A recent report put Texas last among states and DC in mental health care access

During a press conference in Uvalde County, Texas, Gov. Greg Abbott said the state needed to focus on mental health and not restricting gun ownership to prevent future mass shootings like the one that happened at Robb Elementary School. 

He was jeered by former U.S. Rep. Beto O’Rourke, who blamed Abbott for the slaying. 

"This is on you," said O’Rourke, who is running for governor. 

Abbott said Ramos didn’t appear to have a history of mental health problems, but speaking to reporters outside after he was escorted from the building, O’Rourke criticized the state’s mental health care access. 

Texas, O’Rourke said, is "50th in the nation in mental health care access." 

We’ve fact-checked something similar before, back in 2010 when a lieutenant governor candidate said Texas was last in mental health care spending. Back then, the numbers were  close; data published on the Kaiser Family Foundation’s website for fiscal year 2016 put Texas second to last, per capita.

That indicator is no longer on the foundation’s site, but it also wasn’t the source that O’Rourke was citing. Gina Hinojosa, an O’Rourke campaign spokesperson, directed us to an annual report on the "State of Mental Health in America" by Mental Health America, a nonprofit that advocates for people with mental illness.

The report includes a ranking on access to care, which indicates how much access to care exists within a state. This measure considers access to insurance, access to treatment, quality and cost of insurance, access to special education, and mental health workforce availability. In the group’s 2022 report, Texas ranked 51st out of the 50 states and the District of Columbia.  

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"In Texas, the bottom-ranked state, nearly three-quarters of youth with major depression did not receive mental health treatment," Mental Health America tweeted in October 2021, when the report was published. 

Mental Health America did acknowledge its report had limitations — including that the report relies on survey data that could be incomplete and was completed in 2019, before the COVID-19 pandemic.

We reached out to other groups that might also measure mental health care access but found no such rankings elsewhere. 

The Kaiser Family Foundation has never tried to rank states on this measure, said spokesperson Craig Palosky, but it does compile state-by-state data related to mental health. 

Looking at adults reporting an unmet need for mental health treatment in the past year during 2019-20, Texas fared relatively well among the top 10 states with the lowest percentage of such adults. Kaiser notes that the sources for this data were analyses of the Substance Abuse and Mental Health Services Administration’s restricted online data analysis system, National Survey on Drug Use and Health in 2019 and 2020, and the Substance Abuse and Mental Health Data Archive. 

O’Rourke said Texas is "50th in the nation in mental health care access." 

Mental Health America, a nonprofit advocating for people with mental illness, ranked Texas 51st for mental health care access, behind every other state and Washington, D.C. There are some limitations in the data, which Mental Health America acknowledges.

We rate that claim Mostly True.