A growing number of Texans will have difficulty accessing mental health services unless steps are taken now to address a critical shortage of mental health professionals, according to a policy brief (PDF) published by the Hogg Foundation for Mental Health and Methodist Healthcare Ministries.
In 2009, 171 Texas counties lacked a psychiatrist, 102 counties lacked a psychologist, 48 counties lacked a licensed professional counselor and 40 counties lacked a social worker. Mental health professionals with the cultural and linguistic skills needed to serve the state's increasingly diverse population are especially difficult to find.
"As Texans, we can and must address this growing crisis by making access to mental health services a priority and taking steps to reduce shortages in the state's mental health workforce. The consequences of not addressing this critical shortage will cost Texas economically and result in poorer health outcomes statewide," said Dr. Octavio N. Martinez Jr., executive director of the Hogg Foundation.
Underlying causes include an aging workforce that's beginning to retire, recruitment and training challenges, lack of professional internship sites in Texas, a growing and increasingly diverse population, and inadequate pay and reimbursement rates in the public mental health system.
"The shortage of mental health professionals in our state, coupled with the cuts the Texas Legislature has proposed to programs that offer these services, will result in a crisis for families who are struggling to care for loved ones with mental illness," said Kevin C. Moriarty, president and chief executive officer of Methodist Healthcare Ministries in San Antonio.
One in four adults in the U.S. experiences a diagnosable mental illness in a given year. In Texas, an estimated 488,520 adults had a serious, persistent mental illness and an estimated 154,724 children had a severe emotional disturbance in fiscal year 2010. But only 33.6 percent of these adults and 28.9 percent of these children received services through their community mental health system.
"We also are losing talent we have fostered in our community, and the region is losing what should be considered a precious resource given the need that exists for that specialty," Moriarty added. He said Bexar County alone will have an estimated 160 fewer psychiatrists than needed by 2020, based on current and estimated census projections.
The policy brief identifies seven steps Texas can take now to begin reversing the growing shortage:
- Expand graduate education programs for behavioral health professionals, including psychiatry, psychology, social work, counseling and nursing.
- Expand the state's promotion of and investment in the certification of peer support specialists, and increase employers' awareness of the benefits of hiring them.
- Adequately reimburse mental health services to increase the number of mental health professionals who accept patients using Medicaid.
- Expand the types of reimbursable mental health services and the professionals who can provide them, such as social workers, community health workers and promotoras who provide counseling and case management services.
- Promote integrated health care in Texas by addressing barriers identified by a legislative workgroup and by ensuring that Medicaid reimbursement for mental health services is available for a variety of service delivery models.
- Develop tele-health opportunities for mental health providers, such as allowing Medicaid reimbursement for tele-health services of psychologists, social workers, counselors and other mental health professionals.
- Require professional boards to collect data that will aid in identifying specific racial, ethnic, cultural and linguistic workforce shortages.
View the policy brief (PDF) online.