s continued investment in behavioral health care will significantly improve treatment access. Texas hospitals appreciate the 85th Legislature’s commitment to improving behavioral health care for all its residents.

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