Mental health is Nevada's albatross

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 percent 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.

Brett Fisher is a writer and cartoonist who lives in Carson City. He and his wife, Lisa, have resided in the state capital for over seven years.