This case study was first developed in 2018; the data reflects that timeline.
In a state as large as Texas, funding mental health support is a big undertaking — and that support isn’t one-size-fits-all.
The solution is equipping Texans with the skills they need to support each other — with Mental Health First Aid (MHFA) training. With an $8 billion investment in behavioral health services across state agencies over two years, the Texas Health and Human Services Commission (HHSC) used MHFA to make workforce training a central pillar of its strategy.
MHFA empowered Texas state employees, educators and community members to recognize the signs and symptoms of mental health or substance use challenges, respond appropriately and connect individuals to care.
Since fiscal year 2014, Texas has used MHFA to train:
By investing in MHFA, Texas transformed mental health care from a siloed service into a shared responsibility. It’s a coordinated, prevention-focused approach that continues to expand.
Train Your Team Today!In 2013, Texas legislators reviewed statewide mental health services and found that the available services were not meeting the needs of Texans. Growing mental health challenges among youth helped create momentum for major reform.
To address these gaps and improve coordination, lawmakers created a statewide mental health coordinator role through the 2014-2015 General Appropriations Act.
When Sonja Gaines was appointed associate commissioner for mental health coordination, she quickly recognized that many state employees lacked a basic understanding of mental health, even though they regularly interacted with people experiencing mental illness.
“There are several agencies like school districts, criminal justice agencies and child protective services serving children in foster care that all touch people who might have a mental health condition,” Gaines said. “Some of their employees lacked the basic understanding of how to respond to mental health issues, which impacted individuals’ success. We needed an intervention to educate [state employees], and the MHFA program could do just that.”
“Some of their employees lacked the basic understanding of how to respond to mental health issues, which impacted individuals’ success. We needed an intervention to educate [state employees], and the MHFA program could do just that.”
Under Gaines’ leadership, MHFA training became available to all school district educators — and eventually to every staff member in Texas public schools.
Other state agencies soon joined in, expanding MHFA training to employees serving vulnerable populations, such as:
- Older adults
- Military veterans
- Adults and youth involved in the criminal justice system
- Individuals with disabilities
A Coordinated Multi-Agency Effort to Reform Mental Health in Texas
Legislative Impact
The 83rd Legislature authorized the Department of State Health Services to award grants that allowed local mental health authorities to train school personnel and the public in MHFA.
Since 2014, Texas HHSC has used their grants to certify:
875+
Instructors to teach MHFA
23,000+
school district employees as First Aiders
16,000+
community members as First Aiders
In 2015, Texas provided additional funding for MHFA training within the HHSC. Since then, over 3,000 employees have been trained.
Demonstrated Effectiveness
The Texas state agencies administering MHFA periodically collect data to assess growth and impact. They found that MHFA training increased employees’ confidence and effectiveness when interacting with an individual experiencing mental health challenges. Surveys consistently underscored MHFA’s impact:
- 70% of surveyed state employees rated MHFA training as extremely helpful or very helpful.
- 70% reported using their MHFA skills within the past six months.
Gaines noted that MHFA training has also improved retention in state-funded programs, explaining that “people with mental health issues are likely to follow through with treatment and services, and we can help them better, since our staff are now able to identify potential struggles.”
She also emphasized the importance of addressing mental health before, and alongside, other issues:
“Mental illness trumps everything! How can we teach a blind person how to live independently if they’re suffering from severe depression? We must identify and address that problem first.”
The Future of MHFA in Texas
MHFA has scaled rapidly across Texas, but Gaines believes the work is far from finished. As she put it, “The program has been catching on like wildfire, but there’s still a lot more to be done. We must use this momentum and keep building.”
“The program has been catching on like wildfire, but there’s still a lot more to be done. We must use this momentum and keep building.”
Gaines is now focusing on engaging more community partners and stakeholders, including faith leaders, to expand access to MHFA and other mental health supports statewide
Getting Started With MHFA Private Instructor Training
Ready to strengthen your organization’s ability to recognize and respond to mental health and substance use challenges? Host a private MHFA Instructor training and equip your team with the skills to teach these potentially lifesaving tools in your community.
