Texans have limited access to mental health professionals, but there is a way forward
The exacerbation of mental health needs during the COVID-19 pandemic further strained already overburdened health systems and exposed the shortcomings of a more structurally flawed system. Rates of depression and anxiety continue at more than three times their pre-pandemic levels, and research suggests these problems will only worsen as more people feel the effects of a 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 Report, Texas has 1 mental health worker for every 960 residents, a staggering ratio that is among the worst in the country. Before the pandemic, nearly 7 million Texans lived with mental illness and more than half received no care.
This latest crisis hits children especially, with emergency room visits for suicide among youth and young adults doubling and 6 in 7 youths with major depression nationwide not receiving treatment for their needs, according to a report from Texas. Tribune.
Senator John Cornyn, R-Texas, has long focused on the consequences of failing to provide timely care for mental health and substance abuse disorders. He recently co-authored a white paper with Senator Michael Bennet, D-Colorado, calling for a complete overhaul of America’s treatment of mental health. As leaders in impartial and data-driven political advocacy, Inseparable and the Meadows Mental Health Policy Institute strongly support Cornyn’s position and agree that our fundamental systems approaches to the delivery and payment of care must change.
Without early detection and treatment, the potential for mental health crises is much higher, to which police typically respond by default rather than trained health professionals or social workers who can provide people with the support they actually need. The result is unnecessary criminalization, a waste of resources and, too often, a tragedy.
People with mental illness are 16 times more likely to die in an encounter with law enforcement, according to the Treatment Advocacy Center. In fact, the Harris County Jail in Texas is “the largest mental health facility in the state,” according to Sheriff Ed Gonzalez, with 77% of inmates facing a mental health issue. We should not ask law enforcement officers to serve as mental health professionals; we need to have a better medically informed and motivated response to mental health crises.
Despite these grim realities, there is a better path that Cornyn supports. Recently, he introduced a bipartisan bill with Senator Catherine Cortez Masto, D-Nevada. This bill, Senate Bill 1902, would revolutionize the way mental health crises are handled in America, setting federal standards for crisis response, including universal, 24-hour access to designated emergency lines, emergency care facilities, stabilization and observation beds, and walk-in emergency care. It would also support grants to build crisis service capacity and technical assistance to train mental health professionals to defuse crisis situations and stabilize people facing mental health emergencies.
Perhaps most importantly, the bill provides coverage for mobile crisis teams and crisis stabilization services through Medicare, Medicaid, Affordable Care Act health plans, employer-sponsored coverage. , the federal employee health insurance program and by the VA and TRICARE. Currently, these vital crisis services are often not eligible for insurance reimbursement. Setting up and sustaining these services has therefore been piecemeal and costly.
The reforms envisioned by Cornyn’s bill have already proven their worth in Texas. Starting in 2018, Dallas launched the Rapid Integrated Group Healthcare Team (RIGHT Care) program, which provides a comprehensive emergency response to calls involving mental health emergencies. This system allows 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 and prison emergency departments to more useful care.
Dallas and Abilene were among the first cities in America to implement this type of system, and the results are extremely promising. Cornyn’s bill would put this gold standard of care within reach of an exponential number of people.
As leaders of non-partisan organizations advocating for better mental health care policy at national and state levels, we welcome this legislation and mobilize to help enact it.
Cornyn’s funding and crisis reforms offer a solid start, not just for Texans, but for all Americans who are in desperate need of better mental health care options. And the time has come.
Andy Keller is the leader of Texas’ Meadows Institute for Mental Health Policy.
Bill Smith is the founder of Inseparable.
They wrote this column for The Dallas Morning News.
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