Q&A with NAMI Texas’ executive director about mental health during the pandemic

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It’s been a tough year for everyone, which can take a toll on our mental health. Texas continues to set records for COVID-19 cases, and health experts fear the holidays could exacerbate an already dangerous situation. The state has reported over 20,500 virus-related deaths, and over 8,000 were hospitalized in the days leading up to Thanksgiving.

Since March, more than 3.8 million Texans have applied for unemployment relief and teachers, parents and students have had to adjust to an abnormal school year. Add a contentious presidential election, protests against police brutality and a struggling energy sector to that mix of stressors.

Greg Hansch, the executive director for the National Alliance on Mental Illness in Texas, answered questions in our community Facebook group on how the pandemic has affected mental health and mental health care in the state. Below are some takeaways from our conversation. You can read the full conversation here.

What is the current availability of mental health care for Texans compared to the rest of the nation?

Texas ranks 50th out of 51 in overall access to mental health care, according to the 2021 State of Mental Health in America report.

Currently, only 1 in 7 Texas children with major depression receive consistent treatment — almost half the national average. The vast majority of children and youth with mental health disorders do not receive treatment, and those who are receiving care do not receive it when the disorder first presents itself. Data shows the delay from symptom onset to treatment averages eight to ten years.

First Episode Psychosis (FEP) impacts the health and wellbeing of approximately 3,000 Texas children and young adults each year. Texas has only 20% of the Coordinated Specialty Care program capacity needed to facilitate positive outcomes for this population. Other states have invested general revenue to ensure that more young people are able to access this gold standard in care.

In Texas, approximately 1,400 prisoners and jail inmates are awaiting competency restoration through the state psychiatric hospital system. The average number of days to obtain a maximum security and non-maximum security placement are roughly 280 and 80 days, respectively. Prolonged waits for competency restoration can worsen mental health outcomes, contribute to an over-crowded prison and jail systems, and jeopardize the safety of prisoners, inmates and prison or jail staff.

Texas has a long way to go. We have champions in the Texas Legislature. Considering the mental health impact of COVID-19, and the pre-existing mental health epidemic plus the huge gaps in our system, mental health needs to be a huge priority this legislative session.

Has Texas’ decision to not expand Medicaid impacted funding for and access to mental health care in our state? And roughly how many people has that impacted?

Access to coverage and care is essential for people with mental illness to manage their condition and get on a recovery path successfully. Medicaid is the lifeline for much of that care as the nation's largest payer of mental health and substance use condition services — providing health coverage to more than one in four of adults with a serious mental illness.

When states expand Medicaid, more people with mental health conditions can get the coverage they need to access vital care.

The U.S. Department of Health and Human Services estimates that over 400,000 Texans with mental health or substance use challenges could enroll in health insurance if state leaders accepted Medicaid expansion funding.

How is quarantining affecting kids and parents and their mental health? Is it worse than a businessperson being forced to close a business? Totally different?

There is research on both the mental health impact of quarantine / stay-at-home (notably, how isolation can drive depressive symptoms) and how unemployment and economic instability can have far-ranging mental effects. I can't say if one is worse than the other.

How to get help

Texas COVID-19 Mental Health Support Line: 833-986-1919

National Alliance on Mental Illness in Texas: 512-693-2000

Substance Abuse and Mental Health Services Administration’s National Helpline: 800-662-4357

Suicide Prevention Line: 800-784-2433

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