How evolving perspectives on mental health lead to more effective treatment and prevention.

I wasn’t born in Texas, but I got here as fast as I could!  As a new Houstonian and the new Executive Director of The Hackett Center for Mental Health, I am honored to join the Understanding Houston initiative to address important quality of life issues impacting the Houston region. It’s time we all acknowledge that mental health is a critically important part of our overall health. 

Most know that the mind and body are interconnected and intertwined and that our mental health impacts other parts of our physical health. A person with depression is more likely to experience cardiovascular disease, diabetes or stroke. A person with cancer, chronic pain or coronary artery disease is more likely to experience a major depressive episode, as are people with asthma and other respiratory conditions.1 And, when these disorders occur together, the risk of death is significantly increased.2  That is why when we talk about “health” we must include the “mental” as well as the “physical.” 

It’s never too soon to start paying attention 

We know that mental illness is, by definition, a pediatric illness. We say that because the majority of mental illness begins in childhood and adolescence. Half of all mental health conditions manifest by the time a child turns 14, and 75% of all lifetime cases have presented by age 24.3 And like many physical health conditions, early detection and treatment of mental health issues can improve long-term outcomes, allowing those diagnosed to lead full and productive lives.  

“Neuro-biological factors, along with adverse environmental conditions, are all factors underlying mental disorders.4

Our mental health is impacted by many factors during our lifetime. In addition to the biological and brain chemistry factors affecting conditions like depression, bipolar disorder, anxiety and schizophrenia, the natural and mental conditions in which we are raised also play an important role in our long-term mental health. Being bullied or abused, living through natural disasters, experiencing a divorce, going through or witnessing violence, economic hardships, or losing a loved one, all increase the chance that we develop a mental illness, and even more so for people in poverty and people of color given the extra challenges they face.5

Mental health issues are all around us

All of us have circumstances and experiences that may give rise to mental, emotional or behavioral conditions.  In fact, as is the case for me and my family, it is likely that either you or someone you know, has either had or will have a mental health challenge.

“We are never more than “2 degrees of separation” away from a mental health concern.  Our own family. Our co-worker’s child. We all know someone.”

Mental disorders affect people of all ages, backgrounds, races, ethnicities, geography and socioeconomic status. In a recent study, 3 out of 4 Texans stated that they have a friend or family member that has experienced a mental health issue.6 

Fighting the stigma

Mental illness may not discriminate, but people do, which has led to the “stigma” associated with mental disorders. To eliminate the stigma and the prejudice and discrimination that can arise from mental, emotional and behavioral conditions, the Meadows Mental Health Policy Institute created the “Okay to Say™” campaign. 

88% of Texans agree that the “stigma” surrounding mental illness needs to be removed.7  When people “Stand Up and Speak Out” it becomes “Okay to Say” that you or a loved one has a mental illness. This is so important because talking openly about our mental health, and our mental health needs can bring about the support, hope and treatment that people need to recover so that all Texans and Houstonians can lead full and productive lives.

“It is okay to say I have dealt with depression for years. Thanks to some wonderful medical professionals, I was diagnosed at an early stage and have been treated continuously. As a result I have functioned at a high level for 40 plus years. More people will get help if it is okay to say.”

– Tom L.

Building a more supportive community right here in Houston

In the Greater Houston area, I am already learning how fortunate we are to have many talented and caring individuals and organizations that are seeking to prevent mental illness and treat people with mental health conditions. We are also fortunate that the City of Houston, and its partners at the Baylor College of Medicine Menninger Department of Psychiatry, and their affiliate partner Texas Children’s Hospital, just received a system of care grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). This four-year grant will build on the collaborative spirit already present in Houston to create a more coordinated network of effective services and support systems that have been proven to advance partnerships and improve lives.

The focus of this grant will be the 150 youth in Harris County who first experience signs and symptoms of psychosis each year, along with youth who experience bipolar disorder, and this is an amazing opportunity for schools, professionals, youth and families — the entire community — to come together to improve capacity and access to critical services and supports!8

“The evidence shows that treatment is effective and that people can and do recover from mental illness.9

More good news is that we are increasingly better at preventing mental illness, identifying mental health conditions sooner and intervening so that all of us can have emotional well-being.  

Our mission isn’t over

One of the challenges our region still faces is that the majority of children, adolescents, young adults, adults and older adults who have mental health challenges do not receive treatment of any kind. One reason is because of stigma. Another is because people don’t know how to navigate the system. 

31% of Texans said that if they or a family member needed help, they wouldn’t know where to go or who to contact for treatment. That is why The Meadows Mental Health Policy Institute continues to educate Texas legislators to strengthen access to mental healthcare. With Governor Abbott declaring mental health an emergency item for the 86th Texas Legislature, the session was one of the most significant in recent memory. Not only did legislators maintain and build upon previous advancements, but the creation of the Texas Child Mental Health Care Consortium will also impact the treatment of children with mental health issues and cultivate Texas’ need to grow as a research hub for mental health and substance abuse issues for years to come.

It’s “Okay to Say™” that you need help

In addition to policy change and investments in mental health, we need to talk about mental health, identify and implement strategies to improve mental health and make sure that it is “Okay to Say” so we can speak openly about mental illness. So, if you or someone you know can benefit from services and supports, please let them know that it is “okay” to talk their doctor, clergy, school counselor, family member, friend or someone they can trust, and let them know that you care and it’s okay to get help.  

To improve the mental well-being of Houstonians and all Texans, The Hackett Center for Mental Health, and the Meadows Mental Health Policy Institute stand ready to assist with system improvement efforts.  If you have questions or comments or want more information please visit and, or contact Dr. Gary Blau at

Together, we can and will make a difference to improve the lives of our fellow Houstonians and Texans, and I am grateful and eager for the opportunity to help.  

Gary M. Blau, Ph.D is the Executive Director of The Hackett Center for Mental Health, a Regional Center of the Meadows Mental Health Policy Institute.  Prior to this he was Chief of the Child, Adolescent and Family Branch at the federal Substance Abuse and Mental Health Services Administration.  Follow him on Twitter @GaryBlauPhD

Through the generosity of the Maureen and Jim Hackett Family, The Hackett Center for Mental Health was established in January 2018 as the inaugural regional center of the Meadows Mental Health Policy Institute. Leveraging the participation of exceptionally skilled researchers, community leaders, and health care providers, The Hackett Center’s purpose is to transform systems and influence policy through unprecedented collaboration.

The Meadows Mental Health Policy Institute (MMHPI) is a leading policy and research organization that identifies effective mental health care solutions and partners with policy makers and communities to improve access to high quality, mental health services. MMHPI’s vision is for Texas to become a national leader in providing mental health services.  Follow MMHPI on Twitter @TxMind


  • National Institute of Mental Health, Chronic Illness and Mental Health.  Retrieved from, October 6, 2019.
  • Lichtman, J.H., et al. (2008). Depression and coronary heart disease: Recommendations for screening, referral, and treatment: A science advisory from the American Heart Association prevention committee of the council on cardiovascular nursing, council on clinical cardiology, council on epidemiology and prevention, and interdisciplinary council on quality of care and outcomes research: Endorsed by the American Psychiatric Association. Circulation, 118(17), 1768-1775 Tanuseputro, P., Wodchis, W. P., Fowler, R., et al. (2015). The health care cost of dying: A population-based retrospective cohort study of the last year of life in Ontario, Canada. PLoS One, 10(3): e0121759. doi:10.1371/journal.pone.0121759. Pinquart, M. & Duberstein, P.R. (2010). Depression and cancer mortality: A meta-analysis. Psychological Medicine, 40(11)
  • Kessler, R., Amminger, G, Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustun, T. (2007).  Age of onset of mental disorders: A recent literature review. Current Opinion in Psychiatry, 20(4): 359-364.
  • Uher, R. (2014). Gene-environment interactions in severe mental illness.  Frontiers in Psychiatry, 5:48,
  • November 2018, Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States, Melissa T. Merrick, PhD; Derek C. Ford, PhD; Katie A. Ports, PhD; et al,
  • Meadows Mental Health Policy Institute, Talk Openly about Mental Illness, Retrieved from, October 6, 2019
  •  November 2018, Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States, Melissa T. Merrick, PhD; Derek C. Ford, PhD; Katie A. Ports, PhD; et al,
  • Kirkbride, J. B., Jackson, D., Perez, J., Fowler, D., Winton, F., Coid, J. W., Murray, R. M., & Jones, P. B. (2013). A population-level prediction tool for the incidence of first-episode psychosis: Translational epidemiology based on cross-sectional data. BMJ Open, 3(2), 1–12. Estimates of the incidence of first-episode psychosis are extrapolated from studies by Kirkbride and colleagues that used a range of ages (14–35 years) during which the first episode of psychosis is likely to occur.

Published by Gary M. Blau Ph.D

Executive Director, The Hackett Center for Mental Health | Meadows Mental Health Policy Institute

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