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AUSTIN (KXAN) — Almost every county in Texas has a problem with mental health care staffing, state data shows.

A Texas Department of State Health Services dashboard says 248 of 254 entire counties have mental health professional shortages, plus three more counties (Lubbock, Dallas and Nueces) have partial designations. That’s 97.6% of entire Texas counties with shortages.

Texas Health Professional Shortage Area dashboard. Full interactive map online. (Screenshot Texas Health and Human Services)

In Central Texas, all counties except Williamson County currently have a shortage designation.

The state’s behavioral health worker shortage is expected to grow, according to a 2022 strategic plan from Texas’ Statewide Behavioral Health Coordinating Council. This is due in part to experienced practitioners approaching retirement and difficulties producing enough graduates from higher education institutions.

A 2020 Texas Behavioral Helath Workforce report acknowledged the pandemic “will only exacerbate existing behavioral healthcare shortages.”

How are these shortages measured?

The Texas Department of Health Services dashboard scores each county on the severity of its need. The scores come from the U.S. Health Resources and Services Administration.

Geographic areas, like counties, are measured along with low-income population areas and facilities like correctional facilities, rural health clinics or state mental hospitals.

Scores range from 0-25, with 25 as the best score, based on criteria including: 

  • Population-to-provider ratio
  • Percent of the population below 100% federal poverty level
  • Elderly ratio (percent of people over age 65)
  • Youth ratio (percent of people under age 18)
  • Alcohol abuse prevalence
  • Substance abuse prevalence
  • Travel time to nearest source of care outside the HPSA designation area [5 points max]

Here’s how some Central Texas counties rank:

  • Bastrop: 18
  • Hays: 17
  • Caldwell: 16
  • Milam: 16
  • Burnet: 16
  • Llano: 15
  • Travis: 14
  • Lee: 12
  • Blanco: 12
  • Mason: 12
  • Williamson: no designation

In Travis County, the People’s Community Clinic and Travis County Healthcare District facilities are scored at 17.

Bastrop, Blanco and Hays counties are proposed for withdrawal from the mental health professional designation, which means the area no longer meets the federal criteria for a shortage area, according to Texas DSHS.

The designations must be updated at least every three years, but some are updated sooner, according to a Texas DSHS spokesperson.

What could help?

The 2020 Texas Behavioral Helath Workforce report gave several recommendations to help the shortage. Short-term solutions included promoting existing loan repayment programs, recommending the Texas Education Agency include behavioral health careers in career readiness programs, expanding access to health care through telemedicine and re-examining Medicaid rates for behavioral health services.

Two Texas bills propose the repayment of student loans for people pursuing mental health professionals, specifically those who work in a mental health professional shortage area. The bills, Senate Bill 532 and House Bill 1211, would help mental health workers in schools, local mental health authorities and state hospitals.

Both bills are still moving through the Texas legislature. SB 532 is placed on the House’s general state calendar Tuesday, and HB 1211 passed in the Senate Sunday.