Nevada is a bad Samaritan

The recent sad saga of Assemblymember Steven Brooks’ deteriorating mental health, fueled by an insatiable media chasing him down hallways feeding his paranoia and exploiting his delusions, has brought the issue of mental health services in Nevada into full relief. It’s hard to ignore such a spectacular public meltdown although similar incidents happen every day in Nevada, albeit involving persons with a lower profile.

Although the specific nature of Brooks’ mental illness is appropriately private, his struggle heightens the issue among policy makers at an opportune time, as the 2013 Nevada Legislature begins this week. It’s accepted that mental health services are underfunded in Nevada, but what can and should be done to provide care and enhance public safety?

Mental health services in Nevada have never been fully funded, especially after President Reagan famously deinstitutionalized the mentally ill, emptying asylums of their patients but neglecting to provide funding for the promised community-based care to take up the slack. Many patients quickly became homeless, and many died a lonely death.

Nevada experienced its own version of budget devastation in the early ’90s when Gov. Robert Miller solved a budget crisis by decimating mental health services, leading Dr. Brian Lahren to angrily resign his position as the state administrator in protest.

Since then, legislators have slowly repaired the damage, building new mental health hospitals in Reno and Las Vegas, adding community outreach programs, outpatient clinics, and a medication formulary inclusive of newer drugs with significantly better results.

Yet during the most recent budget crises, mental health services again sustained a significant reduction, although this time in better proportion to other areas of the state budget that were also destroyed. But more than $80 million was cut from the budget over the last five years, and much more threatened to be cut in budgets prepared by Govs. Jim Gibbons and Brian Sandoval.

Suspending reality for a minute—because generating new revenue to fund mental health and other essential services has eluded lawmakers for 60 years—here are a few ideas that could help turn the tide in Nevada:

• Restore outpatient clinics in rural Nevada and urban neighborhoods. Make it easy to access care in local communities by removing transportation and other barriers. Welcome family members concerned about a loved one’s bizarre behaviors or suicidal ideation and provide crisis intervention services and access to medications.

• Support and enhance proven innovative programs such as Triage Centers, Mental Health Courts, PACT Teams and Mobile Crisis Outreach Teams. Provide re-entry programs in jails and prisons for seamless transitions to the community, including basic housing and support services to keep “frequent flyers” from escalating.

• Increase funding for school counselors and give them tools for early intervention to treat children and youth when signs and symptoms of mental illness, alienation and psychosis become apparent. Engage family members as they cope with the frustration of trying to get help for a child who is spiraling out of control.

• Fund addiction programs and co-occurring disorder services to address the meth, heroin and prescription drug epidemics that continue to rage in our communities, barely hidden from view. Current levels of funding are ridiculously inadequate.

Sadly, unless Nevada politicians summon the courage to stand up to corporate lobbyists and provide the revenue our state needs, this prescription for enhancing mental health services in Nevada has zero possibility of being filled.

But next time you shop at your favorite big-box retailer you should thank them for contributing to improvements in the mental health budgets in California, Idaho, Utah, and Arizona—and the other 43 states that have a corporate profits tax—while Nevada’s mentally ill and their families make do with the crumbs of a failing system.