Making Democracy Work

Behavioral Health Services

Woman in the dark

Updates from Sherry L. Lee, Behavioral Health Issue Chair

Definition of Behavioral Health (12/23/16)

The term behavioral health is an interdisciplinary science often used interchangeably with mental health. However, there are differences.

Mental health is the psychological state of a person who holistically functions at a satisfactory level. In conditions of mental illness the outcome is not usually changed by changing behavior, but rather by use of medications. In comparison, behavioral health can be improved by changes in behavior. The latter provides a more positive aspect because it indicates that adverse behaviors can be changed for more healthful behaviors. Behavioral health promotes the well being of the individual through the intervention and prevention of incidents of mental illness and/or substance abuse.

Therefore, the term behavioral health provides a broader and less stigmatized view of mental illness and the resulting unsatisfactory behaviors by the individual. Improving the mental illness of an individual may involve not only the use of medications and therapies, but also changes in inappropriate or self destructive behaviors by the individual. Mental illness is usually detected and/or diagnosed by the unsatisfactory behaviors of the individual.

Take Action Today in Response to Centers for Disease Control (CDC) Report on U.S. increased Suicide Rate (8/15/16)

In April 2016 Mental Health America of Texas (MHAT) issued a press release in response to the CDC report that revealed there was a 24% increase in the number of suicides in the U.S. from 1999 to 2014.

What you can do today!

  • Educate yourself about the warning signs for suicide
  • Know how to refer someone at risk for help. Use the Texas Suicide Prevention Toolkit to find answers!
  • Put the National Suicide Prevention Lifeline number in your cell phone: 1-800- 273-8255.
  • Your county community mental health center provides suicide crisis services and has a 24/7 crisis hotline. Find your County Mental Health Center on the Texas Department of State Health Services website

Read the full MHAT Press Release

Testimony

Coalitions and Resources

Resources

  • Mental Health America of Texas transforms the systems that promote mental health, prevent mental disorders and substance abuse, and achieve recovery from mental illness and addictions through innovative education, advocacy and services.

  • Health and Wellness, Center for Public Policy Priorities Access to quality, affordable health care for all is at the core of our mission. We work to protect and improve access to quality public and private insurance, mental health care, and basic health needs for all Texans.

Acronyms: What does that mean?

Positions LWV-TX

SERVICES FOR PEOPLE WITH BEHAVIORIAL HEALTH DISORDERS - 1988

The League of Women Voters of Texas supports the right of all persons who have behavioral health disorders to have access to services designed to help them reach and maintain an optimal level of functioning in the least restrictive environment. The League believes that state government should ensure that the following services are accessible to persons with behavioral health disorders:

  • residential services

  • non-residential services

  • continuity of care services

  • outreach to those who cannot or will not seek assistance

  • programs for special populations.

The League supports these actions to improve the number and quality of services available for people with behavioral health disorders:

  • provide incentives for community-based residential programs

  • implement measures to encourage public and private funding of long-term rehabilitative care

  • provide technical assistance to, and regulation of, housing providers such as room and board homes that house patents with behavioral health disorders

  • implement measures to prevent discrimination and encourage community acceptance of residents with behavioral health disorders, including community education about serious behavioral health disorders

  • supplement federal Supplemental Security Income (SSI) payments for mentally disabled persons

  • allocate state funds to local mental health authorities according to need for services and performance level and quality

  • provide incentives for local mental health authorities to develop residential services for persons who are most difficult to place

  • increase the number of physicians who receive training in the public system for behavioral health disorders

  • expand academic and research opportunities in the public system for behavioral health disorders

  • require continuing education and in service training for mental health professionals and direct care staff in the public system for behavioral health disorders

  • provide higher salaries and benefits as required to attract and retain qualified personnel in the public health system for behavioral disorders

The League supports funding of services for persons who have behavioral health disorders by:

  • state government

  • state government through participation in federal programs

  • city, county and other local governments

  • private insurance

  • individuals to the best of their ability.

The federal government is currently the major funding source for research on behavioral health disorders. The League supports sharing the responsibility for financing research on the prevention, causes, treatment, and need for treatment of those with behavioral health disorders with state government and the private sector.

Position LWV US

Issue Studies and Explanation

League delegates to the 1987 state Convention adopted a new study of the state mental health and mental retardation system, with emphasis on persons who are seriously mentally ill. There was excellent participation in the study with 75% of local Leagues responding. The consensus indicated strong support for access to a range of high-quality services by Texans with serious mental illness, and public education regarding serious mental illness to combat stigma and discrimination against persons who suffer from it. The position on services for the seriously mentally ill was adopted in November 1988.

History of LWV-TX Action

1989: League efforts focused primarily on increasing the Texas Department of Mental Health and Mental Retardation (TDMH/MR) budget in order to initiate programs for youths and to expand services to rural areas. Although the final budget was an expansion over previous levels, it primarily reflected the increased cost of providing current service levels and some court-- mandated reforms for hospitalized clients. A small amount of funding was designated for programs for children and youth. The League also opposed several discriminatory bills, which ultimately died. These bills would have significantly reduced access to housing, within residential areas, for disabled persons including the mentally ill.

1990-1993: During the 1990 interim, LWV-TX testified before a hearing of the Senate Health and Human Services Committee to reiterate our support for private board and care homes operated in a responsible fashion. The 1991 legislative session produced successful legislation clarifying the regulatory and licensing procedures for board and care homes and outlining a "bill of rights" for residents and providers.

Although not active on this specific issue in the 73rd Legislature, the League worked to maintain funding levels for human services programs, including those for the mentally ill.

1994-1995: During the legislative interim, LWV-TX presented testimony to an advisory task force of the TDMH/MR charged with delineating authority/provider roles. The League objected to the proposed separation of local authority from local providers, noting the need for the authority and provider to be one entity at the local level to ensure accessibility, continuity, and flexibility of assistance to those in need of services.

2005: The Legislative Priority for the 2005 session was to work to influence the Legislature to maintain or increase the current funding level for services for the seriously mentally ill, when appropriate, combining efforts in coalition with other organizations. We appreciate being able to work with the Mental Health Association of Texas, and in particular, the Mental Health Association of Greater Dallas.

The final budget bill included the following mental health items: $20 million added statewide for adult community mental health, $3 million added statewide for children's community mental health, $15 million added statewide to increase state psychiatric hospital bed capacity, $3.3 million added for full restoration of CHIP mental health benefit, $44 million added for restoration of Medicaid adult psychological counseling benefit, $195 million for the NorthSTAR program.

The following mental health related bills were signed by the Governor: HB 224 (Corte) preventing a minor from discharging him or herself or refusing psychoactive medication under specified conditions, and SB 1473 (Lindsay)/ HB 2524 (Coleman) requiring that all law enforcement officers, veterans as well as cadets, receive training on de-escalation and crisis intervention techniques for dealing with persons with mental impairments. HB 2572 (Truitt) authorizing a local mental health and mental retardation authority to determine whether to provide services directly or to contract with another organization to provide service, was vetoed.

2007: The LWV-TX worked to influence the Legislature to maintain or increase the current funding level for services for the seriously mentally ill. A request by the Department of State Health Services for $82 million in new dollars for mental health crisis services was full funded. The additional funding will allow the state to pen six new psychiatric emergency observation sites, provide children's outpatient and crisis stabilization for 87,000 people and to train and certify 340 community center staff to respond to crisis calls. In addition funding provided for state mental health facilities totaled $634 million, a $14.6 million increase to maintain the 2007 caseloads. Legislation for "parity" to require health insurance plans to cover treatment for serious mental health disorders advocated by LWV-TX did not make it through the process. However SB 568 (Ellis), which mirrored pending federal legislation, and HB 510 (Fabree) made it through respective chambers. The features of both pieces of parity legislation were attached to HB 1919 relating to health insurance coverage for individuals with brain injury, however at the last minute these were stripped from the bill in conference committee.

2011:The League monitored legislation affecting mental health and substance abuse services throughout the legislative session and encouraged members through the Legislative Newsletter to contact their congressional representatives serving on the relevant committees and when budget considerations came to the floor of both houses in support of League positions. In light of current language being used to describe mental health and substance abuse issues, it was recommended and adopted that the issue title be changed to "Services for People with Behavioral Health Disorders."

Although the State Legislature generally maintained 2010-2011 levels of funding for mental health in the Department of State Health Services budget, this must be understood in the context that Texas is at the bottom of all 50 states in per capita spending for public mental health services. While Community-based Services for Children were increased by almost $21 million, Community-based Services for Adults were decreased by over $11 million, and Substance Abuse Treatment Services were decreased by over $29 million. Substance Abuse Treatment Services are critical because of the large number of people with mental illnesses who have co-occurring substance abuse disorders. 2013: While Texas continued to be at the bottom of all 50 states in per capita spending for public mental health and substance abuse services, the Legislature did provide an additional $350 million for the biennium. This significant increase was in large measure motivated by several tragic mass shootings of people attending a political event, people at a movie, and children and teachers in an elementary school; the three shootings were conducted by young people with histories of mental illness.

Some 70 bills related to mental health were filed and LWV-TX monitored and advocated for those related to our positions. In addition to our highest priority for increased funding, the most significant bills passed include the following: authorization of a study of the mental health workforce shortage; facilitation of best practices in hospital emergency rooms for Screening, Brief Intervention and Referral to Treatment (SBIRT) in cases of injuries from substance use/abuse; authorization of a study of the need statewide for forensic and civil hospital beds; expansion of the number of mental illnesses eligible for treatment (previous law limited coverage to major depression, bipolar disorder and schizophrenia) and funding for Mental Health First Aid training statewide; integration of mental health with the rest of the health care system in the Medicaid program; provision of improved mental health awareness and suicide prevention training for public school educators and staff; and clarification of judicial authority to court-order outpatient treatment for people with mental illness.