Mental health in Texas: where to start when you do not know where to start

Reviewed by a board-certified physician.

If you or someone else is in immediate danger or needs emergency medical help, call 911.

If you need emotional support or are in a mental health, suicide or substance-use crisis, call or text 988. You do not have to know what kind of professional you need before you reach out. The practical path is to decide whether you need immediate crisis support, an ongoing counselor or psychiatrist, help through your insurance plan, or a public community mental-health system. Texas has a public local mental-health authority network that serves communities across the state, and 988 is available nationwide.

The short version

• Immediate danger or emergency medical help: 911.
• Emotional distress, suicide crisis or substance-use crisis: call or text 988, or use the official 988 chat.
• The official 988 Lifeline says the service is free and confidential.
• When you call 988, you hear routing options and are connected to a live counselor. The counselor asks about your safety, listens, offers support, and may share resources.
• For ongoing care, start with your health plan's directory and verify the exact counselor, psychologist, psychiatrist or other clinician in your network.
• Texas Health and Human Services contracts with 37 local mental health authorities and two local behavioral health authorities. They serve defined areas across Texas. Use your county or ZIP code to find the authority serving you.
• A school counselor or student-support office and an employer's Employee Assistance Program can be additional starting doors; the exact services vary by school and employer.

If you need help now

If there is immediate danger, a medical emergency, violence in progress or another situation requiring emergency responders, call 911.

For emotional distress or a mental health, suicide or substance-use crisis, 988 is the national Suicide & Crisis Lifeline. The official Lifeline says calling, texting or chatting is free and confidential. You can use it even if you are not sure whether your situation “counts” as a crisis. The point is to connect with a trained counselor who can listen and help you sort the next step.

Poisoning is a different emergency pathway. If the issue involves a possible poisoning or toxic exposure, Poison Help is 1-800-222-1222. If the person is in immediate danger or needs emergency medical help, use 911.

This guide does not diagnose symptoms or tell you what treatment to choose. It is a map of the systems you can use to find human help.

What happens when you call 988

The details in this section come only from the official 988 Lifeline.

When you call 988, the system first offers service-selection choices, including options for veterans, Spanish-language support and connection to a local 988 Lifeline contact center. While the call is being connected, you may hear hold music. A live counselor then introduces themselves and asks whether you are safe.

After the safety question, the counselor listens to what is happening, works to understand how it is affecting you, provides support and may share resources that fit the conversation. The official 988 site describes the call as free, confidential and judgment-free.

Text and chat follow a similar purpose: connect you with a counselor for support. The exact conversation is not a scripted diagnosis. You do not need to prepare a perfect explanation before reaching out.

Finding ongoing care through insurance

If the need is ongoing rather than an immediate crisis, start with your health plan's directory. Search for the kind of professional you are trying to find, such as a counselor, clinical social worker, psychologist or psychiatrist. Then verify the exact professional and location with the plan and the office.

The Texas Department of Insurance says provider directories can change, so confirm that the clinician is still in network and accepting new patients. Ask whether your plan requires a referral, prior authorization or a particular telehealth platform. If the plan directory does not produce a workable option, tell the plan you need help locating an in-network mental-health provider.

For Texas Medicaid, the HHS provider-search tools can filter by health plan and provider type. Use the managed-care plan listed in your Medicaid materials, because participation can differ by plan.

If you use Original Medicare, check Medicare's provider tools and whether the clinician accepts Medicare assignment. If you use Medicare Advantage, check that plan's network too.

Texas Local Mental Health Authorities

Texas has a public local mental-health system in addition to private insurance networks. Texas HHS contracts with 37 local mental health authorities and two local behavioral health authorities. They serve specific geographic areas across the state, and every Texas county is assigned to one of those service areas. HHS provides a county and ZIP-code search so you can find the authority that covers where you live.

That matters across HERE's footprint. Harris County, Fort Bend County and Montgomery County do not all use the same local authority. Do not choose based on which office sounds closest; choose the authority assigned to your county or service area.

Texas HHS says these authorities assess local needs, coordinate services, and connect people with mental-health resources. Their programs can include crisis services and other publicly supported care. Local rules still apply. The HHS directory is the current source for the authority serving your county.

School and work can be useful doors

For a student, a school counselor, school social worker, nurse, or student-support office can be a starting point. CDC says schools can provide or link students to mental and behavioral health services. What is available varies by school, so do not assume every campus provides therapy on site.

At work, check whether your employer offers an Employee Assistance Program. The U.S. Department of Labor describes EAPs as work-based programs that may offer free and confidential assessments, short-term counseling, referrals, and follow-up. The exact benefit still depends on the employer's program. Ask how privacy works, what short-term help is included, and what happens if you need longer-term care.

These doors do not replace your health plan or the public mental-health system. They can shorten the distance between “I need help” and a real person who can point you somewhere useful.

How to make the first call easier

You do not need to tell your whole life story to the scheduler. Give enough information to route the request.

If you are calling a plan, say what kind of professional you need and your general location. Also say whether you want in-person or telehealth care and whether you need someone accepting new patients. If you are calling an office, give the exact plan name and ask whether the specific clinician is in network and taking new patients.

If language, accessibility, age group or scheduling time matters, say that early. If the first option is not available, ask for the next in-network choice rather than starting from scratch with an unrelated directory.

Before you go

• Immediate danger or emergency medical help: call 911.
• Emotional distress or a mental health, suicide or substance-use crisis: call or text 988 or use the official 988 chat.
• Possible poisoning or toxic exposure: Poison Help is 1-800-222-1222; use 911 for immediate danger or emergency medical help.
• For ongoing care, confirm both network status and whether the clinician is accepting new patients.
• Use the Texas HHS county or ZIP search to find your Local Mental Health or Behavioral Health Authority.

Sources

• 988 Suicide & Crisis Lifeline, What to Expect (https://988lifeline.org/get-help/what-to-expect/)
• 988 Suicide & Crisis Lifeline, Get Help (https://988lifeline.org/get-help/)
• Texas Health and Human Services, Find Your Local Mental Health or Behavioral Health Authority (https://resources.hhs.texas.gov/directories/lmha)
• Texas Department of Insurance, 2026 Texas Health Coverage Guide (https://www.tdi.texas.gov/healthguide/2026-texas-health-coverage-guide.pdf)
• Texas Department of Insurance, Choosing an HMO (https://www.tdi.texas.gov/hmo/hmolink.html)
• Texas HHS, Medicaid provider search (https://hhs.texas.gov/services/questions-about-your-benefits)
• Medicare.gov, accepting assignment (https://www.medicare.gov/basics/costs/medicare-costs/provider-accept-Medicare)
• CDC, school health services (https://www.cdc.gov/healthy-youth/what-works-in-schools/index.html)
• U.S. Department of Labor, Employee Assistance Programs in mental-health parity report (https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/mental-health-parity/report-to-congress-2023)
• Health Resources and Services Administration, Poison Help (https://poisonhelp.hrsa.gov/about-us)
• 911.gov, Using 911 (https://www.911.gov/)

En español

Si usted o otra persona está en peligro inmediato o necesita ayuda médica de emergencia, llame al 911. Si necesita apoyo emocional o atraviesa una crisis de salud mental, suicidio o consumo de sustancias, puede llamar o enviar un mensaje de texto al 988; el sitio oficial de 988 dice que el servicio es gratuito y confidencial. Cuando usted llama, el sistema ofrece opciones de servicio, lo conecta con un consejero, le pregunta primero si está a salvo y después escucha, ofrece apoyo y puede compartir recursos. Para atención continua, use el directorio de su plan y confirme que el profesional específico está dentro de su red y acepta pacientes nuevos. Texas también tiene autoridades locales de salud mental y conductual que atienden áreas definidas; use la búsqueda de Texas HHS por condado o código postal. Una escuela puede tener un consejero o una oficina de apoyo estudiantil, y su trabajo puede ofrecer un Programa de Asistencia al Empleado; pregunte qué servicios existen y cómo se protege la privacidad. Para una posible intoxicación, Poison Help es 1-800-222-1222; use 911 si hay peligro inmediato o una emergencia médica.

The HERE Health team

Lea la página completa en español.

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