Mental Health Shortage Areas in Texas, County by County

As of November 11, 2026, 13,977,427 Texans lived in a federally designated mental health shortage area or belonged to a low-income population group designated as short of mental health providers, according to the Health Resources and Services Administration (HRSA). That is equal to 44% of the state’s population, and all or part of 249 of Texas’s 254 counties carry such a designation.

Most Texas counties are designated

HRSA designates a Health Professional Shortage Area (HPSA) where it finds too few mental health providers for the people who live there. A designation can cover everyone in an area, or a population group within it; in Texas every population-group designation covers low-income residents. In 203 counties, the whole county lies in a geographic shortage area. Most designations are in rural areas: HRSA classes 196 of the state’s 254 geographic and population designations as rural and 39 as partly rural.

The largest designations

The biggest designations by population sit in the large metro counties and along the border. Harris, Dallas, Tarrant, Bexar and Travis, the 5 most populous counties, are each designated for their low-income residents rather than as a whole area. Cameron, Hidalgo and Willacy counties in the Rio Grande Valley form one geographic shortage area covering 1,310,737 people.

The largest counties

To look up any county, download the county file below: each row lists the county’s population and every designation it belongs to, with the HRSA ID, type, score, status and population HRSA counts.

Designations change

HRSA updates designations as provider counts and populations change. As of November 11, 2026, 25 Texas designations covering 1,084,853 people were proposed for withdrawal (17 geographic and 8 low-income). HRSA still counts them as designated until it publishes a withdrawal notice in the Federal Register, usually once a year around July 1. This page includes them, as HRSA’s own totals do.

What this means for Texans looking for mental health care

• Shortages reach almost every county. HRSA counts too few mental health providers for the people in all or part of 249 of the state’s 254 counties. If you are finding it hard to get an appointment nearby, you are not alone, and it can help to look beyond your own county.
• In the big cities, the shortage is counted for low-income residents. In Harris, Dallas, Tarrant, Bexar and Travis, HRSA designates low-income residents rather than the whole county. People on lower incomes may find community clinics, including the state’s local mental health authorities and federally qualified health centers, a place to start. Our Texas mental health resources page lists statewide options.
• Designations bring help to an area. According to the Texas Department of State Health Services, a designation can help a community attract mental health workers through incentive programs and can raise Medicare and Medicaid payments to clinicians already there.
• Telehealth reaches across county lines. A clinician licensed in Texas can see patients by video anywhere in the state, which can widen the choice for people in rural counties. Check that a clinician is licensed in Texas before you book.

Method

We downloaded HRSA’s mental health HPSA detail file, which lists every designation and each county or census tract in it, as of November 11, 2026, from the HRSA data download page. We kept the Texas designations HRSA counts as current (status “designated” or “proposed for withdrawal”) and followed HRSA’s quarterly summary in adding up people: everyone in geographic designations plus the low-income residents in population-group designations. HRSA’s own Texas total, 14,065,653, also adds 88,226 people in prisons and state mental hospitals; we leave those out of “Texans living in” a shortage area.

Texas had 414 current mental health designations: 196 geographic areas, 58 low-income population groups and 160 facilities such as community health centers, rural health clinics and prisons. Our totals match HRSA’s quarterly HPSA summary for September 30, 2026 exactly, including the percent of need met, and the resident and county figures match HRSA’s own shortage-area map service. For each of the 254 counties we recorded whether a designation covers the whole county or only some census tracts, and set it against the Census Bureau’s Vintage 2025 population estimate.

Limits of the data

• A ratio, not a wait time. HRSA designates an area when its ratio of people to providers passes a threshold. HRSA notes that most mental health designations are based on psychiatrists alone, so they do not count other providers such as psychologists, clinical social workers and marriage and family therapists. A designation says nothing directly about how long you will wait.
• HRSA’s population figures. Each designation’s population is the figure HRSA used when it last reviewed that designation, which can be several years old. The 44% share compares HRSA’s total with the Census Bureau’s July 2025 estimate, so treat it as approximate.
• Low-income groups count part of a county. In counties designated for low-income residents, only those residents are counted, as HRSA defines them, not the whole county.
• Designations span counties. Many Texas designations follow the service areas of local mental health authorities and cover several counties at once, so a designation’s population cannot be split between counties. Our county file lists each county’s own population next to the designations it belongs to.
• Facilities are listed separately. Community health centers, rural health clinics, tribal clinics and prisons have their own designations. They appear in the totals above but not in the county map.
• A snapshot. HRSA changes designations through the year. These figures are as of November 11, 2026.

Sources

This page reports public shortage-area data. It is not medical advice and does not describe the quality of care anywhere.