On September 14, the Texas House of Representatives Public Health committee will hold a public hearing focused on rural health. They’ve invited comments concerning resources to strengthen Texas’ health care workforce and rural health care challenges. 

As the executive director for the National Alliance on Mental Illness (NAMI) Texas, I feel especially called to address the importance of mental health care access for rural Texans. I’d also like to recognize a resource already in place addressing this challenge, Medicaid 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, over 3.3 million adults in Texas are living with a mental illness. The conversation around mental health and behavior disorders has shifted as our world changes and we emerge from a global pandemic. In 2022, addressing mental health, especially in our young people, has never been more important.

However, according to Rural Health Information Hub, almost 3 million people live in rural Texas, and in 28% of the state’s counties, there isn’t a single hospital. When it comes to treating mental health conditions, access to care is critical. Medicaid managed care addresses the challenges rural Texans face when it comes to accessing care by increasing routine doctors’ visits, coordinating care plans, and incorporating new strategies such as tele-health.

Managing serious mental health conditions is possible, but routine and high-quality care plays a significant role in achieving successful outcomes. When it comes to diagnoses, like many medical conditions, the earlier the better. Children with Medicaid are 4x more likely to have a consistent source of care than their uninsured counterparts. If children are diagnosed early, care plans can be developed and assessed before their illness or condition worsens. 

Although mental illnesses can be treated, it’s vital, especially in more serious cases, to have continued access to care. Rural health clinics, which are supported by Medicaid managed care, work to close the gap in care often felt by rural Texans. These clinics are available for routine or emergency mental health services and are essential in keeping patients on their care plan. Medicaid managed care and routine treatment for mental health conditions could prevent costly psychiatric hospitalizations, emergency room visits, or in some cases criminal interventions.

Mental illnesses are complex conditions and often require a team of experts for treatment. The coordinated care approach of Medicaid managed care ensures communication within the care team to provide premier care. This approach also alleviates stress and anxiety from the patient, which could compound their condition and worsen symptoms. For individuals on treatment plans that include medications, it is imperative the individual adheres to that care plan. 

Medicaid managed care adapts and progresses to meet society’s changing approach to medicine. In an increasingly virtual world, Medicaid managed care is expanding access to tele-health, allowing patients to connect with their providers over the phone or video call to receive routine care. Especially in cases where a patient may need to see a specialist, tele-health allows patients to receive necessary care without traveling hours to the nearest provider. 

In my years working in the mental health sector here in Texas, seeing all areas of this state, I know Medicaid managed care is especially important for rural Americans experiencing mental health struggles. With this in mind, as the Texas House Committee on Public Health meets this week to assess ongoing challenges in the rural health care system and look for ways to strengthen rural health care, NAMI Texas would urge the members to increase access by strengthening Medicaid managed care to protect our state’s vulnerable populations – especially those living with mental illness.

Editor’s Note: The above guest column was penned by Greg Hansch, executive director for The National Alliance on Mental Illness (NAMI) Texas (NAMI Texas). This organization is dedicated to help improve the lives of people affected by mental illness through education, support, and advocacy.


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