Texas mental health crisis: Parents and professionals say the state is failing children

CENTRAL TEXAS - Investigative Summary: Texas ranks last in the nation for access to mental healthcare.

State data shows more than 90 percent of Texas kids being treated for depression have thoughts of self-harm. The question many parents have is, "where do I go for help in times of crisis? Can I trust facilities to have staff needed to help my child?" Those questions remain unanswered, even for local music legends Guy and Jeska Forsyth. They say when it came to helping their teenage daughter, there were more issues than they, or any parent could expect. We spent months speaking with family, digging through state data, and questioning elected officials to get answers for your children.

_________________________________________________________________________________________________________________________________________________________________________________________________________________

We do want to warn that this story may be triggering for some, as we discuss suicide amongst other topics.

Isabella Bailey, flips through her Snoop Dogg cookbook, looking for new recipes while she cooks eggs and bacon, just like her grandpa used to make her. 

Making food is one of the ways she find time to re-center herself and be away from her thoughts, it’s a tool she’s learned after a suicide attempt.

"I just stop thinking, I go on autopilot," Bailey says. 

Cooking helps, because there are times the weight of the world has felt too much. 

"I had had an incident where I had tried to commit suicide and we had to send me to the hospital," Bailey says. 

With her parents' permission, she’s sharing her story about what happened to her in March of 2022. She says it was coming out of COVID where she says like many families during the pandemic, they faced family issues. 

"Like I felt so done. I had gone out of the house and I had gone on a walk," Bailey remembers. "If somebody is going through that and they say to give them some alone time, give them some alone time, just make sure that you check in on them every once in a while, but give them their space. Because I'm pretty sure the reason I did it is because nobody was giving me space. And I needed that because the reason I had felt so done is because I haven't had space for years."

She ended up in the back of an ambulance and her parents, Guy and Jeska Forsyth rushed their daughter to the emergency room after a suicide attempt. 

The Forsyth’s say their daughter was bullied for her race, body image and identity. A 2022 study by the National Alliance on Mental Illness says about one out of six Texas kids between 6 and 17 years old suffers from a mental health disorder annually. 

"We are in the hospital right now because she tried to commit suicide. What do we do if we can’t depend on the schools to try and keep our children safe," Jeska Forsyth, Isabella’s mother shared in a video she sent us.  

The closest hospital to their home in Buda is Ascension Seton in Hays County where they spent nearly three days waiting in the emergency room waiting for a pediatric psychiatric bed to open up at Dell Children’s Medical Center; they're the region's only children’s hospital that specializes in kids psychiatric emergencies.

"It was a very weird environment. The doctors and the nurses were oddly aggressive," Isabella remembers.

"It’s a trauma unit and it’s traumatic for her to be there, but they couldn’t find her a bed at Dell [Medical Center]," Jeska Forsyth remembers. 

Ascension Seton in Hays county has an emergency room. but no dedicated beds for children in a mental health crisis according to the state’s annual hospital survey of 2021.

We spoke with the Medical Director at Dell Children’s Mental Health at the time to better understand why there were no beds available.

"Right now we can take up to 24 patients in our unit and when you consider the breadth of how many potential patients there may be or come through our ER in any given day, it’s a pretty small amount," Dr. Sean Kerrigan, who’s since left Dell Children’s Mental Health Unit said. "And that’s even if we’re fully staffed and we’re not always able to be fully staffed." 

Dr. Kerrigan says Dell Children’s isn’t alone, psychiatric bed availability is an issue for the entire state of Texas.

Statewide psychiatric bed shortages 

"What we've been seeing at all of our hospitals, and it’s not [only] located in big cities or on the border or any place else. It's consistent [statewide]. There is increasing demand for mental health services for kids and it's kids with really severe mental health issues," Stacy Wilson, president of the Children’s Hospital Association of Texas says. 

CHAT is a group of seven non-profit children’s hospitals in the state including Dell Children’s. 

"So it's suicidal ideation. Or it's self-harm or it's even. Homicidal ideation. These are the kids that are coming into our emergency department seeking care," Wilson says. "They have a demand for those beds. They are almost always full. And sometimes, you know, that leaves kids in crisis and their families trying to figure out how do we treat these kids and where do we get them into."

Here in central texas, Bexar, Bell, Travis and Williamson counties are the only places  with pediatric beds specialized to take these children. Wilson says it’s not enough and right now there’s no accurate way to measure what would be enough.

Finding data when there is no data

"Right after Uvalde happened, Speaker Phelan reached out to us and said, we need to reach out to these kids, we have a mental health crisis in the state, ‘what do we need to do?’ and we go, ‘we don't know.’ They said, ‘what do we have?’ and we go, ‘we don't know.’ And they said, ‘well, how much is it going to cost?’ and we're like, ‘we don't know’." Wilson explained. 

Uvalde’s mass shooting in May of 2022 happened just a few months before the state legislative session. During that time, lawmakers passed a requirement for the state to create a statewide pediatric mental health strategic plan. Texas doesn’t have one. 

"We don't even know how many staffed inpatient hospital beds we have for kids. We don't collect that data," Wilson admits.

We figured out a way to measure the data, we pulled numbers from the state annual hospital survey. Every hospital in Texas gets one the most recent data available was from 2021 when 599 hospitals filled it out. We found there’s only 1384 pediatric psychiatric beds for more than seven million kids in the state, meaning there’s 1 bed per five thousand kids at any given time.

Even the experts at American Psychiatric Association don’t know what’s the optimal number of beds to have for children. One study from Molecular Psychiatry found 60 psychiatric beds per 100,000 people is considered optimal. 

"We just don't have the resources or the infrastructure to help those kids like we need to," Wilson says. 

Getting answers from lawmakers

We went to state lawmakers for answers after Wilson said Republican House Speaker Dade Phelan led the charge in addressing children’s mental health following the Uvalde Massacre. 

"Ever since I got elected in 2015, the legislature has made great strides in mental health reforms and mental health access and the 88th session built on that as well," Phelan said during an interview with him at his Beaumont district office. 

Despite the strides, Mental health America still ranks Texas last in mental health access for adults and children in 2023.

"It's one of the reasons that I've taken on mental health as a cause that I want to use the whole office of the speaker to get behind and change that narrative," Phelan says. "You know, we did pass some legislation to enable and require private insurance insurers to provide mental health services, and that's something that I'm proud of working on as well."

Phelan is referring to House Bill 340. It passed in the House, but failed to make it out of committee in the Senate.

"Again, these big caplin improvements are going to take a little bit of time to improve. The map that you referenced earlier about access is just going to take time. Texas is a huge state," Phelan said. 

In Texas, out of 254 counties, only 22 have pediatric bed availability for kids in mental health crisis. 

"It's not surprising because if you look at the state of texas and where we've addressed mental health, it's been something you don't talk about, for the longest time, it wasn't considered health care. It was kept in the shadows," Texas Speaker of the House Dade Phelan says. 

Failed mental health legislation 

 "It's if we're talking about a child's life, you know, obviously every minute counts when you're talking about a child in crisis, every minute counts. And we have to do more," Speaker Phelan says. 

This regular legislative session Texas set aside the most money ever to mental health in the state at $2.2 billion with $15 million dollars going towards expanding access to mental health services for children and families statewide, but is it enough?

"It requires a 100% match. So for every dollar that the state gives us, we have to provide a dollar, but it's money we didn't have and it'll make our funding go further," Wilson says about the $15 million grants program. 

That money is part of a larger mental health funding plan, most of it focuses on adults and does not pay for staffing or resources before or after a child in mental health crisis needs help. 

One law that failed this session, House Bill 1898, was a grants program for children’s hospitals to build more infrastructure for mental health services. 

"You've got to create a program. You've got to build a bed. You've got to staff that bed. All of that takes money. So where does that money come from?" Wilson says. 

HB 340 also failed, it’s a bill that would’ve required private group health insurance plans to cover mental health services for serious emotional disturbance of a child.

It could’ve helped the Forsyths continue their daughter's care because after a week and a half at Dell Children’s, they couldn’t get her the outpatient care she needed. 

Jeska Forsyth remembers the traumatic incident after they left the children’s hospital. 

"They have no idea that she’s coming [to outpatient]. They don’t know who I am, they don’t know who referred us. We’re not on any lists and I'm showing them the paperwork [from Dell Children’s] that says to go there and then someone comes out of the back and says, ‘I'm sorry, we don't accept your insurance.’ I cried and cried. I was like what do you do, I don’t know what else to do?" Jeska Forsyth says. 

The blame game

"I think the biggest problem is going to be the workforce. I mean, we can build these facilities and we can expand, you know, these these therapy programs across the state, whether it's TCHAT or MST’s, but if we don't have the workforce, I think that's going to be the biggest bottleneck," Phelan says. 

Phelan also says the state is doing their part but parents have to step up too. 

"We need parents to be more involved and pay attention to what the child is doing, especially on the weekends or after school or especially during the summer, because that's when a lot of these issues arise," Phelan says. 

UTHealth Houston researchers say it’s not the case, a study published in JAMA Network Open shows there’s a clear pattern of suicidality related to the academic school calendar. 

"My commitment is to do better and to continue the success and continue the path forward in the state of Texas. I think we're light years ahead of where we were just a decade ago, and I hope to continue those successes and that path forward," Speaker Phelan says. "Again, it's just difficult in this state as a state the size of Texas, when we really have, really a workforce shortage as well, but I give the full commitment of the Texas House and the commitment of the Speaker of the House to continue the path forward, and again, I hate to say it takes time, but just from 2015 to now, I’ve seen a monumental shift." 

It’s time some parents say they don’t have. 

"If nothing changes, we will lose more kids, some kids will commit suicide, some will go down dark avenues and become less able to interact with people and be more isolated," Guy Forsyth says. 

In the meantime, this mom and dad continue their work to make sure their daughter is thriving and well. 

"She’s such a precious kiddo and every kid is and I think a lot about how she has as much right to live as everybody else," Jeska Forsyth says, wiping away tears.

"Those first couple weeks after she came home, just opening her bedroom door to make sure she was alive. It’s weird.I put a baby monitor in her room so that I could see her and she hated it but I was like, I can’t, I can’t, I can’t just wonder," Forsyth says. "I check on her to make sure she’s breathing all the time and that sucks." 

Isabella says she’s now in therapy on a regular basis, hoping that sharing her story will help others like her and our state leaders see the importance of better mental health care access.

"So if you can get a therapist you really should, even if you don't feel like there's anything wrong. It's just good to have," Bailey says. 

January 14th, 2025 is the next time lawmakers will reconvene to help fix the mental health crisis in our stateSince the 2023 legislature convened, Governor Greg Abbott called 4 legislative special sessions with no additional bills focused on mental health funding. Instead, lawmakers prioritized private school vouchers and immigration bills. 

The next time Texans can look to get more mental health legislation passed will be in 2025. 

Mental Health Resources

Getting Immediate Help: 

• The National Suicide Prevention Lifeline – The 988 Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the United States.
• Crisis Text Line is a free, 24/7 texting service for those in crisis. Every texter is connected with a crisis counselor, a real-life human being trained to bring texters from a hot moment to a cool calm through active listening and collaborative problem solving. The text line is available from anywhere in the U.S. Text HOME to 741741.
• The Your Life Your Voice hotline is toll free and open 24 hours a day. You can call, text, chat, or e-mail. Call 1-800-448-3000 or text "VOICE" to 20121.
• The Trevor Lifeline provides crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, queer, and questioning youth. Trained counselors are available 24/7, 365 day a year at 1-866-488-7386 or text 678-678
• Trans Lifeline is a peer support hotline run by trans people, for trans and questioning callers. Their operators are located all over the U.S. and Canada, and are all trans-identified. If you are in crisis or just need someone to talk to, even if it’s just about whether or not you’re trans, call the Trans Lifeline at 1-877-565-8860.
• National Runaway Safeline is a confidential, free source with 24/7 support and guidance for youth facing difficulties. NRS’ mission is to keep America’s runaway, homeless, and at-risk youth safe and off the streets, call NRS at 1-800-786-2929 or 1-800-RUNAWAY
• Austin Center for Grief and Loss: a non-profit organization focused on loss, grief, and bereavement with the mission to assist children, adolescents, and adults as they move from loss to life, transforming their grief through therapy, support, education, training, consultation, and hope.
• Austin Child Guidance Center: Austin Child Guidance Center provides professional, confidential counseling for children ages 0 – 17 and their families/caregivers.

National Alliance on Mental Illness and Counseling Resources: 

• NAMI Teen & Young Adult HelpLine - Teen & Young Adult (T&YA) HelpLine: A free nationwide peer-support service providing information, resource referrals, and support to teens and young adults. NAMI's T&YA Specialists are young people who understand what you're going through because they have been through stuff, too. They are experienced and well-trained. Reach out by phone, text, or chat
• Call: If you are a teen or young adult with questions about mental health, call 1-800-950-NAMI (6264) to speak with a NAMI HelpLine specialist now.
• Text: Text Friend to 62640 to immediately connect with a HelpLine Specialist trained to provide resources, information, and support.
• Chat: Click "Chat With Us" on NAMI.org to connect with a HelpLine Specialist.
• NAMI Teens & Young Adults has essential information and resources on subjects like how to talk to parents, recognize the signs of mental illness, and get support and treatment for yourself or a friend.
• NAMI Teens and Young Adult Resource Directory  - The NAMI Teen and Young Adult (TYA) HelpLine is a free, nationwide teen and young adult peer-support service providing information, resource referrals, and support to teens and young adults who have a mental health condition or may not have a condition but may still be going through a difficult time in their life. NAMI HelpLine Staff compiled this directory of outstanding resources to help you identify possible options to meet your needs.
• NAMI Managing A Mental Health Condition In College provides advice on where to find support and how to set yourself up for success in college. Also see NAMI’s Mental Health College Guide
• Depression and Bipolar Support Alliance  has information, stories, and a screening tool for teens coping with mood disorder symptoms.
• The Grant Halliburton Foundation has a comprehensive list of websites, apps, activities and more to help you or a friend navigate through tough times.
• Mental Health Is Health has answers to your FAQs about mental health, can connect you to resources, and has info on how to participate in Mental Health Action Day.
• Press Pause is a digital self-care and coping tool.
• Staying Engaged with Mental Health: JED Foundation has tips and resources for college students.
• Pathways to Mental Health Toolkit information to help create greater understanding of mental health issues and resources for those who need help.
• UT Health Austin Pediatric Psychiatry at Dell Children’s: UT Health Austin Pediatric Psychiatry at Dell Children’s is a clinical partnership between Dell Children’s Medical Center and UT Health Austin, the clinical practice of the Dell Medical School at The University of Texas at Austin.
• Integral Care:  Integral Care improves the lives of adults and children living with mental illness, substance use disorder and intellectual and developmental disabilities in Travis County.
• Bluebonnet Trails Community Services: Helping Central Texans live Healthy and Fulfilled Lives

En Español: 

• Mental Health America en Español: recursos de salud mental en Español
• Kit de herramientas de salud mental: Este conjunto de herramientas incluye recursos sobre cómo mejorar el bienestar mental para usted y su familia.

BIPOC Resources: 

• Inclusive Therapists: can help folks in the BIPOC community find therapists who have similar lived experiences
• Therapy for Latinx: helps connect people to Latinx therapists
• Contigo Wellness: provides culturally connected mental health help for the Hispanic community
• Hearts 2 Heal: a Black-Latinx, woman and veteran-led nonprofit with resources to community-based grief support and mental health programs that elevate diverse experiences to eliminate stigma and discrimination.
• Institute of Chicana/o/x Psychology and Community Wellness: Working toward the cultural, social, mental, emotional, spiritual liberation and healing of people since 2012
• Office of Minority Health: offering data to improve the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities.

Resources for Mothers: 

• Black Mamas ATX: Black Mamas ATX’s mission is to ensure that Black women survive and thrive before, during and after childbirth.
• Birth Comadres Collective: Empowering The Birthing Experience for Latinx mothers
• ATX Doulas: ATX Doulas is dedicated to providing support for birthing people and families throughout the childbearing year.

Resources for Men: 

• Black Men’s Health Clinic: This is a first-of-its-kind health clinic addressing the long-time care gap for men of color.
• Texas Men’s Therapy: Counseling and Coaching Throughout Texas for Men Experiencing Anxiety, Anger or Depression

Conferences: 

• Central Texas African-American Family Support Conference: conversations about mental health, substance use disorders, and intellectual and developmental disabilities. REGISTRATION DEADLINE: JANUARY 30TH, 2024
• Hogg Foundation for Mental Health: The Hogg Foundation creates platforms for conversation and learning about mental health through coordinated networks and convenings.

TexasAustinMental Health