Skip to content

Texas Shows A Severe Pediatric Mental Health Shortage

Collin County has 17 professionals per 100,000 children
Photo: Prostock-studio | Shutterstock

In recent years, mental and behavioral healthcare is at the forefront of social and political discussions surrounding an array of issues: school shootings, gun safety, suicide rates, substance abuse and more. While many of these issues affect youths the most, according to Mental Health America, Texas ranks last when it comes to children’s access to mental care.

In 2016, the Hogg Foundation for Mental Health released a report stating that mental health is one of the most important public health concerns of our time. The report pointed out some important challenges to meeting the mental health needs of Texas, not the least of them being the availability of professionals. 

The Texas Statewide Behavioral Health Strategic Plan released by the state’s Health and Human Services Commission the same year reported similar concerns. While researchers were rightfully worried about mental and behavioral health workforce shortages at a time when the demand was increasing, there was no way for them to predict a worldwide pandemic hitting the system only four years later. 

“We never kept up with the demand really,” Dr. Sarah Martin, a psychiatrist and medical director of the Texas Child Mental Health Care Consortium, told KERA. “The pandemic just dropped the stigma around mental health to the floor, and it happened so rapidly that lines or waiting lists for therapists are really long.”

According to CBS News, most counties in the country have a severe shortage of child and adolescent psychiatrists (CAPs). Collin County, with a population of almost 300,000 children under 18 according to the latest census data available, only has 43 CAPs. While insufficient, that number seems like a luxury when compared to the neighboring counties like Fanny and Cooke where there are no CAPs at all. 

At a time when suicide is the second leading cause of death for people ages 10 - 14 and 25 - 34, according to the CDC, families with children facing a mental health crisis are many times forced to resort to the next available option: ERs. But, as a study conducted by the American Academy of Pediatrics reported in February 2023, more than a quarter of all children in the sample returned to the ER within a 6-month period.

“ERs are the last stop when all else has failed, and they, too, lack the resources to support or even discharge, these patients,” said Hannah E. Karpman, professor at the University of Massachusetts Medical School. 

But the lack of trained professionals is not an issue for hospitals alone. In 2022, CBS News reported that half of all Texas school districts had no mental health services available for students. Especially when considering strategies to prevent school shootings, accessible mental health care at schools is of paramount importance. 

In the opinion of Dr. David Lakey, the Chief Medical Officer for the University of Texas System, a telehealth program such as Texas Child Health Access Through Telemedicine, could help flag worrisome behavior in students early on. 

“If five years ago we could have had that program there, when he was in 7th grade or so, and figured out that things weren't going well, and then linked him to the services he needed, I think that's a situation where it would have been much less likely that that individual [the Uvalde gunman] would have done what he did."

Experts seem to agree with Karpman’s conclusion that “a massive investment in the education and training, and adequate payment of the behavioral health care workforce are long overdue.”