Parents in Texas are worried about their children’s mental health. Children today are more anxious, less connected, and more likely to have experienced trauma than they were before the pandemic. Yet mental health disorders were alarmingly common — and increasing — in the years leading up to the pandemic. Over the past two decades, the rates of children and youth in Texas who felt hopelessness, struggled with anxiety or depression, and had thoughts of suicide have risen.
Parents are seeking help for their children’s mental health, but the type of services their children need is often beyond their family’s financial reach or simply unavailable. The children’s mental health crisis won’t be solved by any single program, agency, approach, or legislative session. It requires implementation of a range of strategies across multiple systems for years to come. Families, schools, and communities need state leaders to start now by making children’s mental health a priority in the 2023 legislative session.
Part I of this policy brief describes the children’s mental health crisis in Texas before and during the COVID-19 pandemic; how the challenges will endure without a concerted effort by policymakers, parents, and communities; and the pressures that will continue to build within schools, communities, and the state if meaningful action isn’t taken. We point out, for example, that in the decade prior to the pandemic, from 2009 to 2019, there was a 35 percent increase in the number of Texas high school students who reported that they attempted suicide.
Part II examines the progress Texas has made in supporting children’s mental health and some of the critical service gaps that remain. For example, since 2019, the Legislature has provided funding for school-based tele-mental health options for students through Texas Child Health Access Through Telemedicine (TCHATT), a project of the Texas Child Mental Health Care Consortium. Recognizing the importance of reaching students before they are in a mental health crisis, the Legislature also passed comprehensive student mental health legislation in 2019. But school districts are not able to implement and sustain comprehensive mental health strategies because the state does not provide a reliable or sufficient source of funding for them. Instead, districts receive school safety funding from the state that is unpredictable, limited to approximately $10 per student, and intended to cover everything from building security to school counselors.
Part II’s exploration of gaps also looks beyond schools to community-based services for children with intensive mental health needs. From April 2021 to March 2022, for example, 2,656 children statewide were on inquiry lists — essentially waiting lists — for mental health services provided through the state’s YES Waiver Program. The number of children on inquiry lists is nearly double the number of children who were enrolled in the YES program in any given quarter during those twelve months. Meanwhile, there are barriers to peer support services, delays in implementing mental health treatment options envisioned in SB 117 from the 2019 legislative session, hundreds of Texas children who are considered “underserved” by Local Mental Health Authorities, and ongoing concerns about Residential Treatment Centers (RTCs). Many of these challenges are exacerbated by mental health workforce shortages.
Part II also provides policy recommendations for state leaders to address these gaps. For example, our recommendations urge state leaders to provide dedicated, reliable mental health funding to Texas schools. Building on the steps that the Lieutenant Governor and Speaker of the House are considering this summer in response to the school massacre in Uvalde, our recommendations also call for providing funding to expand the state’s TCHATT tele-mental health program statewide. Additionally, several recommendations address the gaps in community-based services, such as increasing funding for Local Mental Health Authorities and considering the forthcoming recommendations from the SB 1575 workgroup on improving RTCs. Our recommendations also urge quick, efficient implementation of SB 1177 (2019) so families with children in Medicaid have cost-effective mental health options, such as crisis stabilization, Multisystemic Therapy (MST), and coordinated specialty care. This recommendation builds on the proposal that legislative leaders are currently considering to fund Multisystemic Therapy (MST) teams in its response to the Uvalde school shooting.
By pursuing these strategies, Texas leaders will ensure that parents and caregivers who are desperately looking for mental health support for their children have a better chance of helping their children grow up healthy and successful.