ShortageKarlos E. Garza

Baptist Health Foundation of San AntonioFall 2016

Mental Health Workforce

Texas

Healing from theINSID

EOUT

What is a Mental Illness?

“A mental illness is a condition that affects a person’s thinking, feeling or mood.”

- National Alliance on Mental Illness

National Statistics

*NH/OPI = Native Hawaiian /Other Pacific Islander**AI/AN = American Indian/Alaska NativeData courtesy of Substance Abuse and Mental Health Services Administration (SAMHSA)

Source: National Institute of Mental Health. Retrieved on November 5th, 2016 at https://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml

Overall Female Male 18-25 26-49 50+ Hispanic White Black Asian NH/OPI* AI/AN** 2 or More0

5

10

15

20

25

30

18.1

21.8

14.1

20.1 20.4

15.4 15.6

19.2

16.3

13.1

22.321.2

27.1

Prevalence of Any Mental Illness Among U.S. Adults (2014)

Sex Age Group Race

Perc

ent

National Statistics (cont.)

“A serious mental, behavioral, or emotional disorder (excluding developmental and substance use) that is diagnosable currently or within the past year resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.”

Overa

ll

Female Male

18-25

26-49 50

+

Hispan

ic

White

Black

Asian

NH/OPI*

AI/AN**

2 or M

ore

0123456789

10

4.15

3.1

4.8 4.9

3.1 3.54.4

3.12.4 2.9

4

8.9

Prevalence of Serious Mental Illness Among U.S. Adults (2014)

Sex Age Group Race

Perc

ent

National Statistics (cont.)

39%

61%

National population with a mental illness (2010)

Adults receiv-ing treatment

Adults not receiving treatment

10.8%

89.2%

Adults re-ceiving treatment Adults not receiving treatment

National population with substance abuse issues

(2010)

Source: Office of National Drug Control Policy. 2013 national drug control strategy [Internet]. Washington (DC): White House; 2013

Health Resources and Service Administration

(HRSA)• Provides threshold• Health Professional Shortage

Area (HPSA)oHigh proportions of youth and elderlyoLow-incomeoAlcohol/substance abuse problems

• Doctors and facilities receive incentives

PsychologistsSocial WorkersLicensed Professional CounselorsMarriage and Family Therapists

Core Mental Health

Professions (CMHP)

Required Ratios for Core Mental Health Professions (CMHP)

• 9,000:1 including psychiatrists• 6,000:1 excluding psychiatrists• 30,000:1 only psychiatristsAreas with high needs

6,000:1 including psychiatrists4,500:1 excluding psychiatrists

20,000:1 OR 15,000:1 only psychiatrists

Status of Texas (2013)

Source: The Mental Health Workforce Shortage in Texas, 2014, Retrieved September 28th, 2016 from the Texas Department of State Health Services

Status of Texas (cont.)

33.6%

66.4%

Adult population (18+ years) in Texas with a mental ill-

ness (2010)

Adults receiving treatment

Adults not receiving treatment

Source: Texas Department of State Health Services (February 2011)

28.9%

71.1%

Children population (9-17 years) in Texas with a se-

vere emotional disturbance (2010)

Children receiving treatment Children not receiving treatment

PsychiatristsCounty 2015 Population

Est.Psychiatrists Ratio Rank

Atascosa 50,278 3 16,759 31

Bandera 22,792 0 NA NA

Bexar 1,882,834 195 9,656 13

Comal 128,347 9 14,261 22

Guadalupe 155,621 2 77,810 76

Kendall 38,993 5 2,316 1

Medina 51,307 0 NA NA

Wilson 49,833 1 49,833 71

Source: Texas Department of State Health Services, Professional License and Certification Unit – September 2015

PsychologistsCounty 2015 Population

Est. Psychologists Ratio Rank

Atascosa 50,278 4 6,185 73

Bandera 22,792 4 5,698 65

Bexar 1,882,834 762 2,470 11

Comal 128,347 42 3,056 24

Guadalupe 155,621 35 4,446 47

Kendall 38,993 15 2,600 13

Medina 51,307 2 25,654 149

Wilson 49,833 9 5,537 63

Source: Texas Department of State Health Services, Professional License and Certification Unit – September 2015

Social WorkersCounty 2015 Population

Est. Social Workers Ratio Rank

Atascosa 50,278 15 3,352 151

Bandera 22,792 2 11,396 209

Bexar 1,882,834 1,781 1,057 26

Comal 128,347 118 1,088 30

Guadalupe 155,621 107 1,454 49

Kendall 38,993 17 2,294 104

Medina 51,307 17 3,018 139

Wilson 49,833 25 1,993 88

Source: Texas Department of State Health Services, Professional License and Certification Unit – September 2015

Licensed Professional Counselors

County 2015 Population Est.

Chemical Dependent Counseling

Ratio Rank

Atascosa 50,278 10 5,028 126

Bandera 22,792 5 4,558 112

Bexar 1,882,834 713 2,641 46

Comal 128,347 33 3,889 98

Guadalupe 155,621 31 5,020 125

Kendall 38,993 14 2,785 54

Medina 51,307 15 3,421 84

Wilson 49,833 13 3,833 97

Source: Texas Department of State Health Services, Professional License and Certification Unit – September 2015

Marriage and Family Therapists

County 2015 Population Est.

Marriage and Family Counseling

Ratio Rank

Atascosa 50,278 0 NA NA

Bandera 22,792 3 7,597 30

Bexar 1,882,834 284 6,630 19

Comal 128,347 14 9,168 44

Guadalupe 155,621 12 12,968 62

Kendall 38,993 9 4,333 9

Medina 51,307 1 51,307 118

Wilson 49,833 4 12,458 59

Source: Texas Department of State Health Services, Professional License and Certification Unit – September 2015

• Aging workforce• Lack of mental health internship opportunities• Inadequate pay• Lack of cultural and linguistic diversity• Insufficient funding for mental health services

Reasons for Shortage

Number of Psychiatry Residents Completing Residency Programs in Texas

Year Number of Residents

2005 68

2006 59

2007 53

2008 49

2009 49

Source: Texas Medical Association– December 2010

Aging Mental Health Workforce in Texas

Mental Health Professional

Median Age Male

Median Age Female

Psychiatrists 57 50

Licensed Chemical Dependency Counselors 53 50

Social Workers 54 47

Source: Statewide Health Coordinating Council (January 2011). Texas State Health Plan, 2011-2016: A roadmap to a health Texas

Recommendations1. Expand graduate education programs for

behavioral health professions.2. Develop tele-health opportunities in multiple

mental health provider categories.3. Provide adequate reimbursement rates for

mental health services. 4. Require professional boards to collect data for

cultural and linguistic purposes.

References1. The Mental Health Workforce Shortage in Texas, Texas Department of State Health

Services (2014)

2. Hogg Foundation for Mental Health. (2011). Crisis Point: Mental Health Workforce Shortage in Texas. Austin, TX.

3. Hoge, M. A., Stuart, G. W., Morris, J., Flaherty, M. T., Paris, M. J., & Goplerud, E. (2013). Mental Health and Addiction Workforce Development: Federal Leadership is Needed to Address the Growing Crisis. Health Affairs, 32(11), 2005-2012.

4. Texas Department of State Health Services. Information received from the Mental Health and Substance Abuse Division: Decision Support Unit in January 2011.

5. Statewide Health Coordinating Council (January 2011). Texas State Health Plan, 2011-

2016: A roadmap to a healthy Texas

Questions?