TX MHMR Budgets Slashed

Our priorities are screwed up. It’s not just Texas, either, but this hits close to home.

Amid state cuts, rural areas fear worst
‘Intolerable’ losses may mean trouble for counties already short on social services

By Andrea Ball
AMERICAN-STATESMAN STAFF
Monday, July 28, 2003
Twenty years ago, Bastrop County’s battered women routinely showed up at Debbie Bresette’s door.

There was no women’s shelter back then, no crisis hot line or support for rape victims. Women literally ran for their lives, escaping with only the clothes on their back — and sometimes less.

“One woman ran four miles in her bare feet,” said Bresette, who in 1981 helped found the Family Crisis Center, a nonprofit agency that helps abused women. “She ran in the middle of the night through the woods to my house and got there at 3 a.m.”

Help is still hard to find in rural Texas, and not just for domestic violence victims.

All across the state, rural residents are struggling with a shortage of services that are plentiful in urban areas: psychological care, teen pregnancy prevention, anger management classes, domestic violence shelters and rape resources.

Thirty-six counties have no licensed social workers. Twenty-four have no primary care physician. Regional mental health centers cover vast geographical areas.

And legislative cuts are expected to make a dire situation worse.

Legislators have cut about $55 million from the state’s mental health centers. West Texas Centers for MHMR, the local mental health and mental retardation authority for 23 rural counties in West Texas, lost $1.6 million in state funding. The agency, based in Big Spring, will cut 44 positions.

Starting Sept. 1, Medicaid will no longer pay for services provided by psychologists, social workers or counselors.

“It was already bad,” Fayette County Attorney John Wied said. “Now it’s going to be intolerable.”

The Family Crisis Center, which helps victims of child abuse, sexual assault and domestic abuse, began when Bresette and a small group of volunteers began sheltering abuse victims in their homes.

“These women were being sent to us by all different agencies,” Bresette said. “Everyone was so supportive because they had nowhere to hide these women.”

Today the center is a $1.8 million agency with 43 full-time employees, a 30-bed shelter, rental apartments and a thrift store. It serves families in Bastrop, Lee, Fayette and Colorado counties.

But many rural communities suffer from a “marked scarcity of services” because they don’t have enough money or resources to develop them, said Michael Daley, a professor of social work at Stephen F. Austin State University in Nacogdoches.

It’s a national problem that has drawn national attention. A 2002 report from the U.S. Department of Health and Human Services states that “despite their importance, rural health care and social services struggle to remain viable because of inadequate service coordination and funding, workforce challenges, barriers and characteristics inherent to rural areas and residents they serve.”

There are 64 rural Texas counties without hospitals, 40 without dentists and 13 without pharmacists, according to the Texas Office of Rural Community Affairs.

Twenty of Texas’ 196 rural counties have family violence shelters, according to the Program for the Reduction of Rural Family Violence, a grant-funded effort based at Texas A&M University.

AIDS and homeless services are spotty. Doctors and nurses are in short supply. Only 4 percent of the state’s licensed social workers, psychologists and psychiatrists live or work in rural areas, said Sam Tessen, executive director of the Office of Rural Community Affairs.

That forces people to depend on their community mental health centers, where waiting lists are expected to grow longer because of budget cuts.

“It’s kind of a double whammy,” Tessen said.

The Family Crisis Center survived the budget ax intact, said Executive Director Sherry Murphy. But with fewer community services available, she expects more people to ask for the kind of help the center doesn’t provide.

“They see the sign `Family Crisis Center,’ and they call here for every issue,” she said.

Rural areas have attracted more attention in recent years as state and local agencies try to highlight their needs.

The Office of Rural Community Affairs was created by legislators in 2001 to help such communities with health care, economic development and community development programs. The Texas Department of Health has awarded grants for new programs in rural areas. The United Way/Capital Area is planning regional partnerships.

Wied said he would like to see that effort translate into more services for Fayette County’s youth. Children need more counselors, and runaways need a place to stay, he said.

“They’re sleeping under bridges,” he said.

Karen Maher was spared such a fate. The Bastrop County paralegal said she came to the Family Crisis Center in April after her boyfriend beat her.

Her face was bruised, her nose broken. Her uterus had ruptured. She is still recovering from the attack, living in the shelter that she says saved her life.

“If it hadn’t been for them,” she said, “I would have stayed.”

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2 Comments on “TX MHMR Budgets Slashed”

  1. Xxxxx x Says:

    Don’t you feel that it’s wrong, even if quoted, to mention a patients name?

  2. Kathryn Says:

    No, not if it was published in the newspaper, which would have obtained an explicit written, signed consent from the the person. I did not publish patient names. The Austin American-Statesman did. This blog is a means of disseminating interesting and helpful information that is publicly available.