Mental health providers in Bexar County, and the gap for low-income residents

Providers for the whole county

County Health Rankings counts every mental health provider with a National Provider Identifier and an address in the county: psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, addiction providers and psychiatric nurse practitioners. Bexar County had 5,602 of them in 2025, or 263 for every 100,000 residents. That is more than Texas as a whole (181) and fewer than the U.S. (348). Among Texas’s 10 most populous counties, only Travis County (434) has more per resident.

The gap for low-income residents

The federal Health Resources and Services Administration (HRSA) designates places and groups of people that are short of health professionals. Bexar County as a whole is not a mental health shortage area. Its low-income residents are: HRSA first designated them on 26 April 2021 and last updated the designation on 22 September 2025.

For mental health, HRSA’s count is of psychiatrists. It finds the equivalent of 11.8 full-time psychiatrists serving Bexar’s 679,508 low-income residents, one for every 57,604 people. At HRSA’s goal of one for every 20,000, those psychiatrists would cover about 235,922 people, leaving 443,586 counted as underserved. The designation scores 17 on HRSA’s scale of 0 to 25, where higher means greater need; among the 8 large Texas counties below with the same kind of designation, scores run from 15 to 17.

Elsewhere in Texas the shortage is wider: in 192 of the state’s 254 counties, the whole county is a mental health shortage area.

What about counselors?

Texas does not publish a reliable count of counselors by county. The Behavioral Health Executive Council’s licensee file lists 35,369 active Licensed Professional Counselors and 7,777 LPC Associates, but gives a county for only 8.5% of its records, and some license holders live outside Texas. The state’s own county workforce tables (Texas DSHS Health Professions Resource Center) could not be downloaded for this page. Counselors are included in the County Health Rankings figures above, alongside the other professions.

What this means if you are looking for care

• There are more providers here than in most of Texas. Bexar County has 263 mental health providers for every 100,000 residents, against 181 statewide. It can still take a few calls to find one with an opening that fits your needs and budget.
• The federal shortage measure is about psychiatrists. HRSA’s designation counts psychiatrists, who prescribe and manage medication. If you need that kind of care and cost is a barrier, community clinics are one place to ask.
• Low-cost options exist. Federally qualified health centers in Bexar County charge on a sliding scale based on income. Our guide to free mental health resources in San Antonio lists local clinics, groups and lines.
• Check what your plan covers. If you have insurance, the plan decides which providers are in network and what you pay. Rates and insurance lists the plans this practice is in network with and the questions to ask.

Method and limits

The provider counts come from County Health Rankings & Roadmaps, which counts providers in the federal National Provider Identifier file by the address they list. A provider who works in several places, or mostly by telehealth, is counted once, where their address is. A provider count is not the same as appointments available: it says nothing about who takes new clients, which insurance they accept, or their caseload.

HRSA’s figures come from its shortage area detail file and are checked against its mapping service. “Low-income” is HRSA’s designation population, generally people below twice the federal poverty level. HRSA counts full-time equivalents, so two half-time psychiatrists count as one.

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