In October of 2018, the Health Resources and Services Administration designated Grayson County as a Health Professional Shortage Area

Note: This story first appeared in the mental health issue of Grayson Magazine.

In October of 2018, the Health Resources and Services Administration designated Grayson County as a Health Professional Shortage Area.

With this title, individuals and employing agencies are eligible to receive certain types of federal resources, including federal and state loan repayment programs for health professionals and money for Medicare and Medicaid services.

While that can be a good thing for employment in the health care field in Texoma, for those seeking mental health treatment, the title means that there are less services in this region, which saw about 112 suicides between 2012-2016.

“Grayson and Fannin county have a much higher suicide rate than Texas and the rest of the nation,” said Business Development Director Harry Lemming of Texoma Behavioral Health Center in Sherman. “Those are actual numbers. We believe that it has to do with being rural. There are a couple of reasons, and we are trying to address those issues. It is definitely a lack of services.”

Texoma's top voted mental health services facilities through the 2019 Best of Texoma contest were Tri-Med Behavioral Health and Wilson N. Jones Behavioral Health Services. TBC won first place in the category.

While any hospital has ebbs and flows in the number of patients seeking treatment, TBC has 60 beds with 48 for adults and 12 for adolescents ages 13-17.

“Sometimes we are full, and sometimes we are not,” Lemming said. “Unfortunately, we do sometimes have repeats, and not everyone can make it one go around or two go arounds. Sometimes it is three or four go arounds. But that is few and far between.”

TBC is an in-patient psychiatric hospital, but they also have out-patient services for adults.

“Sometimes we do have to refer people out,” Lemming said. “If there are ones that do not fit in our age groups, we do refer out to a couple of places in the Metroplex. If there is someone that has mental health and major medical issues then we may have to refer them out. We definitely have to make sure they are appropriate for this facility.”

Because TBC steps in during emergency situations, people are never turned away because of their ability to pay for services.

“In order to meet criteria to be in an in-patient setting,” Lemming said, “they have to be of harm to them self or others. That can even be through psychosis. That can be through not being in the right state of mind or through intentional harm to them self or unintentional.”

Most patients come from area emergency rooms not limited to Wilson N. Jones Regional Medical Center, Texoma Medical Center and the local stand alone ERs. But, sometimes the facility gets calls about individuals who may be a harm to them self or others. The first step for those individuals is to call 9-1-1.

“They can be admitted through voluntary or involuntary status,” Lemming said. “They do not have to accept services. If they are admitted, then they go through our program.”

The program includes group and individual therapy sessions with licensed counselors. Patients go through a medical evaluation, and medications are prescribed. Individuals meet with a psychiatrist within 24 hours of admission.

“We have all kinds of practitioners from licensed nurses to licensed social workers,” Lemming said. “We also have licensed professional counselors and medical health technicians. Those are all a part of the different therapies that we have here. We have occupational therapists, physical therapists. We have practitioners that work together in a group environment. We have multiple different psycho-social programs that we use from cognitive behavioral therapy or trauma informed therapy. We have multiple therapies that are based on what is required in that patient's setting at that time.”

Patients attend multiple sessions in a given day. The average length of stay is between 5-7 days, and according to Lemming, about 90 percent of the patients will never be seen again by the staff.

“These individuals are me and you,” Lemming said. “Everyone in every family has someone that is working through mental illness.”

Lemming says that we should think about mental illness in the same way we think about breast cancer, heart disease and diabetes.

“Those are all important things, but we do not stand up and say something about depression and anxiety because we cannot see it,” he explains. “We cannot measure it.”

Though so much of the mental health care plan is centered around the individual seeking help, the impact builds community.

“My passion and my mission is to help families,” Lemming talks about what makes his work important to him. “The greatest thing is that they come to us in a crisis situation. They are a harm to themselves or to others — when they are in the worst place they can be — and they go through our programs. We help them get their meds adjusted. We help them with coping skills and we help them find outpatient services afterwards.”

Connecting emergency care to daily care, TBC also helps its patients get on a continuum care plan and follows up with the patient after discharge.

“One day I was walking in the lobby, and I see this husband hugging his wife saying, 'I am just so happy to see you,'” Lemming describes a couple of stand out scenes of families being rebuilt. “Then a daughter hugging her father, 'Hey dad, I missed you.' We have visitation all the time. We have visitation all throughout the week, but at discharge, we see happiness and feel like you made a family whole again.”

TBC is a most restrictive environment, and the building is a lock-down facility.

“The least restrictive would be when a person is handling their own mental health care through tools that they have been taught and medication,” Lemming explains the different levels of restriction a person can be on. “Then there are outpatient services that can be intensive. We have intensive outpatient services that are three days a week for three hours and are more restrictive. You can go to a therapist once a week which is also less restrictive.”

The services at the facility include a dual-diagnosis, which includes mental health and substance use programs. Individuals in this program will go through a detoxing period. There is also an intensive out-patient program along with the in-patient adult and adolescent programs.

“The top three ways mental health treatment can affect an entire family is first so they can be a healthy person,” Lemming says. “Next, it is so that person can be involved with their loved ones, and last it is so they can live a healthy life.”

As mental health care services in Texoma work to meet the needs of the area, a new nonprofit organization has made its way into the area. With the hope of serving as a community hub for mental health and wellness, The Texoma Behavioral Health Leadership Team has representatives from the U.S. Department of Veterans Affairs, area police departments, area school boards, Grayson College, Austin College, WNJ, the Child and Family Guidance Center, the Grayson County Health Department, Texoma Community Center, the United Way of Grayson County and more.

“When it comes to health care, and you go to your doctor, you may need an x-ray,” Lemming explains. “They walk you over to get an x-ray. There are other ancillary services there where you can get help. Mental health is not that way. The services are all segregated. For us, we have outpatient right here and in-patient right here. Then over there, we have the pharmacy and other stuff.”

Lemming is the co-chair of the team.

“We are working really hard to close all those gaps,” he says. “We are working to reduce the stigma related to behavioral health, increase access to behavioral health and jail diversion.”

It is okay to say you or someone you know needs help with mental health, Lemming concludes. Do not be afraid because there is help, and the first step is reaching out.

If you or someone you know if having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 or 911.

For more information, on the behavioral health team, visit For more information on Texoma Behavioral Health Care, visit

Future Brown is the Associate Managing Editor of the Herald Democrat. She can be reached at