Annual report
State of Mental Health in Texas 2026
A primary-source review of mental-health care access across all 254 Texas counties. Built from the CDC PLACES dataset and the NPPES Provider Registry. Free for citation, embed, and reuse under CC BY 4.0.
Key findings
Regional breakdown
Provider supply, distress burden, and insurance coverage vary sharply across the ten major Texas regions. The Rio Grande Valley and South Texas carry the highest uninsured rates; the Panhandle and West Texas show the broadest provider shortages relative to population.
| Region | Counties | Providers | per 100k | Distress | Uninsured |
|---|---|---|---|---|---|
| Big Bend | 3 | 30 | 50 | 17.1% | 23.7% |
| Central Texas | 29 | 3,570 | 615.5 | 18.1% | 17.2% |
| East Texas | 37 | 2,134 | 288.4 | 19.1% | 16.7% |
| Gulf Coast | 23 | 3,592 | 780.9 | 17.5% | 19.5% |
| Hill Country | 15 | 1,101 | 367 | 16.1% | 17.5% |
| North Texas | 33 | 5,495 | 832.6 | 18.1% | 15.6% |
| Panhandle | 38 | 1,458 | 191.8 | 18.2% | 22.1% |
| Rio Grande Valley | 4 | 731 | 913.8 | 18.1% | 39.5% |
| South Texas | 27 | 1,772 | 328.1 | 17.7% | 30.9% |
| West Texas | 45 | 2,258 | 250.9 | 17.8% | 23.1% |
Top 10 counties by active provider count
Active NPIs across all five outpatient mental-health taxonomies (NPPES).
Counties with highest adult distress
% of adults reporting frequent mental distress (CDC PLACES).
Counties with highest uninsured rate
Share of adults without health insurance (CDC PLACES).
Largest provider shortages (pop. ≥10k)
Counties of meaningful size with the lowest provider density.
Distress vs uninsured (all counties)
County-level mental-distress prevalence plotted against the adult uninsured rate. Counties trending toward the upper-right represent the highest unmet need.
What the data says
- Provider supply is concentrated. A small number of urban counties (Travis, Dallas, Bexar, Harris) account for the bulk of the state's outpatient mental-health workforce.
- 34 counties have zero local providers in any of the five outpatient taxonomies, leaving telehealth and primary-care referrals as the only realistic care pathways.
- The Rio Grande Valley carries the highest uninsured burden, with an average adult uninsured rate roughly double the state mean — compounding access barriers.
- Distress is more uniform than supply. Adult mental-distress prevalence varies far less across counties than provider density does, meaning under-served counties are not lower-need counties.
Methodology
Provider counts come from the CMS NPPES Registry, queried for active NPIs in each county-seat city across five outpatient taxonomies (psychiatrists, psychologists, licensed clinical social workers, professional counselors, marriage & family therapists). Distress and insurance figures come from the CDC PLACES dataset (measures MHLTH and ACCESS2). Composite county scores follow the formula published in our Mental Health Access Index methodology.
How to cite
State of Mental Health in Texas 2026. texas-therapist.com. Retrieved 5/20/2026.
Released under CC BY 4.0. Charts, tables, and figures may be republished with attribution.
For journalists, researchers, and public officials
We update this report annually as fresh NPPES and CDC PLACES releases land. Requests for raw county-level CSVs, embeddable charts, or interview support are welcome — contact us through the About page.