These dashboards display data from the Behavioral Risk Factor Surveillance System (BRFSS), the National Survey on Drug Use and Health (NSDUH), Texas Vital Statistics (VSTAT), Texas Health Care Information Collection (THCIC), and Texas Health Professions Resource Center (HPRC). Indicators from BRFSS include adults reporting a depression diagnosis and their poor mental health status. Indicators from NSDUH include adults reporting any mental illness, serious mental illness, or major depressive episode, as well as those receiving mental health services. Data from Texas VSTAT includes suicide deaths by demographics and geographic characteristics. Texas HPRC data include the number of mental health providers by type per Texas county. Hospital and emergency department visits for any mental health condition are derived from the inpatient and outpatient public data use files from THCIC.
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The Texas Behavioral Risk Factor Surveillance System (BRFSS), initiated in 1987, is a federally supported landline and cellular telephone survey that collects data about Texas residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services. This surveillance can be used to monitor the Healthy People 2030 Objectives for health indictors, including mental health, as well as other risk factors.
BRFSS Indicators:Diagnosed with depression: Adults in BRFSS were asked whether a doctor, nurse, or other health professional ever diagnosed them with a depressive disorder including depression, major depression, dysthymia, or minor depression.
Mental Health Not Good 5+ Days: Adults in BRFSS were asked how many days during the past 30 days was your mental health not good. This indicator is a calculated variable in BRFSS to identify all adults who answered their mental health was not good for 5 or more days in the last month.
Mental Health Not Good 14+ Days: Adults in BRFSS were asked how many days during the past 30 days was your mental health not good. This indicator is a calculated variable in BRFSS to identify all adults who answered their mental health was not good for 14 or more days in the last month.
Demographics: Race and ethnicity have been combined into Hispanic. Other includes American Indian/Native Alaskan, Asian, Native Hawaiian/Pacific Islander. NH = Non-Hispanic. Lesbian, gay, and bisexual have been combined into LGB.
The National Survey on Drug Use and Health (NSDUH), conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides nationally representative data on the use of tobacco, alcohol, and illicit drugs; substance use disorders; receipt of substance use treatment; mental health issues; and the use of mental health services among the civilian, noninstitutionalized population aged 12 or older in the United States. NSDUH estimates allow researchers, clinicians, policymakers, and the general public to better understand and improve the nation's behavioral health. In depth review of the methodology of the survey can be found in the NSDUH Methodological Resource Book.
NSDUH Indicators:Any Mental Illness: Adults in NSDUH were defined as having any mental illness (AMI) if they were determined to have any of the mental disorders assessed (not including SUDs), regardless of the level of functional impairment.
Serious Mental Illness: Adults in NSDUH were defined as having a serious mental illness (SMI) if they had any of the mental disorders assessed (not including SUDs), and these disorders resulted in substantial impairment in carrying out major life activities, based on GAF scores of 50 or below.
Major Depressive Episode: Adults in NSDUH were asked if, during the past 12 months, they had a period of depression lasting 2 weeks or longer while also having at least one of the following symptoms (1) depressed mood most of the day; (2) markedly diminished interest or pleasure in all or almost all activities most of the day; (3) significant weight loss when not sick or dieting, or weight gain when not pregnant or growing, or decrease or increase in appetite; (4) insomnia or hypersomnia; (5) psychomotor agitation or retardation; (6) fatigue or loss of energy; (7) feelings of worthlessness; (8) diminished ability to think or concentrate or indecisiveness; and (9) recurrent thoughts of death or suicidal ideation. Those who report having had a major depressive episode (MDE) in the past year are then asked questions to measure the level of functional impairment in major life activities reported to be caused by the MDE in the past 12 months.
Received Mental Health Services: Adults in NSDUH were asked whether they received treatment or counseling for any problem with emotions, nerves, or mental health in the past year. Adults were asked if they received services in any inpatient or outpatient setting or if they took any prescription medication in the past year for a mental or emotional condition. Adult respondents were specifically instructed not to include treatment for alcohol or illicit drug use when answering these questions on their use of mental health services in the past year. Also, these NSDUH questions do not ask about treatment that was received for a particular mental disorder. Consequently, references to treatment or counseling for any problem with emotions, nerves, or mental health are described broadly as "mental health service" or "mental health care." For services in an inpatient setting, adult respondents were asked whether they stayed overnight or longer in a hospital or other facility in the past 12 months to receive treatment or counseling for any problems they were having with their emotions, nerves, or mental health. For services in an outpatient setting, adult respondents were presented with the following examples of locations for outpatient mental health care: (a) an outpatient mental health clinic or center; (b) the office of a private therapist, psychologist, psychiatrist, social worker, or counselor that was not part of a clinic; (c) a doctor's office that was not part of a clinic; (d) an outpatient medical clinic; (e) a partial day hospital or day treatment program; or (f) some other place. Based on these examples, adults were asked whether they received any outpatient treatment or counseling in the past 12 months for any problems they were having with their emotions, nerves, or mental health.
The Texas Vital Statistics (VSTAT) death data come from death certificates for Texas residents who died in state and out of state. Each death certificate identifies a single underlying cause of death that is defined as the disease or injury that initiated the events resulting in death. Causes of death are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) implemented in 1999. Texas adopted the new U.S. Standard Certificates of Death and Fetal Death in 2006, so some data items might not be directly comparable with previous years.
VSTAT Data:Death data for 2021 are non-final. They are tabulated based on data that are not yet finalized and may be incomplete. Provided data are subject to change before 2021 data are finalized.
Suicide Deaths in Texas: All-cause suicide including all death certificates for Texas residents regardless of where the death occurred with underlying causes-of-death and ICD-10 codes:
- U03: Intentional self-harm (suicide): terrorism
- X60-X84: Intentional self-harm
- Y87.0: Sequelae of intentional self-harm
The Texas Health Care Information Collection (THCIC) was created by Chapter 108 of the Texas Health and Safety Code (THSC) and is responsible, under Sections 108.011 through 108.0135, for collecting hospital discharge data from all state licensed hospitals except those that are statutorily exempt from the reporting requirement. The Mental Health Hospital Visits dashboard uses the Texas hospital inpatient discharge Public Use Data Files (PUDF) and the Texas hospital outpatient discharge Public Use Data Files (PUDF). For more details on the data source, data collection, and data dictionary, see the Texas Inpatient Public Use Data File and Texas Outpatient Public Use Data File.
THCIC Data:Data was derived using ICD-10-CM codes for general mental health and specific mental health conditions in hospital discharge data for all inpatient, outpatient, and emergency department visits.Inpatient records include information from patients who received non-emergency department care and were discharged by a hospital.Outpatient records include patients who received one or more outpatient invasive/incisive surgical or one or more radiological/imaging procedures.Emergency department records include both inpatient and outpatient patients who were seen in a hospital emergency department or received freestanding emergency medical care.Codes related to mental disorders that are non-specific to mental health, for example, related to substance use, developmental disabilities, or dementia, were excluded. For individual disorder categories where the sample size was too minimal to meaningfully include an individual syndrome definition, codes were placed in the "All Mental Health" definition (e.g., reactive attachment disorder).Citation: 2022 Anderson KN et al. JAMA Psychiatry
Mental Health Condition: F22; F23; F28; F29; F39; F44; F45; F48; F53.1; F54; F63.3; F93.8; F93.9; F94; F98.9; F99; Z63.4
Anxiety Disorder: F40; F41; F43.22; F43.23; F93.0
Depressive Disorder: F32 (except F32.5); F33 (except F33.42); F34.1; F34.9; F43.21; F43.23; O90.6
Bipolar Disorders: F30.1; F30.2; F30.3; F30.8; F30.9; F31.0; F31.1; F31.2; F31.3; F31.4; F31.5; F31.6; F31.70; F31.71; F31.73; F31.75; F31.77; F31.8; F31.9; F34.0
Schizophrenia Spectrum Disorders: F20; F21; F25
Trauma and Stressor-related Disorders: F43
Attention-Deficit/Hyperactivity Disorders: F90
Disruptive Behavioral and Impulse-Control: F43.24; F43.25; F91.0; F91.1; F91.2; F91.3; F91.8; F91.9; F63.81; F63.1; F63.2; F63.9; F63.0; F63.89; F60.2
Obsessive-Compulsive Disorders: F42
Eating Disorders: F50.00-F50.02; F50.2; F50.8; F50.89; F50.9; F98.21; F98.29; F98.3
Tic Disorders: F95; G25.69
Demographics: Race and ethnicity have been combined into Hispanic. Non-Hispanic Other race/ethnicity category also includes American Indian/Eskimo/Aleut, Asian or Pacific Islander, and Other. If a hospital has fewer than ten patients of one race that race is changed to 'Other'. If a hospital has fewer than ten patients of one race the ethnicity of patients of that race is suppressed. NH = Non-Hispanic.
The Texas Health Professions Resource Center (HPRC) was established in 1989 (Texas Health & Safety Code, Chapters 104/ 105). The center was later transferred from the Texas Department of Health to the Statewide Health Coordinating Council in 1997. Administrative oversight is provided by the Center for Health Statistics, Texas Department of State Health Services. HPRC obtains licensing databases for health professionals from the licensing boards and then edits those databases to remove out-of-state and inactive records, and, to correct data entry mistakes when possible. Various levels of editing are done on the data depending on the licensure data type being edited - some licensure board databases being more problematic than others. HPRC uses Texas population data to calculate supply ratios. In most cases, the population data come from the Texas State Data Center (TxSDC). TxSDC regularly updates its population projections; therefore, the population numbers used by HPRC on a supply table for a particular year (for example 2002) may not match the TSDC population estimate for that same year (2002) at a later date (for example in 2008). HPRC uses the population numbers available at any given time and does not revise older tables to reflect new population estimates. In addition, TxSDC has multiple population numbers for any given area, based on various Migration Scenarios and other factors. For more information on how population projections and estimates are determined, please visit the Center for Health Statistic's website.
For counties where the count of mental health professionals is less than and equal to 5, calculated rates are considered unstable estimates and may be unreliable.
La Paz Border Status: Designation of 32 counties along the Texas-Mexico border defined under the La Paz Agreement between the United States and Mexico for the cooperation, protection, and improvement of the environment in the border area.