This story is part of a KXAN series of reports called “Stop Mass Shootings,” providing context and exploring solutions surrounding gun violence in the wake of the deadly Uvalde school shooting. We want our reports to be a resource for Texans, as well as for lawmakers who are convening a month after the events in Uvalde to discuss how the state should move forward. Explore all “Stop Mass Shootings” stories by clicking here.
AUSTIN (Nexstar) — In the legislative year following a 2018 mass school shooting in Santa Fe, Texas, state lawmakers created a multi-million dollar program designed to identify distressed students and get them the mental health care they need.
In 2019, state lawmakers funneled nearly $300 million to create the Texas Child Mental Health Care Consortium. Experts from 13 health-related universities make up the consortium, with their care and resources already available in more than 300 school districts across the state. It was created to “address gaps in mental health care for children and adolescents in Texas.”
But its resources, which lawmakers have touted as means for preventing mass shootings, haven’t reached Uvalde yet.
- Create a Child Psychiatry Access Network (CPAN) to offer child behavioral health services and training for provider
- Offer telehealth services between health institutions and local school districts to identify and help at-risk students
- Provide full-time psychiatrists to serve as academic medical directors at facilities operated by community mental health providers and new psychiatric resident rotation positions at the facilities
- Provide additional child and adolescent psychiatry fellowship positions at health-related institutions
- Develop a plan to coordinate mental health research across the state.
Dr. David Lakey, the consortium’s presiding officer, testified to a Special Senate Committee last Wednesday about its reach and limits.
Lawmakers posed hypothetical questions to Lakey about the Uvalde gunman — who they described had a history of truancy, cruelty to animals and violence at home and at school — to determine if the consortium’s resources could have prevented him from the May 24 violent rampage that killed 19 students and 2 teachers at Robb Elementary School.
Lakey noted on Wednesday, the consortium is unable to help children who aren’t even showing up to school.
“I think at the time that he’s truant, and no longer in school, and there’s no access for the school, that’d be hard for us to reach,” he said.
Laura Cruzada-Davis, a spokesperson for the consortium, said in an email that its resources have not reached Uvalde CISD yet because UT-San Antonio “had not yet had the opportunity to meet with the Uvalde School District.”
Since it was created in 2019, the children’s mental health consortium has received more funding from the state legislature. Cruzada-Davis said via email that the legislature allocated an additional $230 million to the consortium in 2021, in an effort to address the COVID-19 impact on mental health.
Through the consortium, the state has helped more than 6,000 students identified by school staff, doctors and others — including those at high risk for hurting themselves or others. Between Oct. 2021 and May 2022, 0% of referrels to the consortium were related to children expressing intent to harm others.
Greg Hansch, the executive director of the Texas chapter of the National Alliance on Mental Illness (NAMI), said, overall, the consortium is taking the state in the right direction, but it needs to have a broader reach.
With several of the consortium’s resources not available in large pockets of the state, like in the case of Uvalde, Hansch said that might just be the reality of “growing pains” in a relatively new initiative.
“We’re somewhat unique in having such a wonderful initiative available in our state. But it needs to be expanded – not enough schools have access to the consortium’s resources.” Hansch said.
Telehealth care for children with behavioral needs
One of those programs, the Texas Child Health Access Through Telemedicine, or TCHATT, provides in-school behavioral telehealth care to students who are in need. Through TCHATT, the consortium connects schools with a network of physicians, counselors and other mental health professionals at universities across the state.
However, this service is only currently available for 377 school districts out of more than 1200 school districts in Texas. The Uvalde Consolidated School District is one of the districts not yet reached by TCHATT.
Students must get consent from a parent or guardian in order to receive care through TCHATT. Sen. Juan “Chuy” Hinojosa, D-McAllen, expressed concern about this requirement during the Wednesday committee hearing.
“That is part of the problem many times in situations that I’ve seen,” he said. “And I’m familiar with an experience where the child is need help and counseling, but the parent is the problem.”
Dr. Nithya Mani, the associate director of TCHATT at Dell Medical School, said her region serves more than 200,000 students. She said the reach still isn’t wide enough.
“We could always be in more [districts],” Mani said. “We don’t have the funding to continue to increase because anytime we go into a school district, they utilize us and we’ve seen the numbers grow each semester.”
Mani emphasized the importance of the partnership between the mental health consortium and the school districts, relationships that largely exist due to outreach.
“Our partnerships with our schools is really one of the most important things that we do,” Mani said. “We have been blown away by how dedicated these school counselors are and how dedicated the teachers and staff are. Because they really know what’s going on with these students.”
TCHATT allows for students to be referred by their parents, teachers and counselors if they are identified as possibly having a mental health concern. After parental consent has been given, the TCHATT medical team will confer with school personnel.
Network of support for doctors
The Child Psychiatry Access Network (CPAN) is made up of pediatricians, family medicine doctors, nurse practitioners and anyone else who provides primary care to children. It gives those physicians a line they can call to get advice from other health professionals about kids they are treating with mental health concerns.
Mani said doctors can call the line and get a response within 30 minutes or less from a child psychiatrist in that region of the consortium.
“A lot of times, they know specifically what that child needs. And it might be a specific type of therapy or type of testing. And so they can call and get that information right away,” she said. “Oftentimes they may not have had the training to this degree… so it’s really just to help expand that reach.”
In the program’s two years, Mani said they have had a little over 2,500 calls from their 900 primary care providers enrolled in the network.
Mani said most of the network’s calls in the Central Texas region are related to depression and anxiety in teenagers and behavioral concerns in younger children, like disruption in school, that she attributes to the pandemic.
She reiterated that, statistically, adults and children with serious mental illnesses are at “really low risk of any sort of mass violence events,” but noted this type of resource can be helpful with early detection.
“Oftentimes, a child is seeing their primary care provider as their only medical care. And that’s kind of how the system is designed to be,” Mani said. “It helps the pediatricians and primary care providers have tools for what the next steps are.”
Unlike TCHATT, in which physicians with the consortium work directly with children, it is harder for the consortium to measure success with the psychiatry network, since the care is indirect by working with primary care providers.
Mani said success stories have often been intervention in children experiencing suicidal thoughts.
“[These programs] they’re just helping students get access quickly,” she said. “It is very hard to get access to mental health care. It takes a lot of time. There is a waitlist, but this kind of puts the care right in the kids’ community.”