Community leaders unveiled findings Thursday from a comprehensive mental health needs assessment that reveals the July 4 flood will trigger a fourfold to fivefold increase in mental health needs across Kerr County over the coming years.
The Community Foundation of the Texas Hill Country hosted the press conference at St. Peter’s Episcopal Church’s Tucker Hall to present results from a study conducted by the Meadows Mental Health Policy Institute. The flood claimed 119 lives, with two people still missing.
Dr. Andrew Keller, CEO of the Meadows Mental Health Policy Institute, presented data showing the county will see approximately 8,000 adults suffering from PTSD, compared to the typical 1,500 to 2,000 cases. The number of children experiencing severe mental health needs will increase from about 500 to 2,500.
“The needs begin to unfold around month five for adults, and month six is where they really ramp up,” Keller said. “They’re going to continue to unfold over years.”
Keller explained that mental health impacts represent the second disaster within every natural disaster, following the initial event itself and preceding financial recovery challenges.
The institute interviewed more than 70 local residents who collectively represented hundreds of community members to develop the assessment. Keller said the research combines local perspectives with evidence-based practices drawn from studies of Hurricane Katrina, Hurricane Harvey and other disasters.
The assessment identifies four priority areas for investment: awareness and navigation support, trauma and grief-informed care, specialized care for affected populations, and community access points.
Kerr County Judge Rob Kelly described the personal toll of leading recovery efforts while watching floodwaters rise to within three inches of his wife’s front door threshold.
“I was vaguely familiar with PTSD, but really I didn’t even know how to spell it until after this,” Kelly said. “The experience that you have when you’re part of something like this cannot be erased. It cannot be taken away.”
Kelly, who serves as the mental health judge for Kerr County and 18 surrounding counties, said he underestimated the mental health impacts initially. He revealed he received death threats as recently as the prior week while dealing with recovery issues.
“These effects, the mental health side effects of all of a disaster like this, they can go on for weeks, months, years, decades,” Kelly said, citing information from emergency management officials.
Austin Dickson, CEO of the Community Foundation of the Texas Hill Country, announced $1 million in immediate grants aligned with the assessment’s priorities. The foundation has received more than $150 million in donations from over 140,000 donors worldwide.
The grants include three years of mental health navigation services at Light on the Hill, expanded school-based counseling at Hunt Independent School District, specialized care for mental health professionals through the Hummingbird Foundation, a mobile mental health app for law enforcement and their families, and continued funding for the emotional support drop-in center at MHDD.
Dickson said the foundation previously funded emergency mental health responses in August and September, including purchasing an off-road vehicle for MHDD to reach isolated flood victims. The foundation also made multi-year investments in the Children’s Bereavement Center and New Hope Counseling Center.
The foundation created a statewide family mental health care fund through the Meadows Mental Health Policy Institute to reimburse mental health costs for any family member who lost someone in the flood, regardless of where they live. Additional grants went to nonprofits in Houston, Dallas and other Texas metro areas where flood victims resided.
David Rogers, president and CEO of the H.E. Butt Foundation, praised the community’s response and the Community Foundation’s handling of more than $100 million in relief funds.
“Austin, you going from a small community foundation to administering over a hundred million dollars of gifts that came in in a real quick way is really amazing,” Rogers said.
The H.E. Butt Foundation partnered with the Meadows Institute to fund the needs assessment and supports the Mental Health Resilience Flood Relief Coalition, which includes approximately 40 member organizations.
Rogers said the foundation’s three generations of family leadership have maintained wellness as a guiding principle, making mental health recovery a natural fit for their flood relief participation.
Leah Tull, chair of the Community Foundation’s Mental Health and Wellbeing Advisory Council and school social worker for Kerrville Independent School District, said the assessment addresses navigation challenges families face in accessing mental health services.
“Unfortunately, even though we have a lot of great options out there and great institutions, it is easy to get stuck and lost in the navigation of those systems,” Tull said.
Tull, who lost a close friend in the flood and knows others who survived harrowing experiences, said the advisory council will focus on reducing barriers related to cost, transportation, confidentiality and stigma.
The advisory council includes mental health professionals Annie Carlson, Piet Venter, Sam Drain, Mark Goldman and Carol Ola. The council meets monthly to recommend grants to the foundation’s board of trustees.
Keller outlined specific recommendations for community access points, including primary care providers, schools, faith communities and the emotional support center. The assessment emphasizes that first responders need specialized support given that more than 300 responded to the disaster.
“When you do mental health care with folks who have gone through a trauma or even more complexly, people who’ve gone through a trauma and lost somebody they love or fear that they would lose the ones they love, it’s difficult,” Keller said. “It’s not the same.”
The foundation organized its Kerr County Flood Relief Fund into four categories: emergency needs, housing, mental health and wellbeing, and community culture. Each category has a volunteer advisory council of community experts overseeing strategy and investments.
John Reed, senior program officer at the Community Foundation, announced the Mental Health and Wellbeing grant portal opened at noon Thursday for funding requests on a rolling basis.
“We are seeking partners who could expand access to care, build local capacity, and serve our community for the long term,” Reed said.
The foundation will post an executive summary of the rapid mental health needs assessment on rebuildkerr.org next week.
The MHDD emotional support drop-in center at 819 Water Street operates six days a week, providing walk-in services with no appointments or paperwork required. The foundation committed to funding the center for an additional year.
Dr. Bill Blackburn, retired pastor of Trinity Baptist Church, opened and closed the event with prayers. He shared that his two granddaughters and their mother barely escaped the River Inn during the flood. The girls are classmates of one of the two remaining missing children from Zilker Elementary School.
“The impact in Zilker Elementary School is something,” Blackburn said during his closing prayer. “Lord, we need your help.”
Dickson emphasized that mental health recovery forms the foundation of disaster recovery, not a secondary concern.
“If we invest here in mental health, families will heal faster,” Dickson said. “Our schools will be healthy and stronger. Our first responders will remain resilient, and our community will become more unified.”
The Community Foundation committed to transparency, partnership and public accountability throughout the recovery process. Interested organizations can contact Reed for application assistance and eligibility questions.
Pastor David Payne of First United Methodist Church delivered the opening prayer, acknowledging the community’s pain and trauma while expressing gratitude for available resources and expertise.
“The buildings are easy to rebuild and the structures can come back,” Payne said. “The most precious loss from this event has been the human loss.”