Mental health has been a hot topic of public conversation for the past decade, but the full story under the surface is complicated. It is an important determinant of Nevada’s workforce stability, educational outcomes, and economic productivity. If not addressed properly, mental illness can directly drive up healthcare costs, decrease workforce participation, and put a strain on the state’s medical and criminal justice systems. And yet, year after year Nevada consistently ranks 51st in the nation for access to mental healthcare and prevalence of mental illness.
The Scope of the Crisis
Nevada has the 11th highest suicide rate in the nation, the highest number of youth with substance use disorder, and adults with higher prevalence of mental disorders but lower access to mental healthcare options. These problems are especially pronounced in the Silver State’s rural counties. As of 2022, rural and frontier counties combined had only 3 licensed psychiatrists, 9 licensed psychologists, and 28 licensed clinical counselors. Whereas urban counties had 300 licensed psychiatrists, 333 licensed psychologists, and 450 clinical counselors. These numbers effectively put all 15 rural and frontier counties in an extreme healthcare professional shortage zone. On the other hand, the licensure process for all the aforementioned critical shortage professions can take anywhere from 6 to 12 years. Even though the number of mental healthcare professionals in Nevada has been steadily growing, the number of those needing their services has grown at a much faster rate, leaving the market with an astronomical demand. Without immediate and consistent relief, Nevada will continue facing this crisis that is disproportionately affecting underserved and rural communities.
What Can Policy Do? Three Areas of Reform
Recruiting more professionals starts with making the state attractive for those who are already licensed. Nevada’s recent ratification of interstate compacts that allow license reciprocity among member states is a step in the right direction. Counseling Compact and PsyPact have already received the legislative green light, yet more work remains to ensure their full implementation alongside the continued pipeline for out-of-state professionals into Nevada. On the other hand, some compacts, like the Occupational Therapist Interstate Compact and the School Psychologist Interstate Licensure Compact, failed to receive legislative support causing yet another setback in increasing access to mental healthcare.
Physical access to mental healthcare professionals in rural counties can seem like an uphill battle, but telehealth access is the simplest fix to the problem. Nevada laws make telehealth relatively accessible for certain out of state providers and medical services, but there can be more clarification and expansion. By adding a definition for remote patient monitoring and passing easy registration or reciprocity laws for all providers, the state can address its mental health crisis in a timely manner. While regulation can protect consumers and patients, in this case it prevents access to valuable resources that are a much-needed lifeline for many.
For those that are already caught in the Nevada justice system mental healthcare still remains hard to access. States like Kansas and Idaho have seen increased outcomes from Assisted Outpatient Treatment (AOT) programs for incarcerated individuals. While Nevada has an AOT program in place allowing patients to seek mental healthcare alternatives, the application process is complex. By improving the structure of the program, the state can have a policy that is smart both on crime and on care.
Nevada’s mental health crisis cannot be solved by a single policy or a single bill, but if implemented collectively these reforms can steer the state toward progress. Lawmakers made notable progress during the 83rd session. However, joint efforts and compromise of licensing boards, local providers, and political officials will be required to implement all the reforms. The future of Nevada’s mental health depends on consistency and collaboration, and there is no better time to build it.
