For rural Texans, access to mental health care is critical

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Our national public health conversations over the past few decades have shifted to highlight mental health as a growing concern.
As Executive Director of the National Alliance on Mental Illness (NAMI) in Texas, I feel especially called to address the importance of access to mental health care for rural Texas residents. I would also like to learn about a resource that already exists to meet this challenge, Medicaid for Managed Care.
At the end of 2020, a report by NAMI found that 1 in 5 adults will experience some symptoms of mental illness each year. According to Mental Health Texas, there are more than 3.3 million adults in Texas living with mental illness. The conversation about mental health and conduct disorders has shifted as our world changes and we emerge from a global pandemic. In 2022, addressing mental health, especially in our youth, has never been more important.
However, according to the Rural Health Information Hub, nearly 3 million people live in rural Texas, and in 28% of the state’s counties, there is not a single hospital. When it comes to treating mental health conditions, access to care is critical. Medicaid Managed Care addresses the challenges that rural Texas residents face when it comes to accessing care by increasing routine physician visits, coordinating care plans, and incorporating new strategies such as telehealth.
Serious mental health conditions can be managed, but high-quality routine care plays an important role in achieving successful outcomes. When it comes to prognosis, like many medical conditions, the sooner the better. Children who have Medicaid are four times more likely to have a steady source of care than their uninsured counterparts. If children are diagnosed early, plans of care can be developed and evaluated before their disease or condition worsens.
Although mental illness can be treated, it is essential, especially in the most serious cases, that you continue to receive care. Rural health clinics, supported by Medicaid for Managed Care, are working to bridge the gap in care felt in rural Texas. These clinics are available for routine or emergency mental health services and are necessary to keep patients on their care plan. Medicaid managed care and routine treatment of mental health conditions can prevent costly psychiatric hospitalization, emergency room visits, or in some cases criminal interventions.
Mental illnesses are complex conditions and often require a team of experts to treat. Medicaid’s coordinated care approach to managed care ensures communication within the care team to deliver primary care. This approach also relieves the patient’s stress and anxiety, which can worsen their condition and exacerbate symptoms. For individuals who have treatment plans that include medication, it is essential that the individual adhere to this plan of care.
Medicaid managed care adapts and advances to meet society’s changing approach to medicine. In an increasingly virtual world, Medicaid managed care is expanding access to telehealth, allowing patients to contact their providers by phone or video call to receive routine care. Especially in cases where a patient may need to see a specialist, telehealth allows patients to receive the necessary care without traveling for hours to the nearest provider.
During my years working in the mental health sector here in Texas, seeing all of this state, I know that Medicaid managed care is especially important for rural Americans with mental health struggles.
With this in mind, I urge our state’s constituents and representatives to recognize the value of Medicaid managed care in protecting our state’s at-risk populations—particularly those with mental illness.

Greg Hansch is the executive director of The National Alliance on Mental IllnessTexas (NAMI Texas), an organization dedicated to helping improve the lives of people with mental illness through education, support, and advocacy. If you have a potential guest column for The Enterprise, email your idea or column itself to If you have something to say, we want to hear from you!

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