How To Get Affordable State Sponsored Therapy in Texas
Many people don’t realize that publicly-funded mental health services are available in their state. People looking for free or low-cost counseling often think their only options are counselors in private practice and don’t know that publicly-funded providers in their communities may also offer counseling services.
While state-based programs are not for everyone, they are often a great place to start for people who face geographic or financial barriers to therapy. Intake specialists at community mental health programs can help people learn whether they qualify for state-funded services and can refer people who don’t qualify to other low-cost programs that may be able to meet their needs.
When Should You Go to a State Mental Health Program?
Few mental health providers outside of those in the public sector are able to immediately serve people who are in crisis. This makes community mental health programs like Texas’ Local Mental Health Authorities (LMHAs) the best option when you’re having a mental health crisis and need help right away. The people who answer Texas crisis lines can help determine the best response to your crisis, whether it’s assistance with obtaining inpatient treatment or setting up a first appointment with a counselor. They will also listen and offer immediate support.
In Texas, LMHAs are often good options for people with one of the three diagnoses they were originally authorized to treat (schizophrenia, bipolar disorder, and major depressive disorder), especially people who have one of those diagnoses and limited financial means. It is also often easier to obtain substance use disorder services through the public mental health system than through the private sector.
Texas is currently expanding its public mental health system and updating eligibility requirements to extend services to people with other conditions including anxiety or trauma-related disorders. Whether you can get services for one of these conditions currently depends on which LMHA you call and their budget at the time.
Available services vary among LMHAs but typically include psychiatry, medication management, case management, psychosocial rehabilitation, skills training, and counseling. Texas typically restricts counseling by type and diagnosis; most LMHAs that offer counseling offer cognitive behavioral therapy (CBT) to people with major depressive disorder and cognitive processing therapy (CPT) to people with PTSD (note that some LMHAs still aren’t budgeted to serve people with a diagnosis of PTSD unless they also have one of the “big three” diagnoses).
In general, it never hurts to call. The staff that answer the phone lines for LMHAs in Texas aren’t just familiar with their own programs, but also know about other programs in the community that can meet the needs of people who aren’t eligible for public mental health care. A phone call can provide immediate support and help you confirm that you’re ready for treatment.
If you find out that you’re not eligible or that your local LMHA isn’t a good fit, you can search for free or low-cost private practice counselors on OpenCounseling.com or try affordable online counseling with BetterHelp (a sponsor of OpenCounseling).
Who Is Eligible for Public Mental Health Services in Texas?
Texas’s public mental health programs impose stricter eligibility requirements for services than programs in other states.
Many public mental health programs in America restrict access to people who have serious mental health conditions that impact their ability to function and who are at risk of psychiatric hospitalization.
For decades, Texas has limited access to public mental health services even further by only serving people with one of three diagnoses: schizophrenia, bipolar disorder, or major depressive disorder. Recently, a movement to expand services to a wider range of people has gained traction.
In 2013, the Texas Legislature approved a policy that expands eligibility for public mental health services to people with other psychiatric diagnoses. In theory, people in Texas who have post-traumatic stress disorder (PTSD), anxiety disorders, attention-deficit disorders, and obsessive-compulsive disorder can now be admitted to public programs.
However, the law only requires programs to serve this expanded range of clients when they have “sufficient resources,” and many LMHAs continue to limit services to people with one of the “big three” diagnoses. To know whether a program has expanded its eligibility requirements, area residents have to call and ask. Over time, more programs may update and expand their eligibility requirements.
In addition to clinical requirements, many public mental health programs in Texas have financial eligibility requirements. To qualify for services, you usually need to have either Medicare or Medicaid or to have no insurance and limited financial means. It is important to note that not all public mental health services in Texas have income restrictions. Crisis services in each region are open to any area resident who is experiencing a mental health crisis, regardless of their diagnosis or income level.
How Can You Find Out More About Local Programs in Texas?
To find out whether you’re eligible and to learn what services your local LMHA offers, the best approach is to call the LMHA for your region. Each LMHA has multiple phone lines that people in the community can call for help or information, including crisis, referral, and general numbers. The person you speak to may invite you to come in for a more detailed assessment or give you referral information for other community programs if you aren’t eligible for services at an LMHA.
You can use the online search feature at the Texas Health and Human Services page to find your local program or review the entire list. For your convenience, the entire list is also included in the section of this article directly below.
Texas' Mental Health Clinics and Crisis Lines
- Access (Serving Anderson and Cherokee Counties): (800) 621-1693 (crisis line) or (903) 586-5507 (referral line)
- Andrews Center (Serving Henderson, Rains, Smith, Van Zandt, and Wood Counties): (877) 934-2131 (crisis line) or (903) 597-1351 (referral line)
- Austin Travis County Integral Care (Serving Travis County): (512) 472-4357 (crisis line) or (512) 447-4141 (referral line)
- Betty Hardwick Center (Serving Callahan, Jones, Shackleford, Stephens, and Taylor Counties): (800) 758-3344 (crisis line) or (325) 690-5100 (referral line)
- Bluebonnet Trails Community Services (Serving Bastrop, Burnet, Caldwell, Fayette, Gonzales, Guadalupe, Lee, and Williamson Counties): (800) 841-1255 (crisis line) or (512) 255-1720 (referral line) or (844) 309-6385 (intake line)
- Border Region Behavioral Health Center (Serving Jim Hogg, Starr, Webb, and Zapata Counties): (800) 643-1102 (crisis line) or (956) 794-3000 (referral line)
- Burke Center (Serving Angelina, Houston, Jasper, Nacogdoches, Newton, Polk, Sabine, San Augustine, San Jacinto, Shelby, Trinity, and Tyler Counties): (800) 392-8343 (crisis line) or (936) 639-1141 (referral line)
- Camino Real Community Services (Serving Atascosa, Dimmit, Frio, La Salle, Karnes, Maverick, McMullen, Wilson, and Zavala Counties): (800) 543-5750 (crisis line) or (210) 357-0300 (referral line)
- The Center for Health Care Services (Serving Bexar County): (800) 316-9241 or (210) 223-7233 (crisis line) or (210) 261-1000 (referral line)
- Center for Life Resources (Serving Brown, Coleman, Comanche, Eastland, McCulloch, Mills, and San Saba Counties): (800) 458-7788 (crisis line) or (325) 646-9574 (referral line)
- Central Counties Services (Serving Bell, Coryell, Hamilton, Lampasas, and Milam Counties): (800) 888-4036 (crisis line) or (254) 298-7000 (referral line)
- Central Plains Center (Serving Bailey, Briscoe, Castro, Floyd, Hale, Lamb, Motley, Parmer, and Swisher Counties): (800) 687-1300 (crisis line) or (806) 293-2636 (referral line)
- Coastal Plains Community Center (Serving Aransas, Bee, Brooks, Duval, Jim Wells, Kenedy, Kleberg, Live Oak, and San Patricio Counties): (800) 841-6467 (crisis line) or (361) 777-3991 or (888) 819-5312 (referral lines)
- Community Healthcore (Serving Bowie, Cass, Gregg, Harrison, Marion, Panola, Red River, Rusk, and Upshur Counties): (800) 832-1009 (crisis line) or (903) 758-2471 (referral line)
- Denton County MHMR Center (Serving Denton County): (800) 762-0157 (crisis line) or (940) 381-5000 (referral line)
- Emergence Health Network (Serving El Paso County): (877) 562-6467 or (915) 779-1800 (crisis line) or (915) 887-3410 (referral line)
- Gulf Bend Center (Serving Calhoun, DeWitt, Goliad, Jackson, Lavaca, Refugio, and Victoria Counties): (877) 723-3422 (crisis line) or (361) 575-0611 (referral line)
- Gulf Coast Center (Serving Brazoria and Galveston Counties): (866) 729-3848 (crisis line) or (409) 763-2373 (referral line)
- Heart of Texas Region MHMR Center (Serving Bosque, Falls, Freestone, Hill, Limestone, and McLennan Counties): (866) 752-3451 or (254) 776-1101 (crisis line) or (254) 752-3451 (referral line)
- Helen Farabee Centers (Serving Archer, Baylor, Childress, Clay, Cottle, Dickens, Foard, Hardeman, Haskell, Jack, King, Knox, Montague, Stonewall, Throckmorton, Wichita, Wilbarger, Wise, and Young Counties): (800) 621-8504 (crisis line) or (940) 397-3143 (referral line)
- Hill Country Mental Health Centers (Serving Bandera, Blanco, Comal, Edwards, Gillespie, Hays, Kendall, Kerr, Kimble, Kinney, Llano, Mason, Medina, Menard, Real, Schleicher, Sutton, Uvalde, and Val Verde Counties): (877) 466-0660 (crisis line) or (830) 792-3300 (referral line)
- Lakes Regional MHMR Center (Serving Camp, Delta, Franklin, Hopkins, Lamar, Morris, and Titus Counties): (877) 466-0660 (crisis line) or (972) 524-4159 (referral line)
- LifePath Systems (Serving Collin County): (877) 422-5939 (crisis line) or (877) 422-5939 (referral line)
- StarCare Specialty Health System (Serving Cochran, Crosby, Hockley, Lubbock, and Lynn Counties): (806) 740-1414 or (800) 687-7581 (crisis line) or (806) 766-0310 (referral line)
- MHMR Authority of Brazos Valley (Serving Brazos, Burleson, Grimes, Leon, Madison, Robertson, and Washington Counties): (888) 522-8262 (crisis line) or (979) 822-6467 (referral line)
- Harris Center for Mental Health and IDD (Serving Harris County): (866) 970-4770 (crisis line) or (713) 970-7000 (referral line)
- Behavioral Health Center of Nueces County (Serving Nueces County): (888) 767-4493 (crisis line) or (361) 886-6900 (referral line)
- My Health My Resources (MHMR) of Tarrant County (Serving Tarrant County): (800) 866-2465 (crisis line) or (817) 569-4300 (referral line)
- MHMR Services for the Concho Valley (Serving Coke, Concho, Crockett, Irion, Reagan, Sterling, and Tom Green Counties): (800) 375-8965 (crisis line) or (325) 658-7750 (referral line)
- North Texas Behavioral Health Authority (Serving Dallas, Ellis, Hunt, Kaufman, Navarro, and Rockwall Counties): (866) 260-8000 (crisis line) or (877) 653-6363 (referral line)
- Texoma Community Center (Serving Cooke, Fannin, and Grayson Counties): (877) 277-2226 (crisis line) or (214) 366-9407 or (903) 957-4700 (referral line)
- Pecan Valley Centers for Behavioral and Developmental Healthcare (Serving Erath, Hood, Johnson, Palo Pinto, Parker, and Somervell Counties): (800) 772-5987 (crisis line) or (817) 579-4400 (referral line)
- PermiaCare (Serving Brewster, Culberson, Ector, Hudspeth, Jeff Davis, Midland, Pecos, and Presidio Counties): (800) 542-4005 or (877) 475-7322 or (844) 420-3964 (crisis lines) or (432) 570-3333 (referral line)
- Spindletop Center (Serving Chambers, Hardin, Jefferson, and Orange Counties): (800) 937-8097 (crisis line) or (409) 784-5400 (referral line)
- Texana Center (Serving Austin, Colorado, Fort Bend, Matagorda, Waller, and Wharton Counties): (800) 633-5686 (crisis line) or (281) 239-1300 (referral line)
- Texas Panhandle Centers (Serving Armstrong, Carson, Collingsworth, Dallam, Deaf Smith, Donley, Gray, Hall, Hansford, Hartley, Hemphill, Hutchinson, Lipscomb, Moore, Ochiltree, Oldham, Potter, Randall, Roberts, Sherman, and Wheeler Counties): (800) 692-4039 or (806) 359-6699 (crisis lines) or (806) 358-1681 (referral line)
- Tri-County Behavioral Healthcare (Serving Liberty, Montgomery, and Walker Counties): (800) 659-6994 (crisis line) or (936) 521-6100 (referral line)
- Tropical Texas Behavioral Health (Serving Cameron, Hidalgo, and Willacy Counties): (877) 289-7199 (crisis line) or (956) 289-7000 (referral line)
- West Texas Centers (Serving Andrews, Borden, Crane, Dawson, Fisher, Gaines, Garza, Glasscock, Howard, Kent, Loving, Martin, Mitchell, Nolan, Reeves, Runnels, Scurry, Terrell, Terry, Upton, Ward, Winkler, and Yoakum Counties): (800) 375-4357 (crisis line) or (432) 263-0007 (referral line)
If you’re interested in substance use disorder services or have a crisis related to substance use, the best phone number to use often differs from those listed above. The providers assigned to the 11 substance use disorder treatment service areas in Texas are called Outreach, Screening, Assessment, and Referral (OSAR) Centers (note that Regions 3 and 6 are split among two or more providers):
- Region 1 – StarCare Specialty Health System (Serving Armstrong, Bailey, Briscoe, Carson, Castro, Childress, Cochran, Collingsworth, Crosby, Dallam, Deaf Smith, Dickens, Donley, Floyd, Garza, Gray, Hale, Hall, Hansford, Hartley, Hemphill, Hockley, Hutchinson, King, Lamb, Lipscomb, Lubbock, Lynn, Moore, Motley, Ochiltree, Oldham, Parmer, Potter, Randall, Roberts, Sherman, Swisher, Terry, Wheeler, and Yoakum Counties): (806) 740-1414 or (800) 687-7581 (crisis lines) or (806) 740-1421 (OSAR intake line)
- Region 2 – Helen Farabee Centers (Serving Archer, Baylor, Brown, Callahan, Clay, Coleman, Comanche, Cottle, Eastland, Fisher, Foard, Hardeman, Haskell, Jack, Jones, Kent, Knox, Mitchell, Montague, Nolan, Runnels, Scurry, Shackelford, Stephens, Stonewall, Taylor, Throckmorton, Wichita, Wilbarger, and Young Counties): (800) 621-8504 (crisis line) or (325) 673-2242, ext. 100 or (940) 224-6200 (OSAR intake lines) or (940) 397-3391 (main substance use disorder treatment line)
- Region 3 – Life Path Systems (Serving Collin County): (877) 422-5939 (crisis line) or (972) 562-3647 or (972) 422-5939 (general referral lines)
- Region 3 – My Health My Resources MHMR (Serving Cooke, Denton, Erath, Fannin, Grayson, Hood, Johnson, Palo Pinto, Parker, Somervell, Tarrant, and Wise Counties): (800) 866-2465 (crisis and substance use disorder information line)
- Region 3 – North Texas Behavioral Health Authority (Serving Dallas, Ellis, Hunt, Kaufman, Navarro, and Rockwall Counties): (866) 260-8000 (crisis line) or (844) 275-0600 (OSAR intake line)
- Region 4 – Andrews Center (Serving Anderson, Bowie, Camp, Cass, Cherokee, Delta, Franklin, Gregg, Harrison, Henderson, Hopkins, Lamar, Marion, Morris, Panola, Rains, Red River, Rusk, Smith, Titus, Upshur, Van Zandt, and Wood Counties): (877) 934-2131 (crisis line) or (903) 597-1351 (main referral line) or (800) 441-8639 (substance use disorder information and referral line for East Texas)
- Region 5 – Burke / ADAC (Serving Angelina, Hardin, Houston, Jasper, Jefferson, Nacogdoches, Newton, Orange, Polk, Sabine, San Augustine, San Jacinto, Shelby, Trinity, and Tyler Counties): (800) 445-8562 or (800) 392-8343 (crisis lines) or (936) 634-5753 (main referral line)
- Region 6 – The Harris Center (Serving Harris, Liberty, Montgomery, Walker, Austin, Brazoria, Chambers, Colorado, Fort Bend, Galveston, Matagorda, Waller, and Wharton Counties): (713) 970-7000 or (866) 970-4770 (helplines) or (713) 942-4100 (OSAR intake line)
- Region 6 – Gulf Coast Center (Serving Austin, Brazoria, Chambers, Colorado, Fort Bend, Galveston, Matagorda, Waller, and Wharton Counties): (866) 729-3848 (crisis line) or (844) 704-1291 (OSAR intake line)
- Region 7 – Bluebonnet Trails (Serving Bastrop, Bell, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Coryell, Falls, Fayette, Freestone, Grimes, Hamilton, Hays, Hill, Lampasas, Lee, Leon, Limestone, Llano, Madison, McLennan, Milam, Mills, Robertson, San Saba, Travis, Washington, and Williamson Counties): (800) 841-1255 (crisis line) or (844) 309-6385 (OSAR intake line)
- Region 8 – The Center for Health Care Services (Serving Atascosa, Bandera, Bexar, Calhoun, Comal, DeWitt, Dimmit, Edwards, Frio, Gillespie, Goliad, Gonzales, Guadalupe, Jackson, Karnes, Kendall, Kerr, Kinney, La Salle, Lavaca, Maverick, Medina, Real, Uvalde, Val Verde, Victoria, Wilson, and Zavala Counties): (800) 316-9241 or (210) 223-7233 (crisis line) or (210) 261-3076 (OSAR intake line)
- Region 9 – PermiaCare (Serving Andrews, Borden, Coke, Concho, Crane, Crockett, Dawson, Ector, Gaines, Glasscock, Howard, Irion, Kimble, Loving, Martin, Mason, McCulloch, Menard, Midland, Pecos, Reagan, Reeves, Schleicher, Sterling, Sutton, Terrell, Tom Green, Upton, Ward, and Winkler Counties): (844) 420-3964 (crisis line and OSAR referral line)
- Region 10 – Emergence Health Network (Serving Brewster, Culberson, El Paso, Hudspeth, Jeff Davis, and Presidio Counties): (915) 779-1800 (crisis line) or (915) 747-3605 (OSAR intake line)
- Region 11 – Tropical Texas Behavioral Health (Serving Aransas, Bee, Brooks, Cameron, Duval, Hidalgo, Jim Hogg, Jim Wells, Kennedy, Kleberg, Live Oak, McMullen, Nueces, Refugio, San Patricio, Starr, Webb, Willacy, and Zapata Counties): (877) 289-7199 (crisis line) or (800) 813-1233 (OSAR intake line)
As with mental health services, the people who answer the phone lines often have alternative referral information if they believe you may not be eligible for public services or may be better served by another program.
What Types of Community Mental Health Programs Exist in Texas?
The Hogg Foundation for Mental Health, a division of the University of Texas at Austin, publishes an exhaustive 400-page reference document about the public mental health system in Texas every two years. Their report provides detailed updates on eligibility requirements and funding and explains the different types of programs within the Texas mental health system. According to the Hogg Foundation, there are three types of public mental health providers in in Texas:
- Medicaid Managed Care Providers
- Federally Qualified Health Centers
- Local Mental Health Authorities
Medicaid managed care providers are part of a network of organizations that contract with the state to provide services to people who have Medicaid. Programs in these organizations agree to receive a monthly base rate for each Medicaid client that they serve instead of receiving a fee for each service they provide. These managed care networks include a mix of private practices, public programs, and non-profit agencies.
Federally qualified health centers are community organizations that provide medical and mental health services to people in underserved communities. They are funded by federal grants. Their purpose is to provide high-quality coordinated care to people with complex needs and to link behavioral healthcare with primary medical care. Each FQHC accepts Medicaid and Medicare and offers sliding scale fees to people without insurance. You can search for FQHCs using the online search tool on the U.S. Department of Health and Human Services website.
Local mental health authorities are public mental health centers that provide services to people living in designated geographic service areas in Texas. They are the primary state mental health agencies in Texas. In addition to directly providing services, LMHAs are required to develop and direct policy and state resources to address mental health needs in their local communities.
How Does Texas' Public Mental Health System Work?
In the 1960s, Americans started thinking differently about how to treat mental health conditions. New laws required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. Many states’ current public mental health programs can trace their origins back to this period. Texas is no exception.
In 1965, the Texas Legislature passed a bill establishing Comprehensive Community Mental Health Centers as an alternative to institutionalization. These centers started opening across Texas in 1970 and continued to grow and evolve over the following decades. They offer most of the essential services that community mental health programs offer across the nation, including rehabilitative and social services, crisis intervention, case management, and forensic mental health services. However, due to state-imposed budget and service restrictions, these centers serve fewer people and provide fewer services than similar programs in other states.
Texas has historically dedicated fewer resources to its mental health system than other states, and to this day is one of the lowest-ranked states for access to mental health care. In 2019, Mental Health America ranked Texas 50th out of 51 states (Washington, DC, was included in the list as a state) for access to mental health care, with only Mississippi being ranked lower.
While many states have a separate community mental health program for each county, many programs in Texas serve several counties at once. In part, this reflects the sheer number of counties there are to cover—Texas has 254. Still, Texas’ 39 regional mental health centers, also called Local Mental Health Authorities (LMHAs), represent a lower number of public mental health programs than in other states with similar populations, and they serve significantly fewer people. Texas separates service areas for substance use disorder treatment into an even smaller number of districts, with 14 organizations in 11 districts providing services to people in all 254 Texas counties.
Only about 30 percent of Texans with serious mental health conditions and 5 percent of Texans with substance use disorders get the treatment that they need. While Texas has traditionally not prioritized public mental health treatment for its citizens, times are changing and state officials are recognizing and responding to the need to close the gap between the people who need care and the people who get it. You can help change the statistics in Texas by reaching out and learning how to get the help you need to begin or sustain your recovery.