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Mental Health Resources and Protections

Find information on key laws and resources for Texans living with a mental health diagnosis. This page provides information on both resources and contacts that can help when looking for mental health services in the state. Additionally, this page includes a summary of laws by topic that may impact individuals living with mental illness. This section is not intended to be used for legal advice.

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Patient's Rights

(Texas Health and Safety Code, Chapter 576)

A person living with mental illness has the rights, benefits, responsibilities, and privileges guaranteed by the constitution. A patient of an institution has:

  • the right to register and vote at an election;
  • the right to acquire, use, and dispose of property, including contractual rights;
  • the right to sue and be sued;
  • all rights relating to the grant, use, and revocation of a license, permit, privilege, or benefit under law;
  • the right to religious freedom and
  • all rights relating to domestic relations.

Providing court-ordered, emergency, or voluntary mental health services to a person is not a determination or adjudication of mental incompetency and does not limit the person's rights as a citizen, or the person's property rights or legal capacity. A person is presumed mentally competent unless a court has determined otherwise.

An individual who is a patient in an inpatient mental health facility has the right to:

  • receive visitors;
  • communicate with a person outside the facility by telephone or mail; and
  • communicate by telephone or mail with legal counsel, the state agency, the courts, and the state attorney general.

A patient must be informed in writing, at the time of admission and discharge at an inpatient facility, of the existence, purpose, telephone number, and address of the protection and advocacy system in Texas under the Protection and Advocacy for Mentally Ill Individuals Act of 1986.

A patient receiving mental health services has the right to:

  • appropriate treatment in the least restrictive appropriate setting available;
  • not receive unnecessary or excessive medication;
  • refuse to participate in a research program;
  • an individualized treatment plan and to participate in developing the plan; and
  • a humane treatment environment that provides reasonable protection from harm and appropriate privacy for personal needs.

A person may not administer a psychoactive medication to a patient receiving voluntary or involuntary mental health services who refuses unless:

  • the patient is having a medication-related emergency;
  • the patient is younger than 16 years of age, or the patient is younger than 18 years of age and is a patient admitted for voluntary mental health services, and the parent, managing conservator, or guardian consents to the administration on behalf of the patient; or
  • the refusing patient's representative authorized by law to consent on their behalf has consented to the administration.

A patient receiving inpatient mental health services is entitled to obtain at the patient's cost an independent psychiatric, psychological, or medical examination or evaluation by a psychiatrist, physician, or no physician mental health professional chosen by the patient. The facility administrator allows the patient to obtain the examination or evaluation at any time.

If the patient is a minor, the minor and the minor's parent, legal guardian, or conservator is entitled to obtain the examination or evaluation. The cost of the examination or evaluation will be billed by the professional who performed the examination or evaluation to the person responsible for payment of the minor's treatment.

Least Restrictive Appropriate Setting for Treatment

(Texas Health and Safety Code, Sec. 571.004)

The least restrictive appropriate setting for the treatment of a patient is the treatment setting that:

  • is available;
  • provides the patient with the greatest probability of improvement or cure; and
  • is no more restrictive of the patient's physical or social liberties than is necessary to provide the most effective treatment and to protect adequately against any danger the patient poses to themselves or others.

Continuing Care Plan

(Texas Health and Safety Code, Sec. 574.081)

The physician responsible for a patient's treatment will prepare a continuing care plan for a patient scheduled to be furloughed or discharged unless the patient does not require continuing care.

The plan must address the patient's mental health and physical needs, including:

  • the need for outpatient mental health services following furlough or discharge; and
  • the need for sufficient psychoactive medication on furlough or discharge to last until the patient can see a physician.

The physician shall deliver the plan and other appropriate information to the community center or other provider that will deliver the services if the services are provided by:

  • a community center or other provider that serves the county in which the patient will reside and that has been designated to perform continuing care services; or
  • any other provider that agrees to accept the referral provided that the care by the center or provider is appropriate.

A patient who is to be discharged may refuse the continuing care services.

Disease Management

(Health and Safety Code, Sec. 533.0354)

A Local Mental Health Authority (LMHA) must ensure the provision of assessment services, crisis services, and intensive and comprehensive services using disease management practices for adults with bipolar disorder, schizophrenia, or clinically severe depression and for children with serious emotional illnesses. The LMHA must ensure that individuals are engaged with treatment services that are:

  • ongoing and matched to the needs of the individual in type, duration, and intensity;
  • focused on a process of recovery designed to allow the individual to progress through levels of service;
  • guided by evidence-based protocols and a strength-based paradigm of service; and
  • monitored by a system that holds the local authority accountable for specific outcomes, while allowing flexibility to maximize local resources.

A LMHA ensures the provision of assessment services, crisis services, and intensive and comprehensive services using disease management practices for children with serious emotional, behavioral, or mental disturbance and adults with severe mental illness who are experiencing significant functional impairment due to a mental health disorder that is defined by the DSM-5, including:

  • major depressive disorder, including single episode or recurrent major depressive disorder;
  • post-traumatic stress disorder;
  • schizoaffective disorder, including bipolar and depressive types;
  • obsessive-compulsive disorder;
  • anxiety disorder;
  • attention deficit disorder;
  • delusional disorder;
  • bulimia nervosa, anorexia nervosa, or other eating disorders not otherwise specified; or
  • any other diagnosed mental health disorder.

Each LMHA is required to incorporate jail diversion strategies into the disease management practices for managing adults with schizophrenia, bipolar disorder, post-traumatic stress disorder, schizoaffective disorder, anxiety disorder, or delusional disorder to reduce the involvement of those client populations with the criminal justice system.

Court-ordered Mental Health Services

Duties of Attorney (Texas Health and Safety Code, Sec. 574.004)
Administration of Medication under Court Order (Texas Health and Safety Code, Sec. 574.103)

An attorney representing a proposed patient during a hearing for court-ordered mental health services must interview the proposed patient within a reasonable time before the date of the hearing.

The attorney must thoroughly discuss with the proposed patient the law and facts of the case, their options, and the grounds on which the court-ordered mental health services are being sought. A court-appointed attorney must also inform the proposed patient that they may obtain personal legal counsel at their own expense instead of accepting the court-appointed counsel.

Before a hearing, the attorney must:

  • review the application filed for court-ordered mental health services, the certificates of medical examination for mental illness, and the relevant medical records;
  • interview supporting witnesses and other witnesses who will testify at the hearing; and
  • explore the least restrictive treatment alternatives to court-ordered inpatient mental health services.

The attorney must advise the proposed patient about:

  • the procedures for appeal, release, and discharge if the court orders participation in mental health services; and
  • other rights the proposed patient may have during the period of the court's order.

An attorney may not withdraw from a case unless the withdrawal is authorized by court order. To withdraw from a case after interviewing a proposed patient, the attorney must file a motion to withdraw with the court. An attorney is responsible for a person's legal representation until:

  • the application is dismissed
  • an appeal from an order directing treatment is taken
  • the time for giving notice of appeal expires; or
  • another attorney assumes responsibility for the case.

A person may not administer a psychoactive medication to a patient under court-ordered inpatient mental health services who refuses to take the medication voluntarily unless the patient is having a medication-related emergency, the patient is under a court order authorizing the administration of medication regardless of refusal, or the patient is a ward older than 18 years old with the consent of their guardian.

Restraints and Seclusion

(Texas Health and Safety Code, Chapter 322)

A person may not administer to a resident of an inpatient facility a restraint that:

  • obstructs the resident's airway, including a procedure that places anything in, on, or over the resident's mouth or nose;
  • impairs the resident's breathing by putting pressure on the torso; or
  • interferes with the resident's ability to communicate.

A person may use a prone or supine hold on the resident of a facility only if the person:

  • limits the hold to no longer than the period specified by rules adopted by the executive commissioner of the Health and Human Services Commission;
  • uses the hold only as a last resort when other less restrictive interventions have proven to be ineffective; and
  • uses the hold only when an observer, who is trained to identify the risks of asphyixation, is not involved in the restraint and ensuring the resident's breathing is not impaired.

A facility may not discharge or otherwise retaliate against:

  • an employee, client, resident, or other person because they files a complaint, present a grievance, or otherwise provide in good faith information relating to the misuse of restraint or seclusion at the facility; or
  • a client or resident of the facility because someone on their behalf files a complaint, presents a grievance, or otherwise provides in good faith information relating to the misuse of restraint or seclusion at the facility.

An Health and Human Services agency that regulates a facility under another law has the authority to impose an administrative penalty for violations under this chapter.

Detaining a Mental Health Patient

Apprehension by Peace Officer without Warrant (Texas Health and Safety Code, Sec. 573.001)
Preliminary Examination (Texas Health and Safety Code, Sec. 573.021)
Rights of Persons under Emergency Detention (Texas Health and Safety Code, Sec. 573.025)

A peace officer, without a warrant, may take a person into custody, regardless of the age of the person, if the officer has reason to believe that

  • the person has a mental illness and because of that illness:
    • there is a substantial risk of serious harm to the person or others;
    • the person evidences severe emotional distress and deterioration in the person's mental condition; or
    • the person evidences an inability to recognize symptoms or appreciate the risks and benefits of treatment.
  • the person is is likely without immediate detention to suffer serious risk of harm or to inflict serious harm on another person; and
  • there is not sufficient time to obtain a warrant before taking the person into custody.

A peace officer who takes a person into custody must immediately:

  • transport the person to the nearest appropriate inpatient mental health facility or a mental health facility deemed suitable by the LMHA, if an appropriate inpatient mental health facility is not available; or
  • transfer the person to emergency medical services personnel of an emergency medical services provider.

A jail or similar detention facility may not be deemed suitable except in an extreme emergency. In such situations, a person detained for this purpose shall be kept separate from any person who is charged with or convicted of a crime.

A physician shall examine the person as soon as possible within 12 hours after the time the person is brought into a facility by the peace officer or transported for emergency detention by the person's guardian.

A person may be admitted to a facility for emergency detention only if the physician who conducted the preliminary examination of the person makes a written statement that:

  • is acceptable to the facility;
  • states that after a preliminary examination it is the physician's opinion that the person is someone with a mental illness and evidences a substantial risk of serious harm to themselves and others, a severe emotional distress and deterioration in their mental condition, or an inability to recognize symptoms or appreciate the risks and benefits of treatment. The described risk of harm must be imminent unless the person is immediately restrained and emergency detention is the least restrictive means by which the necessary restraint may be accomplished.
  • includes a description of the nature of the person's mental illness, a specific description of the risk of harm the person evidences to the extent that the person cannot remain at liberty, and the specific detailed information from which the physician formed the opinion.

A person transported for detained by a peace officer for emergency detention should be released on completion of the preliminary examination unless the person is admitted to a facility.

This same individual has the right to:

  • be advised of the location of detention, the reasons for the detention, and the fact that the detention could result in a longer period of involuntary commitment;
  • a reasonable opportunity to communicate with and retain an attorney;
  • be transported to a location if the person is not admitted for emergency detention, unless the person is arrested or objects;
  • to be released from the facility after the completion of the preliminary examination unless they are admitted to a facility;
  • to be advised that communications with a mental health professional may be used in proceedings for further detention;
  • to be transported to a mental health facility; and
  • to a reasonable opportunity to communicate with a relative or other responsible person who has a proper interest in the person's welfare.

Resources

Contacts for Urgent Services

  • The 988 Suicide and Crisis Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources, and best practices for professionals. Call or text 988 or use the chat.
  • For mental health or substance use emergencies where safety is at immediate risk, dial 911.
  • Connect with the Veterans Crisis Line to reach caring, qualified responders with the Department of Veterans Affairs. Many of them are Veterans themselves. Call 988 and press 1, text 838255, or use the chat feature.
  • 24/7 Crisis Text Line: Text TX to 741741
  • To find services go to Texas 2-1-1 or dial 211, option 8
  • 24/7 Local Mental Health Authority Crisis Hotlines for substance use and other crisis services

Contacts for Non-Urgent Services

The first step when seeking help for non-emergency mental health or substance use challenges is to call your Local Mental Health Services.

Additional Resources