Nevada Mental Health Services Face Hurdles

LAS VEGAS -- As the economic recession took its toll on Nevada, the pain of state budget cuts deeply impacted mental health services.

A "Needs Assessment" issued last year by the Nevada Division of Mental Health and Developmental Services wasted no time addressing its budget woes.

The division suffered a 12.5 percent cut in its budget over the past two years and a 13.9 percent decrease in general fund revenue, resulting in a loss of 150 positions. The lost jobs included those in inpatient and outpatient treatment centers. Like other state agencies, those employees who kept their jobs also endured 2.5 percent salary reductions and mandatory unpaid furloughs.

From fiscal 2009 through fiscal 2012, Nevada saw its mental health budget decline by 28.1 percent, the nation's fifth highest drop during that time.

"The cuts have raised concerns regarding meeting client needs," the report stated. "Budget cuts and elimination of positions and services has been a trend since the last comprehensive Needs Assessment in 2008."

One hurdle facing the division is that Nevada already ranks poorly in mental health spending per resident in comparison to most other states. Nevada also was dead last in Medicaid spending per resident from fiscal 2004 through fiscal 2009 and was 49th in 2010. That year, Medicaid spending averaged $1,224 per U.S. resident but only $505 per Nevadan.

Another hurdle is that Nevada ranks high in such negative categories as suicide and the prevalence of mental illness.

Nevada is one of only three states -- along with Alaska and South Carolina -- that is the sole provider of the public mental health system within its borders. The division, which oversees Southern Nevada Adult Mental Health Services, employed 1,467 individuals statewide as of last year. The division also runs Northern Nevada Adult Mental Health Services, rural services and the Lakes Crossing Center in Sparks, a maximum security facility that treats offenders with mental disorders.

Southern Nevada Adult Mental Health Services includes five offices and the Rawson-Neal Psychiatric Hospital, which has 238 staffed beds and 293 licensed beds. The agency also provides treatment services for participants in the Clark County Mental Health Court, works with the Southern Nevada Health District and participates on an advisory board with executives of area hospitals.

The mental health agency also works on a referral basis with numerous other state and local government agencies and nonprofit organizations such as the Salvation Army.

Faced with budget constraints, these were among the challenges the state agency identified:

* "Increased community-based services for adults and children with mental disorders are desperately needed in all areas of the state."

* "In the past (the division) addressed unmet needs by requesting sufficient funding to expand programs and to meet caseload growth. However, given the severe general fund revenue shortfall, it is highly unlikely that any additional funding will be available in the next biennium."

* "The tremendous growth in Clark County has created a hospital emergency room crisis for individuals with mental health problems needing inpatient care. This has been ongoing since 2003 … Providers to transport clients from the emergency room to inpatient care are in short supply and the state has denied budget requests to add medical services within the state mental health inpatient system."

* "Hundreds of children seen in emergency rooms have been warehoused in University Medical Center's Pediatric Unit, sometimes for months, while waiting for appropriate care … Lengths of stay for uninsured youths were twice as long as lengths of stay for Medicaid and commercially insured youths."

* "There is a phenomenal amount of data signifying that mental illness is a public health concern. Yet, Nevada's efforts have been minimal in gaining specific data as to the needs of its citizens."

 

 


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