Overview of community mental health needs and services Page: 1
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OVERVIEW OF COMMUNITY MENTAL HEALTH NEEDS
AND SERVICESTexas operates 39 local mental health authorities to provide
specialized outpatient community mental health services.
Based primarily on rules established by the Health and
Human Services Commission, local mental health authorities
serve the highest-need individuals suffering from serious
mental illness. In addition to crisis services, local mental
health authorities provide adults and children with
medication, counseling, case management, treatment, and
supports.
Local mental health authorities have more contact with
clients discharged from state hospitals than when the
authorities were established in the 1960s. With the exception
of two centers, local mental health authorities make face-to-
face contact within seven days with a majority of clients
discharged from state-funded psychiatric stays. This increased
focus on the smallest but neediest population groups has
resulted in a case mix that serves primarily adults with bipolar
disorder, schizophrenia, or major depression with psychosis.
FACTS AND FINDINGS
f Individuals with serious and persistent mental illness
will typically experience symptoms, often debilitating,
throughout their lives. Most of these individuals need
access to long-term treatment. Due to the persistence
of symptoms, even with treatment, many of these
individuals require assistance and supports for daily
living.
f During fiscal year 2017, an estimated 532,295 Texas
adults had serious and persistent mental illness. Local
mental health authorities provided mental health
services, including short-term crisis services, to
approximately 226,913 adults that year.
f Since fiscal year 2012, the number of adults served
by local mental health authorities has increased.
However, the challenge remains to serve individuals
that attempt to access services adequately. During
fiscal year 2017, approximately one in 10 interactions
between these authorities and eligible adults resulted
in the individual being underserved.
f During fiscal year 2017, 9,049 adults who completed
comprehensive assessments at local mental health
authorities in seven metropolitan regions either werehomeless or were at imminent risk of being homeless.
Among these adults, 27.1 percent received help with
housing from these authorities. Among adults who
completed a comprehensive assessment and were
unemployed, 15.2 percent received employment-
related services from authorities.
DISCUSSION
Local mental health authorities (LMHA), also known as
community centers or local behavioral health authorities, are
political subdivisions of the state. The responsibilities of
Texas' 39 LMHAs, as established in state law, are twofold:
planning and coordinating mental health policy and
resources; and serving as a provider of last resort for
community mental health services in their regions. LMHAs
contract with providers and coordinate with multiple entities,
including schools, federally qualified health centers, and law
enforcement. Based primarily on rules established by the
Health and Human Services Commission (HHSC), LMHAs
serve the highest-need individuals with serious mental illness.
In addition to crisis services, LMHAs provide adults and
children with medication, counseling, case management,
treatment, and supports.
Individuals may come into contact with an LMHA through
a crisis hotline, walk-in visits, or through a referral from a
community partner, such as a local jail or school. Individuals
are screened using standard assessment tools to determine
the most appropriate level of care. In addition to diagnosis-
related eligibility criteria, HHSC sets requirements for the
minimum level of functional impairment needed for adults
to be eligible for services. Clients that meet these criteria and
who lack insurance are provided services at no cost to the
client or on a sliding-fee schedule, as determined by a
financial assessment. Many clients are enrolled in the Texas
Medicaid program, in which case LMHAs are reimbursed as
network providers.
Although LMHAs have been important providers of mental
health services, their role has changed significantly since they
were established. Understanding the needs of Texans with
mental illness and the evolving role of LMHAs helps explain
the constraints and opportunities for improving equitable
access to mental health services in Texas.LEGISLATIVE BUDGET BOARD STAFF -APRIL 2019 LEGISLATIVE BUDGET BOARD STAFF REPORTS - ID: 4830
LEGISLATIVE BUDGET BOARD STAFF -APRIL 2019
LEGISLATIVE BUDGET BOARD STAFF REPORTS - ID: 4830
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Texas. Legislative Budget Board. Overview of community mental health needs and services, report, April 2019; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1486773/m1/1/: accessed June 5, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.