Blue Promise: Understanding the Mental Health Crisis in Texas

Do you know someone struggling with their mental health? Chances are, that person is also having a hard time managing their overall health. The impact of mental illness is broad. Can Texas meet the increasing need for mental health professionals? Hear from Dr. Philip Huang, Director of Dallas County Health & Human Services, in this episode of Blue Promise. 

You can listen to the complete discussion on Apple Podcasts  , SoundCloud  or wherever you listen to podcasts. You can also watch the video recording of this podcast on YouTube 

Blue Promise is a podcast and online video blog that aims to address complicated health issues with candid conversations from subject matter experts. New editions are published regularly and are hosted by Dr. Dan McCoy, President of Blue Cross and Blue Shield of Texas, and his co-host, Ross Blackstone, Director of Strategic Influence. 

Show Transcript

DAN: Do you know someone struggling with their mental health? Chances are that person is also having a hard time managing their overall health. The impact of mental illness is broad, but can Texas meet the increasing need for mental health professionals? Find out in this episode of Blue Promise.  

DAN: Thanks for tuning in to Blue Promise. I’m Dr. Dan McCoy and I’m the President of Blue Cross Blue Shield of Texas. I have a special guest in the studio today, Dr. Philip Huang, with the Dallas County Health and Human Services Department. Phil, tell me a little bit about mental health, are we in a crisis now? 

PHILIP: You know, Texas in particular, probably has more issues regarding mental health. We were ranked 39 out of 50 states overall. Reflecting both sort of the burden and number of people with mental health issues and then also the access to care. I think in terms of specifically access to care, I think we’re ranked 49 out of 50 states.  

DAN: I’ve heard a statistic that 80 percent of Texans are challenged in finding a behavioral health professional. Does that seem like a wild statistic or could that be correct? 

PHILIP: It certainly can, you know and one of the issues is I think that two thirds of the licensed professionals are in five largest counties in Texas. So, then you’ve got 249 or let’s see, yeah 249 other counties where there’s not the availability and so that’s part of the problem.  

DAN: There’s many counties that have no behavioral health professional. So, tell me some of the issues that that causes. I mean, I would expect that in acute episodes of mental illness and even chronic manage of mental issues, that becomes a huge challenge.  

PHILIP: It really does, and you know we’re more and more seeing and understanding the relationship between mental health issues and physical health. And so, you know they’re important. It has those impacts on physical health as well as you know I think one of the things that in Texas, the largest mental health provider is the criminal justice system. The jails. And so, you know those are closely linked too. I think that there are many people who are in jail because of lack of treatment of their mental health issues and that’s the only place where they can get it. 

DAN: And I suspect that in places like Dallas County, there’s even mental health assistance within the jail but then in many areas of Texas, if you don’t have a mental health professional in your county, it’s very unlikely you’re going to have a mental health professional at the jail. What are the other issues that it seems as in the past that family physicians and local primary care physicians have provided a lot of mental health assistance but even today we’re seeing shortages of primary care providers. I think, 35 counties in Texas today don’t have a primary care physician in that county. What role is that playing? Is that exacerbating this problem with mental health access? 

PHILIP:  Well again, I mean the lack of professionals to provide this mental health support and services is a huge problem.  

DAN: So, what are some of the solutions you think that could be out there to kind of help mitigate part of the shortage? 

PHILIP: Well one of the things that is being developed is some of the telehealth and tele-mental health programs which can help increase access in some of the rural areas. And I think Dallas has a really good program where they’re trying to have mental health workers work with the police department, with other first responders. You know to assess calls to 911 and things and identify which are mental health issues. Have a professional available, sometimes even through telehealth services and you know address these issues up front. And I think I’ve seen some results where you know it really decreased arrests in these situations and are able to get them to mental health services.  

DAN: So, just kind of for our audience, I think when we say telehealth a lot of people think they use their smartphone and just call up a doctor. And that’s true, right? There are telemedicine things on people’s smartphones but a lot of the telehealth that’s in behavioral health might include a warm transfer from a physician to a social worker, right, with a remote psychiatrist in another town doing medication changes of that order. To get people on the right dose, is that sort of what you’re referring to? 

PHILIP:  Right, yes that’s part of it. 

DAN: So, one quick thing I want to kind of focus on too. You talked a little bit about access to mental health. It’s always struck me that it is important for people to have access to mental health resources. In the times of maybe first episode or acute need and yet we tend to focus a lot of our energies on the tertiary or the long-term consequences of mental health like institutions and things of that nature. But talk to me a little bit about, do you believe that maybe attacking first episode schizophrenia for instance, would that have a benefit long-term on the state to put resources there? 

PHILIP: You know, absolutely and one of the principles of public health is to catch these things earlier, do as much prevention efforts and to address it so we’re not dealing with things downstream. And so, certainly more efforts, more resources towards those efforts will be helpful. 

DAN: So, you’re here in Dallas County. If people wanted to find access to information about mental health resources here in Dallas, do you have a place you could point them that maybe they could find information?   

PHILIP: Yeah you know, locally I know Metrocare is one of the providers. Also, at the state level, there’s Health and Human Services Commission who has resources. Also, you know, federal level, National Institute of Mental Health.  

DAN: Dr. Huang, thanks for being here and thanks for joining us for this episode of Blue Promise.  

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