by Andy Keller, PhD, President and CEO, Meadows Mental Health Policy Institute
This year’s Legislature was one of the most productive ever in terms of helping Texans who suffer from mental illness. Lawmakers passed more than a dozen bills that will improve mental health access and treatment, start modernizing our aging state hospital system, and help break the cycle of repeat jail use, hospitalization and homelessness among our fellow Texans with the most severe and entrenched mental illnesses.
Several legislators deserve special thanks for their leadership on mental health. State Rep. John Zerwas, M.D., R-Richmond, is one of them.
A physician by training, Rep. Zerwas understands better than most the high human and financial costs of unmet mental health needs. Texas local governments spend more than $2.2 billion annually in jail, emergency department, hospitalization and shelter costs related to undertreated mental illness. And less than one in twenty children with severe mental health needs receive the intensive, community-based services they need, too often instead ending up in our juvenile justice system. With smart policy reforms and strategic investments, the state can greatly improve life for Texans with mental health challenges.
During the prior two legislative sessions in 2013 and 2015, lawmakers made substantial progress on reforming mental health services. They increased spending on mental health and started an innovative matching grant program to help veterans and their families, as well as homeless Texans with mental illness. But a huge amount of work remained for the 85th Legislature.
Rep. Zerwas recognized this and continued to drive progress on mental health this session despite facing major obstacles. His work as Chairman of the House Committee on Appropriations was especially challenging for two reasons: lawmakers had significantly less money to spend than two years ago, and the House and Senate had starkly different fiscal and legislative priorities.
Rep. Zerwas carefully navigated the competing priorities and conflicting personalities. Perhaps most important, he successfully worked with his Senate counterparts to find a $300 million down payment for modernizing our state hospital system.
State hospitals in Texas are publicly funded psychiatric hospitals that serve mostly adults with severe mental illness. Some patients need treatment to restore their mental competence before a criminal proceeding; others are not involved with the justice system but are too ill to be treated in another setting. Because too few get the treatment they need early enough and intensively enough, too many Texans need state-funded hospital beds – and the wait list for beds included hundreds of names and was growing by the day.
Nearly all of the hospitals themselves fall into two categories: moderately obsolete and dangerously obsolete. Three hospitals were built before the turn of the last century. What is more, the hospitals are often far from population centers. That makes it harder to recruit mental health professionals to staff them, harder for patients’ families to visit, and harder on law enforcement agencies that must transport prisoners to and from the hospitals. The system must be redesigned and modernized.
Because of the leadership of Rep. Zerwas and his colleagues, the state will now begin that process. He convinced lawmakers to appropriate $300 million to start planning, designing, and building new state hospitals. We envision facilities that are safer for patients and staff, and closer to urban centers so they can partner with academic institutions to anchor state-of-the-art care, research and training. In addition, the budget also includes $160 million for critical repairs to our existing state hospitals and state-supported living centers.
Rep. Zerwas also was instrumental in securing other critical mental health funding, including three important pieces of legislation that will maximize the impact of state dollars for mental health. Senate Bill 292 created a $37.5 million matching grant program to help counties that want to reduce recidivism among offenders with mental illness. House Bill 13 established a $30 million matching grant program to help local communities address gaps in mental health services. And finally, Rep. Zerwas helped ensure there was $2 million in funding to surge needed intensive capacity to help children in foster care receive intensive mental health services in the communities where they live.
We recognize this Legislative session ranked among the most rancorous and challenging, but Rep. Zerwas’ constituents can be assured he didn’t let that stop him from making their lives better. His leadership will help some of the state’s most vulnerable residents receive better mental health services – a worthy accomplishment in any Legislature.
About Meadows Mental Health Policy Institute – The Meadows Mental Health Policy Institute (texasstateofmind.org) provides data driven, nonpartisan policy research and technical assistance to improve behavioral health services in Texas.