Mental Health Services & Treatment

The following services are covered for Community First Members. Check your plan documents for benefit limitations and prior authorization requirements.

Applied Behavioral Analysis (ABA): A type of therapy for people with autism and other developmental disorders that can help children learn new skills, improve their social interactions, and increase positive behaviors.

Local Mental Health Authority (LMHA): Community mental health center that provides a wide range of person-centered mental health services, including outpatient therapy, medication management, crisis support, long-term treatment, and programs.

Outpatient Therapy (Counseling): In-person and/or virtual individual, group, or family counseling from a licensed counselor, therapist, or social worker to help manage anxiety, depression, stress, trauma, and other symptoms. Therapy provides a safe space to express feelings and learn coping skills.

Medication Management: Help from a primary care provider, psychiatrist, or psychiatric nurse practitioner to monitor or adjust medications for mental health conditions.

What are mental health medications?

Targeted Case Management: A special service to help individuals with serious mental illness get access to care and support they need to improve their quality of life and stay active in their community.

Mental Health Rehabilitative Services: Independent living services, coordination of care, and assistance with employment and housing for adults or children with serious mental illness.

Certified Family Partners: Support for parents or caregivers of a child diagnosed with a mental illness to learn about treatment, advocacy, and available services. Certified Family Partners have completed specialized training and have first-hand experience as primary caregivers of children with a mental health diagnosis.

What are the benefits of Family Partner Support Services?

Peer Support Specialist (PSS): Person-centered support, mentoring, and advocacy from a certified specialist who has lived experience with a mental health or substance use disorder.

Neuropsychological and Psychological Testing: Testing and assessments to find a diagnosis and guide treatment.

Transcranial Magnetic Stimulation (TMS): Procedure for adults that uses magnetic fields to stimulate cells in the brain to improve major depression and other mental illnesses.

Electroconvulsive Therapy (ECT): Procedure for adult patients with severe mental illness that have not responded well to other treatment that uses electricity to stimulate cells in the brain and can improve brain function and provide quick relief.

Inpatient Acute Hospitalization: A hospital stay to assess and stabilize patients in a mental health crisis or who may be a danger to themselves or others.

IN-LIEU-OF SERVICES AND SETTINGS (ILOS)

ILOS are different services that you or your child can get to treat a behavioral health condition or substance use disorder in a setting approved by Texas Health and Human Services Commission (HHSC) in lieu of (instead of) a hospital. ILOS may work better for you or your child and your personal health care needs. If your behavioral health provider recommends ILOS, they can refer you to a qualified provider once the request is approved.

Partial Hospitalization Program (PHP)

Day treatment for people who need ongoing mental health treatment, but don’t require hospitalization.

Intensive Outpatient Program (IOP)

A structured program (in‑person and/or virtual individual, group, and family therapy) that provides more support than traditional outpatient therapy while the patient continues living at home.

Coordinated Specialty Care for First Episode Psychosis (CSC-FEP)

Team-based care with a recover-focused approach designed to meet the needs of people between the ages of 15-30 who have experienced their first episode of psychosis.

What is Coordinated Specialty Care (CSC) for First Episode Psychosis?