Time to turn the corner on Nevada’s mental health crisis
The semicolon has become a symbol of mental health awareness. (Photo by Timothy L Brock on Unsplash)
May is Mental Health Awareness month in the U.S., and our state is certainly aware of the needs surrounding this public health issue now more than ever. As Nevada emerges from the COVID-19 pandemic and our political, business, and community leaders launch efforts to strengthen our economy and train Nevadans for new jobs to secure a better future for themselves and their families, our state’s recovery will not be complete until our neighbors, co-workers, friends, and children recover fully from the pandemic’s mental health effects.
The American Academy of Pediatrics noted that the “worsening crisis in child and adolescent mental health is inextricably tied to the stress brought on by COVID-19,” and “[…] the pandemic has struck at the safety and stability of families. More than 140,000 children in the United States lost a primary and/or secondary caregiver, with youth of color disproportionately impacted.” With students now returned to school, an unprecedented surge in violence against teachers, staff, and among students in the Clark County School District is yet another reminder of the importance of mental health care for our youth.
It is important to note that COVID-19 did not create a mental health crisis in Nevada. It made a dire situation even worse. Nevada has consistently ranked at the bottom of national mental health metrics since at least 2015.
A recent publication from Brookings Mountain West and The Lincy Institute reported that Nevada ranked last (51st) among states and the District of Columbia in providing mental health professionals and services for adults and children, according to data from Mental Health America’s 2022 report, “The State of Mental Health in America.”
Identifying and treating mental health issues is challenging under the best of circumstances. Nevada’s chronic shortage of mental health and social work professionals makes this challenge even more daunting. Nevada currently has just one mental health professional available for every 460 Nevadans. For comparison, neighboring Mountain West states of Colorado and Utah have a mental health professional to population ratio of 1 to 270, and 1 to 290, respectively.
In 2021, April Corbin Girnus of the Nevada Current reported that “Nevada would need to double the number of psychologists and psychiatrists to be considered average by national standards.” In addition, she noted that “Other specialties are in even lower supply: Nevada would need to quadruple the number of clinical professional counselors to meet the national average. The national average is 45.4 clinical professional counselors per 100,000 residents. Nevada has 10.3 per 100,000.”
The data reveal an even more troubling story for the youth mental health landscape. A second report from Brookings Mountain West and The Lincy Institute found that Nevada has just one school psychologist available for every 1,866 students, with a recommended ratio of 500 to 1. The availability of school social workers is further lacking, with just one social worker available for every 8,730 students; the recommended ratio of students to school social workers is 250 to 1. This means that Nevada’s school mental health workforce is currently operating with 26.8 percent of the recommended number of school psychologists, and just 2.9 percent of the recommended number of school social workers.
With hospitals and health centers still reeling from the impact of COVID-19, the importance of dealing with mental health issues in our communities, businesses and schools falls to all of us. Failure to address mental health issues threatens the lives of our most vulnerable residents and places increased burdens on overpopulated hospitals, schools, prisons, and mental health facilities.
Moving forward, the influx of federal resources and state actions in response to the coronavirus pandemic can begin to address our mental health deficiencies.
In 2020, amid the COVID-19 pandemic, CCSD spent $761,000 in relief dollars on a “platform to monitor data like absences, behavior, and academic changes that may be a red flag …” for student mental health challenges. During the 2021 legislative session, Nevada provided funding for the Children’s Mobile Crisis Response Team ($600,000). Sen. Catherine Cortez Masto is co-sponsor of the Behavioral Health Crisis Services Expansion Act that proposes to expand mental health services in Nevada and nationally.
In February, Sen. Jacky Rosen introduced the Youth Mental Health and Suicide Prevention Act seeking to provide direct funding assistance for mental health in K-12 school districts to stem the rise in youth suicides. The bill is endorsed by the Lyon County and Clark County School District (CCSD) superintendents. And in March, the Nevada System of Higher Education received $2.6 million in federal funds to support a systemwide mental health needs assessment.
Certainly, the American Rescue Plan Act (ARPA) provides a critical influx of dollars to begin this long road to recovery. As ARPA funds continue to become available, and as state, county, and local governments determine allocations for these funds, the governor and state legislature should require complete and transparent reporting of spending decisions.
The launch of a Nevada “data dashboard which transparently tracks how the State is spending federal American Rescue Plan funds,” available at NevadaRecovers.com, is a great step in this direction. Another way the public can monitor government spending of these funds is through the recent launch of The Local Government ARPA Investment Tracker, an “online resource that compiles information from local governments to offer a detailed picture of how large cities and counties (with populations of at least 250,000) are deploying ARPA funds. Another publication from Brookings Mountain West and The Lincy Institute explores data from the ARPA Investment Tracker for the Mountain West states of Arizona, Colorado, New Mexico, Nevada, and Utah. The report detailed spending in Henderson, Clark County, and Washoe County totaling $37,400,000.
The state’s regional economic development agencies should include mental health professionals among their priorities in workforce development plans.
Funding and transparency are critical to solving the mental health crisis in Nevada. But allocating money to programming and services without considering workforce deficits may further challenge the state’s ability to turn the corner on mental health. No amount of programmatic funding can solve this problem if there are not enough highly qualified mental health professionals ready and capable to implement services and interventions. As municipalities commit to carving out funds for mental health, decision makers cannot ignore that the mental health workforce pipeline is a critical aspect of this policy ecosystem, and strategic investments must seek to fill the pipeline appropriately.
Building a mental health workforce in Nevada will take time and money. With a shortage of as many as 1,300 licensed educators in Clark County alone, not to mention thousands of displaced gaming and hotel workers, the absence of mental health professionals may be relegated to a long line of local, county, and state needs. Public health officials and advocates must identify critical needs across the state and bring pilot programs with targeted goals, supported by legislative mandates, for state and local governments, school districts, and appropriate public agencies. Equally as important, we must ensure that funding to address mental health includes targeted strategic investments to help fill the mental health workforce pipeline with trained professionals. The state’s regional economic development agencies should include mental health professionals among their priorities in workforce development plans and report on efforts made in this essential sector. They should also work with public and private sector partners to recruit and train employees and facilitate the certification of individuals who relocate to Nevada to work in the mental health field.
Cooperation between federal, state, county, and local governments is essential to maximize the benefits from the resources coming to Nevada. To maximize improvements, we must include our existing mental health professionals in the conversation to ensure that policy decisions are made in collaboration with those who know the issues most intimately. Whether through state and local offices, non-profits, hospitals and healthcare facilities, schools and universities, or other community outlets, Nevada’s leaders must ensure that resources to improve mental health infrastructure and services reach those most in need without delay.
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William E. Brown, Jr.
Caitlin J. Saladino