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MENTAL HEALTH

For questions about this data, email aat@dshs.texas.gov

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Summary

These dashboards display data from the Behavioral Risk Factor Surveillance System (BRFSS), 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. Data from Texas VSTAT includes suicide deaths by demographics and geographic characteristics. Hospital and emergency department visits for any mental health condition are derived from the inpatient and outpatient public use data files from THCIC. Texas HPRC data include the number of mental health providers by type per Texas county.

Data Sources

Texas Behavioral Risk Factor Surveillance System (BRFSS)

Texas Department of State Health Services - Vital Statistics Data (VSTAT)

Texas Department of State Health Services - Texas Health Care Information Collection (THCIC)

Texas Department of State Health Services - Health Professions Resource Center (HPRC)

Data Description

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 for the Hispanic category. Non-Hispanic Other includes American Indian/Native Alaskan, Asian, Native Hawaiian/Pacific Islander. NH = Non-Hispanic.

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, therefore 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:

Demographics: Race and ethnicity have been combined for the Hispanic category. Non-Hispanic Other race/ethnicity category also includes cases with Unknown race/ethnicity and Multiple race responses. NH = Non-Hispanic.

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). The dashboard does not include Q4 2022 Late facility Submissions. 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 for the Hispanic category. 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 or 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.