‘Too Little, Too Late’? Small Changes Aren’t Adding Up To Fix Texas’ Mental Health Care System

“They have so much to make up for that these tiny little bites are not quite enough to make a huge impact on the entire system.”

By Jill Ament & Caroline CovingtonMarch 4, 2021 1:57 pm,

A yearlong investigation by The Houston Chronicle revealed more about the severe limitations of Texas’ mental health care system. It’s a system overburdened with patients in the criminal justice system, and one that doesn’t have enough preventive resources to keep people in need out of a vicious cycle of crises and incarceration.

Alex Stuckey led the investigation. She told Texas Standard that Texas’ limitations start with the low number of beds in psychiatric hospitals that are available to patients outside the criminal justice system.

“Experts say that you should have 50 psychiatric hospital beds that are public, that aren’t requiring a ton of money to access, per 100,000 people,” Stuckey said. “Texas has less than eight [per 100,000] right now.”

She says 840,000 Texans are in need of some form of mental health care and can’t get it.

Part of the problem goes back to the Kennedy administration that deinstitutionalized mental health care. That meant reducing the role of state-run psychiatric hospitals, and creating a more community-based mental health care system with a number of smaller clinics to serve patients closer to home. But that vision was never fully realized.

“The following presidents did not follow up,” Stuckey said. “In fact, they often decreased mental health funding at the federal level. And so, you know, you’re kind of left with all of these people who might have needed inpatient care at one of these hospitals but now there are no beds.”

What’s more, Stuckey says the community clinics haven’t received enough funding or resources over the years to keep up with demand.

SEE MORE: Will New Funding And A Comprehensive Plan Be Enough To Bring Change To State Psychiatric Hospitals?

There are solutions. Texas is in the middle of a long-term process of revamping its state hospital system to add more beds, modernize hospitals and make them more functional for patients’ needs today. That plan also will eventually include enhancing the local mental health care system, but major changes could be years away. Stuckey says those changes and more are needed to accommodate Texans in need.

cars driving in front of a construction site

Construction for a new building began on one part of the Austin State Hospital campus in February 2020.

“There certainly needs to be more psychiatric beds,” Stuckey said. “But there, also, on the flip side, needs to be more investment in community mental health care. There needs to be a way for people, especially people who, they can’t afford to go see a therapist, they need kind of those outpatient needs where they can get their medication and they can get stabilized … without having to pay a significant amount. So there needs to be more funding in that regard as well so that they can get the help before they are in crisis.”

Along with updating the system statewide, lawmakers have done other things to try to fix the system. Stuckey says a prison diversion program has had some success, in which police officers can send people with mental health issues who are involved in a crime to the diversion program rather than prison or jail. But such programs are small efforts compared to what’s needed.

“I don’t want to say it’s too little too late because it’s never too late,” Stuckey said. “But they have so much to make up for that these tiny little bites are not quite enough to make a huge impact on the entire system.”

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