Mental health and substance use closely related to each other¹ and have been clearly identified with increased HIV risk^{2, 3} as well as poor retention in HIV treatment.^4-6 Furthermore, there is considerable evidence of high levels of untreated mental illness and severe substance abuse among Hispanic/Latinx communities.  In 2019, it was estimated that 7.0% of Hispanic adults had a substance use disorder, 18.0% had a mental illness, and 3.4% had both.⁷ 

While prevalence of any mental illness among Hispanic adults in the U.S. was lower compared to whites (18% versus 22.2%),⁸ utilization of existing behavioral health services is less than optimal among Hispanic/Latinx communities.⁹ For instance, the 2020 National Community Health Survey showed that Hispanic adults were less like than non-Hispanic white adults to receive any mental health treatment (12.6% versus 24.4%).¹⁰ With close to 40% of the 29 million Texas residents identifying as Hispanic/Latinx,¹¹ there is a considerable need to address simultaneously their HIV, substance use and mental health needs.

The Latino Commission on AIDS proposes an exploratory assessment of needs, availability, utilization, and appropriateness of mental health and substance use services among Hispanic/Latinx communities living with or at high risk for HIV in Texas. This includes assessing the individual, cultural, community, service, and policy barriers and facilitators to accessing and utilizing existing behavioral health services.

Taking into consideration the geographic, sociocultural, political, and economic diversity within the Texas Hispanic population,  this assessment will look at the specific and particular needs of the following 6 areas based on Texas Public Health Regions (Texas Department of State Health Services):

1. Public Health Region 1 – Lubbock
2. Combined Public Health Region 2/3 – Arlington, Public Health Region 4/5 – Tyler; And Public Health Region 7 – Temple;
3. Public Health Region 5/6  – Houston
4. Public Health Region 8 – San Antonio
5. Public Health Region 9/10 – El Paso; and
6. Public Health Region 11 – Harlingen.

The overarching goal of this assessment is to provide up-to-date information on utilization of mental health and substance use services among Hispanic/Latinx communities in Texas, particularly for individuals living with HIV or at risk of HIV, to (a) help behavioral health programs tailor and enhance their mental health services for Hispanic/Latinx individuals in a culturally and linguistically appropriate manner and (b) guide/inform community leaders and health advocates to advocate for enhancement of behavioral health services in Hispanic/Latinx communities.

This project will assess (a) behavioral health service needs and availability, utilization, and appropriateness of mental health and substance use services; (b) local behavioral health service priorities, core challenges, and key lessons learned; and (c) state-wide policy and funding recommendations to enhance behavioral health services for Hispanic/Latinx communities in Texas, particularly for Hispanic/Latinx individuals living with HIV or at risk of HIV.