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Texas ranks last in mental health care among U.S. states


Governor Greg Abbott rejected calls for gun control following the school shooting in Uvalde and said Texas and society as a whole need to do a better job with mental health. In fact, a recent report found that, when it comes to mental health care access across the country, Texas ranks last. Now, access is improving, partly due to the work led by organizations like the Texas Child Mental Health Care Consortium. Dr. Sarah Mallard Wakefield, the chair of psychiatry at the Texas Tech University Health Sciences Center School of Medicine, is on the executive committee of the consortium and joins us now from Lubbock. Dr. Wakefield, thanks so much for being with us.

SARAH MALLARD WAKEFIELD: Thanks for having me.

SIMON: Let's start with that report from Mental Health America that ranks Texas last in terms of mental health access. Does that seem to you, from what you see on the ground, to be right?

WAKEFIELD: I think it is right. I think we have an access problem all over the country, but Texas is a very big state with lots of people, but also lots of rural areas, and it is difficult to cover and have mental health professionals across this vast expanse of space.

SIMON: I understand there's a mental health hotline. I would like you to give us the number for anyone in Texas listening and tell us what kind of help is available there.

WAKEFIELD: Sure. There are actually many mental health hotlines across Texas, but the mental health hotline that the consortium is supporting and distributing and staffing for Texas is called the Child Psychiatry Access Network. The number to CPAN, as we call it, is 1-888-901-2726. This is really a clinician-to-clinician hotline for those pediatricians and family medicine docs and frontline clinicians who are seeing children who are walking into their medical home - their clinic - with mental health distress, symptoms of depression or anxiety or other mental health conditions, and are feeling like they would like to send them to a child psychiatrist or to another mental health professional, but know that the wait lists are so long that if they don't do something and act now, that child and family will continue to suffer.

SIMON: Hmm. Dr. Wakefield, you're a trained psychiatrist. What are some of the signs people might be alert for?

WAKEFIELD: Well, I think any time that we're seeing someone isolate and when we see violent reactions - whether against self or others - oftentimes, isolation, despair and hopelessness have been a part of their stories. So when you see a change in that functionality - if someone is withdrawing from things that they've done and enjoyed in the past or not seeking out to supports that exist, those are signs that someone is in distress and needing some attention and intervention.

SIMON: But what do you do to deliver them to a professional?

WAKEFIELD: Well, I think, you know, first, we really have to meet people where they are. Things like CPAN are meeting kiddos where they are by helping their frontline clinician facilitate better care, but also school-based programs where a counselor or a teacher or an administrator who is concerned about a student - that they can refer to a program like our program under the consortium called TCHATT, Texas Child Health Access Through Telemedicine, for a mental health assessment. And I want to emphasize that a mental health assessment is really a well-being assessment. It's looking at your social needs. It's looking at how you're functioning at school and at home, what supports you have.

SIMON: Mmm hmm. You know, I feel compelled to note that authorities in Uvalde say that this shooter had - they were unaware of any criminal or mental illness history. So what kind of use could a program like this be?

WAKEFIELD: Well, I can't pretend to know everything about what happened in this case - those details are still coming out - but there have been reports about things that would indicate that there was mental health distress. When - you know, often, people think of mental health distress or psychiatric illness as someone coming forward and saying, you know, I'm struggling, I'm having these issues, or someone having a frank diagnosis, but it's also isolating after bullying or fighting with peers, truancy. You know, it presents in many, many different ways. And one of the things - you know, really looking at a focus on well-being - and when our kiddos are not engaging in school, that that is an indication that something may be awry and an opportunity for assessment and intervention if there is adequate access.

SIMON: I have to ask you bluntly, Dr. Wakefield - recognizing that you hold a position at an important state school - knowing that mental health is important, is it still any kind of replacement for gun measures?

WAKEFIELD: Well, I think that any act of violence is multifactorial, and there are lots of opportunities to reduce risk. The mental health programs are really about preventing crisis, and I think that they are an absolutely important and critical piece of the answer.

SIMON: Dr. Sarah Mallard Wakefield of the Texas Tech University Health Sciences Center School of Medicine. Thank you so much for being with us.

WAKEFIELD: Thanks for having me. Transcript provided by NPR, Copyright NPR.

Scott Simon is one of America's most admired writers and broadcasters. He is the host of Weekend Edition Saturday and is one of the hosts of NPR's morning news podcast Up First. He has reported from all fifty states, five continents, and ten wars, from El Salvador to Sarajevo to Afghanistan and Iraq. His books have chronicled character and characters, in war and peace, sports and art, tragedy and comedy.