In-patient psychiatric treatment for youth plunges as beds go empty

Beds in state-run psychiatric facilities for Nevada’s children are empty because of a staffing shortage, and inpatient treatment has plunged by 60 percent since 2015, according to data from the Division of Child and Family Services, which is under investigation by the U.S. Department of Justice for allegedly placing too many children in institutions.   

The Division “is aware of the Department of Justice investigation and is cooperating with any and all requests for information,” Karla Delgado of DCFS wrote via email. “The State is fully responding to all of the requests from the DOJ regarding its investigation.”

The state’s provision of inpatient psychiatric services to children with severe emotional disturbances has plummeted in recent years — from 447 youth served and 63 on a waiting list in 2015, to 185 served and 25 on the waiting list in the last fiscal year, according to data from the state.  

The decline, according to Delgado, “is due to the Division’s inability to staff the facility for the fully budgeted capacity.”

Nevada’s state-run psychiatric treatment facilities for youth are treating fewer than one-third of the children they were designed to help, according to data from DCFS, and more than half of the young residents were placed there by their parents, not the state.  

“Placements are based on the medical needs of the youth,” says Delgado. “Whether a child is in the custody of their parents or a public agency does not prevent them from accessing services provided at DCFS facilities.”

Desert Willow Treatment Center, the state’s psychiatric hospital for youth, has a total of 58 beds, but only 32 have assigned staff, according to the state.  Of those, only 19 were occupied on average in September.

The majority of patients, 70%, were placed in the hospital by their parents.  

Oasis, the state’s psychiatric residential treatment center in Southern Nevada, has 28 beds, but only 8 were occupied on average in September.  36% of patients were in the custody of their parents while 64% were in agency custody.  

Enterprise, the state’s treatment center in Reno, has 20 beds but only six were occupied on average last month.  The majority of youth, 57%, were in the custody of a parent. 

Psychiatric Residential Treatment Facility North in Sparks has 16 beds but only 7 occupied on average in September.  About two-thirds of the patients were in the custody of their parent.

The state can’t document how many youth are in its care and housed in private residential treatment facilities throughout the state. Officials say they can only account for the 40 youth housed in the four state-run facilities.  

“The Department does not have the number of all children placed in private RTC (residential treatment) facilities in Nevada,” Delgado said via email. 

A state dashboard containing data mandated by 2019 legislation pinpoints the location of hundreds of youth Nevada sends each year to out-of-state facilities as far away as Florida and New York.  

“In the last 6 years, there has been a 57% decrease in the number of youth Nevada placed out of state,” says Delgado, adding Nevada is “committed to reducing the out-of-state placements to keep youth in their communities. It is important for these youth to be able to form relationships within the community and be near their support system.”

Delgado says in fiscal year 2016 the state placed 262 youth in out-of-state facilities. That was down to 112 for the fiscal year that ended in July.  

“When it is in the best interest of the child and family, the goal is to keep the family together and to provide the family with the tools and resources needed to succeed,” Delgado wrote. “Building capacity and partnerships at the local level are key to moving forward.”

That capacity is sorely lacking and Delgado says Nevada’s limited mental health services have been strained by the pandemic.

“This is especially evident in our rural communities. The Department is working to build partnerships in communities across the state to support youth and families in need of services, and while there is a struggle in identifying intensive in-home services and community-based services, the Department is exploring all ideas to address this issue,” she wrote.  

The Governor’s Commission on Behavioral Health is finalizing a plea to Gov. Steve Sisolak to increase pay for mental health providers in adult facilities, and intends to expand its request to include staff in facilities for youth.