Nevada’s shortage of mental health providers is putting additional stress on the state’s child welfare systems, county administrators told lawmakers last week.
New data presented to an interim legislative committee on health and human services last week suggests what child and family welfare program administrators have long said: that some children are finding themselves in the custody of the state due to mental health issues that could have been addressed earlier.
Nevada has a higher overall rate of children in state care — 6.3 per 1,000 children versus 5.6 per 100,000 children nationally
Almost nine out of 10 — or 89% — of children placed into Nevada’s foster care system are removed from their homes because of neglect, according to the 2020 Child Maltreatment Report by the U.S. Department of Health and Human Services. Nationally, 65% of children are..
‘Neglect’ as a classification for the removal of a child from their home can encompass many situations, but one contributing factor identified by state administrators is mental health.
“When a child is removed from an adult caregiver who is not receiving mental health treatment and is unable to take care of their child, that goes into our system as neglect,” said Timothy Burch, an administrator with the Clark County Department of Family Services. “It was asked earlier why our rate of neglect is so high. That is a contributing factor.”
Burch noted that so far more than 80 children have been brought into Clark County's child welfare system since August because their parents could not provide for the child’s mental health. The current pace suggests that “well over 120” children this year will be surrendered to the county for this reason.
“We desperately need more assistance in mental health treatment and wraparound services for the children in our community,” added Burch, “so they don’t end up in child welfare.”
Ryan Gustafson, the director of children’s services at Washoe County Human Services Agency, similarly identified mental health services as one of the agency's primary challenges. He said intensive treatment options have decreased in Washoe County, referencing the closure of West Hills Hospital and Project Safe and Growing -- in addition to a general decrease in psychiatric services that are available.
Project Safe and Growing offered free therapeutic day treatment for children ages 3 to 7 who were victims of crime, such as neglect and abuse. It was serving up to 36 kids per day, according to KOLO, which profiled the program and its risk of closure due to lack of funding last year.
West Hills Hospital closed in December after the company conducted a “comprehensive review and evaluation of multiple factors including the cost to renovate the aging infrastructure,” according to local news reports. The behavioral hospital, which opened in 1981, had 95 beds, 35 of which were for children.
“We lost one of our two psychiatric hospitals,” said Gustafson, “so when kids (need help) they are now going to medical hospitals where they’re waiting to get a bed in the one psychiatric hospital that we have left. That creates backlogs. And that creates difficulties and undue stressors for kids and families.”
Further exacerbating the problem is that community-based programs have their own enrollment backlogs or cap the number of Medicaid recipients they accept, he added.
The shuttering of West Hills Hospital prompted some, including Reno Mayor Hillary Schieve, to call on the allocation of American Rescue Plan Act dollars on mental health resources.
According to the Reno-Gazette Journal, Gov. Steve Sisolak promised during a December meeting with Northern Nevada mental health care service providers to do his best to free up ARPA money for the cause but noted that “the (federal funding) isn’t as flexible as I’d like it to be.”
The Nevada Department of Health and Human Services earlier this month announced more than $43 million in ARPA money would be earmarked for grants to support behavioral health programs, including $14.9 million for “crisis services and stabilization,” $4.9 million for direct services and treatment, $3.1 million for “pregnant women and women with children services,” and $2.2 million for “early serious mental illness.”
More than 40 private, public, nonprofit and community coalitions are expected to benefit, according to a news release.
Separately, Clark County Commissioners last week approved a $1.9 million contract with Silver State Pediatric Behavioral Services through June 2023 to provide long-term, inpatient care to children within the county’s custody. Silver State will provide up to six beds for inpatient treatment for children who need more intensive help -- a move that is expected to relieve conditions at Child Haven, the county’s temporary housing for abused and neglected children, which workers have described as an understaffed, ill-equipped dumping ground for children with mental health issues.
Sisolak has also spoken of an ARPA-funded $20 million investment in a 9-8-8 phone number that will connect people around the clock to trained National Suicide Prevention Lifeline counselors. The hotline is expected to launch in July.
Nevada’s shortage of mental health providers and resources is well documented. Mental Health America ranked Nevada dead last on its overall mental health ranking, indicating higher prevalence of mental illness and lower access to care. In the subcategories, Nevada ranked last for youth mental health, second-to-last for overall access to care, and 47th for adult mental health.
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