Real Stories From Texans
The data behind Texas's mental health shortage lives on our Crisis page.
This page belongs to the people behind those numbers. Clinicians, patients, and families, in their own words.
“I was asked by my supervisors in the Defense Health Agency to seek prescriptive authority because of the need for prescribers for mental health conditions. After obtaining the necessary training and experience and through their support over a 5-year timespan, I have been able to serve Active Duty Service Members with prescriptive and psychological care. I serve individuals from 4 Military Treatment Centers in TX. These individuals must pick up their prescriptions from a military pharmacy. In TX, I am not allowed to send a prescription to a local pharmacy or through a mail order service because there is no prescriptive authority law. This restriction sometimes causes difficulty for my patients, requiring them to take time out of work to pick up their prescriptions or find another provider if they are away for a short-term assignment or training. However, they relay gratitude for integrative care that includes prescribing and deprescribing when appropriate. ”
— Lynette Pujol, PhD, MSCP, ABRxP
“I currently practice at a Federally Qualified Health Center in Matagorda County, a very rural and secluded county south of Houston. Our clinic is actually very lucky to have a psychiatrist who comes in one day a week to see patients. However, as the only provider in the area, he is swamped with cases. His new patient wait list is insanely long. Medical providers in the area are also strained and fearful of dealing with mental health, so they are either unwilling to address the concern or over-address it, placing patients on high dosages of medications, in particular benzodiazepines. I am seeing people who have been taking high-dosage benzodiazepines for years. I personally never wanted to see psychologists prescribe medications. I think all the concerns that are noted about it are valid. However, my experiences here have softened that stance. It's sad to think that right here in the United States, there are people who are still essentially receiving 19th-century care due to limited access.”
— John Thomas Saglime Jr., PsyD“I had a patient who was in a depression crisis. He had an extensive history of depression in his family and thought it was important that he get on an antidepressant before his symptoms worsened. I referred him to three psychiatrists, all of whom had six-week waiting lists for new patients. He then started calling psychiatrists in his insurance network, one after another. He reported that he called 108 psychiatrists before he found one who could get him in within a two-week period. Patients frequently complain that psychiatrists in their network have very long wait times for an appointment, usually six weeks or more. The only psychiatrists who can respond quickly do not take insurance.”
— Jayne Raquepaw, PhD“In Houston, it takes three months on average for a parent to get their child or adolescent in to see a child psychiatrist. Although not suicidal or homicidal, children in crisis are not able to see a psychiatrist in a timely manner.”
— Grace Jennings, PhD“I was contacted by a young mother with three small children who lived in an extremely rural part of the state. She had been suffering with depression for over a year and related that she had been on an antidepressant for 10 months. She was having passive suicidal thoughts, wishing she would not wake up. She did not want to leave her children but thought perhaps they would be better off without her. Essentially, this young mother had been placed on a low dose of medication for a long time by a physician who was not a specialist in mental health. She improved when I called the PCP, and he was receptive. I continued to follow up with him until the dose was right, with significant remission of symptoms. This patient suffered needlessly for over a year, and her children were unnecessarily affected by the fact that their mother was depressed. Why are we losing prescribing psychologists to states like New Mexico and Louisiana?”
— Cheryll Hall, PhD, MSCP“I am a psychologist working in the Houston area for over 15 years. A great number of my patients are Hispanic whose parents very often speak only Spanish. The ONLY Spanish-speaking psychiatrist that prescribed medication for my ADHD patients retired two years ago, and currently, I'm unable to find physicians that can or are willing to prescribe stimulants to my patients. Most of them don't accept Medicaid, and the ONLY physician (psychiatrist) willing to help my patients to access their medication does not speak Spanish. It is quite a nightmare as the only other two psychiatrists willing to help my patients have a months-long waiting list. Many of the PCPs don't feel comfortable prescribing for many reasons, one of which is the lack of training in this particular field of ADHD. Not allowing properly trained psychologists to prescribe medication to meet the needs of their patients is a case of medical neglect.”
— Jorge Carrillo, PhD“I live in El Paso, Texas, where there is an extreme shortage of psychiatrists for a city of almost one million. Even the Local Authority (MHMR) must contract with out-of-town psychiatrists to perform telemedicine in order to serve their clients. In my own private practice, I am constantly facing the fact that when I refer clients for medication management, at best, they must wait for up to four months to be seen due to the long waiting lists. Worse yet, none of the local psychiatrists accept Medicaid or Medicare. In the last year, I have referred 99% of my clients to two prescribing psychologists in New Mexico for medication treatment. Psychologists are allowed to treat El Paso patients because there is a law that allows treatment within 50 miles of the state boundary.”
— Betsy Nacim, PhD“I cannot tell you how often I am asked, in private practice, if I prescribe medications. Of course I do not, and I make referrals to other doctors. But my office is in Wichita Falls, which is still relatively rural. The local psychiatrists commonly see patients for medication management appointments every four to six months, for about 15 minutes at a time. No wonder nobody ever seems to be showing much improvement.”
— Timothy J. Nyberg, PhD“An elderly woman was brought into my practice having just been released from a local psychiatric inpatient facility. She was told she had to see a psychiatrist for her medications within ten days. After attempting to get an appointment with all the psychiatrists they located in El Paso, her family discovered most were not taking new patients, and those that were, it would be up to six months for a new patient appointment. I was concerned about the dose and powerfulness of the prescribed medications. Given the patient’s age and history, which was negative for any previous mental health issues, and the rapidity of the onset, I suggested that the patient be taken to her PCP for a complete physical. Her PCP determined that this patient had an advanced UTI which caused the psychiatric presentation. This elderly woman came to me on three powerful medications that contributed to her poor cognitive state never previously seen by family. If psychologists were prescribers, they would be able to discontinue medications, not just prescribe them.”
— Elizabeth L. Richeson, PhD