The two largest mental health providers in Texas are the Harris County and Dallas County jails. Why? Texas has more uninsured adults than any other state, and has more uninsured adults with mental health or substance abuse conditions. Combine that with limited access and low funding, and you wind up with jails as mental health providers.

In mental health measures, Texas ranks near the bottom nationally: 47th in access to mental health care; 48th in per capita spending on mental health; and 50th in the number of mental health care providers. Texas “leads” the nation with the highest number of uninsured adults with mental health or substance abuse conditions — 652,000, according to a 2015 survey by Mental Health America.

Yet as a nation, we spend the highest percentage of our health care dollars on mental health. Again, why? In part because we deliver some of that care in the least efficient, most expensive ways, such as jails.

If you are uninsured in Texas, your access to mental health treatment is difficult or non-existent. Or available via your county jail, which is inefficient, costly and piecemeal: Maybe you’ll receive needed treatment, but what happens to your prescribed medicines and therapy plan when you leave jail? If you’re uninsured, treatment mostly disappears.

Federal law requires parity, or equality, regarding mental and physical health benefits in insurance policies. Texas insurers agree, and our policies cover diseases of the brain at the same levels as other health challenges. There are no higher copayments, limits in benefits, or extra hoops to jump through.

We will never achieve true big-picture parity, however, when so many Texans remain uninsured with little or no access to care, and while we still stigmatize and even criminalize mental illness. It is time to respect mental health — and to treat mental illness with the same seriousness we treat other disease.

Joe Straus, speaker of the Texas House, took a major step earlier this year by commissioning a select committee on mental health. That committee, led by Rep. Four Price of Amarillo and including an equally stellar group of 12 other state representatives, is exploring a range of smart solutions. These include:

• jail diversion programs and other ways to decriminalize mental health conditions;

• improving state facilities;

• finding earlier, less costly interventions;

• adjusting insurance coverage for mental health services;

• increasing the number of mental health providers;

• and reducing the fragmentation among programs and providers funded by state and local taxes.

This is the kind of detailed, fact-based research legislators need to do in preparation for the next session. It is being conducted via hearings with testimony from a wide range of stakeholders.

Last week I testified before Rep. Price’s committee about the importance of ensuring parity between mental health and other covered benefits in insurance policies, as did other members of the Texas Association of Health Plans, and the staff of the Texas Department of Insurance. We explained the challenges that insurers like us face, and recommended improvements.

Why do I, an insurance company CEO, advocate for mental health parity? It's not just that parity is both a federal mandate and simply the right thing to do. It's also because improving access and care for mental health delivers all the benefits of physical health: lives saved, costs lowered, and productivity improved.

The organization I lead is a nonprofit, community-based health plan, created by the Harris County Hospital District. Community Health Choice is committed to getting more people covered by insurance (whether the insurance is issued by us or by our competitors).

Community Health Choice and our parent organization, Harris Health, believe the most important thing the Legislature could do to improve mental health services in Texas is to expand coverage opportunities so that everyone who needs access to care has it. When we respect mental health on par with physical health, not only do we save lives and money, we reduce a dangerous burden on law enforcement.

My complete testimony, available on the New Healthy Texas website, covers topics including improved outcomes, workforce stability, financial savings, systemic reforms, providers and the rural/urban divide, and happier, healthier families.

A coverage expansion for mental health can and should be included in the renewal of Texas’ current Medicaid 1115 waiver. It would be funded primarily by the federal government, returning to our state some of the tax money we Texans pay. All Texans will benefit when all Texans experience genuine parity for mental health care.

Ken Janda (@HealthyTexans) is president and CEO of the nonprofit Community Health Choice, a managed-care organization headquartered in Houston, Texas, that serves both Medicaid and marketplace consumers.

Check out more Gray Matters. There are no higher copayments, limits in benefits, or extra hoops to jump through.

