More than 4.3 million Texans, including 1.2 million children, live with some form of mental health disorder. Of these, 1.5 million cannot function at work, school, or in the community. Over the past decade, reduced state funding eroded Texas’ ability to care for patients with mental disorders. As the availability of services declined, these patients, insured and uninsured alike, had to seek care in hospital emergency rooms. Texas’ prison system also warehouses mentally ill patients who are waiting for a psychiatric bed or community help to become available. Mental illness costs the state and local governments more than $1.5 billion per year. Each person repeatedly jailed, hospitalized, or admitted to a detoxification center costs the state $55,000 per year.
In 2007, legislators invested $82 million to redesign the state’s mental health crisis system. Even though the new funds only represent about 5 percent of local mental health authorities’ (LMHAs’) budgets, it was a much-needed boost. LMHAs were directed to use the funds to support 24/7 crisis hotlines and mobile crisis outreach teams to respond to crises at schools, homes, or other settings. Other services that LMHAs may develop include expanded outpatient services, extended observation services (up to 48 hours), 14-day crisis stabilization units, and coverage of costs incurred by local law enforcement transporting patients with behavioral health needs. Congress passed legislation in 2008 that requires group health plans with 51 or more employees to treat mental health disorders the same as other medical conditions. Mental health parity in health coverage is an important step. However, much more is needed to ensure Texans with mental health disorders receive the care they need.
Medicine’s 2009 Agenda
- Support funding to expand the availability of community-based mental health care for adults and children, including prevention and early intervention.
- Support funding to sustain, expand state investments to redesign mental health crisis services.
- Texas ranks 49th in the nation for per-person spending on mental health care. Inadequate state funding puts the burden on local resources, and increases rates of incarceration and use of public hospital emergency rooms, homeless shelters, and the foster care system.