2013 Lege Wrap-Up: Mental Health

Mental health has received a lot of well-deserved attention this legislative session after the recent violent tragedies in our nation.  Texas legislators deserve praise for recognizing that all Texans benefit from a stronger mental health system with increased funds for prevention and better access to services. Of the more than 250 bills related to mental health filed this session, I focused on a number of bills that move the state forward in preventing and treating mental illness, assist communities in addressing their local needs and improve the outcome of individuals of all ages with mental illness.  Although numerous mental-health-related bills passed, I would like to tell you about one in particular – HB 2625 by Rep. Garnet Coleman (SB 1912 by Sen. Sylvia Garcia), which was included as an amendment to two different bills that passed.  This legislation revises the clinical criteria for adults to receive public mental health services at the local mental health centers.
Currently, Texas law (as the result of HB 2292 in 2003) mandates that state dollars can only fund mental health services for individuals who are medically indigent and meet the target population criteria.  To receive services, an adult must have at least one of the “Big 3 diagnoses”–schizophrenia, major depression, or bipolar disorders.  The door to community-based outpatient services has been closed for adults with other mental illness diagnoses (e.g., PTSD and other Anxiety Disorders). Therefore, these individuals only get services when in crisis: in the emergency rooms and through crisis services via the local mental health center.  Crisis services are only temporary, do not provide continuous care, and are very costly to our local communities.
Rep. Coleman’s bill created two tiers of criteria to receive adult outpatient services in the local mental health centers. The first tier is the current law, serving those adults with the Big 3 using funds appropriated.  A new second tier permits the centers to also provide clinically appropriate treatment services, with available resources, to adults with mental illnesses when their psychological, social, and occupational functioning deteriorates.  The intent is to ensure that all individuals with mental illnesses, regardless of a specific diagnosis, are able to access services.  This legislation opens the door to providing continuous and comprehensive outpatient behavioral health services for adults who today are cycling through the crisis system because they do not have the “right” diagnosis.

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