• Salient Strategies

Mental Health Access in Rural Texas

As the state’s population continues to boom, that growth has not been equally distributed amongst the state’s 268,597 square miles. Between 2010 and 2018, 94 counties in Texas lost population, while urban and suburban counties saw massive growth. These rural counties, primarily in the Panhandle and high plains, now face a unique struggle of providing infrastructure, economic development, and education while the urban population of the state continues to grow. Access to mental health professionals has been an issue across the state, but rural counties have had a particularly hard time attracting and retaining licensed mental health professionals.

While COVID-19 has hit densely populated areas of the state particularly hard, rural areas have faced a different set of challenges and seen an opportunity to grow mental health services despite the pandemic.


The state has long struggled with meeting the mental health demands of the public. As mental health professionals gravitate to the major urban centers, people in rural Texas have had to deal with diminishing options for mental health services. But now, partially due to COVID, rural parts of the state have greater access to tele-mental health services. This increase in access, however, highlights the growing electronic divide being played out across the country.

Tele-mental health services are able to broaden access to mental health professionals, particularly in a state like Texas where we need more than 540 new mental health professionals to meet our current needs(highest in the nation). Thanks to legislation passed last session, the state has entered into a multi-state pact to streamline the licensing credentialing process for mental health professions. But rural areas of the state still struggle to attract and retain mental health professionals.

Although telemental health has the ability to increase access to mental health treatment in rural areas, it is dependent on the broadband infrastructure in those counties. COVID-19 has highlighted the “digital divide” between urban and rural parts of the country when it comes to access to adequate internet service.

Next session, the legislature should look to make Governor Abbott’s temporary relaxing of provider rule regarding tele-mental health permanent. Particularly the rules permitting reimbursement for tele-mental health services.

©2020 by Salient Strategies