In 2007, North Austin-based Samaritan Center began focusing its counseling and mental health care program on serving veterans, active-duty military members and their families.

Although now 36 percent of patients seeking treatment at the Samaritan Center are current or former military members, CEO Carlos Rivera said he would like to reach more.

“We are only able to touch the tip of the iceberg,” said. “There’s still a lot of need out there. We’re not able to meet it.”

Rivera said in general, area residents seeking treatment for mental illnesses do not have a lot of options. Texas has the fourth-lowest number of psychiatrists per 100,000 residents in the U.S., with 4.1 psychiatrists per 100,000 residents, according to physician consulting firm Merritt Hawkins’ 2015 North Texas Regional Extension Center report.

“There’s an increasing awareness among our leadership that this is an issue that has been ignored for far too long,” said Greg Hansch, National Alliance on Mental Illness-Texas public policy director.

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Resources in Central Texas

Although the state faces a mental health care shortage, Austin and Travis County residents are probably “[some] of the most fortunate in Central Texas” because of the variety of mental health care resources that exist in the area, said Karen Ranus, executive director for the Austin affiliate of NAMI.

“I think you can put a little circle around Austin, Travis County and even if you move a little farther beyond that [as an area with mental health care options],” she said.

At Northwest Counseling & Wellness Center in Northwest Austin, Executive Director John Harvey said most of his patients do not have any difficulty accessing care, although coverage varies by insurance plan.

NCWC is a holistic practice that offers outpatient treatment for substance use disorders and other mental illnesses such as anxiety and depression. Treatment includes yoga, acupuncture and mindfulness, Harvey said.

Although the center is set up to mostly deal with insurance, Harvey said a sliding-fee scale is available for those without insurance.

“I worry about the indigent population,” he said. “We’re not structured very much to serve that. We’re here in suburbia. I know there’s Bluebonnet [Trails] and there are some places out there, but the waiting list is really long.”

Serving those in need

The indigent population is one the Samaritan Center hopes to reach, Rivera said. The organization recently revised its strategic plan to focus efforts on serving patients who live in the area but cannot afford the full cost of care.

The Samaritan Center treats mental illnesses such as depression, anxiety or anything trauma-related. Patients without insurance can bring proof of income and pay on an adjusted-fee scale. Rivera said the average cost per session for low-income clients is $10-$20 compared with the full-cost cash price of $120.

The Samaritan Center accepts all forms of insurance, including Medicare. About 66 percent of its clientele is Caucasian, which Rivera said is not representative of the nearby community.

“That’s why we’re building relationships with Dobie Middle School, with Burnet Middle School, where we’ll be doing yoga and tai chi in September,” he said. “We’re reaching out to Restore Rundberg and participated in that [neighborhood revitalization] initiative. We’re working with the Latino community. We’re hiring Latino clinicians to make sure we can meet the need of that population.”

The center has a waitlist of 90 people seeking treatment. Because of demand, the Samaritan Center is in the process of hiring three new counselors. The center’s telepsychiatry program allows the center to connect a therapy patient virtually with a psychiatrist within about a week.

Community needs

In March 2015, Cross Creek Hospital opened in Northeast Austin, offering treatment to children, adolescents and adults for mental illnesses such as anxiety, depression, schizophrenia and bipolar disorder. For adult patients, the hospital offers both an intensive outpatient program for substance abuse treatment and a partial hospitalization program for mental health treatment.

In July the hospital will open its inpatient detox treatment wing, said TJ McDow, the hospital’s director of business development. Detox is just one of the many needs she said the 90-bed hospital has tried to fill in the community.

“Although there are multiple facilities, multiple psychiatric beds in the region, by this time next year we will have outgrown those beds,” she said. “Access is still a challenge.”

McDow said Cross Creek’s mission includes educating the public not only about mental health in general but how people can access care and where they can get it.

In May the hospital launched a mobile assessment program, Clinical Community Liaison Patrick Gorman said. After receiving a call from a physician, hospital, clinic, school or nursing home, Gorman will then meet with them, the patient and the family to determine the best course of action for the patient.

“You have a lot of people that get their all-encompassing care through their [primary care physician] or a clinic,” he said. “When there’s a psychiatric disorder in the mix and somebody is having distressing symptoms, oftentimes it’s that frontline provider and it’s not their expertise.”

He said it is often difficult for area residents to obtain appointments with outpatient psychiatrists.

“As a result of that, you have people going untreated for longer periods of time and then falling into crisis where otherwise they would have gotten caught [through proper care],” he said.

McDow said what sets Cross Creek apart is CEO Jennifer Miller is also a licensed clinical social worker, which is rare in the industry.

“It makes such a big difference in our treatment programs, care and leadership,” McDow said.

Statewide shortage

Merritt Hawkins cites a statewide trend that indicates although primary care doctors are anticipated to be in short supply, the steepest shortage may be among psychiatrists.

This shortage can be attributed to a few factors, including an aging psychiatrist population—60 percent of Texas psychiatrists are age 55 or older. Other factors include the small numbers of medical school graduates who choose psychiatry residency programs and the continued stigma of mental health issues, Merritt Hawkins’ 2015 report states.

The Texas Legislature, through the help of sponsor Sen. Charles Schwertner, R-Georgetown, passed a student loan repayment program during the previous legislative session. The program encourages recent medical school graduates to focus on underserved geographic areas, or Health Professional Shortage Areas, by offering school loan repayment assistance for certain mental health professions.

Three new medical schools are slated to open in Texas, but growing the number of psychiatrists in Texas will require retaining them after they finish medical school, Hansch said.

The state’s recent increased mental health focus may account for more people accessing mental health care, reduced wait lists for treatment and more community centers, Hansch said.

“Texas in the past few years has come a long way in bolstering resources that are dedicated to the public mental health system,” he said. “[However], there’s a need for more resources for the public mental health system.”

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