Good News on Mental Health in Texas

Monica Villarreal, CPPP staff, Hogg Mental Health Policy Fellow

Building on the state’s recent progress in mental health capacity and quality is a top priority for lawmakers this Legislative Session, as identified in the interim report by the House Select Committee on Mental Health. CPPP is pleased to see this comprehensive and timely report.

The report provides a detailed review of eight public hearings held across the state, each of which looked at Texas’ mental health needs and best practices. The report’s 79 recommendations reflect a high level of interest in combating mental and behavioral health challenges with a call to action for the work ahead:

“If we fail to adequately invest and earnestly address the issues now, we do so at our own peril because the societal, medical and criminal justice costs alone will be extremely high.”

A number of the recommendations in the report will require additional state investment in mental health. The recently introduced House budget includes a placeholder to set aside funding to invest in the proposed recommendations from the Committee, in the form of $95.6 million in General Revenue Funds contingent on passage of legislation produced by the House Select Committee on Mental Health.

The Committee’s “charges” did not specifically direct the study of barriers to mental health care for Texas’ uninsured. The committee did explore in depth the barriers that can still face the insured population, those presented by workforce shortages, and the best practices in treatment options and preventive integration with criminal justice systems.

CPPP Priorities are among the committee report’s key focus areas:

Insurance Coverage: Parity

The report identifies mental health parity as a complex issue involving health insurance companies providing (or not) mental health and substance use disorder care coverage that is no more restrictive than coverage of medical services.

The report points out that the Texas Department of Insurance (TDI) has limited authority or enforcement capabilities when it comes to mental health parity. To address this issue the Committee recommends that the Legislature “enact a mental health “Parity” state law” to ensure that mental health parity protections are regulated and enforced in the state.

Criminal Justice and Jail Diversion

The Committee also identified issues of the intersections between mental health and the criminal justice system. The report recognizes that sheriffs and police departments are often the first responders to address an individual potentially needing mental health treatment. The report notes that, “[j]ail diversion programs are an alternative and are being utilized, for both adults and juveniles, in many areas of the state to prevent persons needing mental health or behavioral treatment from ever going to jail.” Programs that train and prepare law enforcement agencies to deal with persons in mental health crises, coupled with available alternatives to jail for those in crisis are best practices that can potentially benefit both individuals and communities statewide.

The Committee recognized the high priority need for continued investment in a variety of jail diversion programs and strategies.

Peer Support Services

The report also identifies that peer support provided by certified recovery coaches for substance use disorder treatment and certified peer support specialists for individuals with mental health needs decreases substance use; reduces utilization of inpatient and emergency room care; decreases incarceration; and increases consumer engagement in care. As the report explains, “[i]ncreasing access to peer support services offers a cost-effective strategy for expanding the behavioral health workforce and reducing reliance on crisis, inpatient, and other more restrictive types of care.”

The Committee recognized that peers can play an important role in crisis response and critical transitions, including community re-entry after hospitalization and incarcerations. The report identifies the importance of increasing access to peer support services to improve continuity of care and reduce recidivism.

What’s Next?

CPPP believes that access to a comprehensive spectrum of behavioral health services and supports is a win-win proposition that can enhance the lives and potential of Texans with mental health and substance use disorder conditions and their family members, while also making communities safer and using taxpayer resources in the most efficient way.

With so many reported recommendations, we look forward to seeing what priorities are reflected in the legislation expected to be filed soon, to bring to life the recommendations of the Select Committee.

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