In her third year of medical school, Karen Duong found herself on the other side of Texas. She had driven 12 hours north from where she grew up on the Gulf Coast to a panhandle town called Hereford.
鈥淗ereford is known for being the beef capital of the world,鈥� she says, laughing. 鈥淭here鈥檚 definitely more cows than people out there.鈥�
It鈥檚 even named after a breed of cattle. Out here, there aren鈥檛 many people who provide mental health care. In fact, there aren鈥檛 any psychiatrists. That鈥檚 the reason Duong went there 鈥� she鈥檚 studying psychiatry as a medical student at the . This assignment showed her just how severe the state鈥檚 mental health care shortage is.
鈥淵ou have a patient that comes in and they need immediate care or something more acute, and then you tell them that the soonest they can get in for an appointment is six months from now,鈥� Duong says. 鈥淚t鈥檚 not really what we want to tell our patients.鈥�
Hereford is one of many areas in Texas lacking adequate access to mental health care.
Of the 254 counties in Texas, 185 , according to Travis Singleton, who tracks physician shortages for , a Texas-based consulting firm. 鈥淭hat鈥檚 almost 3.2 million [people],鈥� he says.
The shortage goes beyond Texas. In the past year, Singleton鈥檚 firm has been asked to recruit more psychiatrists nationwide than ever before.
鈥淲hile we knew the demand was high, I don鈥檛 think anyone expected it to that extent,鈥� he says.
Supply issues have crept up on psychiatry, Travis says. 鈥淵ou have less and less residents wanting to go in this specialty in genera,l and then you have those that actually do practice medicine not necessarily in the most optimal settings for us.鈥�
Medical student Karen Duong worked in Hereford, Texas, with Dr. Akinyele Lovelace, an instructor with the University of North Texas Health Science Center鈥檚 rural medical education program. (Photo by Lauren Silverman/KERA)
So how do you persuade students to become psychiatrists, social workers and psychologists, and then be willing to work in rural areas?
Republican state Sen. is trying cash. He a law that, starting in 2016, will help around 100 medical health professionals repay loans if they go to work in underserved areas. Schwertner says the investment will pay off.
鈥淲here we don鈥檛 have those services for mental health patients, they wind up cycling back through our jails and our emergency rooms,鈥� he says.
There are a number of loan repayment programs for students focused on mental health across the country. They鈥檙e 鈥渁t least somewhat successful,鈥� says , director of state policy and advocacy with the National Alliance on Mental Illness.
But she doesn鈥檛 think they go far enough.
鈥淭he most successful strategies are to find young people within the rural community. They know the community, they have an investment in the community,鈥� Diehl says. 鈥淥therwise the turnover rates in these loan repayment programs are pretty high.鈥�
For medical student Duong, it鈥檚 also important to address the stigma of seeking and treating mental health care.
鈥淓ven I have some family members who aren鈥檛 supportive of me going into psychiatry,鈥� she says. 鈥淭here are people out there who don鈥檛 think mental illness should be considered a diagnosis.鈥�
But Duong says she鈥檚 now committed to working in a rural Texas town, despite some sacrifices.
鈥淚t doesn鈥檛 compare,鈥� she says, 鈥渉aving all these luxuries in a city versus being able to go out there and really make a difference in your patients鈥� lives.鈥�
This motivation is exactly what Schwertner is looking to spark with the state鈥檚 loan repayment program.
This story is part of a reporting partnership with , and Kaiser Health News.