Libraries for Health

Reimagining Mental Health Care Delivery in Central Texas

Addressing depression, anxiety, and other mental health conditions are some of our region’s most pressing needs. And while both urban and rural communities struggle with access to timely and affordable quality mental health services, issues in rural communities are exacerbated due to inadequate mental health resources.

Libraries for Health, an initiative designed and funded by St. David's Foundation and in partnership with Via Hope and RAND, seeks to reimagine the delivery of mental health services by building upon a community anchor - a local public library - that is already in place. Libraries are trusted and accessible gathering places that bring together people from diverse backgrounds and offer access to resources for those who may be uniquely at risk for mental health conditions – particularly those who may experience the greatest barriers to care. This initiative recognizes and elevates the opportunity for an anchor institution that is woven into our social infrastructure to purposefully support and improve the mental wellness of its patrons.

A key component of the initiative has been the placement of peer support specialists in each of the libraries, non-clinical mental health workers with lived experience who can offer library patrons evidence-based assistance. In each of the libraries, their contribution is tailored to the needs of that community— “office hours” to meet with adult patrons individually, attending existing library groups or offering new activities, and providing mental wellness assistance to library staff.

Below are portraits and interview quotes from each of the eight participating libraries and their staff, peer support specialists, and patrons. Both the words and images aim to provide a closer look at how libraries can serve as thriving community ecosystems that expand access to care and meet the pressing mental health needs of underserved Texans.

"“The Libraries for Health program is bringing the mental health access to where the people are already gathered, where they're already looking for resources, looking for services, and that's the public library. It is a community service institution by all means.”

Smithville Public Library Director

Smithville Public Library

“I love to help people. I feel at the end of the day that I've done something, that is my gratification, not the paycheck.”

Smithville Public Library Peer Support Specialist

“I’m not going to lie to you, if Britany never came into my life, I would not be sitting here talking to you today. I just felt like I didn't have any other way out. I was literally at the bottom of life. And then she showed up like, tada, you still have a chance. So yeah, you still have a chance.”

Smithville Public Library Patron

“People sometimes think that the library is just for books, just to find books. But here at the library, you find a lot of help here, physically and mentally. Because sometimes I have problems, sleeping at night or whatever, and I come here and I talked to Britany, and she explained to me what her work is, what's she done today, what she's going to do the next day. It makes me feel good to know that we have someone in our community that really loves the community. So that’s how she helps me.”

Smithville Public Library Patron

Martindale Community Library

“We come to the library every Thursday. I homeschool my son, and so we use the library as kind of a supplement to add on to his education and for reading programs, socializing, and just getting out of the house and having a classroom in a different area for the day. It helps out a lot.”

Martindale Community Library Patron

Martindale Community Library Peer Support Specialist

 "I think peer specialists, as a position and as a resource, are really good because it's being able to talk with someone that knows where you've been. If I had something like that when I was going through my struggle with mental illness, that would have been a fantastic resource. I would have loved to have that. It's so validating to know you're not alone. And we're trained on how to work in a trauma-informed manner so we don't re-traumatize people.”

Mary Beth
Martindale Community Library Volunteer

“The library and City Hall and the cafe, we’re the only businesses downtown. City Hall is open Monday through Friday. But someone with a mental health crisis is not going to go to City Hall because that's a scary thing. That's where they have to go for utility bills and that's where the cop lives, that's where the mayor's office is. They don't want to go there for mental health. And the library, we're kind of low key. We're just a welcoming presence in town.”

“It is a small library, but for what we do, we have made it a big library. We try to be here for the people of Martindale. Not just books, not just information, but to be here for them.”

Martindale Library staff

Elgin Public Library

“There's no senior center in Elgin. And they stepped up to the plate and gave us space and gave us programs…I'm so grateful because seniors need to get together with seniors, and it is so fun. We have so much fun."

Mary, Avis, and Sue
Elgin Public Library Patrons

“We just didn't have the funds to do all these programs that we've been offering over the last couple of years. It's definitely made a huge impact in our community. I have visited with several different individuals that come into these programs. Speaking with, for instance, some of the seniors, they have just shared their testimonies with me saying what a difference it's made in their life personally.”

Elgin Public Library Staff

San Marcos Public Library

“The San Marcos Public Library doesn’t just talk the talk but walks the walk, and has engaged in multiple initiatives that show they truly care about our community members.”

San Marcos Public Library Patron

San Marcos Public Library Director

“When I myself have had a mental health issue or my daughter had a mental health issue, we sought out help right away. But people don't do that. There's still such a stigma attached to asking for help. I look at it as just another health option. But people do still feel a real stigma, especially older people, that the asking for help is some sort of sign of weakness.”

“Coming out of COVID, it was really apparent that people were having trouble rejoining their community again. They had spent so much time at home. There were no churches, no social groups getting together, and it just seemed like there were a lot of lonely people. And the way you can tell we have a lot of lonely people is they come in and they're checking out a book and then they just talk and talk. They're just so happy to have an outlet for their conversation."

“We're hoping that we'll use some of our funding to train some more peer counselors that live in our community. I think there's a lot of people in our senior community that could really take this on as a volunteer experience that once they're paid and trained, that then we could have more scheduled time, or have better hours, or have just a better chance when somebody does drop in that they'll have somebody here that can talk to them.”

“I just met Victoria here. I saw that they have the program for adults, so I decided to come and see what it was like and there's sometimes more than one or two other people here. And lately it's just been me. It’s just peaceful, calm, just talking to her openly.

San Marcos Public Library Patron

“I think peer support specialists are uniquely equipped because of they're boots on the ground approach. A lot of people, once the clinical aspects get involved, it deters people. There's a relatability aspect. And to be peer to peer, person to person, I think it's really important to maintain people's integrity. So, they aren't seeking help. They're just helping themselves. But there's someone there to sit with them while they do it. And I think it's a lot more empowering that way.”

Peer Support Specialist - San Marcos and Buda Public Libraries

Buda Public Library

An evening therapeutic art class provided for free to Buda Public Library patrons.

Kelly is an art therapy instructor who the library was able to hire to provide classes because of the Libraries for Health initiative.

Buda Public Library Director

“I was not aware of a peer support specialist as a thing. I think it's a great thing. I think that that's really a good connection point when you don't have someone in your family or a close friend that you can talk to. But to have these people already in a place where you can go safely, both safely in terms of non judgment, and it's right down the road, and you're not automatically going to be labeled if you're coming to the library other than possibly nerd. But you know, we love the nerds.”

Taylor Public Library

Taylor Public Library Peer Support Specialist

“The library's the hub. You start from there, make connections within your community and see how we can better reach out and just increase the prevention of things that are going on. It's accessibility for a rural community because a lot of people live way out and they're not as close to the resources. It's thinking of different ways, innovative ways, thinking outside the box as far as how we can better reach a community like this.”

Taylor Public Library Director

“As a library staff, we know our patrons. We know them. We know what their problems are. We know what books they like, what authors they're following. But we also know when they're in distress. We're the people who connect with these patrons on a regular basis. They trust us and the library is a happy place for them. The best thing we do is connect with our public.”

“In Del Valle, we have a real lack of any kind of social services and there's a lot of people that fall through the cracks.”

Garfield + Del Valle Library Director

Garfield Library

“Libraries are one of the few places where you can literally just exist for free. A lot of the time you have to buy something to go somewhere. Or if you want to use the bathroom, you have to buy something. Libraries are public. They're free. They're paid for with taxpayer money. And shouldn't taxpayers have all the resources available to them that they can get if they're paying taxes for it? And I think that Libraries for Health is a great initiative because we can bring health to a central location where people will come, especially when there's nothing else in the area, because truly there is nothing else in this area.”

Garfield + Del Valle Libraries Peer Support Specialist

 “I help connect people with resources that they need, ranging from help with utilities, employment, domestic violence situations. And then I also meet with people one on one if they want to, to just talk and be a support and empathize and help them set goals if they're interested. “

Jarrell Community Library Peer Support Specialist