Texas Last in the Nation for Access to Mental Health Care, Report Says

A 2022 report from Mental Health America ranks Texas last for access to mental health care — but the data was collected in 2019, before the COVID-19 pandemic.

After a gunman killed 19 children and two teachers in a shooting at Robb Elementary School in Uvalde, Texas, Governor Greg Abbott linked mental health issues to school shootings.

“We as a state, we as a society, need to do a better job of mental health,” he said.

Abbott’s statement drew criticism from advocacy groups such as the National Alliance on Mental Illness (NAMI).

“Mental illness is not the problem. It is incorrect and harmful to link mental illness and gun violence, which is often the case after a mass shooting,” NAMI wrote in a statement after the shooting.

Public figures, including the Texas gubernatorial candidate Beto O’Rourke and author Meena Harris have also criticized the state since the shooting, saying it ranks last in the nation for access to mental health care.


Is Texas ranked last in the nation for access to mental health care?



This statement needs context. A 2022 report from Mental Health America ranks Texas last in the nation for access to mental health care — but the data has limitations. Additionally, other sources rank Texas higher in areas related to access to mental health care.


A spokesperson for O’Rourke told VERIFY in an email that he was referring to the nonprofit Mental Health America’s annual Access to Care ranking when he made his statement that Texas was last for access to mental health care.

The ranking indicates “the degree of access to mental health care in a state”, which includes access to insurance, treatment and special education, quality and cost of insurance and availability of the mental health workforce, according to Mental Health America.

In the association’s 2022 reportTexas ranks No. 50 overall in the nation, behind Alabama, and No. 51 when Washington, DC, is included.

The report ranks accessibility to mental health care in U.S. states based on nine categories, including the percentage of adults with mental illness who have not received treatment and the number of health care providers available in the state.

In several of these categories, Texas ranked last, including adults with mental illness who are uninsured at 21.5%; adults with cognitive impairment who were unable to see a doctor due to cost at over 40%; and for young people who did not receive treatment at around 73%, according to the report.

But the state has fared better in some categories. Texas ranked 19th for adults with mental illness who reported an unmet need, with 24% of people indicating they were unable to receive the treatment they needed.

Mental Health America also reviews workforce availability, including licensed psychiatrists, psychologists, and clinical social workers, among other mental health professionals.

Massachusetts leads the state in mental health workforce availability with a rate of 150 people for every mental health provider, the report said. Alabama ranks last at 920:1, and Texas is second to last at 830:1.

Mental Health America recognizes that there are limits to the data, including the fact that they were collected until 2019 – before the COVID-19 pandemic. Data reflecting the pandemic will not be available until 2023, the nonprofit organization said.

But “higher-ranking states might have been better prepared to deal with the mental health effects of the pandemic in its early stages,” the nonprofit says.

Although VERIFY was unable to find other data sources focused on multiple facets of access to care, such as Mental Health America, some surveys and analyzes paint Texas in a more favorable light in specific areas.

The household surveyconducted by the National Center for Health Statistics (NCHS) and the US Census Bureau, shows that Texas ranked 15th among US states for people who needed counseling or therapy but did not get it not got in the past month, with 12.7% of people reporting an unmet need, compared to nearly 21% in Washington, D.C., which was ranked worst at No. 1. Responses were collected from April 27 to May 9, 2022.

Kaiser Family Foundation (KFF) also published an analysis 2019-2020 data from the Substance Abuse and Mental Health Services Administration (SAMHSA) Restricted Online Data Analysis System (RDAS), National Survey of Drug Use and Health (NSDUH) and archives addiction and mental health data.

KFF found that Texas ranked among the top 10 states with the lowest percentage of adults reporting an unmet need for mental health treatment at No. 7.

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