Malekeh Amini and Laurel Williams speak during Techquity programming at the ViVE 2023 conference in Nashville, March 2023

Learning from Texas’ approach to statewide mental health care access

A standing-room-only crowd gathered at ViVE 2023, to learn how the State of Texas and Trayt.Health are accomplishing something that many other states find elusive: expanding access to mental health care.

Dr. Laurel Williams, medical director for the centralized operations of the Texas Child Mental Health Care Consortium, took the stage with Trayt founder Malekeh Amini to share Texas’ success story. While other states are struggling with piecemeal approaches, Texas has built standardized, statewide primary care and school-based access programs that connect the entire care ecosystem and bring care as close to patients as possible.

What’s unique about the TCMHCC?

In 2019, the Texas legislature took a bold step, requiring health systems and government agencies across the state to work together under the leadership of the newly formed Texas Child Mental Health Care Consortium

“The Consortium consists of the 12 Departments of Psychiatry across our big state, along with several important agencies and nonprofits,” Dr. Williams explained. “Together our team is charged with developing programs that will help all children in our state, regardless of where they are.”

The ViVE presentation addressed two of TCMHCC’s five initiatives: the Child Psychiatry Access Network (CPAN), which facilitates consultation and behavioral health training for primary care providers, and The Texas Child Health Access Through Telemedicine (TCHATT) program, which provides in-school direct intervention via telehealth to at-risk children and adolescents. 

Both programs offer services across the state, regardless of zip code, demographics, insurance, or economic abilities. Therefore, in Texas, they are helping eliminate behavioral health deserts, which exist for 570 counties across the United States. Delivering care at school or in the primary care setting, means families don’t have to drive hours to see a behavioral health specialist or lose precious time trying to secure an appointment. 

“It’s fabulous that we can do this across the state,” Dr. Williams said. “So, whether you’re in Lubbock, Corpus Christi, El Paso, or Dallas, you’re going to get the same service.”

As of March 2023, the Consortium had enrolled nearly 10,000 primary care providers and 500 school districts, making its state-funded services available to 2.5 million children. 

Supported by technology

Statewide coordination required a technology platform that could break silos and facilitate collaboration across organizations. 

The Consortium partnered with Trayt.Health to create the technology infrastructure that supports the initiatives. From a workflow standpoint, the Trayt platform unites the care ecosystem onto one platform, connecting primary care providers and schools with psychiatry clinics that can provide behavioral health services. It also connects the 12 institutions, which don’t typically work together, enabling them to support each other and deliver consistent programs across the state.

The program also depended on data and analytics to generate metrics required for state and agency reporting. With Trayt, they found a data platform that not only provides engagement metrics but also helps improve care decisions and measure patient outcomes.

“Trayt, at the foundation, is a measurement-based care platform for behavioral health,” Malekeh Amini explained. “It really is focused on collecting the right patient data and synthesizing it, providing clinicians with the tools they need to make more informed decisions.”

The Trayt platform has digitized a large library of standardized behavioral health assessments, automating them for easy administration and measurement over time. Additionally, through a patient- and caregiver-facing app, Trayt collects between-visit insights that provide a more complete patient view. Combining granular, between-visit data with validated standardized measures results in a much higher precision framework to track treatment efficacy and patient outcomes. 

The ability to measure outcomes was a game-changer for the Texas team. 

“At the end day, I’m a clinician, and I want to help you get better,” Dr. Williams said. “If I can’t know that I’m getting you better, that’s not a win for the parent, for the child, or for the state.”

Scaling Texas’ success

Collaboration at the state level is the key to replicating Texas’ success across the country, according to the panelists. While the psychiatry department chairs had been meeting to explore partnership, it wasn’t until the state legislature mandated collaboration and formed the Consortium that the program came to life. Their efforts created the infrastructure and provided the financial backing to facilitate a coordinated approach to mental health care.

Bringing statewide stakeholders to the table may sound daunting, but Amini noted that there’s precedent not just in Texas but also in other sectors of public health.

“We saw during the pandemic how quickly agencies and the private sector worked together to get a vaccine out in nine months,” she noted. “We hear from the Surgeon General consistently that the mental health crisis is a major public health issue in the United States. It’s time for the government, the public health agencies, and the private sector to come together again.”