AUSTIN (Nexstar) — The days between Christmas and New Year’s Day usually bring people together with friends and family. For many Texans, this year is different.
Dana Bear started taking medication for depression when she was 25. She said they helped temporarily but did not last. She had suicidal tendencies and turned to alcohol. Bear learned about a noninvasive treatment at Texas Tech University Health Sciences Center called transcranial magnetic stimulation (TMS), which helped manage her symptoms.
The COVID-19 pandemic exacerbated difficulty for Bear, as she, like many others, spent the holidays alone instead of with family due to coronavirus concerns.
“We’ll talk on the phone and everything,” Bear, who recently turned 72, said.
“It’s okay to not be okay; it’s okay to be sad and disappointed,” said Dr. Joanne Sotelo, director of the psychiatry division at Baylor Scott & White Health.
Sotelo said long-term loneliness can have lasting effects on the brain, “to the point of it affecting our long-term risk as the way smoking or obesity can.”
“It increases our chances of having heart disease and dementia on top of the depression and the anxiety,” Sotelo explained.
“One of the hypotheses is that it changes kind of the stress hormones that increase your blood pressure, getting to that inflammation cascade that makes us more at risk of getting ill,” she continued.
“But then also, when we’re by ourselves, we don’t take good as good care of ourselves, we don’t move as much,” Sotelo said. “So there are several components that contribute to those changes.”
Sotelo said reaching out to a friend, or better yet, a doctor, is critical for people feeling down. She said beyond mental health, people can experience physical symptoms including changes to sleep schedule, difficulty concentrating, headaches, muscle tension and upset stomach.
“We cannot ignore it, we cannot minimize it, we can not just, ‘I’ll just toughen up and push through,’” Sotelo said. “If you are struggling with those emotions, it is very important to acknowledge it, and get help.”
Bear, who also suggested people in situations similar to hers try to talk with someone about their emotions, said she also battles seasonal affective disorder. She looks for a silver lining at the end of each winter to pull her through.
“My depression usually amps up in November, and gets worse until around February,” she said, eagerly awaiting the “first pretty day” of the new year.
“It’s like, ‘oh, boy, spring really is coming,’” she said with a smile. “It kind of gives me a little hope and energy that ‘okay, yeah, everything is going to be alright.’”
Sotelo said talking about mental health is an important first step to getting help. The Texas Health and Human Services Commission launched a statewide 24/7 mental health hotline for anyone anxious or stressed during the COVID-19 outbreak. The toll-free number is (833) 986-1919.
Demand for telehealth services grows
The pandemic led the state to waive some restrictions on telehealth services. Advocates for mental health want state lawmakers to extend those waivers even after the pandemic is over.
Earlier this month, doctors voiced that request to members of the Texas Senate Health and Human Services Committee.
Dr. Andy Keller, Meadows Mental Health Policy Institute CEW addressed the committee hearing through a remote connection. “Extend the waivers temporarily through the end of session, give the legislature time to weigh this and extend them out, make them permanent.” Dr. Keller said.
State Representative Four Price, a Republican from Amarillo, championed improvements in telehealth in previous sessions. He said the pandemic highlighted the need for increased telemedicine services in Texas.
“We’ve realized, especially during this entire year, utilization has really increased both from a patient aspect or patient side of the equation,” Rep. Price said. He noted that more doctors in Texas have also implemented some form of telehealth to serve patients.
But Price says as telehealth options expand, lawmakers should make sure rural Texans have access to care.
“You can pass all the telemedicine legislation in the world, but it’s not going to help those folks who don’t have reliable internet access,” Price said. He added that parts of the state are either unserved or underserved when it comes to broadband access.
“I think it’s every bit as important today as electrification was over 100 years ago,” Price said, emphasizing the need for technology improvements. “We just rely on it for education and health care and commerce and job training and so much of what we do every single day.”
Price says he sees the upcoming session as an opportunity to improve on progress made in previous years.
“Going forward, I think we can improve and improve the payment parity for mental health services through through telehealth in Texas, we can bolster the resources that we allocated and appropriated last session with regard to student mental health in particular,” Price said.
“This is just no time to go backwards,” Price added. “This has been stressful on everybody, this year in Texas. And, you know, I think, I think we’ve made great strides, and I anticipate that we’ll be able to keep that going in the next session.”
Finding funding and focus to improve mental health care
Addressing mental health needs in the state will take money. Finding that funding could be a tough task for lawmakers, as Texas faces the demands of the ongoing pandemic.
One lawmaker taking on the challenge is State Senator Sarah Eckhardt, a Democrat from Austin. She took office last year in a special election, filling the Senate seat held for 13 years by Kirk Watson, who retired in April.
Watson helped lead the effort to redesign and reimagine the Austin State Hospital. The $305 million plan calls for building a new 240-bed psychiatric hospital, as well as other improvements. Watson has said the plan would create the equivalent of the M.D. Anderson Cancer Center for the brain.
“Senator Watson was such a champion in the area of healthcare generally, and also specifically in the area of mental health care, and substance use disorder,” Sen. Eckhardt said. “I’m grateful for all of his work and very much look forward to carrying it across the line.”
Austin State Hospital will need an additional already committed but not yet funded, $124 million to finish the redevelopment.
“But when it’s done, it will be a wonderful campus that anyone could walk into and say, hey, I need I need to know about or to access resources with regard to mental health care,” Eckhardt said.
In addition to upgrading the statewide system of mental health care facilities, Eckhardt says policy makers also need to make deeper investments in mental health care outside of a facility.
“First, we need to destigmatize reaching out to get services. And second, we also need to expand the amount of services that are available to people,” Eckhardt said. “I have unfortunately been privy to many instances where individuals who are highly resourced can’t even get resources for mental health care. And we we need to expand those statewide services and get them out of the criminal justice context to the greatest extent possible.”
“Right now, if an individual is suffering with mental illness, and the only services that are available to them are through the criminal justice context, they’re not eligible for Medicaid coverage for those services received in jail,” Eckhardt explained. “That is a that’s a ridiculous system.”
Eckhardt said that while investing in mental health care takes money, it is an effective use of funding. Providing quality care, including treatment for substance abuse and behavioral health can actually save money in the long run, similar to preventative physical health care.
“We really need to get folks who are suffering with mental illness out of the criminal justice context and into a healthcare context,” Eckhardt said.