What’s driving the increased demand for mental health care in Texas?
A new survey from the American Psychological Association shows that the demand for mental health services has continued to climb since the start of the COVID-19 pandemic. A majority of the psychologists surveyed said they saw higher numbers of patients that needed 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 the demand for mental health services across the country. That national trend is reflected here in Texas, too. To get to the bottom of the issue, the Texas Standard spoke with Dr. Alfonso Mercado. He’s 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 lightly for clarity:
Texas Standard: Do you consider the current situation in Texas a mental health crisis?
Alfonso Mercardo: My answer to that would be absolutely. We’ve had the COVID-19 pandemic for some time now, but realistically, we are going through multiple pandemics. An additional one is that of mental health. The pandemic has caused a lot of distress. We have individuals with increased depression and anxiety not only from the pandemic, but from the other factors that the pandemic has also contributed to: unemployment, financial issues and also, people of color being affected by the different disparities that we’re seeing in our health care.
Have you personally seen increased demand for mental health services? What are the common issues people are seeking treatment for?
Yes. Right now in the state of Texas, we’re seeing an increased demand for mental health care. I do have colleagues in the field that are no longer taking patients. We have community mental health programs that cater to the different underserved areas having a waitlist. And unfortunately, many people are not being seen.
Many of the common issues that we’re seeing right now not only are related to the COVID-19 pandemic, but we are looking at significant distress. We’re looking at financial and job-related concerns, family issues, divorce, separations. Many things are interrelated. And currently we are in a mental health emergency where many of our communities are in dire need.
We’ve spoken with E.R. doctors and nurses who have discussed how they can provide triage. But then, you have to have an action plan to move forward with that. And there just aren’t the doctors or facilities available. How have you and your fellow psychologists here in Texas dealt with this rising demand other than closing off availability once your logbooks fill up?
You’re correct. Many people resort to either their primary physicians or the emergency room when they’re having these panic-like symptoms, which really many times it’s anxiety. Sometimes depression can lead someone to seek emergency care in the local hospital, in the waiting rooms. There is a lack of mental health providers in these urgent care facilities and the clinics and the psychologists and mental health professionals that are already in the communities unfortunately don’t have the capacity to effectively see everyone who needs help.
Ideally, we’d have an integrative care program where mental health professionals are present in those emergency room rooms, in the family doctor visits. Those would be ideal settings for many of us to be in. But because many of these programs don’t have funding here in Texas, we ranked last in the United States to receive mental health funding for our communities. Especially now amid a global pandemic, it’s very concerning.
During this pandemic, telehealth has become a common practice for psychologists. How has telehealth affected the mental health care field? Does it open up opportunities to help folks in distress?
One thing that we could look at in a positive lens during this pandemic has been the access to mental health programming in a different platform. Underserved communities like rural communities have been using telehealth for quite some time. In Texas, we have a lot of rural and underserved areas. We have families traveling 3 to 6 hours to see a psychologist. Rural health programs in the United States have used telehealth, so they were at an advantage when the COVID-19 pandemic hit. Now we’re using their platform, their resources and learning from them.
Are they as effective as in-person treatment options?
Yes. As you know, psychotherapy and many services that clinical psychologists provide do require face-to-face and telehealth, the video conferencing system… There have been some studies that have identified its effective use. Of course, when we’re dealing with more complex cases when psychological testing and evaluation is warranted, that telehealth becomes an obstacle. But for psychotherapeutic interventions and support, that access to care via that telehealth platform has been beneficial for many.
Earlier, you said that the increased demand for mental health services is particularly prevalent in young people and people of color. What are the factors there that could be driving these populations to seek therapy?
Well, earlier I said we are not only going through one pandemic, we’re going through multiple pandemics. And one of them is the pandemic of racism, too. During the early onset of the pandemic, we had George Floyd and the Black Lives Matter movement that also contributed to psychological distress to these disadvantaged communities. Also, there have been many different actions filed here in Texas with other disadvantaged groups, whether it’s immigrant groups or individuals who are transgender – transgender community-affirming care has also been attacked by our elected leaders. So, having these policies that cause psychological distress and really freeze treatment – evidence-based treatment that has proven to be effective across clinical groups – is very concerning.
Is there any way to do something about the shortage of professionals who are qualified to treat people who may be suffering with some degree of mental illness?
Yes. I think psychologists have a responsibility to assist with advocacy. Both the American Psychological Association and our Texas Psychological Association – our priority is our guild and protecting psychologists and our profession and our training standards. But another one is to also ensure that education and welfare and equitable treatment is available. We have worked with different entities. We have our legislative session coming up next year right here in Texas. At TPA, one of our legislative agendas is to increase loan repayment programs to those psychologists wanting to work and assist with different communities where we see an underserved area, where we have rural health communities.
For example, here in South Texas, in McAllen, we’re missing about 170 clinical psychologists to meet national health standards. And that’s just one community. Texas is a big state. So we’re supporting increasing mental health loan repayment programs to mental health providers, not only psychologists. We’re working together so we can have that support for those professionals wanting to assist in these communities that are direly underserved.