NMHA Issue Update: March 7, 2005

MHA in Texas Releases Report on State’s Failing Mental Health System and Need for Reforms

NMHA is excited to announce that the Mental Health Association in Texas recently released a groundbreaking report entitled Turning the Corner: Toward Balance and Reform in Texas Mental Health Services documenting the economic and human costs of Texas’ failure to prioritize mental health care. The report also proposes a broad set of reforms for improving the state’s mental health system.

State funding for mental health care is always an issue. Turning the Corner can serve as a tool for Mental Health Associations to demonstrate the outcomes of under-funding mental health services. In addition, MHAs may consider whether resources might be available to commission a similar report, which could serve as an impetus to restore access to critical services for individuals with mental health care needs in their state.

The report is a comprehensive look at the state of mental health care in Texas. It provides current and historical background on Texas’ mental health system, and details the legislative changes that drastically cut mental health funding and services in 2003. In addition to measuring statewide economic and fiscal impacts of mental illness, the report measures the effects of mental health cuts on Texas’ criminal justice, foster care, emergency health care, and other systems.

In 2003, the Texas Legislature dramatically cut mental health funding and services through a series of reforms. The Texas health and human services system underwent a radical reorganization and its funding was reduced by more than $1 billion. A change to eligibility criteria for mental health services prioritized specific mental health diagnoses, so that 14,000 Texans lost access to community mental health treatment. The state’s mental health agency budget was cut by 3.5 percent, or $50 million. Access to psychotropic medications was restricted by the implementation of a Preferred Drug List (PDL). Finally, children lost mental health services under the Children’s Health Insurance Program (CHIP).

Among the report’s major findings: Mental illness cost state and local governments $1.5 billion in 2003. Mental illness costs Texas up to $16.6 billion per year in lost productivity and family revenue. Texas ranks 49th in per client spending on mental health care services.

These changes provided the springboard for a broad evaluation of the chronic under-funding of the state’s mental health system. The MHA in Texas secured funding from the Texas-based T.L.L. Temple Foundation to commission this report and worked with MGT of America, Inc. to complete the study.1

The Turning the Corner report lays out a comprehensive set of recommendations for reforming the state’s mental health system, including:

• Restoring “priority” population guidelines of who is served by the mental health system based on need rather than diagnosis;
• Removing PDL restrictions on psychotropic drugs;
• Fully restoring mental health benefits to children under CHIP;
• Expanding cost-effective mental health practices, by investing in jail diversion programs and behavioral health managed care programs;
• Adopting cost-effective behavioral health purchasing cooperatives between state agencies;
• Utilizing Medicaid home and community-based waivers to increase funding of mental health services.

Since its release, the report has garnered much media attention in the state and is well on its way toward fueling discussion on restoring Texas’ mental health system. The MHA in Texas is considering ways to ensure that the report is updated to measure future mental health reforms.

The full report may be accessed at http://www.mhatexas.org. For more information on this report, contact Laura Galbreath, Director, Healthcare Reform, at (703) 797-2594 or lgalbreath@nmha.org.

1. For more on MGT of America see http://mgtofamerica.com.

National Mental Health Association
2000 N. Beauregard Street, 6th Floor
Alexandria, VA 22311
Phone 703/684-7722
Fax 703/684-5968
Mental Health Resource Center 800/969-NMHA
TTY Line 800/433-5959