To save state taxpayers millions of dollars, Texas no longer automatically treats every mentally ill patient who relies on public help.

Now, just the "sickest of the sick" get on-demand access to the state's 10 mental hospitals. That includes people with schizophrenia (search) and bipolar disorder (search).

"It made sense to institute a rational, rationing system because we all know we have more mental health need than we have resources," said Joe Lovelace of the National Alliance of Mental Illness (search) in Texas.

Texans with less serious conditions, like obsessive-compulsive disorder (search), will no longer receive state treatment until they're in a "crisis" situation, like being suicidal.

"It's a real tragedy. And for those — I can't, I get scared when I think about those individuals who don't have access to medication and wouldn't be — would have to reach a crisis stage, because when I'm at a crisis stage, it's really bad," said mental health patient Susan Marshal.

Marshal and others who oppose Texas' new mental health care policy and say that 20,000 fewer Texans will now get the help they need.

But Texas Republicans and advocates of the reform say the state's overall safety net is still in place.

"They're not being thrown out or overboard in any sense of the term," Lovelace said. "The system will still have a crisis engagement. There will still be a fire station on every corner."

The Texas model of patient prioritization has been in effect now for over two months — and other states are watching closely. But program managers say it's too soon to say whether the money-saving rationing has resulted in poorer mental health care.

Click in the box near the top of the story to watch a report by FOX News' Phil Keating.