For nearly 75 years, the U.S. has observed May as Mental Health Awareness Month. At this unique point in the nation’s history, that long drive to turn awareness into progress continues with both propulsive force behind it and headwinds working against it.
On the one hand, for example, there’s the continued destigmatizing of mental health – a widespread effort to dismantle the long-standing, societally driven discouragement of talking about or seeking care for it.
On the other, there’s the sheer overwhelming human toll of a post-COVID-19 mental health crisis. The pandemic, combined with other associated and unassociated factors, has both created and crystallized behavioral health struggles for people of all ages.
Hospitals that offer behavioral health treatment are an indispensable piece of improving the nation’s mental well-being, and these competing factors affect their ability to do so. As a result, mental health awareness goes hand in hand with awareness of what hospitals need to successfully treat mental health conditions.
Fort Worth-based JPS Health Network, a system of acute-care facilities, has borne the brunt of the pandemic’s impact on Texas’ psyche.
“During the pandemic, our volumes really did not drop significantly. So we kept seeing patients, both inpatient and outpatient and in our psych emergency center. In ’21 and ’22, our volumes have gone up in all of those areas,” said Zelia Baugh, executive vice president of behavioral health at JPS. “Our psychiatric emergency center sees close to 20,000 patients a year in the psych ED. Our inpatient volumes have gone up, and our outpatient volumes have grown probably 20% year over year the last two years, because the demand has become much higher than it has in the past.”
For the Texas Hospital Association, May is a particularly appropriate month to shine a light on behavioral health. THA is spending this May – the final month of the Texas Legislature’s 2023 session – working to convince lawmakers to sign off on several major steps to make May not just a month of mental health awareness, but one of advancement.
The battle, then and now
Congress designated May as Mental Health Awareness Month in 1949, after the organization now known as Mental Health America first launched a week dedicated to mental health. Back then, the impetus for the month was the increasing mental illness among veterans who had returned from World War II. Nowadays, each annual Mental Health Awareness Month carries a theme; this year’s is “More Than Enough.” As the National Alliance on Mental Illness explains, “We want every person out there to know that if all you did was wake up today, that’s more than enough. … Showing up, just as you are, for yourself and the people around you is more than enough.”
Baugh calls the dedicated month a “great opportunity to raise awareness and be able to use it as a platform to educate the general public on what mental health is: how you can seek help, bring some normalcy to it instead of it being this thing [that’s] stigmatized somewhere else, so that people understand they don’t have to go through their challenges … [in] mental health alone, and that there is help out there, and how you can access some of those resources.”
But 74 years after its founding, on the heels of a pandemic that itself frequently elicited analogies to wartime, indicators of a mental health crisis abound, both because of COVID-19 and other factors.
Research from the Kaiser Family Foundation (KFF) shows that 90% of the public believes the U.S. is experiencing such a crisis, with 47% of parents reporting the pandemic had a negative impact on their child’s mental health. KFF data also shows that in February 2021 – about a year after the pandemic began – 39% of adults reported having symptoms of anxiety and/or depressive disorder. This past February, that number was still at 32%. And 2021 was the highest year for substance use deaths in U.S. history, with more than 106,000.
Just under 5,000 of those drug overdose deaths were in Texas, according to KFF’s analysis of U.S. Centers for Disease Control and Prevention data. Meanwhile, across Texas, patients don’t have the access to behavioral health services they need – partially because hospitals themselves need more.
“All of THA’s behavioral health priorities are centered around growing the continuum of care for mental health, growing the mental health workforce and increasing mental health inpatient and outpatient capacity in both state hospitals and private hospitals,” explains Sara González, vice president of advocacy & public policy for THA. “The demand for services far outpaces the supply, so anything we can do to create more infrastructure is a priority.”
To realize that boost to behavioral health infrastructure, THA is pushing for a wide array of legislative steps in line with its pre-session priorities.
From the session’s earliest days, for example, both chambers committed to a massive infusion of funds for the Loan Repayment Program for Mental Health Professionals, with the budget proposal from both allocating $28 million to the program over the next two years. The 2022-23 budget meted out just $2 million for that program. The current version of the budget also includes increased funds for community mental health grants and additional inpatient psychiatric beds in both rural and urban settings. And with the intertwinement of behavioral health and another top-level THA priority – workforce – steps to increase nurse staffing at hospitals across the state would help as well, Baugh said. THA-supported Senate Bill 25 by Sen. Lois Kolkhorst (R-Brenham), for one example, would provide wide-ranging support for nurse faculty training by expanding grants and offering scholarships and loan repayment.
The need for Mental Health Awareness Month will continue beyond the end of May, however, and so will continued advocacy for Texas hospitals’ behavioral health needs – even if THA comes away with major success in that area when the Legislature adjourns on May 29.
“Even after this session, based on the projected mental health needs in this state, continued investment in infrastructure and policies that support fixing foundational issues in the system will still be needed,” González said. “Things like building capacity not only in state hospitals, but also in hospitals across the state, continuing to grow the workforce and generally ensuring services are accessible to Texans everywhere.”