Health Care Quarterly:

Nevada’s numbers lag when it comes to mental health care

Nevada is suffering from a mental health crisis.

According to the National Health Service Corps, most of the state is now considered a Health Professional Shortage Area (HSPA). Last year, the nonprofit Mental Health America painted a bleak of the Silver State in its State of Mental Health Report.

Nevada ranked last in the nation among adults with mental illnesses who did not receive treatment (67.5 percent) and 46th among youth with “major” depression who did not receive mental health services (71.6 percent). Mental Health America also ranked Nevada last in the nation in its overall mental health rankings.

Most jarring of all, Nevada ranks last in access to mental health care — but thankfully, no one would have been able to tell in early October after mental health practitioners from all over the state rallied together to serve survivors of the mass shooting. The days and weeks following that devastating event illustrated the depths our community will go to serve one another with compassion and generosity.

Unfortunately, the level of response we saw in October is not sustainable long-term without more practitioners and low-cost services for the underprivileged. The lack of mental health services for individuals and families who don’t have the economic means to pay out of pocket is a clear situation of the haves versus the have-nots. Even health insurance does not guarantee timely access to adequate and affordable mental health services.

That begs the question: How can Nevada provide its residents with better mental health care?

Free help is out there, but not enough

There are countless disadvantaged individuals in our community who simply need to be made aware of the nonprofit organizations and both the state and county benefits available to them. In doing so, we can help decrease some of our community’s systemic issues, such as substance abuse, food insecurity and the physical ailments that result from neglecting mental health.

Nonprofit medical clinic Volunteers in Medicine of Southern Nevada (VMSN) offers a Social and Behavioral Health Intervention Services (SBHIS) department that provides care coordination, case management, and behavioral health group interventions.

Based on a client’s needs, VMSN refers them to community partners or one of our few low-cost mental health clinics in the region.

As education goes, so goes Nevada mental health care

The new UNLV School of Medicine will enhance mental health services for all Nevadans. A major tenet of the medical school is to foster mental and behavioral health workforce development by collaborating with existing UNLV mental and behavioral health training programs, as well as community partners. Rather than conduct traditional hospital-based training, the school’s focus will be community-based, featuring integrative partnerships that give students hands-on and interdisciplinary experiences devoted to assisting the underprivileged.

The new medical school will train aspiring doctors who will ultimately practice in Nevada. This means there will be an influx of professionals here to advocate for our community’s mental and behavioral health needs. Additionally, this focus on community involvement and mental health will foster the next generation of medical volunteers who will consider the whole person — mind, body and spirit.

Care integration is key

It’s time to dedicate our health care resources to the men, women and children who are struggling with mental and behavioral health ailments.

Arguably 100 percent of what primary care providers see in their clinics has a psychosocial component. Take, for example, diabetes. A newly diagnosed diabetic requires targeted behavioral intervention and specialized education to help manage their disease and understand how their current behaviors impact health outcomes. It’s especially important because citizens with diabetes and other long-term diseases are especially susceptible to mental illness.

According to the Mayo Clinic, the rigors of managing diabetes and the impact of the disease on one’s health can exacerbate symptoms of depression. Additionally, it’s been found that individuals undergoing regular cognitive behavioral therapy are typically less depressed and are better able to manage their illness.

Encouraging providers to work in an interdisciplinary fashion would bridge the gap between primary and behavioral health care and improve patient outcomes across the board. The American health care system is dominated by a fee-for-service (FFS) model, where medical professionals are paid for each service separately instead of a “bundled care” system. This is a less efficient form of health care and often leaves behavioral health treatment as an afterthought.

Nevada is far from unique in its struggles to provide acceptable mental and behavioral health services to its citizens. Our community’s recent tragedy is not only a reminder of the need, but of the extraordinary commitment we have to keep moving toward a solution that leads to a stronger, healthier Nevada.

Tabitha Pederson is the social services director at Volunteers in Medicine of Southern Nevada.

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