“Good news.”
That’s not something we hear often these days, particularly in the context of mental health. But those are the words of Dr. Celeste Caballero, a pediatrician at a Lubbock urgent care facility.
But she is also asking for help. She said new mental health programs in the state are showing good signs but they need support. Mental health is one of the things the Senate Committee to Protect All Texans is considering while it weighs legislative options to address the shooting at a Uvalde elementary school last month.
Representing the Texas Medical Association on Wednesday, Dr. Caballero shared this story about her experience with the Child Psychiatry Access Network, or CPAN:
“I was in urgent care, seeing the regular cough and colds throughout the day. And all of a sudden, a very distraught father came in with his adolescent son,” Caballero said. “I felt that this adolescent needed help immediately. And I also felt that I needed the help of a psychiatrist. I called CPAN and within five minutes, I was connected to a psychiatrist. I was able to give the details of the case and the psychiatrist gave me his opinions and his recommendations. And that moment, that day, that adolescent received the mental health care he needed.”
She added the father had gone to six pediatric offices who turned him down because of his child’s mental health complaint.
CPAN, a telemedicine-based program in Texas mental health care, launched in 2020 with the goal of increasing access to mental health training and resources for children, families and primary care doctors.
In her testimony, Caballero said one estimate suggests a shortage of around 1,000 psychiatrists in Texas. That means families are generally seeking mental health care from “front-line” or primary care doctors.
While front-line doctors need the continuation of programs like CPAN, Caballero said social programs that strengthen families and support children who are suffering from mental health crises can be life-changing.
Caballero highlighted situations where children are more exposed to “adverse childhood experiences.” These are traumatic situations in the child’s life which can adversely affect their mental health and development.
More common examples that Caballero mentioned in her testimony include child abuse or neglect, parents struggling with mental health or substance abuse, witnessing domestic violence, divorce or death in the family.
“So we know, as physicians, that as children are exposed, repeatedly, to these ACEs or adverse childhood experiences, we know that later on in life they’re much more at-risk for things like depression, suicidal ideation; they’re much more likely to use drugs and alcohol, they’re much more likely to be involved in intimate partner violence and teen pregnancy,” she explained. “But there’s good news here.”
Caballero recounted another experience, from her San Angelo practice, where a child’s parents began using methamphetamines, and the child was removed from the family by Child Protective Services twice over six years.
She continued to care for the child over this period, monitoring his poorly controlled asthma and coordinating a supportive team of adults around him, including his foster parents and teachers, who encouraged reading by providing him with books.
“Over time, his parents worked really hard at their substance abuse disorder, and eventually they were reunited,” Caballero recalled to senators with a smile, “and you know what, he was happy, and he was a resilient child.”
She testified the child was in school and excelling, including reading above grade level and being invited to join the gifted and talented program. In addition, she stated his asthma was even better controlled.
“Positive experiences in childhood: specifically safe, secure, nurturing relationships with trusted adults such as teachers, extended family members, parents, counselors, we know that those types of relationships can negate the toxic effects of ACEs, and that’s a powerful thing,” Caballero said. “We feel that as we address these effects, we know that children can thrive and be more resilient, and through this, it’s our hope that we can start preventing gun violence in our communities.”
The Senate committee is also looking at school safety, social media, police training and firearm safety.
One of the members on the committee, Lubbock’s State Senator Charles Perry, thanked Caballero for her testimony, calling it “encouraging.”
“We need to hear encouragement from things that worked the way we hoped they would,” Perry said. “Because a lot of the time, all we hear is when it doesn’t work.”