As the Legislature responds to the heartbreaking school massacre in Uvalde, we appreciate policymakers’ interest in addressing the rise in children’s mental health challenges over the last decade. Too many desperate parents have struggled to find mental health support for their children across our state.
Because of the growing need for mental health services for kids in Texas, today we’re offering our expertise and perspective on the mental health steps currently under consideration at the Legislature. We hope the policy response to the Uvalde massacre will be a robust one, and we hope legislators acknowledge that firearm-related injuries are now the leading cause of death for children age one to nineteen in our country, according to analysis of CDC mortality data.
The Legislature Needs to Address Gaps in Community-Based Mental Health Services for Children with Significant Mental Health Needs, Including Those in Crisis.
Despite increased investment in recent years, there are still significant gaps in these services. For example, YES Waiver services are helping keep kids with their families and out of hospitals, residential treatment centers, and foster care — but many Texas families are stuck waiting for these services.
There are also delays in implementing mental health services envisioned in SB 1177 (2019). We’re pleased to see the Legislature’s proposed response to the Uvalde tragedy includes funding for Multisystemic Therapy (MST), coordinated specialty care, and pediatric crisis stabilization. Those important mental health services will reach more children if the Legislature also ensures that HHSC moves quickly to add them as Medicaid benefits, as directed by SB 1177, and ensures that the reimbursement rates are high enough for mental health providers to offer the service. As Speaker Dade Phelan recently noted, adding these services as Medicaid benefits would also help offset general revenue costs.
But We Must Also Reach Children BEFORE They Are in a Mental Health Crisis.
The Legislature’s current proposal, and many of the services currently in place in Texas, focus on stabilizing children when they are in crisis. It’s a key goal but can’t be the only approach.
Fortunately, the Legislature’s proposal to expand the Texas Child Mental Health Care Consortium’s TCHATT tele-mental health program, which currently reaches 40 percent of Texas school districts, is an important step to reach children before a crisis. Continuing that expansion during the next legislative session is one way to help close the gap in services for children before they are in a mental health crisis.
However, TCHATT on its own is not sufficient for reaching this goal.
To Reach Children Before They Are in Crisis, the Legislature Should Provide Dedicated School Mental Health Funding.
Schools can play a critical role reaching children before they are in crisis by providing low-intensity, non-clinical support to students and — for students who need a little more support — giving parents the opportunity to sign their kids up for mental health treatment.
Some school districts are able to identify funding sources to partner with community mental health providers, but Texas currently does not provide dedicated funding to support these school-based mental health services.
One way the Legislature could start providing dedicated, sustained school mental health funding is by increasing the School Safety Allotment funding and directing a portion of the Allotment to promote student mental wellness.
Additional Considerations
We also want to briefly flag the following considerations:
All of the Legislature's mental health efforts will also require work to build up the state’s mental health workforce. Bringing new services “online” won’t do any good if providers don’t have the staff to deliver those services — or if low reimbursement rates preclude providers from offering the services or treatments to families at all.
The Legislature should leverage new mental health resources to assist child care providers and school districts in addressing early childhood mental health concerns and helping children in child care and early elementary grades develop skills for managing conflict, anger, and anxiety.
As policymakers and education leaders discuss increasing the presence of school police as part of the response to the tragedy in Uvalde, it’s important to limit school police officers’ roles to law enforcement. Clearly defining their role will help officers avoid being called on to address school discipline and minor misbehavior, which can have particularly alarming consequences for children of color and students with disabilities.
Successful, healthy kids require strong, healthy families, so policies that help parents and families thrive are also part of the solution.
In the days ahead, we will be releasing additional research on children’s mental health challenges and potential Texas solutions. We look forward to sharing that research with you and continuing to work with our partners and legislators to ensure more Texas children are healthy and thriving.