During this year’s legislative session, my wife and I approached our state legislators about resources for Nevada’s most underserved population: The mentally ill.
There is a health crisis in our state, one which has grown
into an epidemic across the nation, but one that is especially endemic right
here in the Silver State.
Having lived more than twelve years in a state that seems to
cater to many human vices, this comes as no surprise to me.
Nevada legalized statewide gambling in 1931. Gaming has
lasted longer in Nevada than it has in most other states. Ours is also the only
state that has legalized prostitution. Urban Nevada is notorious for its
24-hour lifestyle. And, the Silver State has a reputation for easy access to alcohol.
This is not to say that the legal vices in our state have
caused a mental health crisis here, but they sure haven’t helped matters any,
either.
Gaming, substance, and also sexual addictions are poignant
examples of mental health problems that have sprung from the promotion and sale
of the vices that cause them.
According to a White House study performed from 2007-08,
Nevada ranked in the top 10 nationally for the rate of substance abuse among
residents. The rate of illicit drug use and substance-related suicides in
Nevada were higher than the national averages, too.
The Volberg Report, released in 2002, cited a problem
gambling prevalence rate of 6.4% in Nevada based on year 2000 figures. The
information was used by the State of Nevada’s Department of Health and Human
Services in formulating its problem gambling prevention strategic plan of 2009.
Figures indicate that Nevada has one of the highest gambling
participation rates in the United States, and also one of the highest
prevalence rates of problem gambling in the nation.
This information should not be surprising to Nevadans, who
have generally accepted addiction-based mental illness as coming with the
territory of more libertarian policies toward the human vices.
But what should not be acceptable is the lack of mental
health resources available to combat these problems and other mental illnesses
that plague our population.
Besides the sale and promotion of various vices, Nevada also
has a rather large transient population. Many of these people are homeless, and
in desperate need of services; including access to mental health treatment.
In fact, the Las Vegas Review Journal in October 2014 cites
Nevada as leading the country in its increase in homelessness. And, the Las
Vegas Sun published an article in November 2011 that stated native Nevadans are
a minority in the Silver State, consistent with the high rate of transience
that Nevada attracts.
Perhaps this is one reason why Nevada’s mental health
resources have historically been—and continue to be—woefully inadequate. Why
should a state with such a high rate of transience invest money in treating
illnesses that come and go with many of the residents that pass through its
borders?
Point taken.
But what about those residents who actually live here, want
to live here, and must cope with their illnesses in the face of inadequate
resources?
I’m not talking about the basic outpatient services. There
are a lot of counseling centers and clinics in Nevada. What I’m referring to
are more intensive treatment services that offer the kind of support that
severe mental illness requires; such therapeutic modalities as day treatment
centers and residential care or support for those who struggle to live on their
own. These are individuals who have fallen through the proverbial cracks of our
community because they aren’t deemed severe enough to be institutionalized, but
they are severe enough to pose a risk to themselves or others in the community
due to significant functional deficits.
Even the number of psychiatric institutions is inadequate to
meet demand for inpatient mental health services in Nevada, so those who need
to be institutionalized end up in jail because there is no place else for them.
My wife and I found out first-hand just how inadequate
Nevada’s mental health resources are. You know it’s bad when you have to look out
of state for resources and services that are appropriate for your loved ones,
because the state you live in does not have what your loved one needs.
In Nevada, the situation is serious.
Among our state’s youth, the problem is worse than that.
It’s dire.
Compounding the problem of mental illness amidst our state’s
young people is the number of children that end up in foster care in Nevada
each year. Displacement from the home—and homes that, quite frankly, are
placing Nevada’s children at high risk of exploitation, neglect and
endangerment—is a root cause of many problems facing the thousands of youth in
foster care in our state. The trauma they experienced while in the homes from
which they were taken, and the trauma of displacement, lead to deeper, more
chronic, and pervasive mental, emotional, and behavioral health problems.
If the number of adults suffering from mental illness hasn’t
been enough for the Silver State to take action on behalf of its residents,
then perhaps the number of children and youth suffering in our state will.
There are plenty of reasons for Nevada to finally step up to
the plate and begin addressing its endemic mental health problems: about 2.84
million of them, to be precise.
If Nevada is going to continue propagating the vices of
gambling, prostitution, and alcohol consumption, then it only stands to reason
that our state should lead the way in providing adequate mental health
resources to people suffering from psychiatric illnesses.
As Nevadans, proud of our independent heritage and
libertarian ways, we must take responsibility for the social and recreational
activities we allow to flourish here. We must hold ourselves accountable for
the consequences of socio-economic policies that naturally lend themselves to psychiatric
problems.
It’s time for Nevada to be a stand-up state, advocating for
the mental health of its residents, old and young. Recognizing we have a problem
is one thing, but actually doing something about it is quite another.
I advocate a greater portion of the gaming tax be allocated
to support the treatment of mental illnesses that can and have resulted from
problematic gambling.
I’m in favor of levying a tax on legalized prostitution to
assist in funding mental health resources, as well as state and county foster care
services.
Finally, there should be a nominal liquor tax specific to
funding not only psychiatric treatment related to alcohol abuse, but also the
lifelong residuals of prenatal alcohol and drug use.
I’m talking about fetal alcohol and fetal drug spectrum
disorders that are the direct—and, sadly, highly preventable—result of using
alcohol or other drugs while pregnant. These are mental disorders that should
never be. But, unfortunately, they are. And, their prevalence is comparable to
that of Autism Spectrum Disorders. Only the latter seems to get the lion’s
share of media attention.
Those individuals suffering from FASD have lifelong
deficiencies that require highly supportive and structured treatment. Once
again, Nevada is woefully deficient in providing services, supports and
resources for individuals suffering from FASD.
I’d like to think that a state which promotes liberal
consumption of alcohol would step up to the plate and provide adequate
resources for the casualties of this use.
I’d like to think that Nevadans aren’t ignorant or blind to
the consequences of promoting social or recreational vices, and neglecting the
resources needed to combat problems arising from them.
If Nevada’s mental illness problems are going to be
adequately addressed, then our state needs more than John and Jane Q. Public to
foot the bill. The purveyors of the vices that contribute to social problems
need to be carrying a larger share of the burden if we are going to begin
sufficiently helping those who need the help.
I hope this column catches the eyes of more than a few
public officials, and that they take my plea, my appeal with serious zeal.
I hope many of you will join me in the fight to combat our
state’s sad mental health condition. Things need to change, and it only happens
when we do.
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