With the 89th Texas Legislature now in session and COVID-19 relief funds from the American Rescue Plan expiring, advocates are asking Texas lawmakers to prioritize mental health.
“The Texas Legislature has made historic, life-saving investments in mental health over the last decade,” Andy Keller, president and CEO of the Meadows Mental Health Policy Institute, told the Texas Tribune. “The 89th legislative session presents an opportunity to build on that commitment.”
During the previous Texas legislative session, $11.6 billion of the state’s $312 billion budget was committed to mental health services. Approximately 1.37% of that $11.6 billion was set aside to account for the mental health workforce shortage. Measures included increasing salaries for mental health workers, with an emphasis on those in crisis and hospital programs. Texas Senate Bill 532 was also passed, which allowed mental health professionals working in the public sector to apply for student loan repayment programs after three years, instead of five years.
The Mental Health Needs of Harris County 2024 report said the investment “marked a historic milestone by committing unprecedented funding to mental health initiatives.” The report was prepared by the Mental Health Needs Council of Harris County, which includes the Kinder Institute for Urban Research as a member organization.
Despite having more dedicated funding for mental health, there are shortfalls throughout the system, including the state’s suicide hotline operating at a $7 million deficit, according to another Texas Tribune report.
Harris County’s mental health workforce shortage can be measured by several metrics. Currently, 246 out of 254 Texas counties, including Harris County, are fully or partially classified as mental health professional shortage areas. Any area with a ratio of 30,000 citizens to 1 mental health provider or 20,000 to 1 if there are “unusually high needs in the community” is considered a shortage area.
The Health Resources and Services Administration designated Harris County as a health professional shortage area based on its number of low-income residents.
The Harris Center for Mental Health and Intellectual and Developmental Disabilities has been impacted by the shortage. The Mental Health Needs of Harris County 2024 analysis indicated that it took an average of 300 days to fill vacant psychiatrist positions. For nurses, physician assistants, doctors and pharmacists it took an average of 182 days.
Ninfa Escobar is the interim vice president for human resources at the Harris Center and oversees talent acquisition. She said the length of time it takes to go from an undergraduate student to a clinical therapist is among the biggest challenges when hiring candidates.
“In the last fiscal year, our time to fill all positions was under 45 days,” Escobar said. “We did make a big improvement. The amount of education and time that’s dedicated to becoming a licensed clinical therapist is a long road. We have to be there along the road with them, so that when the time comes to decide where they would like to work, they consider our organization.”
In 2020, the Statewide Behavioral Health Coordinating Council published a report that recommended establishing pipelines into the mental health profession by increasing entry-level employment opportunities for high school and undergraduate students, which has been implemented at the Harris Center.
“One of the exciting things we’re doing is really investing in our internship experience,” Escobar said. “We’ve learned that we need to get ahead of the therapist. We need to get them while they’re trying to become therapists, and bring them into the Harris Center so that they can see the day to day, and then give them a great experience while they're here.”
Despite having success through its internship program, Escobar said there are more applicants than staff members who can serve as mentors. The Harris Center launched a new program this month in hopes that more employees will help teach students.
“If we don’t continue to build the pipeline, we’re going to continue to be in need of help,” Escobar said. “We’re going to give participants in the preceptor initiative program a stipend in hopes that they raise their hand, saying that they’re willing to guide students.”
Multiple pieces of legislation addressing mental health and the workforce shortage have been filed for the current Texas legislative session. On Thursday, Sen. Kevin Sparks introduced several pieces of health legislation, including Senate Bill 469, which would expand the range of providers eligible for mental health work and provide financial reimbursements.
“Texas’ health care workforce is in the midst of a crisis,” Sparks said in a statement. “Too many families face challenges accessing the health care required to live. By reducing regulations for physicians, expanding telehealth and removing barriers for mental health professionals, we can build a stronger health care workforce and a healthier future for our communities.”
