TMA Testimony of Nhung Tran, MD
Senate Health and Human Services Committee
Submitted on behalf of:
- Texas Pediatric Society
- Federation of Texas Psychiatry
- Texas Medical Association
Feb. 12, 2019
Chair Kolkhorst, Vice Chair Perry, and Committee Members,
My name is Nhung Tran, MD, and I am a developmental-behavioral pediatrician practicing in Temple. I am testifying on behalf of the Texas Pediatric Society, the Federation of Texas Psychiatry, and the Texas Medical Association in support of Senate Bill 10. We appreciate the dedication of Sen. Jane Nelson and this committee in leveraging the expertise and capacity of our health-related institutions of higher education to improve our state behavioral health care system.
Senate Bill 10 establishes a Texas Mental Health Care Consortium among health-related institutions of higher education and the Statewide Behavioral Health Coordinating Council to enhance collaboration and alignment among these entities and improve effectiveness of and access to behavioral health care. As a Texas physician, I can speak to our overall behavioral health workforce challenges, and as a Texas pediatrician, I can speak to the particular challenge of connecting children with mental health supports.
Although one in five children in the United States suffers from a diagnosable mental health disorder, only 21 percent of affected children actually receive needed treatment. Mental illness is like any other disease; the earlier it is identified and treated, the better the health outcomes. Across the United States, there are serious shortages of pediatric subspecialists and child mental health providers, both groups that provide essential services to children and adolescents with special mental and physical health care needs.[1]
Behavioral health concerns often present in the primary care setting and can significantly impact long-term physical health.[2] Recent years have seen a push toward integrating behavioral health and primary care, but our behavioral health workforce shortage poses significant barriers in achieving this goal. One critical component of SB 10 is the establishment of a network of Texas child psychiatry access centers (CPACs) at health-related institutions of higher education. CPACs will support primary care pediatricians across the state in meeting the behavioral health needs of children by providing access to teleconsultation services with psychiatrists and other licensed behavioral health professionals. Centers can also establish or expand telemedicine or telehealth services to improve access to behavioral health services. This will not only support primary care pediatricians in meeting the mental health needs of children but also free up the behavioral health workforce to address higher-acuity concerns. The consortium also will increase the number of psychiatric residency training positions, helping to address the shortage of psychiatrists and retain the physician workforce we invest in through our robust network of medical schools.
In 2004, Massachusetts initiated a similar program called the Massachusetts Child Psychiatry Access Project. Several other states have since developed comparable access programs, and in 2014, the Connecticut, New Jersey, Oregon, and Wisconsin legislatures approved funding for similar state programs. Thirty-two states have formed the National Network of Child Psychiatry Access Programs to promote the development of new psychiatry access programs nationwide. As of 2014, programs represented in this national network were available to primary care physicians and providers who served 32 percent of children in the United States. [3]
Telehealth and telemedicine are not the sole solution to addressing our behavioral health workforce shortage, but this bill takes a critical step in leveraging technology to fill the gap and working with our health-related institutions to create long-term solutions and improve care. Thank you again for the opportunity to testify and for prioritizing this important legislation. We look forward to continued partnership with this committee and the legislature to improve the health and safety of people in our great state.
[1] American Academy of Pediatrics. (2019). Promoting Children’s Mental Health.
[2] Ader, J., Still, C.J., Keller, D., Miller, B.F., Barr, M.S., and Perrin, J.M. (2015). The Medical Home and Integrated Behavioral Health: Advancing the Policy Agenda. Pediatrics 135:5.
[3] Straus, J.H., and Sarvet, B. (2014). Behavioral Health Care for Children: The Massachusetts Child Psychiatry Access Project. Health Affairs 33:12.
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