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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.

Update: In the 86th legislative session, Texas authorized the creation of the Child Psychiatry Access Program as part of school safety bill Senate Bill 11 (Taylor).

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

Update: House Bill 2080 (Coleman) was filed to create a Medicaid reimbursement code for Certified Family Partners. The bill did not receive a hearing.

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

Update: The legislature did not fund Texas Education Agency’s Exceptional Item 1.  Senate Bill 11 included major steps to improve mental health services in schools. This includes the creation of a rubric to identify existing mental health resources that can be used by schools. The bill also requires teachers to receive training on trauma-informed practices.

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

Update: Mental health and suicide prevention are required subjects as part of the student health curriculum across Texas. School districts are also now required to develop plans to engage and educate parents when their child in experiencing mental health concerns. Specific funding streams were not appropriated for NAMI programs, but there are opportunities for local affiliates to seek out funding.

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

HB 18 (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.

What does the bill do?

  • Provides a variety of incentives and strategies to offer guidance to school districts on how to improve their response to the mental health and substance use disorder service needs of students, including:
    • School district planning for suicide prevention, intervention, and post-vention
      Trauma-informed and grief-informed practice training for school employees
    • Mental health as part of health education for students

What does this mean for mental health?

  • Transforms the school mental health landscape by improving guidance and increasing incentives for schools to invest in improving student mental health and suicide.
SB 11 (Bonnen) – Relating to policies, procedures, and measures for school safety and mental health promotion in public schools and the creation of the Texas Child Mental Health Care Consortium.

What does the bill do?

  • Establishes the Texas Child Mental Health Care Consortium.
  • Requires the integration of trauma-informed practices in each school environment and in the district improvement plan.
  • Requires local school health advisory councils to develop parental awareness and engagement strategies regarding mental health, suicide, and substance abuse.
  • Provides school districts with an annual “school safety” funding allotment, which allows for schools to fund student mental health and suicide prevention strategies in addition to certain approved school safety activities.
  • Requires Texas Education Agency to disseminate information on mental health resources for regional education service centers.
  • Requires mental health and suicide prevention as part of the health curriculum.
  • Requires all school resource officers to receive de-escalation training.

What does this mean for mental health?

  • Dramatically expands access to child psychiatrists and children’s mental health resources through collaboration within medical schools in the consortium.
  • Helps improve response to student mental health issues through educator training and processes for responding to mental health and safety concerns, including self-harm.
HB 19 (Price) – Relating to mental health and substance use resources for certain school districts.

What does the bill do?

  • Requires local mental health authorities (LMHAs) to employ a mental health professional who would be housed at the regional Education Service Center and serve as a resource for school districts in their region.

What does this mean for mental health?

  • Provides a significant resource for educator training and resources to improve school response around student mental health.
HB 53 (Minjarez) – Relating to the transitional living services program for certain youth in foster care.

What does the bill do?

  • Adds tax filing, insurance acquisition, and civic education to life skills training for youth aging out.
  • Requires transitional living services to help youth access mental health services.

What does this mean for mental health?

  • Helps youth aging out of foster care learn how to access mental health services and insurance on their own, a common challenge for this group

 

Testimony on Child and Youth Mental Health

HB 198, School-Based Mental Health Center bill, Testimony 2.26.19

Senate Finance Article III Written Testimony 2.11.19
HHSC LBB Written Testimony on Child Mental Health 9.19.18
Department of Family and Protective Services Legislative Budget Board Testimony 9.13.18
Public Health and Human Services Committee Testimony 8.9.18
House Select Committee on Opioid Use Testimony 8.8.18
School Mental Health Select Committee Testimony 7.18.18

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