2011 mental health in texas an overview

7/31/2019 2011 Mental Health in Texas an Overview

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Mental Health In Texas:Mental Health In Texas:The Hidden Cost of Budget CutsThe Hidden Cost of Budget Cuts

Presented By:Presented By:

Lillian Ortiz, MSWLillian Ortiz, MSW

Mental Health America of Greater HoustonMental Health America of Greater Houston

Lt. Mike LeeLt. Mike Lee

Houston Police Department Mental Health UnitHouston Police Department Mental Health Unit

Amanda Jones, JDAmanda Jones, JD

Harris County Office of Legislative RelationsHarris County Office of Legislative Relations


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Mental Health inMental Health in

4.3 million Texans have a4.3 million Texans have adiagnosable mental healthdiagnosable mental healthdisorder, including 1.2disorder, including 1.2million childrenmillion children

Of these individuals, 1.5Of these individuals, 1.5million are not able tomillion are not able tofunction at work, school,function at work, school,or in the community dueor in the community due

to their illnessesto their illnessesSource: Texas Medical AssociationSource: Texas Medical Association

Texas ranks 49Texas ranks 49thth in perin percapita spending on mentalcapita spending on mentalhealth serviceshealth services

Over 6.1 million TexansOver 6.1 million Texansare uninsuredare uninsured

Most Texas counties areMost Texas counties arefederally designated mentalfederally designated mental

health professionalhealth professionalshortage areas as of Marchshortage areas as of March20102010Source: Texas Department of State Health ServicesSource: Texas Department of State Health Services


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Funded Mainly With GR DollarsFunded Mainly With GR Dollars

TX Department ofState Health Services

Community HospitalsLocal Mental Health

Authorities & NorthStarState Hospitals

Texas Public Mental Health SystemTexas Public Mental Health System


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7878ththTexas Legislative SessionTexas Legislative Session

In 2003, a $10 billion deficit led lawmakers to makeIn 2003, a $10 billion deficit led lawmakers to make

serious cuts to mental health programsserious cuts to mental health programs Cuts to community mental health servicesCuts to community mental health services

Cuts to state hospital capacityCuts to state hospital capacity

Changed priority populationsChanged priority populations Cut most Medicaid mental healthCut most Medicaid mental health

benefitsbenefits

Eliminated inEliminated in--home and familyhome and familysupport benefitsupport benefit

Consolidated state agenciesConsolidated state agencies


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Results of CutsResults of Cuts Limited slots for community based servicesLimited slots for community based services

Only those with big 3 diagnoses, which include bipolarOnly those with big 3 diagnoses, which include bipolardisorder, schizophrenia, and major depression, are eligible fordisorder, schizophrenia, and major depression, are eligible forservicesservices

Significant waiting lists for these servicesSignificant waiting lists for these services

Crisis drivenCrisis driven Lack of community based services forces individuals intoLack of community based services forces individuals into

repeated and expensive crisis episodesrepeated and expensive crisis episodes

Lack of intermediate care/step down programsLack of intermediate care/step down programs Forces people into criminal justice systemForces people into criminal justice system

State psychiatric hospital beds increasingly used for forensicState psychiatric hospital beds increasingly used for forensiccommitments, meaning people need to go to jail to get a bedcommitments, meaning people need to go to jail to get a bed


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Harris County has more

children and adults withsevere mental illnesses thanany other county in Texas

552,000 adults in Harris552,000 adults in Harris

County haveCounty have a mental illnessa mental illness

153,000 of these individuals153,000 of these individuals

have a serious mental illnesshave a serious mental illness

Only 18% of adults withOnly 18% of adults with

serious mental illnesses inserious mental illnesses in

need of services from theneed of services from the

public mental health systempublic mental health systemin Harris County are able toin Harris County are able to

access treatmentaccess treatment

Daily waiting list of 900+Daily waiting list of 900+

186,000 children in Harris186,000 children in HarrisCounty have a mental illnessCounty have a mental illness

83,525 of the these83,525 of the these

individuals have a seriousindividuals have a seriousmental illnessmental illness

Only 25% of children withOnly 25% of children withserious mental illnesses inserious mental illnesses in

need of services from theneed of services from thepublic mental health systempublic mental health systemin Harris County are able toin Harris County are able toaccess treatmentaccess treatment

Source: Mental Health Needs CouncilSource: Mental Health Needs Council


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Lack of Access to TreatmentLack of Access to Treatment Individuals unable to access communityIndividuals unable to access community--based services endbased services end

up in our publicly funded emergency roomsup in our publicly funded emergency rooms

12.5% (12 million out of 95 million) of ER visits12.5% (12 million out of 95 million) of ER visitsin 2007 were related to mental illness or substancein 2007 were related to mental illness or substance

abuseabuse

Over 4.1 million visits had mental illness or substanceOver 4.1 million visits had mental illness or substance

abuse as a firstabuse as a first--listed or principal diagnosislisted or principal diagnosis

40% of the 12 million resulted in hospital admission,40% of the 12 million resulted in hospital admission,making ER visits for mental illness and substance abusemaking ER visits for mental illness and substance abuse

2.5 times more likely to lead to hospitalization than visits2.5 times more likely to lead to hospitalization than visits

for all other conditionsfor all other conditionsSource: Healthcare Cost and Utilization ProjectSource: Healthcare Cost and Utilization Project

Individuals unable to access communityIndividuals unable to access community--based services endbased services endup on the streetsup on the streets Approximately 60% of homeless individuals are mentally illApproximately 60% of homeless individuals are mentally ill

Half of these individuals also have a substance use disorderHalf of these individuals also have a substance use disorderSource: SAMHSASource: SAMHSA

Utilize emergency services for careUtilize emergency services for care


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Criminalization of Mental Illness: AdultsCriminalization of Mental Illness: Adults

Harris County Jail is the largestHarris County Jail is the largest

provider of mental health servicesprovider of mental health services

in the statein the state

About 25% of inmates at HC Jail receive mental health services,About 25% of inmates at HC Jail receive mental health services,which is more than our ten state psychiatric hospitals combinedwhich is more than our ten state psychiatric hospitals combined

According to the US Department of Justice, the national averageAccording to the US Department of Justice, the national averagein local jails is 16%in local jails is 16%

80+ inmates at the HC Jail are waiting for a forensic bed at a80+ inmates at the HC Jail are waiting for a forensic bed at astate psychiatric hospital for competency restoration servicesstate psychiatric hospital for competency restoration services

TDCJ estimates the rate of offenders with mental healthTDCJ estimates the rate of offenders with mental healthissues to be at 19%issues to be at 19%

According to the US Department of Justice, incarceratingAccording to the US Department of Justice, incarceratinginmates with serious mental illnesses is roughly 60% moreinmates with serious mental illnesses is roughly 60% more

expensive than housing typical inmatesexpensive than housing typical inmates


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Criminalization of Mental Illness:Criminalization of Mental Illness:

Children/YouthChildren/Youth Half of the children in the Harris County Juvenile ProbationHalf of the children in the Harris County Juvenile Probation

Department have a diagnosable mental illnessDepartment have a diagnosable mental illness


55% of the children in the Harris County Juvenile Probation55% of the children in the Harris County Juvenile ProbationDepartment have been diagnosed with a substance abuse and/orDepartment have been diagnosed with a substance abuse and/orchemical dependence problemchemical dependence problem


According to the Texas Youth Commission:According to the Texas Youth Commission:

47% of their new arrivals in FY 2009 were47% of their new arrivals in FY 2009 were

chemically dependentchemically dependent 37% of their new arrivals in FY 2009 had37% of their new arrivals in FY 2009 had

serious mental health problemsserious mental health problems


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Economic Impact on TexasEconomic Impact on Texas 2009 report by Texas economist Ray Perryman stated that:2009 report by Texas economist Ray Perryman stated that:

Expanding funding for both traditional and innovativetreatment options would pay sizable economic benefits evenbeyond the immeasurable quality-of-life improvement for thoseinvolved and represents an appropriate and highly productive

use of State funds.

Even beyond the often devastating consequences for theindividuals involved, severe mental health and substance abuse

disorders cost the Texas economy some $269.343 billion in totalspending each year and 1,675,582 permanent jobs. Finding waysto reduce these negative effects is clearly a worthy goal.

Source: Costs, Consequences, and Cures!!! An Assessment of the Impact of Severe Mental Health and Substance Abuse Disorders on Business Activity in Texasand the Anticipated Economic and Fiscal Return on Investment in Expanded Mental Health Services


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80th & 8180th & 81stst Legislative SessionsLegislative Sessions 8080thth Legislative SessionLegislative Session

Appropriated $82 million for crisis mentalAppropriated $82 million for crisis mentalhealth serviceshealth services

8181stst Legislative SessionLegislative Session

Appropriated $109.4 million for maintenanceAppropriated $109.4 million for maintenance

of crisis mental health servicesof crisis mental health services

$55 million in new funding for transitional and ongoing$55 million in new funding for transitional and ongoing

community mental health servicescommunity mental health services Additional funds for indigent psychiatric inpatient services,Additional funds for indigent psychiatric inpatient services,

childrenchildrens services, and adult servicess services, and adult services


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2011 mental health in texas an overview

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