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Texas Laws Forcing Psych NPs Out of State

Of the 254 counties in Texas, 185 do not have a single practicing psychiatrist. Texas is 47th in the nation in mental health care access and coverage. Much like primary care advanced practice registered nurses (APRNs), psychiatric APRNs are often called upon to meet the gap left in rural and underserved areas throughout Texas. HB 1415/SB 681, introduced by Texas Representative Klick and Senator Hancock, would allow APRNs to practice to the full extent of their training and education—without being held to outdated, costly, and oftentimes unfair delegation agreements with physicians.

Kate (who asked to remain anonymous for this interview to protect her privacy) is a board-certified Family Psychiatric-Mental Health Nurse Practitioner who knows first-hand what the Dallas Morning News called the “Texas talent drain.” Kate is a product of that drain. Her story highlights the steep price Texas pays by not allowing psychiatric APRNs the ability to practice without considerable financial and regulatory barriers.

Kate graduated with her MSN from the University of Texas at Austin alternate-entry Psychiatric-Mental Health Nurse Practitioner program. Before training in Austin, she lived for several years in Dallas where she volunteered with CASA, worked in community mental health care, and worked as a research assistant in psychiatry and neurology at UT Southwestern. All these experiences led her to become the dedicated APRN she is today. So why did she leave?

Passionate about the mental health of children and adolescents, she realized over the course of her clinical experiences in Austin that “the restrictions on APRN practice would pose some difficulties, particularly for those of us who want to work in child and adolescent psychiatry.” Kate found herself in the difficult position of choosing between working with youth or working in Texas. Ultimately, Kate chose to work with youth outside of Texas, where she is free to practice her the profession without navigating the difficult and expensive delegation agreements necessary for APRNs to practice here.

Currently practicing in Kansas, Kate is grateful for the opportunity to provide quality care for psychiatric patients. In Kansas, she is the only Spanish-speaking provider in her clinic, in a county with the highest concentration of Spanish speakers in the state. While her current community is grateful to have her as a care provider, she feels “as though some of that gratitude should perhaps be directed toward all of my professors, colleagues, and patients in Texas who trained me.”

One thing is for sure: as Kate continues to serve patients in Kansas, she remains deep in the heart of Texas and we hope to have her return home to practice one day.

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