Social media isn’t the only cause of mental health woes among Texas youth, advocates say

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Over the last four months, a joint committee of state House and Senate members has met twice to listen to hours of testimony on the effects the online world is having on minors, with lawmakers classifying social media as “the most dangerous thing our kids have legal access to in Texas.”

Lt. Gov. Dan Patrick has made examining social media for youth a legislative priority for the Senate, and so far, six bills have been filed this state legislative session to address the issue, including one that would prohibit minors from creating accounts on social media sites and require age verification for new users.

No bills have been filed yet to meaningfully address workforce shortages beyond sharing workers with other states and loan repayment programs that have been in place for years, and the state is unlikely to fully replace the more than $19 billion Texas schools have received over the last four years in COVID-19 funds, with a large percentage of it going to address youth mental health needs.

Even though it has received heavy attention from lawmakers, social media is just one reason for the surge in youth mental health problems, according to mental health providers, advocates and school officials, and addressing social media shouldn’t come at the expense of building up the state’s mental health providers and funding life-changing programs on the brink of extinction.

“The surge in youth mental health challenges stems from multiple interconnected factors. Today's youth face intense academic and social pressures, often without adequate (mental health) support systems,” said Lyssette Galvan, public policy director for the National Alliance on Mental Illness in Texas. “The 89th legislative session presents a vital opportunity to address these challenges comprehensively.”

Roughly one in five of Texas’ 7 million youth report having a mental, emotional, behavioral or developmental problem.

And the mental health of young Texans has only gotten worse. Over the last five years, the rate of Texas youth who reported at least one major depressive episode has increased from 12% to 19% — or 483,000, according to Mental Health America.

Programming needs

When the COVID-19 pandemic swept across the world, she witnessed a different level of investment in youth mental health, said Andrea Guerrero, director of public health for Bexar County.

“It allowed us to expand our reach and approach to community-based mental health, especially youth mental health,” she said.

About $100 million of $350 million in COVID-19 relief funds that Bexar County received were used to hire clinicians and start programs, including a Boys and Girls Clubs mental health initiative and multiple school programs catered for each district.

This is why Guerrero considers the rise in mental health referrals in Texas and across the nation as an awakening, not a crisis being brought on by one specific thing, such as social media. The rising number of cases shows that the stigma around mental health is dropping, she said.

However, meeting the mental health needs of so many young Texans will become even more challenging as COVID-19 funds expire in the coming year or two, putting programs across the state in danger, she warns.

The pandemic emergency funding helped create and sustain many innovative mental health efforts in Texas, including telepsychiatry programs in rural schools, peer-to-peer services done by fellow students, and library programs for teenage mental health.

Pandemic relief funding is also supporting 11 of the 48 teams that provide specialty outpatient treatment for people who experience psychosis for the first time, often children. These teams are made up of a psychiatrist, case manager and education specialist, among other providers, who treat patients for up to three years.

The service helps families who might not have financial resources. Without additional funding, several of these teams are at risk of going away, Galvan said.

House Bill 1594 by Rep. Mihaela Plesa, D-Dallas, which would require commercial insurance policies to cover these crisis team services, would plug just one of many holes in the mental health system that the expiration of COVID-19 relief funds leaves behind.

Guerrero said the county does not have funding to immediately replace the $100 million in pandemic relief funding that went toward mental health. The county has already contacted school districts it has supported for their plans on staying afloat.

“For example, if you hired five clinicians, can you keep one of them? How much can they budget for themselves? We are also working on creating an ecosystem of additional partners to try and provide a warm handoff,” she said.

Galvan said schools currently receive a $400 million safety allotment from the state, and because schools must spend so much on security, only a mere 1.6% of these funds are being directed toward mental health support.

A 2023 statewide survey found that 714 school districts that participated reported using the Elementary and Secondary School Emergency Relief Fund for mental health, primarily to provide services for students to transition back into the classroom after the pandemic. These $19 billion in funds must have been committed by the end of 2024 and be spent by March 2026.

Sen. José Menéndez has offered a way to help keep funding these services with Senate Bill 176. It would allow schools to partner with local mental health authorities to provide on-campus services for eligible low-income students that are funded with Medicaid reimbursements.

House Bill 462 by Rep. Ryan Guillen, R-Rio Grande City, and House Bill 1728, also by Plesa, would also create a mental health allotment for schools. Guillen’s bill would give $100,000 a year and Plesa’s would provide funding based on student attendance.

Provider shortage

Round Rock school district superintendent Hafedh Azaiez said he welcomes any help from lawmakers to address social media because his top priority right now for youth mental health is funding.

“The last session, they wanted a police officer on every campus and all these security measures, but it was an unfunded mandate,” Azaiez said. “Some school districts, including ours, were able to fulfill it and provide some mental health resources, but a lot of school districts aren’t as big, and they have to make tough choices between security and mental health.”

Azaiez said his school district, one of the largest in the state, takes pride in providing mental health resources to their students, but he needs more funding for providers.

“We have over 47,000 students, and we have 12 or 11 social workers at a time,” Azaiez said. “With that ratio, can you confidently say that you meet every kid's needs?”

Social workers on their campus are spending most of their time responding to crises, even though they would prefer to be more proactive, using skills like case management, basic needs, and mental wellness.

“Right now, we have two individuals to cover 11 campuses,” said Byron Gerard, Round Rock’s assistant superintendent of student support services. “That is a heavy lift.”

Today, 246 of Texas’ 254 counties are wholly or partly designated by the federal government as “mental health professional shortage areas.” This has had a profound effect in rural, border, and frontier counties in Texas, where there may only be one mental health professional or none.

“If we hired 10 clinical providers right now for mental health services, we would probably keep all 10 of them busy,” Guerrero, the director of public health for Bexar County, said. “It’s really about building up that workforce specifically for youth because it takes an additional thousands of hours to be clinically certified to provide mental health services to kids.”

Texas has 4,017 licensed school psychology specialists, a 27.6% increase from the 3,148 providers in 2015. However, in 2023, there were 97 counties without licensed school psychology specialists.

The state’s crisis response infrastructure also requires significant improvements, Galvan said, as the state only has eight youth crisis outreach teams and six youth crisis respite units among 39 local mental health authorities.

“Proper staffing, funding, and youth-specific resources are essential for an effective crisis continuum of care, including 988 call centers,” she said.

Social media’s advantages

Although research on the effects of it is still new, social media has been shown to put young people at a greater risk of depression, anxiety, and other mental health challenges.

“While technology is an integral part of modern life, its use must be balanced to ensure children develop the critical and social life skills necessary to thrive,” said Bryan Mares, government relations director for the Texas chapter of the National Association of Social Workers.

Lawmakers have suggested several initiatives in the next session to address the online dangers affecting Texas children, including training teachers about cyberbullying, banning the use of people’s likenesses in artificially created pornographic images, and even adding warning labels on social media platforms that state what social media can do to a minor’s mental health.

“We have heard youth talk about how social media creates intense levels of comparison for them and their peers. For girls specifically, social comparison is the number one predictor of poor body image,” said Ana O’Quin, advocacy manager for the Girls Empowerment Network.

A sign of the state’s increased effort to lessen social media’s negative impacts, the Texas Health and Human Services Commission recently awarded Bexar County’s mental health authority a $1.2 million grant to create a program to educate teens and parents on the pros and cons of social media and video games.

Jelynne LeBlanc Jamison, head of the mental health authority, said the goal of the program is not to villainize social media, but to have parents understand the critical role these platforms play in their children’s lives and for children to understand the dangers of this digital landscape. She said most of the problems with social media come from a lack of understanding between generations.

“I think we have been really lazy in terms of really guiding people on how to use these tools,” said Jamison, who is using the new social media funding to expand their outreach specialists from one to nine. “And I think we’ve made some mistakes and I hope we don’t go much further without making some common sense rules about usage and access.”

Jennifer Edwards, executive director of the Texas Social Media Research Institute at Tarleton State University, said there are clear benefits of social media, especially for those who live in rural areas, as they get the opportunity to become positively exposed to different viewpoints and issues and to find their own community that might not exist in their small town.

Youth can use social media to learn, create content and express themselves because they have information at their fingertips, according to researchers.

“Having that sense of community is especially beneficial for wellness and mental health,” she said.

Putting all the blame on social media for the adverse mental health outcomes of young Texans ignores the pandemic’s varying effects on children's developmental years, according to mental health advocates.

After schools reopened after pandemic-related closures, a majority of students returned with what appeared to be generalized anxiety, Guerrero said.

In 2021, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association declared a national emergency in child and adolescent mental health due to the pandemic.

These organizations predicted mental health disorder rates are likely to increase over time, given that sustained COVID-19 stressors may result in years-long mental health impacts.

“There isn’t a magic wand or one policy solution to youth mental health. But instead, we need to tackle this issue from multiple angles,” Mares said.