| Perspectives on Texas

As Senate Bill 674, which unanimously passed the Senate in late March, progresses in the 85th Legislature, it is encouraging to watch lawmakers take bold steps to address the state’s critical shortage of mental health professionals.

Building on the work of the 84th Legislature, which provided for the expansion of graduate medical education and loan forgiveness for mental health professionals who provide care in underserved areas, SB 674 will require the Texas Medical Board to expedite licensure so that well-qualified psychiatrists from other states can more quickly set up practices in Texas.

Texas has a huge deficiency in psychiatrists and graduates less than 100 from Texas residencies each year. A 2014 report released by the Texas Department of State Health Services found that only 1,933 psychiatrists were actively licensed and offering direct patient care in Texas; over 60 percent of them were located in Texas’ five most populous counties. We need at least 1,000 more adult and 200 more child psychiatrists today, yet Texas remains one of only eight states without a reciprocity or current fast-track option for out-of-state medical licensure.

SB 674 gives us another important means toward solving our workforce crisis.

While there is movement toward increasing psychiatric residency slots, many graduating medical students still leave the state to complete their training. For those who wish to return — and others who just want to move here — licensing is unduly burdensome on both the mental health professionals and potential employers recruiting them.

Expecting experienced physicians to sit for exams just like fresh graduates is both a waste of precious time and a message that we do not want them in Texas. Can you imagine how many Fortune 500 companies would be wanting to move their executives and operations to the state if we treated them the same way? We need to take a page from our playbook for economic development and apply it to health systems.

For a psychiatrist who is a U.S. graduate with impeccably clean paperwork, transferring a medical license to Texas can take nine months or longer. Any complications can tie up that application for well over a year. Most provider agencies simply cannot afford to employ expensive staff for months while they wait to practice, and even fewer people are able to go without salaries for a long period, leading too many out-of-state psychiatrists to stay put or move to other states with reciprocity or fast-track options.

SB 674 provides a pathway to expedite the full and unrestricted licensure of out-of-state psychiatrists to engage in the practice of medicine in Texas and would not change existing licensure laws. It would be even better for Texas if other behavioral health professionals — psychologists, social workers, advance practice nurses, licensed professional counselors, licensed marriage and family therapists and licensed chemical dependency counselors — worked with their trade associations and licensing boards to take similar steps.

Texas needs to address this crisis boldly; there are mental health professionals willing to move and relocate their practices to our great state. It simply makes sense to remove unnecessary burdens that discourage qualified psychiatrists in other states from moving here. Let’s make it easier for “got here as fast as I could” Texans to help us out!