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Of course we don’t do nearly enough for mental health

Because Republicans rush to talk about “mental health” every time there’s another mass shooting, it’s important to remember that their response to meeting the demand for mental health, in schools and elsewhere, has been completely inadequate.

Tucker’s was the kind of positive outcome state lawmakers pictured in 2019, when they worked to increase mental health resources for students after the mass shooting at Santa Fe High School that left eight students and two teachers dead.

Access to those services again is at the forefront as Republican leaders respond to last week’s massacre in Uvalde.

Mental health experts say the 2019 initiatives, including hundreds of millions of dollars more in funding, have only begun to address Texas’ mental health crisis, and that the state does little to track even their limited outcomes. Many school districts are left to fund their own interventions.

There is little evidence that mental illnesses cause mass shootings or that people diagnosed with them are more likely to commit violent crimes. Advocates also warn that scapegoating mental illness can stigmatize the wide spectrum of people living with psychological disorders.

“It’s absolutely something that should be addressed — but it’s not a panacea,” said Greg Hansch, executive director for the Texas chapter of the National Alliance on Mental Illness. “It’s more of a secondary or tertiary factor.”

Gov. Greg Abbott and other top Republicans have pointed to the shortage of mental health resources, especially in rural Texas, as a key factor in the Uvalde shooting, while rejecting calls for stricter gun laws.

The 18-year-old gunman, who killed 19 children and two adults, legally purchased the assault-style weapon he used in the shooting spree and had “no known mental health history,” Abbott said.

Even with the 2019 reforms, mental health care remains vastly underfunded in Texas. That largely is because of budget cuts two decades ago and years of stagnant funding to community mental health services. Today, Texas provides less access to care than any other state, and nearly three quarters of children and teenagers with major depression do not get treated, the highest rate in the country, according to the nonprofit group Mental Health America.

Without a direct source of state funding for mental health care, school districts in Texas are forced to rely on a patchwork of state and federal programs, most of which do not guarantee that money will flow to mental health services for students or training for teachers. As a result, only a tiny fraction of Texas’ roughly 1,200 public school and open-enrollment charter districts have enough counselors, social workers and psychologists to meet professionally recommended student-to-provider ratios, according to a recent Houston Chronicle analysis.

Central to lawmakers’ 2019 response was a new mental health consortium overseen by the University of Texas System, with a $99 million initial investment for programs focused on children and teens, including virtual visits between child psychologists and students referred by school staff. The Legislature also increased funding to Communities in Schools, which places staff directly on campuses and had employed Tucker’s social workers.

In addition, lawmakers required school officials to form “threat assessment teams” to identify students who may pose a risk of violence, and put forth another $100 million to school districts every two years that can be used to hire security personnel, provide mental health services and buy physical upgrades, such as metal detectors and bullet-resistant glass.

In the first year, however, just 12 percent of Texas school districts reported using any of the funds for mental health support, while 8 percent said the money was used for behavioral health services, according to a survey by the Texas School Safety Center at Texas State University.

A task force later found the Texas Education Agency was not collecting meaningful data on mental health programs in schools, including the number of students they serve or “any standard outcomes” they measure. The Legislature responded with a bill last year to bolster reporting, but the agency has yet to release any results.

Annalee Gulley, director of public policy and government affairs for Mental Health America of Greater Houston, said lawmakers have taken encouraging steps to support mental health but should have paired the funding with more direction for school officials on how to spend it.

“A critical lesson learned in the years following the Santa Fe High School shooting is funding alone is not enough,” Gulley said. “Instead, the state must connect financial resources to guidance on the most effective strategies to support the safety and well-being of educators and students following such a catastrophic event.”

Much of the focus since 2019 has been on the telehealth effort known as TCHATT, including more than $50 million in added pandemic funding last year. The program has been slow to expand, however, serving only about 6,000 students so far. By comparison, Communities in Schools serves 115,000 students annually on a $35 million budget. There are more than 5 million students in Texas.

So yeah, still a long way to go, and that’s before we get to things like the challenges of hiring all of the counselors that would be needed in Texas’ 1200 school districts and thousands of schools. And this story never mentions the need to expand Medicaid, which would be the single biggest thing that we could do in Texas to improve mental health care for everyone, not just for students. I started the draft of this post a couple of weeks ago, before the Cornyn/Murphy gang got what passes for traction on a bipartisan framework for a gun control bill (still no bill, and the framework remains under negotiation, but there’s an agreement to come to an agreement, and that’s the progress in question), and since then we’ve had that, more ridiculous talk about all of the non-gun things that actually cause mass shootings, the lunatics at the Texas GOP convention basically accusing Cornyn of treason, and a bunch more people getting shot and killed, but we haven’t had much talk about mental health. As with gun control itself, the Republicans and their gun enablers will be happy to just let that fade away, until the next time it has to be trotted out as an excuse for the latest mass casualty.

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  1. […] discussed this before, and this is another illustration of the problem. We can count on hearing two things whenever […]

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