In Victoria, there are just three psychiatrists.

For a county of this size, that’s not nearly enough to meet the needs of residents suffering from mental illness, according to federal and state estimates. That shortage – not enough medical providers to treat people in need – exists throughout the state of Texas.

Two years ago, as leaders at Hogg Foundation for Mental Health were thinking about how they could better address this crisis, they decided to re-frame the question.

“We realized there were some bigger issues that we knew were contributing to poor mental health,” said Tammy Heinz, a program officer at Hogg. “How could we impact those things that actually get people to the place of needing treatment?”

This line of thinking eventually led to the Hogg Foundation’s current mission, which is to fund projects that look at the root factors that affect a community’s mental health and well-being.

That’s the mindset behind Be Well Victoria, the mental health coalition that the Hogg Foundation is supporting for three years. The group, which is part of the Victoria County Public Health Department, just finished its first year of work.

Community health workers Jodi Sandoval, Jizyah Shorts and Kayla Gutierrez are leading the effort by creating a coalition of residents, nonprofits and service providers. The group is focused on highlighting people from historically underrepresented groups, who frequently have less access to quality mental health care. Together, that coalition will focus on what big-picture changes they can make to improve the well-being of all residents.

This approach sometimes means that residents who turn to the Be Well team for aid find a new type of relationship.

Liz Williams, 53, was diagnosed with depression more than 15 years ago. Williams said she also suffers from post-traumatic stress disorder after she was attacked as a young child. After Williams read about Hogg’s grant to the county’s health department, she went there looking for help.

“I went and sat down and around the corner came a young lady that knew me personally,” Williams said, describing Sandoval. “When I was asking for help, she said, ‘We actually need your help. We’re starting this program, and we need to know what needs to be done.’”

Now, Williams has gotten involved with Be Well and another community group in her neighborhood.

Alicia Garza, 33, said she was eager to participate in Be Well meetings and share her story after going years without talking about it. Garza has struggled with bipolar disorder since she was a teenager, but after a bad reaction to prescription drugs, she turned to marijuana, cocaine and alcohol to self-medicate. It took more than a decade for her to get the help and support she needed.

Now, Garza makes sure to be open with her 13-year-old daughter and her 10-year-old son about her diagnosis so they feel comfortable seeking help should they need it.

“I want her to know it’s OK to talk about it, and if you can’t talk to me about it, there’s a doctor, there’s a counselor, there’s a friend, there’s always somebody you can talk to,” she said.

In the next year, Sandoval, Shorts and Gutierrez hope to bring more people into the conversation but also to begin identifying what areas the group wants to focus on and where they’d like to make concrete changes.

These changes could be as simple as, for example, investing resources into a community park, which could in turn provide a safer place for kids to exercise and play, an area for parents to gather and a community hub for events. The link between a better local park and improved mental health outcomes might not seem immediately obvious. But Hogg’s approach urges grantees to look at the bigger picture.

Heinz, the Hogg officer, explained that in a hypothetical neighborhood that lacks safe places for kids to play, they might be more prone to mental illness if they’re witnessing or experiencing violence or unsafe conditions.

“If they’re not living in a safe environment, obviously we’re creating conditions that are conducive to mental illness,” Heinz said. “So the opposite of that seems obvious that those are the kinds of things that we want to work on.”

But even as Be Well remains fixed on addressing the systemic issues that affect mental health in Victoria, they’ve also found ways to make immediate impact. At one community meeting, a woman came up and asked Sandoval why Victoria no longer had a peer support group for people recovering from a mental illness.

As a result, Gutierrez decided to use her own time to take a training with the National Alliance on Mental Illness, and now runs a peer support group in Victoria for people in recovery.

In the remaining two years of the grant period, Be Well will stay focused on what Rick Ybarra, another program officer at Hogg, describes as an “upstream” approach to tackle the underlying causes of mental illness. As the science behind mental health has developed, researchers have shown that biology alone doesn’t cause poor mental health; a complex web of biology, life experiences, stress, trauma and more can all contribute to a mental illness like depression.

As experts probe deeper into the complex factors that affect mental well-being, Hogg is part of a small but growing group of grant makers that are emphasizing a community-based approach.

For the team at Be Well Victoria, that’s where the work, and their dedication to it, has always been.

“I love my community, and I can tell you that we have a lot of hurting people,” Sandoval said. “We should be reaching across the table to people who are not like us and who are like us and people who are hurting and (asking), ‘What can I do to help you?’ And I think if we had more people doing that, we’ll have less people hurting.”

Ciara McCarthy covers local government for the Victoria Advocate as a Report for America corps member. You can reach her at cmccarthy@vicad.com or at 580-6597 or on Twitter at @mccarthy_ciara.

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Health Reporter

Ciara McCarthy covers public health for the Advocate as a Report for America corps member. She reports on insurance, the cost of health care, local hospitals, and more. Questions, tips, or ideas? Contact: cmccarthy@vicad.com or call 361-580-6597.

(1) comment

Ciara McCarthy Staff
Ciara McCarthy

Hi readers -- Just wanted to share a few more thoughts on this story, and about Be Well's approach to this work, as there was so much I couldn't fit in.

If you want to know more about the shortage of psychiatrists in Victoria County and throughout Texas, you can read about projections by downloading a report from the state health department here: https://www.dshs.texas.gov/Legislative/Reports-2018.aspx

In Victoria's public health region (South Texas), the demand for psychiatrists is expected to grow by 15.9% by 2030, while supply is only expected to grow by 3.9%.

That's the daunting health challenge that Texas and other states are grappling with: There are lots of people who need mental health services (by some measures, an increasing number of people in need) but not enough direct services available.

Also, if you have other mental health resources to share (either local or online), please do post them in the comments!

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