The old saying is "everything is bigger in Texas" — including its problems.
Mental health ranks atop.
In the wake of the Uvalde massacre, conservative politicians are waving away talk of gun control and stressing that mental health is the real culprit. And in boastful Texas, mental health is a big problem.
Mental Health America ranks Texas dead last in access to mental health care. The Kaiser Family Health Foundation found that Texans suffer depression at higher-than-average rates.
In data released by the Texas Education Agency, more than half of Lone Star schools don't have a psychologist or access to telehealth.
Texas has also opted out of Medicaid expansion under the Affordable Care Act. In various studies, that amounts to tens of billions of dollars in federal funding, which could insure more than a million Texans and provide reimbursements for mental health professionals.
Canutillo Independent School District is north of El Paso, Texas. It's like Uvalde, with a supermajority Hispanic population and a mental health desert. It's chief concern is access for those services for its 6,200 students
"So, one of the things that is most important is social workers, counselors and prevention specialists working together," social worker Rosario Olivera said.
The school district is Title I funded, meaning more than 40% of its students fall below the poverty line.
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Administrators grappled with various problems across 10 schools, like how to get students access to medical care and in a pandemic, access to mental health and more counselors.
"We do the best we can do to service children of highest need," Olivera continued. "However, it's the same thing as with counselors. The ratio is very high."
In Canutillo, it meant a pilot program of bringing in social workers and social work interns from the University of Texas El Paso.
"For every campus that has 350 students, you need one counselor. The majority of our campuses have 500 and above," Canutillo Independent School District Director of Student Support Services Monica Reyes said.
Another glaring indicator in mental health access is poverty.
"This is typically what you'll see: A mobile home with six or seven family members in it," said Francisco Mendez with Familia Triunfadores.
In the colonias of San Elizario, access to mental health is a question of whether there are any therapists close by. But oftentimes, the answer is no.
"It's really difficult for them," Mendez said. "They'll have to drive at least 35 miles to El Paso."
In Kingsville, Texas, the schools have one mental health professional for more than 2,800 students.
Tracy Warren is a licensed school specialist psychologist, or LSSP. She's an intern completing her doctorate. The challenge for Kingsville Independent School District is holding on to her and getting more people like her.
"We are trying to let everybody know how important mental health is and that if we don't have the mental health foundation, the education is not going to take place," Warren said.
She is the front line. The school district leans on nonprofits to help kids outside of class.
"There are a lot more anxious students this year than I've ever seen," Warren continued. "We actually had a student that was at one of our campuses — he's 4, going into Pre-K. First day of school, he stopped outside to count the police cars that he can see to ensure that he was safe before he came into school."
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The small school district's leader, Superintendent Cissy Reynolds-Perez, says more mental health professionals and counselors need to be trained to work in rural schools.
"It's very difficult because not everybody wants to come out to this area," she said. "You know, you have your metropolitan areas, which I'm not saying it's easier, but there are more resources there."
At nearby Texas A&M Kingsville, the school has opened an institute for rural mental health.
Steve Bain is the director of the Rural Mental Health Institute. His goal is to create a mental health graduate student counselor pipeline direct to public schools.
"We have an opportunity now to reverse this trend of being last, or toward the last, in terms of accessibility of mental health services," he said. "Only about 25% of students in K-12 who suffer from depression are getting mental health services. And depression has increased among our student population in the last five to eight years, significantly so."
In Texas, licensed school specialty psychologists and social workers can be mental health caregivers to emotionally fraught kids, but there is a catch.
"Texas Education Agency has not recognized social workers as TEA employees yet, per se. We don't have a specific job description, like teachers or counselors do," Olivera said.
That means school districts miss out on funding and insurance reimbursements when social workers provide mental health care for kids.
Newsy’s mental health initiative “America’s Breakdown: Confronting Our Mental Health Crisis” brings you deeply personal and thoughtfully told stories on the state of mental health care in the U.S. Click here to learn more.
