What’s Driving the Increased Demand for Mental Health Care in Texas?

A new survey by the American Psychological Association shows demand for mental health services has continued to rise since the start of the COVID-19 pandemic. A majority of the psychologists surveyed said they saw a higher number of patients requiring treatment for anxiety, depression and substance abuse. But 60% of them also said they were too busy to take on new patients.

Young people and people of color are driving demand for mental health services across the country. This national trend is also reflected here in Texas. To get to the bottom of it, the Texas Standard spoke to Dr. Alfonso Mercado. He is a licensed clinical psychologist and an associate professor in the Department of Psychological Science at the University of Texas Rio Grande Valley. Listen to the story above or read the transcript below.

This transcript has been edited slightly for clarity:

Texas Standard: Do you view the current situation in Texas as a mental health crisis?

Alfonso Mercardo: My answer to that would be absolutely. We’ve had the COVID-19 pandemic for a while now, but realistically we’re going through multiple pandemics. Another is that of mental health. The pandemic has caused much suffering. We have people with increased levels of depression and anxiety, not only because of the pandemic, but also because of the other factors that the pandemic has contributed to: unemployment, financial woes, and also people of color who are affected by the diverse differences we see in our life see health care.

Have you personally noticed an increased demand for mental health services? What are the most common problems people seek treatment for?

Yes. Right now in the state of Texas we are seeing an increased demand for mental health care. I have colleagues in the field who are no longer accepting patients. We have community mental health programs that cater to the various underserved areas that have a waiting list. And unfortunately, many people are not seen.

Many of the most common issues we are currently seeing are not only related to the COVID-19 pandemic, but we are also facing significant issues. We take care of financial and professional worries, family problems, divorces, separations. Many things are related. And right now we are in a mental health emergency that has many of our communities in dire need of help.

We spoke to doctors and nurses in the ER who talked about how to do triage. But then you have to have an action plan to move forward with it. And the doctors or facilities just aren’t available. Other than closing availability once your logs fill up, how have you and your fellow psychologists here in Texas dealt with this increasing demand?

You’re right. Many people contact either their family doctor or the emergency room when they experience these panic-like symptoms, which are often related to anxiety. Sometimes depression can lead someone to seek emergency care at the local hospital or waiting rooms. There is a shortage of mental health providers in these emergency care facilities, and unfortunately the clinics and psychologists and mental health professionals that are already in place in the communities do not have the capacity to treat everyone who needs help.

Ideally, we would have an inclusive care program where mental health professionals are present in these emergency departments and during family doctor visits. That would be ideal conditions for many of us. But because many of these programs have no funding here in Texas, we rank last in the United States when it comes to receiving financial support for mental health in our communities. This is of great concern, especially now in the midst of a global pandemic.

During this pandemic, telemedicine has become a common practice for psychologists. How has telemedicine impacted the mental health care space? Does it open up opportunities to help people in need?

One thing we could see positively during this pandemic was access to mental health programs on another platform. Underserved communities such as rural communities have been using telemedicine for quite some time. In Texas we have many rural and underserved areas. We have families who travel 3 to 6 hours to see a psychologist. Rural health programs in the United States have used telemedicine, giving them an advantage during the COVID-19 pandemic. Now we use their platform, their resources and learn from them.

Are They As Effective As Personal Treatment Options?

Yes. As you know, psychotherapy and many services that clinical psychologists provide require face-to-face and telemedicine, the video conferencing system… There have been some studies that have identified its effective use. Of course, when we are dealing with more complex cases that require psychological tests and assessments, this telemedicine becomes an obstacle. But for psychotherapeutic interventions and support, this access to care via this telehealth platform has been beneficial to many.

You said earlier that the increased demand for mental health services is particularly prevalent among young people and people of color. What are the factors that might drive these populations to seek therapy?

Well, I said earlier, we’re not going through just one pandemic, we’re going through multiple pandemics. And one of them is the pandemic of racism. At the beginning of the pandemic, we had George Floyd and the Black Lives Matter movement also adding to the psychological toll on these disadvantaged communities. Also, here in Texas, many different lawsuits have been filed with other disadvantaged groups, whether they be immigrant groups or individuals who are transgender – community-affirming care for transgender people has also been attacked by our elected leaders. Therefore, it is very worrying to have these policies that cause psychological distress and really freeze treatment – an evidence-based treatment that has been shown to be effective in all clinical groups.

Is there a way to address the shortage of professionals qualified to treat people with some level of mental illness?

Yes. I think psychologists have a responsibility to help with advocacy. Both the American Psychological Association and our Texas Psychological Association – our priority is our guild and the protection of psychologists and our profession and our training standards. But another is making sure that education and welfare and fair treatment are also available. We have worked with various institutions. We have our next year legislature right here in Texas. At TPA, one of our legislative agendas is to expand loan-repayment programs for those psychologists who want to work and serve with various communities where we see an underserved area where we have rural health communities.

For example, here in South Texas, at McAllen, we are short of about 170 clinical psychologists to meet national health standards. And that’s just one community. Texas is a big state. That’s why we’re increasingly supporting mental health loan-repayment programs for mental health providers, not just psychologists. We work together so we can have that support for those professionals who want to help in these severely underserved communities.

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