NHS FPX 6008 Assessment 4 Lobbying for Change

Governor Greg Abbott

Office of the Governor
State Capitol
Austin, TX 78701

Dear Mr. Greg Abbott

This letter aims to support a policy action in regard to the growing alarm on economic limitations to access affordable mental health care services in Texas. Restricted access to mental health care, including the high cost out-of-pocket expenditure, low rates of insurance coverage as well as lack of mental health practitioners have caused massive economic and health effects on Texans. Having one of the largest numbers of uninsured people and a low number of mental health providers, Texas boasts 246 counties of 254 that can be classified as mental health shortage areas and 5 million uninsured people (Simpson and Messmer, 2024). This has led to constituents waiting to receive the required care, and is now in need of emergency care, which may not only be costly but also include hospitalizations.

Policy intervention opportunities in this problem include but are not limited to, the integrated behavioral health in primary care, extension of telehealth, and the program of incentives for workforce development. On 100 dollars spent on behavioral health sponsored by an employer, 190 savings is possible on overall health claims as shown in numerous studies (Hawrilenko et al., 2025). Behavioral health interventions that are technology-based have also been demonstrated to become cost-effective when attempting to target differences in underserved groups (Ali et al., 2024). Those states that have workforce plans related to the behavioral health workforce pipeline and systems of value-based integrated care reach higher access to care, higher compliance rates with care, and reduced use of emergency services (Connors and Mayes, 2026; Galbreath, 2025). Therefore, to tackle the problem, via evidence-based approaches is important in order to enhance the health outcomes of the community. Conversely, if the problem is not resolved, it will continue to drive up ED costs, homelessness, loss of workforce productivity, and the disparities between rural and urban health care. Untreated costs of mental illness are related to higher comorbidity costs and billions of dollars annually in avoidable costs (Hawrilenko et al., 2025). It translates to an increase in Medicaid expenditure within the Texas communities, an increase in police calls due to mental health problems, and missed economic opportunities that would not have occurred.

To the professional aspect, I have seen first-hand the difficulties it has created for mental health, which has resulted in a higher level of symptomatology and more extensive coordination and visits. That is why my resource planning and risk analysis focus lies on the role of a balance of cost management and the stabilization of the workforce. The embeddedness of primary care providers into the local community helps with the degradation of stigma and cultural acceptability, and behavioral health providers support the process on the ground (Ahad et al., 2023). There is also an increased penetration of telehealth and programs, including the loan forgiveness and tuition support, which further achieve geographic diversity and workforce resiliency. This will coincide with the ethical value of justice and beneficence, whereby care/welfare will not be determined by its price. This, in addition, contributes to a prevention and value-based health care approach as opposed to a reactive approach to health care or a crisis approach in the state of Texas, and will have positive implications on the financial sustainability of health care in the state. I beg you to take seriously the need for state legislation and investments in integrated behavioral health, growth of telehealth, and incentives to develop the workforce. This will not only result in increased benefits to Texans, but will also reduce unnecessary spending in public dollars and increase a healthier, more prosperous State of Texas.

Thanks, you are the one who leads, guides, and directs.

Yours Truly,