There’s a mental health workforce shortage in Texas, according to a report by the Texas Health and Human Services Commission.

HB 1023 (Burkett/Nelson) directed the commission to develop policy recommendations to address the shortage. The commission is looking for recommendations from counselors and other stakeholders on how to do any of the following:

1) Improve employee recruitment and retention

2) Give greater attention to the needs of rural and border area

3) Increase cultural and linguistic diversity

4) Reevaluate and update the educational curriculum for health professionals 

5) Collect more data at the state and national level to fully inform workforce planning initiatives

Check out the report and send your feedback by April 1, 2014 HPRC@dshs.state.tx.us.

According to the report:

• There were 3,062 marriage and family therapists (MFTs) practicing in Texas as of September 2013, giving a ratio of 8,708.2 persons per MFT.

• Within the state’s five most populous counties the population to MFT ratio was 6,442:1 while it was 11,923:1 in the rest of the state, comprising proportions of 41.35% and 58.65%, respectively.

• In 2013, 27.7% of MFTs were 65 or older and another 31.8% were between 55 and 64 years old, meaning that 59.6% of the workforce will be of retirement age by 2023.

• Average annual growth of the MFT workforce in Texas has been 1.8% from 2008-2013. Yet when considering population growth, there has been just 0.2% average annual growth.

The Texas Counseling Association plans to submit comments on the following areas, according to an email to its members.

• Include Licensed Professional Counselors in the Core Mental Health Professions. LPCs credentials, experience and clients completely align with the mental health professionals listed as Core Mental Health Professions. LPCs are the largest group of independent mental health Medicaid providers (3,733) in Texas as of July 2013. LPCs are identified as eligible providers to address unmet need under the National Health Service Corps Loan Repayment program. (There is no cost associated with this change. It would require either a rule change (agency) or a change in definitions in statute.)

• Allow LPC-Interns to bill for services under the Medicaid program. These mental health professionals have completed their graduate degrees, earned practicum experience and passed their licensure and jurisprudence exams. They are licensed to deliver mental health services directly to clients under the supervision of an LPC-Supervisor. Their education and experience level are comparable to Psychological Associates and Provisionally Licensed Psychologists who are currently allowed to bill for their services under Medicaid. Allowing LPC-Interns to bill for services under Medicaid will also create a pathway to increase the number of fully licensed mental health professionals willing to work with this population, which will also address the aging-out of mental health professionals in Texas. (The cost for this change could be handled through existing Medicaid allocations to reduce waiting lists and expand services. It would require a rule change (agency) and may require legislative action.)

• Expand the focus of this report to include access to services provided in educational settings. Professional school counselors in Texas are required to hold at least a master’s degree, have two years of teaching experience and pass a unique certification exam. Through individual planning and responsive services, they often provide the link between students struggling with psycho-social-emotional issues and mental health services. Mental health professionals working in the counseling offices of Texas universities and community colleges provide a similar service.

A Letter from HAMFT President Anne Way

As I begin my journey as president of HAMFT, I am aware that several generations of marriage and family therapists are housed under the strong, 40-year-old roof of TAMFT. Never before was this more evident than at the recently concluded 40th anniversary TAMFT conference held this past week in Sugar Land. This powerful roof has withstood the challenge of gaining licensure in this great State, fortified itself to maintain that licensure despite the great storm of opposition it has faced in Texas and covered several generations of therapists who came of age under its protective shield. This formidable terrain housed under a single roof calls for equal measures of grit and grace, wit and wisdom. If we are to sustain this great profession we must keep our roof hardy, repair any leaks that arise and quite truthfully tear it down and rebuild it when necessary. This roof needs to last for generations to come. How will we sustain our organization while remaining relevant to the entire membership? We must shepherd these transgenerational marriage and family therapists through a variety of successful career trajectories.

Clear and sustainable pathways must be available for:

• private practitioners,

• group practices,

• the nonprofit agency settings,

• hospital settings,

• managed care managers,

• EAP clinicians,

• academic clinicians,

• and family researchers.

How can we design a viable succession plan as some of the wise sages in our organization retire, close their practices, or begin a new phase of life? We are fortunate in our HAMFT family to have members who gladly mentor students and young professionals just as the younger generation smiles politely when their elders discuss the good ole days when live supervision involved the use of high tech drop in microphones, rotary phones, and beta max recordings.

Recently Past President Joan Harwood sent an email blast out to members that she needed “all hands on deck” to help with our Awards Banquet. On a naval vessel this means everyone on board assembles on deck to help out with whatever needs to be done. Answering the call to help with the business of HAMFT in supporting its members is essential to sustaining our vessel and keeping it sound. Generations of leaders have steered us through rough seas and calm seas, but in all conditions it was the membership who kept the machinery running smoothly. We need members to continue efforts in inviting colleagues to join HAMFT, serve on committees, run for board positions, develop creative and relevant programs and make it a goal to attend our monthly educational opportunities. There may be rough seas ahead for practitioners and clients but we must stand ready. We must ask:

• How can we equip students and the beginning professionals to navigate the new world of mental health care?

• How will we meet the challenge that the affordable health care act presents in our practice settings and more importantly what can we do as a collective, multi-generational collaborative of therapists to dream together and shape a mental health care system that promotes our profession as marriage and family therapists while also promoting healthy families?

I invite all members to get on board to help get this vessel moving. We will need all hands on deck. For me faith has sustained and energized me; it is my life raft that helps me weather storms in my family, in the families I witness in my practice, in our profession, and in our world. For some it is faith that helps us traverse rough waters, for others it is science that helps construct what is needed to make a worthy vessel, still others it is clear guideposts and rules that make navigation more smooth…whatever “floats your boat” my hope is that we promote faith in ourselves as healers, faith in our collective and individual vision for our profession, ourselves, our families, our clients--moving us to envision a better world, one progress note at a time.

If you have suggestions on HAMFT's role in the profession's future, questions on how you can get involved or would like to offer ideas on the association's events, send an email to president@hamft.org.