Texas Resources for Families of Adults With Serious Mental Illness: Understanding Help Available Through HCBS-AMH Recovery Management

If you have a loved one living with schizophrenia, bipolar disorder, or another serious mental illness, you probably know that treatment can involve much more than finding a therapist or psychiatrist.

Families often find themselves trying to coordinate appointments, keep track of medications, help their loved one maintain housing, respond to crises, communicate with different providers, navigate benefits, and figure out what resources are even available. Over time, a parent, sibling, spouse, or other family member can essentially become the person's unofficial case manager.

One thing I have learned through my work with individuals with serious mental illness is that families are often doing an incredible amount of work with very little guidance about the systems available to support them. That's one reason I want more families to know about a Texas program called Home and Community-Based Services–Adult Mental Health, or HCBS-AMH.

What Is HCBS-AMH?

HCBS-AMH is a program through the Texas Health and Human Services Commission designed to help eligible adults with serious mental illness successfully live and recover in the community.

And that last part is important.

The goal isn't simply to treat someone's psychiatric symptoms. The program takes a broader, recovery-oriented approach to helping someone build a life in the community.

Depending on an individual's assessed needs and recovery plan, HCBS-AMH services can include recovery management, psychosocial rehabilitation, community psychiatric supports and treatment, peer support, residential services, substance-use services, respite, transportation, employment supports, home-delivered meals, adaptive aids, and other supports. 

For the right person, that's a very different level of support than simply having a psychiatry appointment every few months.

This Is More Than Traditional Case Management. This is a Higher Level of Help.

What I especially appreciate about the model is its focus on recovery.

Recovery from serious mental illness does not necessarily mean that someone never experiences another symptom.

Recovery may mean learning to recognize symptoms earlier. It may mean staying in an apartment successfully. It may mean developing healthier relationships, managing appointments more independently, finding meaningful work, returning to school, improving physical health, or simply having more say in one's own life.

Texas describes the program's recovery goals as including managing physical and mental well-being, obtaining safe and stable housing, participating in meaningful daily activities, developing relationships in the community, building a positive identity, and regaining belief in oneself.

That's the kind of recovery I want families to know is possible.

Who May Qualify for HCBS-AMH?

This is an important point: having a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder by itself does not automatically make someone eligible.

According to Texas HHSC, initial requirements include being 18 or older, having a primary diagnosis of serious mental illness, meeting specified financial and Medicaid-related requirements, and being able to live in the community with program supports. The program then has specific eligibility pathways involving histories of long-term psychiatric hospitalization, frequent arrests and psychiatric crises, or frequent emergency department visits and psychiatric crises.

Because eligibility is individualized and program requirements can change, I would encourage families not to try to determine eligibility solely from a website—or assume their loved one won't qualify.

Ask.

Texas HHSC states that people interested in enrollment can contact their local mental health authority (LMHA) to begin the referral process; for someone in a state hospital, the hospital social worker can also assist with referral.

How Sage Supportive Services Fits In

At Sage Supportive Services, our work with serious mental illness extends beyond traditional psychotherapy. We are an HCBS-AMH Recovery Management Entity, which allows us to provide Recovery Management services to eligible participants enrolled in the program.

Our approach is consistent with the same principles that guide the rest of our work: recovery orientation, person-centered planning, collaboration, community integration, and respect for individual choice.

We work with participants to identify meaningful recovery goals, coordinate services, address barriers, advocate for needed resources, and help make sure that the different parts of their support system are actually working together.

And whenever appropriate and desired by the participant, we recognize families and other natural supports as important members of that recovery network.

If You're a Family Member, Start by Asking the Question

If you're caring for an adult with serious mental illness who has experienced repeated psychiatric crises, hospitalizations, emergency room visits, or involvement with the criminal justice system, HCBS-AMH is worth learning about.

You can learn more about HCBS-AMH directly from Texas Health and Human Services.

Families shouldn't have to figure out serious mental illness care entirely on their own. Knowing what resources exist is a good place to start.