Texas’ $25 billion mental health investment hasn’t curbed shootings

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Less than 24 hours after a gunman killed eight people at an Allen outlet mall, Gov. Greg Abbott took to Fox News’ airwaves and quickly swatted down questions about gun reform.

“We’ve seen an increased number of shootings in states with easy gun laws as well as states with very strict gun laws,” Abbott told “Fox News Sunday” host Shannon Bream during the broadcast.

From there, Abbott steered the conversation away from guns, as he has done following mass shootings in Santa Fe, El Paso and Uvalde — three of seven mass shootings in Texas since the governor took office in 2015 — and supplanted it with a push for more mental health services in the state.

“And what Texas is doing in a big-time way, we are working to address that anger and violence by going to its root cause which is addressing the mental health problems behind it,” Abbott said during the national interview on Sunday. “People want a quick solution. The long-term solution here is to address the mental health issue.”

To date, Texas has invested $25 billion during Abbott’s watch as part of a statewide behavioral health plan to address the state’s floundering mental health system as demand continues to grow with the state’s booming population. It’s a tremendous dollar amount to be sure, but one that has done little to lift Texas nationally when it comes to mental health offerings.

In 2022, the state ranked dead last when it comes to access to mental health services, according to Mental Health America, a nonprofit advocacy group.

Today, 98% of Texas’ 254 counties were wholly or partially designated by the federal government as “mental health professional shortage areas.”

Also unclear is how all this funding is supposed to reach potentially violent shooters. While studies consistently show that most mental illness doesn’t lead to mass violence, there’s been a psychiatric component linked to all seven mass shootings in Texas during Abbott’s term as governor.

“While mental health is undoubtedly a critical piece of the puzzle when it comes to preventing mass shootings, it is also essential to address the opportunity for individuals to acquire firearms,” said state Rep. Ray Lopez.

The San Antonio Democrat this year proposed House Bill 2148 that would have studied veteran deaths caused by suicide to find the percentage of veterans who were diagnosed with mental health problems or were receiving medication at the time of their death. The bill never made it to the House floor.

“The reality is that firearms can potentially end up in the hands of anyone and everyone, including those who are mentally unstable, experiencing distress or lack maturity,” Lopez said. “This presents a significant challenge that must be tackled in order to ensure public safety.”

Guns and mental illness 

Despite polling that shows 76% of Texas voters favor some gun restrictions, Republicans here — who have controlled the Texas Legislature since 2003 — have steered clear of gun restrictions.

In fact, since 2000, Texas lawmakers have approved more than 100 bills that loosened gun restrictions.. And just this week, an attempt to raise the minimum age to buy semi-automatic rifles appears to have failed after it lost its momentum when it was left off the Texas House’s agenda ahead of a key deadline.

Mental illness has been considered a factor in all seven mass shooting events in Texas since 2015.

Shortly after Micah Johnson killed five Dallas police officers during a Black Lives Matter protest, it was revealed the 25-year-old gunman, a former Army soldier, had shown signs of post-traumatic stress disorder but he was not formally diagnosed with the condition.

In 2012, five years before Devin Kelley shot and killed 26 church members in Sutherland Springs, he escaped from a mental health facility while in the Air Force, after he had attacked his wife and stepson and made threats to superiors.

Patrick Crusius was reportedly in a “psychotic” state after he was arrested for killing 23 people in an El Paso Walmart in 2019. His lawyers say their client has a history of mental disabilities.

Seth Ator, who was killed after he fatally shot seven people in Midland and Odessa in 2019 had failed a gun background check because of a “mental defect” court ruling in his past and purchased the AR-15 he used in 2019 from another person, who was later sentenced to federal prison for the transaction.

Dimitrios Pagourtzis, accused of killing 10 people in the 2018 Santa Fe High School shooting has yet to be prosecuted because he has been confined at a state psychiatric hospital after it was determined he has been — so far — incompetent to stand trial.

Although Salvador Ramos, the 18-year-old shooter who killed 21 people at Robb Elementary exhibited signs of depression and committed acts of violence toward animals, there is no evidence he ever received a psychiatric diagnosis or any mental health assistance in a town that was starved for mental health services before the deadly attack nearly a year ago.

And this week, officials say that Mauricio Garcia, who killed seven people in Allen was removed from Army basic training because of “mental health concerns.”

Since Abbott has been governor and particularly after mass shootings, there’s been an increase in dollars set aside for more mental health services. But mental health experts say the funding of services isn’t the only answer to mass shootings. And they point to how what Texas actually funds is actually more reactive than preventive.

“There have been some increases in various mental health programs since [the shooting in] Uvalde. It has not been to the level to impact structural barriers that many Texans face trying to access care,” said Alison Mohr Boleware, policy director for the Hogg Foundation for Mental Health.

The state’s mental health system is ranked low because access is limited in rural areas of the state due to a lack of providers, plus the quality is uneven, costs are high and too many people are currently uninsured. About 20% of Texans do not have health insurance.

Still, Abbott has not elaborated on how his push to fund more mental health services is supposed to reach potential mass shooters and prevent future catastrophes. His office did not respond to questions about how more mental health programs are supposed to do that.

A closer look at that funding

This year, a Texas Health and Human Services Commission report confirmed that Abbott has invested more into the state’s mental health systems, with their budgets increasing year over year.

The report states that mental health funding has increased by about $1.1 billion from the 2018-19 biennium to the 2022-23 biennium.

“Funding supports a variety of programs at multiple agencies and articles, including outpatient and inpatient mental health services at the Health and Human Services Commission, behavioral health services provided through Medicaid and CHIP, and payments made to providers to promote and improve access to services,” the report states.

“Governor Abbott has always worked diligently to fully fund and expand mental health programs and services for Texans,” said Andrew Mahaleris, a spokesperson for the governor. Abbott made addressing statewide mental health needs an emergency item in the 2019 legislative session. That year, he signed into law the Texas Child Mental Health Consortium and the Child Psychiatric Access Network, which is designed to intervene and treat children and adolescents showing signs of emotional distress.

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“The expansion of mental health services continues to be a priority of the Governor and legislature, as current budget discussions look at increasing mental health funding from $8.9 billion to more than $11 billion,” Mahaleris said.

While the funding has increased and some preventive services have been created, the best example being the state’s Child Mental Health Consortium, nothing seems to be slowing the rate of mass shootings in Texas.

Mental health experts say their profession isn’t the only answer to mass shootings and that state leaders need to expand their focus.

“It’s important to note that the majority of people with mental health conditions are not violent, and focusing on mental health only can increase that stigma,” Boleware said.

Greg Hansch, the executive director for the Texas chapter of the National Alliance on Mental Illness, said the state needs to look beyond child and community services, saying investments need to be made where distressed adults intersect with government and hospitals.

“A strong effort has been made to fund mental health in Texas, but we still have a long way to go,” Hansch said. “The state would be well served to focus more attention on increasing funding for first-episode psychosis treatment, crisis services, [mental health] workforce initiatives and jail diversion.”

Also, a lot of money has gone to upgrading the state’s psychiatric hospital system. This inpatient system treats the most seriously mentally ill patients in the state, most of which come from the state’s jails. Of the $25 billion set aside for mental health in the state budget over the past nine years, at least $4 billion has been spent renovating, constructing and staffing state hospitals.

Both Hansch and the Hogg Foundation’s Boleware point to how Texas needs a more specific plan that includes how to recruit more health care workers, intervenes more directly and provides such universal access that everyone in this vast state can easily find services, not just children and those accused of a crime in large urban areas.

“We recognize that there is a need for more funding going to prevention, early intervention and supports for anyone who needs to access, rather than only focusing on funding for those in the highest level of crisis,” Boleware said. “Unfortunately, funding alone does not ensure equitable access to services across the state.”

Disclosure: Hogg Foundation for Mental Health has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

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