Texas is grappling with a severe shortage of mental health professionals, affecting nearly every county in the state. This shortage is particularly acute in rural, border, and frontier areas, where access to mental health services is extremely limited.
Key Takeaways
- 246 out of 254 Texas counties are designated as mental health professional shortage areas.
- The mental health workforce is aging and predominantly white, with a significant lack of Spanish-speaking providers.
- Various types of mental health professionals, including psychiatrists, psychologists, social workers, and counselors, are in short supply.
- State lawmakers have implemented measures to address the shortage, but long-term solutions are still needed.
The Scope of the Shortage
According to federal designations, 246 of Texas’ 254 counties are considered mental health professional shortage areas. This is particularly concerning in a state where approximately 5 million residents lack health insurance. The shortage is most severe in rural, border, and frontier counties, some of which have only one or no mental health professionals at all.
Demographic Disparities
The mental health workforce in Texas is not only insufficient but also demographically imbalanced. More than 40% of Texas’ population is Hispanic, yet over 80% of mental health providers are white. Additionally, less than 20% of the state’s mental health providers offer services in a language other than English.
Types of Mental Health Professionals
Psychiatrists
- Role: Medical doctors specializing in mental health, including substance use disorders.
- Numbers: 2,651 psychiatrists in Texas as of 2023, but 170 counties have none.
- Aging Workforce: 23% are over 65, and nearly 42% will be over 65 within ten years.
Psychologists and Psychological Associates
- Role: Evaluate mental health, provide therapy, but cannot prescribe medication.
- Numbers: 5,138 licensed psychologists and 734 licensed psychological associates. 143 counties lack a licensed psychologist.
- Aging Workforce: 40.5% will be over 65 within ten years.
Social Workers
- Role: First point of contact for many seeking mental health help, provide specific services and therapeutic techniques.
- Numbers: 10,675 licensed clinical social workers, 12,146 licensed master social workers, and 3,236 licensed baccalaureate social workers. 91 counties lack licensed clinical social workers.
Licensed Professional Counselors
- Role: Evaluate mental health and provide counseling.
- Numbers: 25,519 licensed professional counselors, but 29 counties still lack one.
Behavioral Analysts
- Role: Provide therapy for individuals struggling to control emotions, often children.
- Numbers: 3,467 behavioral analysts, but 140 counties lack one.
Licensed Specialist School Psychologists
- Role: Work in schools to ensure mental wellness.
- Numbers: 4,017 licensed school psychology specialists, but 97 counties lack one.
Marriage and Family Therapists
- Role: Provide individual and group counseling for couples and families.
- Numbers: 3,268 licensed marriage and family therapists, but 140 counties lack one.
Efforts to Address the Shortage
State lawmakers have tried various methods to increase the number of mental health workers, including extending student loan forgiveness and expanding state hospital capacity. Last year, the budget for state psychiatric hospital staff and local mental health authorities was increased, along with funding for the Loan Repayment Program for Mental Health Professionals.
However, these are not short-term solutions. Increasing Medicaid payments for mental health services could provide immediate relief, as many providers leave Medicaid due to low reimbursement rates.
Alison Mohr Boleware from the Hogg Foundation for Mental Health believes the state is on the right track but emphasizes the need for long-term solutions. "There are a lot of people working on this issue with innovative ideas, but we have to think about the big picture," she said.
Sources
- A closer look at Texas mental health workforce shortage | The Texas Tribune, The Texas Tribune.
