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Public Policy: Child and Youth Mental Health

Half of mental health conditions begin by the age of 14 and 75% begin by the age of 24, but these issues often go undetected and untreated until they reach a crisis point. Texas should ensure that effective mental health intervention, support, and promotion strategies are readily available throughout the school system and other child/youth-serving agencies.

NAMI Texas Child and Youth Mental Health Policy Priorities

Child and Adolescent Psychiatry

Youth who have psychiatric needs in Texas often do not have access to a psychiatrist or other mental health professional.  The ratio of children to child psychiatrists in Texas is six times higher than what is recommended by the American Academy of Child and Adolescent Psychiatry.  Policy opportunities to increase access to child and adolescent psychiatry include:

  • HHSC Exceptional Item 49 to fund the Pediatric Telemedicine Grant Program for Rural Texas
  • Creation of a Child Psychiatric Access Program to integrate necessary psychiatric services into pediatric primary care settings through telehealth services and education for pediatricians on mental health care.
Certified Family Partners

Family support is critical in the recovery process for those with a mental health disorder, but families may struggle to understand the process of accessing care for their child.

A Certified Family Partner (CFP) is a parent or guardian with lived experience raising a child with mental, emotional, or behavioral health challenges and who has at least one year navigating a child serving system. The Certified Family Partner uses their experience to educate, role model, and promote hope in recovery for other families.

Policy options may include:

  • Defining Certified Family Partners in state code to legitimize scope of practice
  • Medicaid reimbursement for Certified Family Partners
  • Funding to Local Mental Health Authorities to expand services
School mental health professionals

Schools can serve a critical role in identifying and treating early mental health issues in children, but many schools do not have the resources they need to succeed.  Policy strategies to increase capacity may include:

  • Increase the number of social workers and counselors working in schools
  • Stronger mental health and trauma-informed practice education for teachers
  • Texas Education Agency (TEA) Exceptional Item 1 to enhance mental health services and education in schools.
  • Capacity-building at the state government or higher education levels to disseminate best practices and provide technical assistance
    • NAMI Parents and Teachers as Allies
    • NAMI Ending the Silence
    • Positive Behavioral Intervention and Supports
    • Social-Emotional Learning
    • Mental Health First Aid
Mental health education for students and parents

Recognizing the signs of mental illness should not be limited to mental health or educational professionals. Students and parents must be empowered with information on mental health disorders and how to seek treatment.

  • Required mental health education throughout the K-12 health and science curriculum
    • Funding for NAMI Ending the Silence for Students
  • Funding for parental education on mental health issues in school, clinic, and other community settings
    • NAMI’s Ending the Silence for Families program
Mental health services for foster youth

Youth in foster care are up to four times more likely to have a mental health disorder than youth outside the foster care system and are more likely to have a substance use disorder by the time they reach young adulthood.  Texas should also ensure youth and children who are in foster care or aging out receive appropriate and individualized treatment along the spectrum of needs

  • DFPS Exceptional Item 8 to fund prevention and early childhood intervention supports for both parents and children.
  • DFPS Exceptional Item 5 to fund Preparation for Adult Living staff and Supervised Independent Living programming and supports.


86th Legislative Session Key Bills on Child and Youth Mental Health

Senate Bill 10 (Nelson) – Relating to the creation of the Texas Mental Health Care Consortium.

Senate Bill 10 would create a consortium of universities and other mental health stakeholders to improve access to mental health services with technology, improved training for professionals, and other strategies. It also would create a Child Psychiatry Access Program, which would increases access to child psychiatrists through telemedicine.

This bill is currently in committee.  Testimony was taken on February 12, 2019.

Austin-American Statesman article on February 12, 2019
Press release from Senator Jane Nelson on February 5, 2019.

Senate Bill 355 (West) – Relating to developing a strategic plan to ensure the provision of prevention and early intervention services complies with federal law.

Senate Bill 355 would require the Department of Family and Protective Services to develop a strategic plan to implement the federal Family First Act, which is a recent federal law requiring certain standards for residential treatment centers, increased focus on prevention and early intervention programming, and programming for special foster care populations, and offers federal funding to the state for compliance.  Texas has chosen to defer the law for two years, but in two years it will need to reach compliance in its practices.

This bill has been referred to the Senate Health & Human Services committee.

Austin-American Statesman article on January 16, 2019.

Senate Bill 504 (Seliger) – Relating to the inclusion of certain information in postsecondary education and career counseling academies developed for certain school counselors and other postsecondary advisors employed by a school district.

Senate Bill 504 would allow training centers for school counselors and postsecondary advisors to include social-emotional learning and indicators of behavioral issues as part of the training curriculum.

This bill has been referred to the Senate Higher Education committee.

House Bill 129 (Bernal) – Relating to the assignment of certain certified or licensed professionals to certain public schools.

House Bill 129 would require schools with extremely high rates of educationally disadvantaged students employ at least one professional, of primarily a list of mental health professionals on campus, and would offer state aid to employ the professionals.

This bill has been referred to the House Public Education committee.

House Bill 198 (Thierry) – Relating to providing mental health services and mental health education to public school students at school-based health centers.

House Bill 198 would add add mental health services to the list of possible services offered at a K-12 school-based health center.

This bill has been referred to the House Public Education committee.

Press release from Representative Thierry on January 15, 2019.
Press release from Representative Thierry on November 12, 2018.

House Bill 204 (Thierry) – Relating to the inclusion of instruction about mental health in the required curriculum for public school students.

House Bill 204 would add mental health as a required component of health curriculum offered in K-12 public schools.

Press release from Representative Thierry on January 15, 2019.
Press release from Representative Thierry on November 12, 2018.

House Bill 876 (Allen) – Relating to the model training curriculum and required training for school district peace officers and school resource officers.

House Bill 876 would expand training requirements for school resource officers and district police around mental health issues from to all school districts. Training requirements would include curriculum around positive behavior interventions and supports, child and adolescent psychiatry, de-escalation techniques, mental health needs, and crisis intervention.

House Bill 906 (S. Thompson) – Relating to the establishment of a collaborative task force to study certain public school mental health services.

House Bill 906 would create a Task Force on Public School Mental Health Services to evaluate school mental health services and school employee training on mental health. The task force would evaluate ethnicity, gender, special education status, and geographic location of individuals who receive mental health services, evaluate services and employee training, best practices for districts and schools around services and training, and disparities across different populations.

House Bill 1069 (Price) – Relating to consideration of the mental health of public school students in training requirements for certain school employees, curriculum requirements, counseling programs, educational programs, state and regional programs and services, and health care services for students and to mental health first aid program training and reporting regarding local mental health authority and school district personnel.

House Bill 1069 would set standards for school employee training to increase mental health training, require student mental health curriculum, include comprehensive school counseling as part of district improvement plans, integrate mental health as part of student health centers, increase access to providers and mental health training for school employees.

House Bill 1160 (Jarvis Johnson) – Relating to the use of the compensatory education allotment for a school district’s school guidance and counseling program or counseling or social work services.

House Bill 1160 would allow compensatory education allotment (funds to compensate for student disparities and disadvantages) to be allowed to be used to fund school counselors and licensed social workers and professional counselors.

House Bill 1190 (Hernandez)/House Bill 517 (Israel) – Relating to unprofessional conduct by mental health providers who attempt to change the sexual orientation of a child; providing penalties.

House Bill 1190/House Bill 517 would define conversion therapy for LGBTQ youth (ex. attempting to change a gay youth’s identity/orientation to straight) by a mental health provider as an act of unprofessional conduct subject to discipline from regulatory boards.

San Antonio Current article on House Bill 517 on December 17, 2018.

House Bill 1312 (Moody) – Relating to the provision of on-campus mental health services by a school district and reimbursement under Medicaid for certain services provided to eligible students.

House Bill 1312 would allow for school districts to contract with local mental health authorities to provide mental health assessment and treatment to students on campus, and allows for Medicaid reimbursement for the service if the child is on Medicaid.

House Bill 1335 (Price) – Relating to the establishment of school-based behavioral health centers by school districts and a grant program administered by the executive commissioner of the Health and Human Services Commission for the operation of those centers.

House Bill 1335 would create a grant program for certain entities to fund a school-based behavioral health center in school districts.  Special priority would be given to established programs and schools with funding needs and disadvantaged students.

House Bill 1467 (Talarico) – Relating to a mental health professional to school law enforcement official ratio for public schools.

House Bill 1467 would require school districts to employ a certain ratio of mental health professionals for every one school law enforcement official depending on district size, but would provide option for waiver application to school districts that could not meet this requirement.

House Bill 1623 (Coleman) – Relating to training for public school personnel to identify and intervene if a student suffers from behavioral health issues.

House Bill 1623 would add trauma-informed practices to list of required staff trainings for new staff and for recurring training every five years, and would add suicide prevention training to the trainings required every five years.


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