Two Views: Telemedicine, mental health courts could improve access to treatment

Here’s the good news: the Texas Legislature put hundreds of millions of additional dollars into mental health for Texas in the new biennial budget. The state now allocates $8 billion for services ranging from community mental health services to substance abuse treatment, and more.

The bad news is it isn’t always about the money. Texas still faces challenges, including its size, which exacerbates the nationwide shortage of mental health professionals, and our continued reliance on jails as our default mental health treatment centers.

But smart policies at the state and local levels can help Texas overcome those challenges.

The shortage of mental health professionals is a pervasive problem. According to the Kaiser Family Foundation, Texas has 419 mental health care health professional shortage areas, with a population within those areas of 12.5 million. According to Kaiser, less than 40 percent of Texas’ mental health needs are met, and we would need to add 547 practitioners to end shortage areas.

Here’s where the internet can help. Telemedicine — with virtual doctor visits and the ability of practitioners to reach their patients without travel — holds real promise for Texans in those shortage areas.

Lawmakers recently passed a number of bills expanding the scope of telemedicine. House Bill 1, for example, included $5 million to fund a Telemedicine Wellness Intervention Triage and Referral Project at Texas Tech University Health Science Center. It will help “link remote rural schools that are without sufficient counselors, psychiatrists, and other mental health service providers.”

There are other examples of ways in which telemedicine can help, but the regulatory process is cumbersome and slow. The state “reviews eligibility of services through telehealth on a service-by-service basis which is resource draining and often requires a year or more for final approval and implementation,” according to the Hogg Foundation for Mental Health at the University of Texas.

The state should work to streamline those processes to help bring mental health services to more Texans.

In too many Texas counties, the jail is still the largest mental health facility, though mental health courts are increasing in number. Measures that divert suitable offenders with mental illness from lockups to effective treatment programs can produce net savings while furthering public safety and offender accountability.

More than 20 mental health courts are operating in Texas, mostly in the larger counties. But these courts can benefit mid-size and even smaller counties.

Studies show that mental health court participants were half as likely to be re-arrested as similarly situated individuals who went through the traditional court system; and participants who complete the mental health court program are re-arrested less than a quarter as often as similar defendants in the traditional criminal justice system.

More counties should consider establishing and encouraging mental health courts.

Many of our neighbors and family members struggle with mental illness. With the right tools we can help ensure they receive the help they need.

Levin is vice president of Criminal Justice Policy at the Texas Public Policy Foundation and its Right on Crime initiative.