House panel warns of "peril" in Texas mental health system

If Texas doesn't take bolder steps to fix its mental health system, the consequences could be perilous for the state, a House committee report warned Thursday.

The 109-page report by the Texas House Select Committee on Mental Health, released just days before the start of this year's legislative session, outlines challenges and opportunities for the state in tackling issues troubling the system such as patient access to mental and behavioral health services; increasing the number of beds available in state hospitals; early intervention for schoolchildren with behavioral health issues; investing in jail diversion programs; and beefing up the state's mental health workforce.

House Speaker Joe Straus said in a news release that the report "will give the House valuable guidance."

"The opportunity to improve our mental health system this year is real and it's important," Straus said. "A smarter approach to mental health will improve treatment and care while saving taxpayers money."

In the report, the committee wrote that mental health "is absolutely one of the most critical areas of concern" facing the state right now.

"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," the report read. "In short, the problems will not simply go away on their own. In fact, they will only increase as Texas continues to grow and so will the costs — loss in human potential; detrimental social impact on families, communities and businesses; and financially."

Throughout the report, the committee cited findings from the eight hearings it held in the past year and found that community collaboration was key to helping solve access issues.

Notable recommendations in the report included weaning the state off the short-term Medicaid funding program known as the 1115 waiver; increasing the use of telemedicine; increasing health provider payment rates in rural areas; increasing the Texas Department of Insurance's budget for investigating behavioral health plans; enacting a state mental health parity law; remodeling and building new state hospitals; and increasing access to substance abuse counseling and supportive housing.

The report comes as Texas legislators prepare for the start of what is likely to be a tight-fisted legislative session. In its report, the committee said the state appropriated $6.7 billion toward behavioral and mental health services for 2016-17, with half of that funding going to Medicaid. Texas lawmakers increased funding in the previous two legislative sessions, but the committee warned it was aware that "funds, whether federal, state, or local, are limited.”  

The committee also expressed concern for 1115 waiver projects. In May, the state and federal governments agreed to extend those funds until December 2017, meaning state agencies could be forced to pick up the tab if the funding isn't renewed again.

However, members wrote in the report they were "optimistic that the services being provided can be maintained and enhanced even in these challenging fiscal times."

Read more of the Tribune’s related coverage:

• As Republicans prepare to dismantle Obamacare, mental health advocates are worried that benefits for counseling and substance abuse treatment will be lost in the shuffle.
• Texas lawmakers tout recent improvements to the state’s mental health safety net, citing new funding and program expansions. But the state still struggles to provide psychiatric care for all patients who need it.
• A program created recently will help pay mental health professionals’ student loans if they practice in a medically needy area. The program seeks to alleviate the state’s shortage of mental health professionals, which watchdogs are calling a "public health emergency."