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Mental Health

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We are healthy.

We have adequate nutrition and achieve and
maintain optimal physical and behavioral health.

22% of adults in Travis County report poor mental health

Indicator: Percent of adults in Travis County who report poor mental health

Goal: Reduce the percentage of people reporting poor mental health

Target: 15% by 2017

Significance of Indicator: The United States Department of Health and Human Services states that "good mental health is essential to overall health and personal well-being. It also contributes to the ability to lead a healthy, balanced, and productive life. Emotional problems can impair a person's thinking, feelings, and behavior and, over time, can become increasingly serious and disabling."

what the data tell us

Twenty-two percent of Travis County residents report poor mental health. Although relatively large margins of error make comparisons over time and across geographic areas somewhat uncertain, the share of Travis County residents reporting poor mental health appears to have increased in recent years, exceeding rates for the 5-county Metro Area and Texas as a whole.

Definition: Adults who report to have had 5 or more days of poor mental health which includes stress, depression, and problems with emotions, within the last 30 days.

Data Source: Texas Behavioral Risk Factor Surveillance System (BRFSS)

Data Considerations: The BRFSS collects data through phone interviews. In 2011 the surveying process was expanded to include people with cell phones as well as people with landlines. As a result, this data is not comparable to BRFSS data from years prior to 2011. The sample sizes for BRFSS data are very small. Changes shown in this graph fall within the margin of error for the data and are not statistically significant.

the story behind the indicator

About 1 in 5 adults in Travis County reported experiencing poor mental health in 2013. This includes people who report 5 or more days of poor mental health, including stress, depression, and problems with emotions, in the last 30 days. Although small sample sizes for local estimates preclude definitive conclusions, the percent of local residents experiencing poor mental health appears to have increased since 2011. During the same time period, the percentage of Texans experiencing poor mental health has declined from 21% to 18%.

Younger adults are most likely to experience poor mental health in Travis County. In 2013, 32% of people between 18 and 29 experienced poor mental health. People with disabilities are also more likely than those without a disability to experience poor mental health, with 38% reporting poor mental health.

some local efforts to improve this indicator

Collaborative Initiatives

  • Huston-Tillotson University has partnered with the Dell Medical School at the University of Texas and other local partners to create the Sandra Joy Anderson Health and Wellness Center to increase access to mental health services in East Austin.

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  • Central Health is the lead agency for a six county Regional Healthcare Partnership Plan that describes how the region will transform healthcare delivery as part of a state-wide 1115 Waiver. Austin Travis County Integral Care will operate 11 of these initiatives that include mobile crisis intervention, hospital and jail diversion, chronic disease prevention, expanding prescriber capacity, and telemedicine. Integral Care also offers Mental Health First Aid training to law enforcement, health care providers, school personnel, landlords and others in the community so they can respond appropriately to people experiencing a mental health crisis. A new Seton Psychiatric Emergency Department opened at Central Health’s Brackenridge Campus in April 2014, so that people experiencing a psychiatric emergency can be treated in the most appropriate setting. Waiver projects will also expand telepsychiatry services to enhance access to psychiatric services for low-income patients at community health clinics, and are training peer support specialists to promote health and wellness for adults with serious mental illness.

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  • Partnership between Central Health and Austin Travis County Integral Care has allowed the integration of health and behavioral health services in CommUnity Care Health Clinics, resulting in more people receiving mental health care.  In late 2013, ATCIC and CommUnity Care opened a new integrated healthcare clinic that will serve the Dove Springs area. The new Southeast Health and Wellness Center also includes mental health observation facilities in order to deter use of inpatient facilities.

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  • Austin Travis County Integral Care's (ATCIC) mission is to improve the lives of people affected by behavioral health and developmental and/or intellectual challenges. As part of the statewide 1115 Medicaid waiver, ATCIC created a mobile crisis outreach team to divert people who are having a mental health crisis from jail and emergency departments. The organization has also launched a Health Justice Learning Collaborative with the Travis County Sheriff’s Office to enhance mental health planning prior to an individual’s release from jail. Through the Healthy Community Collaborative, ATCIC worked with partners to develop housing for clients based on the ‘housing-first’ model.

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  • The Travis County Youth Substance Abuse Prevention Coalition works to reduce substance use among children in Travis County.

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  • The Indicator Improvement Initiative and the Child and Youth Mental Health Planning Partnership are local collaborations that help coordinate behavioral health planning needs.

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  • The Austin Recovery Oriented System of Care (ROSC) Initiative is a network that builds on the strengths and resilience of individuals, families and communities to achieve improved health, wellness, and quality of life for those with or at-risk of alcohol and drug problems through a long-term, community-based recovery approach.

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  • The Psychiatric Services Stakeholder Group, a collaboration of government, healthcare, and other organizations coordinated by Central Health, is working to create a stronger, more viable mental health crisis system including a round the clock crisis hotline, mobile crisis outreach services, 24-hour psychiatric emergency services, observation beds in a safe and structured environment, inpatient crisis services, crisis intervention teams, and crisis respite beds.

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  • The Austin/Travis County Suicide Prevention Coalition is one of many coalitions and statewide agencies in Texas working together to implement the Texas Suicide Prevention Plan. This year the Austin/Travis County coalition has a goal of providing training to community and clinical service providers on the prevention of suicide and related behaviors. An example of such a training being provided is Mental Health First Aid.

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  • In 2007, Travis County became the first county in the nation to have a Mental Health Public Defender’s Office.

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Plans, Data, and Reports

  • Local partners worked together to develop the Travis County Children’s Mental Health Plan, a five year plan to improve the wellness of children and youth in Travis County. Goals of the plan include: promoting wellness and supporting resilience; providing a continuum of services; responding effectively to children, youth, and families in crisis; and improving outcomes and accountability across the system.

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  • Local public health, human services, and criminal justice partners have worked together to develop a Substance Abuse Plan for Travis County. In May 2014, the group released a set of initial recommendations which included a focus on people experiencing homelessness and women with children.

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  • In 2012, the Austin/Travis County Health and Human Services Department, in partnership with other health care partners, completed a Community Health Assessment (CHA) which found that the need for mental health services was one of the foremost community health concerns raised by residents. The partners have developed a Community Health Improvement Plan with strategies to deal with the issues identified in the assessment. Access to primary health and behavioral health care are one the four priority areas of the plan.

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a closer look at the story behind the indicator:

Click on one of the titles below for more information.

» Mental Health in Travis County - Behavioral Risk Factor Surveillance System Data

% of adults in Travis County who Report Poor Mental Health by Income

People with low-incomes generally report higher levels of poor mental health. In 2013, 29% of adults in Travis County with incomes less than $25,000 reported poor mental health. This compares to 20% of adults with incomes between $25,000 and $49,999 and 19% of adults with incomes of $50,000 or higher.

Definition: Adults who report to have had 5 or more days of poor mental health which includes stress, depression, and problems with emotions, within the last 30 days

Data Source: Texas Behavioral Risk Factor Surveillance System (BRFSS)

Data Considerations: The BRFSS collects data through phone interviews. In 2011 the surveying process was expanded to include people with cell phones as well as people with landlines. As a result, this data is not comparable to BRFSS data from years prior to 2011. The sample sizes for BRFSS data are relatively small. Differences appearing on the graph may not be statistically significant at the 95% level and should be interpreted with caution.

% of adults who report poor mental health by age

Younger adults are more likely to experience poor mental health than older adults. In 2013, 7% of adults ages 65 and over reported poor mental health compared to 32% of 18-29 year olds, 23% of 30-44 year olds, and 17% of 44-64 year olds.

Definition: Adults who report to have had 5 or more days of poor mental health which includes stress, depression, and problems with emotions, within the last 30 days

Data Source: Texas Behavioral Risk Factor Surveillance System (BRFSS)

Data Considerations: The BRFSS collects data through phone interviews. In 2011 the surveying process was expanded to include people with cell phones as well as people with landlines. As a result, this data is not comparable to BRFSS data from years prior to 2011. The sample sizes for BRFSS data are relatively small. In 2011, the data for the population ages 18-29 is considered unstable because it either has a relative standard error greater than 30% or because the denominator represents fewer than 50 respondents. Differences appearing on the graph may not be statistically significant at the 95% level and should be interpreted with caution.

% of adults in Travis County who Report Poor Mental Health by race and ethnicity

Small sample sizes make definitive conclusions about disparities in mental health by race in Travis County difficult. In 2013, 20% of Hispanics and 16% of Whites in Travis County reported poor mental health. Data for the Black population were unavailable due to small sample sizes. In Texas as a whole, Blacks are more likely to report poor mental health than Whites or Hispanics. In 2013, 24% of Texans identifying as Black reported poor mental health, compared to 16% of White Texans and 17% of Hispanic Texans.

Definition: Adults who report to have had 5 or more days of poor mental health which includes stress, depression, and problems with emotions, within the last 30 days

Data Source: Texas Behavioral Risk Factor Surveillance System (BRFSS)

Data Considerations: The BRFSS collects data through phone interviews. In 2011 the surveying process was expanded to include people with cell phones as well as people with landlines. As a result, this data is not comparable to BRFSS data from years prior to 2011. The sample sizes for BRFSS data are relatively small. Differences appearing on the graph may not be statistically significant at the 95% level and should be interpreted with caution. In 2012, the data for the Black population is considered unstable because it either has a relative standard error greater than 30% or because the denominator represents fewer than 50 respondents. Data for the Black population were not reported in 2013, due to the small sample size.

% of adults who report poor mental health by disability status

People with disabilities are also more likely than those without a disability to experience poor mental health. In 2013, 38% of people with a disability reported experiencing poor mental health, compared to 18% of people without a disability.

Definition: Adults who report to have had 5 or more days of poor mental health which includes stress, depression, and problems with emotions, within the last 30 days, by disability status

Data Source: Texas Behavioral Risk Factor Surveillance System (BRFSS)

Data Considerations: The BRFSS collects data through phone interviews. In 2011 the surveying process was expanded to include people with cell phones as well as people with landlines. As a result, this data is not comparable to BRFSS data from years prior to 2011. The sample sizes for BRFSS data are relatively small. Differences appearing on the graph may not be statistically significant at the 95% level and should be interpreted with caution. In 2012, the data for the Black population is considered unstable because it either has a relative standard error greater than 30% or because the denominator represents fewer than 50 respondents. Data for the Black population were not reported in 2013, due to the small sample size.

» Behavioral Health Issues in Central Texas schools

% of students with disciplinary actions that resulted in removal from classrooms

Negative behavior that results in a removal from the regular classroom may be associated with underlying mental health issues. Across local districts and the state of Texas disciplinary rates have declined substantially. Disparities remain across area school districts, however. Districts in eastern Travis County generally have higher rates of disciplinary removals than schools in the central and western portion of the county.

Definition: % of students who experienced disciplinary action that resulted in their removal from the regular classroom for at least one day

Data Source: Texas Education Agency

Data Considerations: Students removed from the classroom may experience one or more of the following disciplinary actions: in-school suspension, home-school suspension, expulsion, juvenile justice alternative education programs, or disciplinary alternative education programs.

% of students reporting that their ability to cope with stress or negative emotions is poor or very poor

While there is no measure of sad, unhappy, or depressed youth in our community, AISD surveys students on their ability to cope with stress and negative emotions. In the 2013-2014 School Year, 17% of middle school and 19% of high school students reported that their ability to cope with stress or negative emotions is poor or very poor.

Definition: % of Austin ISD students reporting that their ability to cope with stress or negative emotions is poor or very poor

Data Source: Austin Independent School District, Student Substance Use and Safety Surveys

Data Considerations: The data reported in this survey is not directly comparable to data reported for other regions. Data are based on a sample of students and may not represent statistically significant changes.

% of students who missed school because they felt too sad or depressed to attend

Poor mental health can have an influence on students’ academic performance. During the 2013-2014 school year, 12% of Austin ISD middle school students and 18% of high school students missed school because they felt too sad or depressed to attend. Research by the E3 Alliance, as part of their Missing School Matters campaign, has shown that increased absences negatively affect dropout and graduation rates.

Definition: % of Austin ISD students who missed school because they felt too sad or depressed to attend

Data Source: Austin Independent School District, Student Substance Use and Safety Surveys

Data Considerations: The data reported in this survey is not directly comparable to data reported for other regions. Data are based on a sample of students and may not represent statistically significant changes.

» Suicide Data

overall suicide rate per 100,000 people

Travis County’s suicide rate has remained relatively constant over time. In 2012, the rate appears to have risen a bit, though the change from 2011 is not statistically significant at the 95% confidence level. In 2012, there were 11.8 suicides per 100,000 people in Travis County. At the same time, there were 13.6 suicides per 100,000 people in Texas.

Definition: The age-adjusted deaths from intentional self-harm per 100,000 people

Data Source: Texas Department of State Health Services

Data Considerations: The suicide rate is calculated using age-adjusted weights from 2000 Census population data. Differences appearing on the graph may not be statistically significant at the 95% level and should be interpreted with caution.

» Substance Abuse Issues in the Greater Central Texas Region

% using illicit drugs in the past month - Ages 12 and up

Over time, Central Texas has had a higher percentage of people ages 12 and up who report using illicit drugs than the state and the nation. From 2010-2012, 11% of Central Texans ages 12 and up reported using illicit drugs compared to 7% in the state of Texas and 9% across the nation.

Definition: The percentage of people ages 12 and up who reported using an illicit drug (marijuana/hashish, cocaine/crack, heroin, hallucinogens, inhalents, prescription-type psychotherapeutics used non-medically, etc.) within the past month

Data Source: National Survey on Drug Use and Health (NSDUH)

Data Considerations: NSDUH does not survey people who are homeless, active duty military, or people who are in jails or hospitals. Small sample sizes may impact the accuracy of data, especially in smaller geographic regions.

% using illicit drugs other than marijuana in the past month - Ages 12 and up

When marijuana use is removed from drug use data, the percentage of people who report having used illicit drugs within the past month decreases substantially. Use of illicit drugs other than marijuana decreased between the 2006-2008 and 2010-2012 time periods for Central Texas, the State, and the Nation (note that the decrease in Central Texas was not statistically significant due to a larger margin of error in the data). During the 2010-2012 time period, 4% of Central Texans reporting having used an illicit drug other than marijuana in the past month compared to 3% of Texans and 3% of Americans.

Definition: The percentage of people ages 12 and up who reported using an illicit drug (cocaine/crack, heroin, hallucinogens, inhalents, prescription-type psychotherapeutics used non-medically, etc.) other than marijuana within the past month

Data Source: National Survey on Drug Use and Health (NSDUH)

Data Considerations: NSDUH does not survey people who are homeless, active duty military, or people who are in jails or hospitals. Small sample sizes may impact the accuracy of data, especially in smaller geographic regions.

Alcohol Dependence in the Past Year - Ages 12 and Up

From 2010-2012 3% of Central Texans, Texans, and Americans were dependent on alcohol. The percentage of Central Texans experiencing alcohol dependence appears to have declined between 2006-2008 and 2010-2012 in Central Texas and is now not statistically different from the rate in the state and nation.

Definition: Survey respondents were defined as having alcohol dependence if they met three or more of the following criteria:

  • Spent a great deal of time over the period of a month getting, using, or getting over the effects of alcohol
  • Used alcohol more often than intended or was unable to keep set limits on alcohol use
  • Needed to use alcohol more than before to get desired effects or noticed that the same amount of alcohol had less effect than before
  • Inability to cut down or stop using alcohol every time tried or wanted to
  • Continued to use alcohol even though it was causing problems with emotions, nerves, mental health, or physical problems
  • Alcohol use reduced or eliminated involvement or participation in important activities
  • Experienced withdrawal symptoms (e.g. having trouble sleeping, cramps, hands tremble)

Data Source: National Survey on Drug Use and Health (NSDUH)

Data Considerations: NSDUH does not survey people who are homeless, active duty military, or people who are in jails or hospitals. Small sample sizes may impact the accuracy of data, especially in smaller geographic regions.

Illicit Drug Dependence in the Past Year - Ages 12 and Up

The percentage of people who are dependent on illicit drugs has remained at about 2% for Central Texas, Texas, and the Nation for all years represented on the graph below.

Definition: Survey respondents were defined as having illicit drug dependence if they met three or more of the following criteria:

  • Spent a great deal of time over the period of a month getting, using, or getting over the effects of illicit drugs
  • Used illicit drugs more often than intended or was unable to keep set limits on illicit drug use
  • Needed to use illicit drugs more than before to get desired effects or noticed that the same amount of illicit drugs had less effect than before
  • Inability to cut down or stop using illicit drugs every time tried or wanted to
  • Continued to use illicit drugs even though it was causing problems with emotions, nerves, mental health, or physical problems
  • Illicit drugs reduced or eliminated involvement or participation in important activities
  • Experienced withdrawal symptoms (e.g. having trouble sleeping, cramps, hands tremble)

Data Source: National Survey on Drug Use and Health (NSDUH)

Data Considerations: NSDUH does not survey people who are homeless, active duty military, or people who are in jails or hospitals. Small sample sizes may impact the accuracy of data, especially in smaller geographic regions.

% needing but not receiving treatment for Alcohol use in the Past Year

More Central Texans need but do not receive treatment for alcohol use than the general U.S. population. From 2010-2012, 9% of Central Texans with alcohol dependence needed but did not receive treatment, compared to 6% of Texans and Americans with alcohol dependence.

Definition: The percentage of people ages 12 and up meeting the criteria for alcohol dependence but not receiving specialty treatment for alcohol use in the past year

Data Source: National Survey on Drug Use and Health (NSDUH)

Data Considerations: NSDUH does not survey people who are homeless, active duty military, or people who are in jails or hospitals. Small sample sizes may impact the accuracy of data, especially in smaller geographic regions.

% needing but not receiving treatment for Illicit drug use in the Past Year

Over time roughly 2% of Central Texans, Texans, and Americans have reported needing but not receiving treatment for illicit drug use in the past year.

Definition: The percentage of people ages 12 and up meeting the criteria for illicit drug dependence but not receiving specialty treatment for drug use in the past year

Data Source: National Survey on Drug Use and Health (NSDUH)

Data Considerations: NSDUH does not survey people who are homeless, active duty military, or people who are in jails or hospitals. Small sample sizes may impact the accuracy of data, especially in smaller geographic regions.

» Concentrations of Clients Receiving Behavioral Health Services from ATCIC

map of Austin Travis County Integral Care (ATCIC) clients, 2014, by ZIP code

This map shows clients of Austin Travis County Integral Care (ATCIC) in Travis County. ATCIC serves populations with bipolar disorder, major depression, and schizophrenia. This population data also include clients with intellectual or developmental disabilities. ATCIC’s clients are largely concentrated along the I-35 corridor and in Del Valle.

Definition: Unduplicated number of clients served by ATCIC from January 1, 2014 to December 31, 2014

Data Source: Map was produced by Community Advancement Network. Data was provided by Austin Travis County Integral Care.

Data Considerations: This data reflects only the number of people served in zip codes in the 5-county Austin Metro Area.

selected populations