Policy Updates

Policy Updates

Welcome to the Institute’s resource page for public policy professionals. Below are original MMHPI products, updates about our policy-related activity, and information from sources that help inform our work in state policy development.

Select from the icons below to explore updates and activity across multiple key areas.

Introductory and General Information

In the wake of the Santa Fe school shooting, Lieutenant Governor Dan Patrick appointed a bi-partisan Select Committee, headed by Senate Education Committee Chairman Larry Taylor, to review comprehensive strategies to address school violence. In Summer 2018, the Select Committee met to hear invited and public testimony. MMHPI President and CEO Dr. Andy Keller provided testimony during the hearing on Interim Charge 3, which included examining the root cause of mass murder in schools including, but not limited to, risk factors such as mental health and substance use disorders. The final report was released in August 2018.

Senate Select Committee on Violence in Schools and School Security Interim Report

Texas’ first-ever Select Committee on Mental Health released its report just before the start of the 85th Legislature. The committee’s charge included studying and recommending improvements to every aspect of behavioral health in Texas. Speaker of the House Joe Straus appointed committee members during the legislative interim and designated Representative Four Price (R-Amarillo) as chairman. MMHPI personnel attended select committee hearings over eight separate days during 2016, and our in-house experts provided testimony and analysis to committee members and staff. The report is a blueprint for Texas, which will help lawmakers and local officials help improve the delivery of mental health care in Texas for years to come.

House Select Committee on Mental Health Interim Report – December 2016

In June 2016, with the help of former Texas Supreme Court Justice and Institute Board Member Harriet O’Neill, the Texas Judicial Council established the Mental Health Committee to examine the administration of civil and criminal justice for those suffering from or affected by mental illness. The committee, chaired by the Honorable Bill Boyce, was charged with providing formal recommendations to the full Judicial Council and the legislature in advance of the 85th Legislative Session. The Institute contributes to committee meetings and provided research and technical assistance to committee members.

The 2016 report, released in October 2016, contains the committee’s findings, recommendations, and priority issues for future study.

The 2018 report, released in June 2018, contains the committee’s findings, recommendations, and priority issues for future study.

MMHPI addresses, in brief form, the factors that shape mental health needs in Texas. It addresses key questions such as how many Texans need mental health services, the costs of untreated needs, state spending, and the public and private systems.

Texas Mental Health Landscape – February 2016

The mental health policy discussion in Texas can leave some listeners with the impression that the state hasn’t accomplished much. That isn’t true. Texas has accomplished quite a lot, especially around crisis care and targeted populations.

A Decade of Public Sector Progress – January 2016

Many important terms are used in the mental health policy discussion. MMHPI has distilled them down into a handy reference guide.

During the 84th Legislative Session, in an effort to improve coordination between state agencies and create a strategic approach to providing behavioral health services, lawmakers directed 18 state agencies that receive General Revenue behavioral health funding to work collectively to develop a collaborative five-year behavioral health strategic plan and coordinated expenditures proposal (2016-17 General Appropriations Act, H.B. 1, 84th Legislature, Regular Session, 2015 (Article IX, Section 10.04)).  This strategic plan is the result of months of collaboration involving these agencies, which represent the diverse landscape of behavioral health services in Texas.

Statewide Behavioral Health Strategic Plan

Children

Drawing on the work of Dr. Charles Holzer, a leading psychiatric epidemiologist, MMHPI is able to apply the best national epidemiological studies to Texas’ population data and estimate the number of children and adolescents who have severe emotional disturbances in a given year.

Estimates of Prevalence of Mental Health Conditions among Children and Adolescents in Texas – March 2016

This MMHPI white paper looks at the pattern of risk Texas youth face moving from a school setting and into the justice system. Students are more likely to be arrested now than they were 10 years ago. With leadership from the top, school discipline can shift from a system of punishment to a system of student development.

Closing the School to Prison Pipeline in Texas – February 2016

The Texas House Select Committee on Mental Health was created by Speaker Joe Straus to take a comprehensive look at mental health services across state agencies as well as legislative committees. The following testimonies provide insights into challenges facing children’s mental health care.

Dr. Anu Partap, MD, MPH
Assistant Professor of Pediatrics, UT Southwestern Medical Center
Children and Mental Health – Clinical Setting
Dr. Partap’s testimony handout
Watch Dr. Partap’s presentation (begins at 0:04:40)

Lauren Lacefield-Lewis
Assistant Commissioner, Division for Mental Health and Substance Abuse, Department of State Health Services
Commissioner Lacefield-Lewis’s testimony handout
Watch Commissioner Lacefield-Lewis’s presentation (begins at 2:58:41)

Craig Shapiro, MEd
Interim Associate Superintendent of High Schools, Austin Independent School District
Children and Mental Health – Education Setting K-12: Examples of Collaboration and Innovation
Superintendent Shapiro’s testimony handout
Watch Superintendent Shapiro’s presentation (begins at 4:46:20)

Tracy Spinner, MEd
Assistant Director, Comprehensive Health Services, Austin Independent School District
Children and Mental Health – Education Setting K-12: Examples of Collaboration and Innovation
Tracy Spinner’s testimony handout
Watch Tracy Spinner’s presentation (begins at 4:55:56)

Elizabeth Minne, PhD
Licensed Psychologist, Executive Director, Vida Clinic
Children and Mental Health – Education Setting K-12: Examples of Collaboration and Innovation
Minne’s testimony handout
Watch Dr. Minne’s presentation (begins at 5:06:00)

Dr. Billy Philips
Executive Vice President and Director, F. Marie Hall Institute for Rural and Community Health
Professor, Family and Community Medicine and Public Health, Texas Tech University Health Sciences Center, Lubbock
Children and Mental Health – Education Setting K-12: Telemedicine, Wellness, Intervention, Triage, and Referral (TWITR) Project
Dr. Philips’s testimony handout
Watch Dr. Philips’s presentation (begins at 5:50:50)

The following white paper provides an overview of school-based mental health services, approaches for addressing mental health in schools, and an overview of school-based professionals and organizations that may have a role in providing mental health services or connecting students to school-based mental health services.

School-Based Mental Health – December 2016

MMHPI examined prevalence estimates, reviewed literature and national best practices, and talked with key informants in Texas to describe how the state’s major child serving agencies have operationalized trauma-informed care for children and youth involved with the child welfare system.

Trauma-Informed Care – July 2017

Today, children in foster care receive some services that are fully funded by the state because Texas is not drawing down federal dollars for services eligible for federal match. Maximizing Federal Funds for Child Welfare in Texas, finalized in February 2017, identifies strategies to maximize federal funding for services provided to children in foster care and better serve children with mental health needs.

The Appropriations Committee met to consider the following interim charge:

  • Examine the availability of federal funding and Governor’s Criminal Justice grants that may directly or indirectly improve school safety. Evaluate the potential costs of proposals identified by the Governor and House Committees related to improving access to mental health services for children, improved school safety, and enhanced firearm safety.

Committee handout

Veterans

The Texas House Select Committee on Mental Health was created by Speaker Joe Straus to take a comprehensive look at mental health services across state agencies as well as legislative committees. The following testimonies provide insights into challenges facing veteran’s mental health care.

Sonja Gaines
Associate Commissioner, Mental Health Coordination, Health and Human Services Commission
Commissioner Gaines’s testimony handout
Watch Commissioner Gaines’s presentation (begins at 0:40:18)

Lauren Lacefield-Lewis
Assistant Commissioner, Division for Mental Health and Substance Abuse, Department of State Health Services
Commissioner Lacefield-Lewis’s testimony handout
Watch Commissioner Lacefield-Lewis’s presentation (begins at 0:04:13)

Suzanna Hupp
Associate Commissioner,Veteran Services, Health and Human Services Commission
Commissioner Hupp’s testimony handout
Watch Commissioner Hupp’s presentation (begins at 1:44:28)

Kenneth Wilson
President and CEO, Haven for Hope, San Antonio
Leon Evans
President and CEO, The Center for Health Care Services, San Antonio
Kenneth Wilson and Leon Evans’ testimony handout
Watch Kenneth Wilson and Leon Evans’ presentation (begins at 3:32:41)

Susan Garnett, MSW
CEO, MHMR of Tarrant County
Susan Garnett’s testimony handout
Watch Susan Garnett’s presentation (begins at 5:36:52)

Janie Metzinger
Public Policy Director, Mental Health America of Greater Dallas
Director Metzinger’s testimony handout
Watch Director Metzinger’s presentation (begins at 6:12:42)

Josette Saxton
Director of Mental Health Policy, Texans Care for Children
Director Saxton’s testimony handout
Watch Director Saxton’s presentation (begins at 6:29:24)

Kyle Mitchell
Senior Director of Veteran and Military Policy, Meadows Mental Health Policy Institute
Mr. Mitchell’s testimony handout
Watch Mr. Mitchell’s presentation (begins at 2:23:30)

Smart Justice

The Texas House Select Committee on Mental Health was created by Speaker Joe Straus to take a comprehensive look at mental health services across state agencies as well as legislative committees. The following testimonies provide insights into challenges facing veteran’s mental health care.

Kim Vickers
Executive Director, Texas Commission of Licensing Enforcement (TCOLE)
Kim Vickers’s testimony handout
Watch Kim Vickers’s presentation (begins at 5:14:00)

Chris Kirk
Sheriff, Brazos County
Representative Rural County Law Enforcement and Criminal Justice
Watch Chris Kirk’s presentation (begins at 5:36:50)

Barbara Dawson
Deputy Director, Comprehensive Psychiatric Emergency Services, The Harris Center for Mental Health and IDD
Representatives of Urban County and Municipal Law Enforcement and Collaboration with Local Mental Health Authority
Watch Barbara Dawson’s presentation (begins at 6:08:49)

The Texas House Select Committee on Mental Health was created by Speaker Joe Straus to take a comprehensive look at mental health services across state agencies as well as legislative committees.

Ron Stretcher
Criminal Justice Director, Dallas County
Board Chair, North Texas Behavioral Health Authority
Mental Health Hospitals and Criminal Justice
Mr. Stretcher’s testimony handout
Watch Mr. Stretcher’s presentation (begins at 2:23:25)

In response to 85(R) Senate Bill 1849, known as “The Sandra Bland Act”, Texas county jails are required to make changes to minimum jail standards as of September 1, 2017. The Texas Commission on Jail Standards (TCJS) asked MMHPI to help assess jail readiness. MMHPI took the lead in developing a questionnaire based on the requirements of the Sandra Bland Act and administered it, through collaboration with TCJS, to all jail administrators throughout Texas. This report provides a summary of survey responses received.

SB 1849 Survey: Summary of Major Findings – January 2018

Additionally, MMHPI assisted TCJS with revising the screening form for suicide and medical/mental/developmental impairments in response to the death of Sandra Bland.

New Jail Intake Screening Form

As a result of concerns expressed by Texas sheriffs regarding the provision of appropriate psychotropic medication in Texas jails, MMHPI investigated the status of selected jail behavioral health medication formularies, comparing them to one another and to the state formulary created by the Department of State Health Services (DSHS) for use in state hospitals (September 2016).

Jail Formulary Review – September 2016

In 2011, Seattle, Washington piloted the Law Enforcement Assisted Diversion (LEAD) program.  LEAD, now growing across the country, is an evidence-based, collaborative, pre-arrest diversion program.  The program focuses on providing harm reduction–oriented intensive case management, behavioral health, and substance abuse care rather than filing a criminal charge and seeking prosecution and incarceration.

Law Enforcement Assisted Diversion Overview

Higher Education

The Texas House Select Committee on Mental Health was created by Speaker Joe Straus to take a comprehensive look at mental health services across state agencies as well as legislative committees. The following testimonies provide insight into issues regarding mental health care on college campuses.

Rito Silva, PhD
Vice President for Student Affairs, Del Mar College
Mental Health Services on Campuses of Public Institutions of Higher Education, Community Colleges
Dr. Silva’s testimony handout
Watch Dr. Silva’s presentation (begins at 4:04:57)

Maggie Gartner, PhD
Executive Director for Student Counseling Services, Texas A&M University
Mental Health Services on Campuses of Public Institutions of Higher Education, Texas A&M University System
Dr. Gartner’s testimony handout
Watch Dr. Gartner’s presentation (begins at 4:22:15)

Dayna Schertler
Health Integration Specialist, West Texas A&M University
Mental Health Services on Campuses of Public Institutions of Higher Education, Texas A&M University System
Ms. Schertler’s testimony handout
Watch Ms. Schertler’s presentation (begins at 4:35:45)

Richard A. Lenox, PhD
Licensed Psychologist, Director, Texas Tech University Student Counseling Center
Mental Health Services on Campuses of Public Institutions of Higher Education, Texas Tech University System
Dr. Lenox’s testimony handout
Watch Dr. Lenox’s presentation (begins at 4:52:55)

Drew Miller, PhD
Assistant Vice President for Student Services, Sam Houston State University
Mental Health Services on Campuses of Public Institutions of Higher Education, Texas State University System
Dr. Miller’s testimony handout
Watch Dr. Miller’s presentation (begins at 5:24:42)

Norma Ngo, PsyD
Director of Counseling and Psychological Services, University of Houston
Mental Health Services on Campuses of Public Institutions of Higher Education, University of Houston System
Dr. Ngo’s testimony handout
Watch Dr. Ngo’s presentation (begins at 05:42:42)

Christopher Albert, PhD
Director of Counseling and Psychological Services, University of Texas Rio Grande Valley
Mental Health Services on Campuses of Public Institutions of Higher Education, University of Texas System
Watch Dr. Albert’s presentation (begins at 6:28:43)

Senate Bill 239 (SB 239), which passed in the 84th Texas Legislative Session, created a program offering up to five years of student loan repayment assistance to mental health providers working in Mental Health Professional Shortage Areas (MHPSAs), to be administered by the Texas Higher Education Coordinating Board (THECB). This brief provides an overview of the program as well as considerations for potential program improvement.

Loan Repayment Program for Mental Health Professionals – April 2017

In March 2018, MMHPI prepared the Texas Mental Health Research Framework upon the request of the chairs of academic departments of psychiatry in the state of Texas and behavioral health leaders in state government in an effort to promote synergistic collaborations in mental health research.

Beginning in 2013, the 83rd Texas Legislature appropriated $14 million to support several efforts to increase the number of first-year residency positions available in the state through the Graduate Medical Education (GME) Expansion.

In 2015, the 84th Texas Legislature streamlined these efforts and appropriated $53 million to increase the number of first-year residency positions and to establish new residency programs.

The 85th Texas Legislature increased funding to $97.1 million to continue support for the program in the 2018-2019 biennium. The Texas Higher Education Coordinating Board provided a break out of the awardees and program specialties funded through the 2018-2019 GME Expansion Grant Program.

Invited Testimony

Texas House Committees on Corrections and Criminal Jurisprudence
August 29, 2018
BJ Wagner
Senior Director of Smart Justice, Meadows Mental Health Policy Institute
Ms. Wagner’s testimony handout

Texas Joint Legislative Committee on Aging
August 28, 2018
Kyle Mitchell
Senior Director of Veteran and Military Policy, Meadows Mental Health Policy Institute
Mr. Mitchell’s testimony handout
Watch Mr. Mitchell’s presentation (begins at 59:00)

Texas House Committee on County Affairs
August 23, 2018
BJ Wagner
Senior Director of Smart Justice, Meadows Mental Health Policy Institute
Ms. Wagner’s testimony handout

Texas Senate Select Committee on Violence in Schools and School Security
July 18, 2018
Andy Keller, PhD
President & CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation (begins at 1:40)

Texas House Committees on Public Health and Public Education
June 28, 2018
Andy Keller, PhD
President & CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation (begins at 2:46:57)

Texas House Committees on Appropriations Subcommittee on Article II and General Investigating & Ethics
June 27, 2018
Andy Keller, PhD
President & CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation (begins at 12:40:30)

Texas Senate Committee on Veterans Affairs and Border Security
May 22, 2018
Kyle Mitchell
Senior Director of Veteran and Military Policy, Meadows Mental Health Policy Institute
Mr. Mitchell’s testimony handout
Watch Mr. Mitchell’s presentation (begins at 2:23:30)

Texas House Select Committee on Opioids and Substance Abuse
March 27, 2018
Andy Keller, PhD
President & CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation (begins at 5:23:54)

Texas Senate Health and Human Services Committee
March 22, 2018
Andy Keller, PhD
President & CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation (begins at 4:14:36)

Texas Senate Finance Committee
March 20, 2018
Andy Keller, PhD
President & CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation (begins at 4:14:15)

Texas House Committee on General Investigating & Ethics
January 18, 2018
Andy Keller, PhD
President & CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout

Texas House Select Committee on Economic Competitiveness
December 5, 2017
Andy Keller, PhD
President & CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation (begins at 2:50:00)

Andy Keller, PhD
CEO, Meadows Mental Health Policy Institute
Invited Testimony on SB 674
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation

Invited Testimony on SB 74
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation

Texas Mental Health Workforce Needs
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation

Invited Testimony on HB 13s
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation

Invited Testimony on SB 292
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation

Michele R. Guzmán, PhD
Vice President of Administration, Senior Director of Evaluation,
Meadows Mental Health Policy Institute
Invited Testimony on HB 1600
Dr. Guzmán’s testimony handout
Watch Dr. Guzmán’s presentation

B.J. Wagner
Director of Smart Justice, Meadows Mental Health Policy Institute
Invited Testimony on HB 337, HB 1734
Ms. Wagner’s testimony handout
Watch Ms. Wagner’s presentation

Invited Testimony on SB 344
Watch Ms. Wagner’s presentation

Texas Senate Health and Human Services Committee
June 16, 2016
Andy Keller, PhD
CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation (begins at 4:02:02)

Texas Senate Committee on Criminal Justice
May 17, 2016
BJ Wagner
Director of Smart Justice, Meadows Mental Health Policy Institute
Ms. Wagner’s testimony handout
Watch Ms. Wagner’s presentation (begins at 2:08:21)

Senate Committee on Veterans Affairs and Military Installations
March 10, 2016
Kyle Mitchell
Senior Director of Veteran and Military Policy, Meadows Mental Health Policy Institute
Mr. Mitchell’s testimony handout
Watch Mr. Mitchell’s presentation (begins at 1:00:12)

Texas House Select Committee on Mental Health
February 18, 2016
Andy Keller, PhD
CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation (begins at 6:32:00)

Texas Senate Finance Committee
January 26, 2016
Andy Keller, PhD
CEO, Meadows Mental Health Policy Institute
Dr. Keller’s testimony handout
Watch Dr. Keller’s presentation (begins at 3:15:30)

Deeper Dives

The 85th Legislative Session saw mental health issues assume a large focus, resulting in strong progress toward smarter, more effective mental health policy in Texas. The Institute has furthered this progress by providing Texas legislators, state officials, members of the judiciary, and local leaders with objective, trustworthy data and policy analysis. MMHPI summarized highlights and budget allocations from Texas’ most material advances in mental health policy during the 85th Legislature.

85th Regular Legislative Wrap up: Improving the Texas State of Mind

Behavioral Health Appropriations in the 85th Legislature

Laws designed to put mental health coverage on similar footing with physical health coverage are complex and contain gaps that make true parity difficult to accomplish. This MMHPI paper walks through some of the issues in response to the June 2, 2016 hearing of the Texas House Select Committee on Mental Health.

In the 85th Legislative Session, Representative Price (R-Amarillo) and Senator Zaffirini (D-Laredo) teamed up to pass HB 10, which expanded the state’s parity enforcement authority to ensure that mental health coverage is treated the same as physical health coverage. Effective September 1, 2017, HB 10 also required the Texas Department of Insurance (TDI) to conduct a one-time data collection and report assessing mental health parity, specifically related to non-quantitative treatment limitations. The report – Study of Mental Health Parity to Better Understand Consumer Experiences with Accessing Care – was released in August 2018 and summarizes TDI’s findings.

Also effective September 1, 2017, HB 10 required the Health and Human Services Commission (HHSC) to conduct a study and prepare a report comparing benefits provided by Medicaid managed care organizations (MCOs) for medical and surgical expenses to those for mental health and substance use disorder (SUD).  Released in September 2018, Report to Assess Medical or Surgical Benefits, and Benefits for Mental Health and Substance Use Disorders, summarizes HHSC’s findings.

Our list of Background Reading Resources provides more information on key policy topics in mental health including:

  • The Overall System
  • Local Systems Assessments
  • Best Practice Briefings
  • Medicaid and 1115 Waiver (DSRIP)
  • Needs of the Texas Workforce
  • Texas Veterans
  • Justice System
  • Super Utilizer Use Reduction
  • First Episode Psychosis, and
  • Deeper Background on Mental Health Needs in Texas.

Substance Use Disorder Landscape
MMHPI summarizes key facts regarding substance use disorder (SUD) needs and current services in Texas. It addresses key questions such as how many Texans need SUD services, facts related to the opioid crisis, state spending, and the public and private systems. This document is updated frequently so check back often.
Substance Use Disorder Landscape
SUD Landscape Supplement: Methamphetamine Use in Texas – February 2018

Substance Use Disorder Glossary of Terms
MMHPI summarizes key terms related to substance use disorder needs and current services.
Substance Use Disorder Glossary of Terms

In the summer of 2016, a survey was conducted by the Texas Business Group on Health in partnership with the Meadows Mental Health Policy Institute and with promotional assistance from the Dallas-Fort Worth Business Group on Health, Houston Business Coalition on Health, Mental Health America of Greater Houston, and Texas Association of Business.

Depression in the Workplace serves as a report of the survey findings related to current policies, practices, and strategies of Texas employers to address untreated and inadequately treated depression in the workplace. The report includes a descriptive analysis summarizing the characteristics and perceptions of participating Texas employers.

In November 2017, MMHPI conducted a brief literature review of epidemiological studies that estimated the prevalence of tobacco use among adults with serious mental illnesses (SMI).

Smoking Prevalence and SMI

The Legislative Budget Board (LBB) provides an overview of the state hospital system in Texas.

LBB State Hospital Primer – April 2016

The Health and Human Services Commission (HHSC) issued a comprehensive plan for state-funded inpatient mental health services (August 2017) in accordance with 2018-19 General Appropriations Act, S.B. 1, 85th Legislature, Regular Session, 2017 (Article II, Health and Human Services Commission, Rider 179).  The plan provides a three-phased approach to improve the state hospital system.

Comprehensive Plan for State-Funded Inpatient Mental Health Services – August 2017

The Texas House Select Committee on Mental Health was created by Speaker Joe Straus to take a comprehensive look at mental health services across state agencies as well as legislative committees. The following testimonies provide insight into issues regarding mental health care access within the state hospital system and the role of academic institutions.

Texas Select Committee on Mental Health
September 22, 2016
David Lakey, MD
Chief Medical Officer, Associate Vice Chancellor for Population Health, The University of Texas System
Dr. Lakey’s testimony handout
Watch Dr. Lakey’s presentation (begins at 1:16:55)

John Warner, MD
Vice President and CEO, University Hospitals, University of Texas Southwestern Medical Center
Dr. Warner’s testimony handout
Watch Dr. Warner’s presentation (begins at 02:09:24)

In response to the 2018-19 General Appropriations Act, S.B. 1, 85th Legislature, Regular Session, 2017 (Article II, Health and Human Services Commission, Rider 45), the Meadows Mental Health Policy Institute (MMHPI) performed a review of performance measures for individuals with serious mental illness (SMI) in Texas and other states’ Medicaid managed care programs and provided recommendations for improving Medicaid managed care for members with SMI.

Medicaid Managed Care Performance Measures Recommendations – March 2018

This report provides a quantitative perspective on the prevalence of deaths that have resulted from mass public shootings, including school shootings, and from deaths associated with murder and suicide, which occur with much greater frequency.

Severe Violence Trends: Suicide, Murder, Mass Shootings, School Shootings – August 2018

The research is clear that severe mental illness alone is not a good predictor of violence. A large-scale, multi-year epidemiological study found that people who only had a severe mental illness and did not have a co-occurring substance abuse condition or a history of violence had less than a 2% probability of engaging in any type of violence over a two to three year period, about the same as the general population.

Read the preliminary summary of current research on violence and mental illness or view Dr. Andy Keller’s testimony (begins at 1:40) to the Texas Senate Select Committee on Violence in Schools and School Security from July 2018. Dr. Keller’s testimony and accompanying presentation to the Committee can also be found in the Invited Testimony tab on this page under 85th Legislative Interim (2017-2018).