When Char Frost’s adolescent son began to show signs of post-traumatic stress disorder and depression around 2005, she contacted mental health providers in Las Vegas to get him the care he needed.
Almost every provider gave her the same response: We don’t serve children.
“The one who did had a waitlist that was three or four months long,” Frost said.
Inspired by her own experience seeking treatment for her now-adult son, Frost has become an advocate for youth mental health in Southern Nevada. Her goal is to destigmatize mental health conditions, shine a light on the importance of youth mental health services and expose local gaps in services. The gaps are significant.
Youth in Nevada have the least access to mental health care relative to their mental health needs in the nation, according to a state-by-state ranking from the nonprofit Mental Health America. In Nevada as a whole and Clark County, in which nearly three-quarters of the state’s population resides, youth suicide rates are on the rise, Frost said.
The rise in mental health conditions among youth here is in line with national trends. Social media use and a greater awareness of mental health issues are among the reasons why reported anxiety and depression are increasing among young people, some research suggests.
But what is perhaps unique to Nevada is the exceptional dearth of mental health care, starting with the limited providers, said Robert Weires, director of the psychological services department at the Clark County School District.
“There are challenges for the state of Nevada, real challenges here in terms of service providers and so on,” Weires said. “There’s room to grow.”
Other than the UNLV School of Social Work and a new child and adolescent psychiatry fellowship at the UNLV School of Medicine, there are few programs in Southern Nevada to train new mental health professionals, much less youth specialists, Frost said. As a result, the region has struggled to fill the provider gap ever since the recession, she believes.
“Our population has been increasing and we just have not been very good about growing our own professionals,” Frost said.
In August, the Las Vegas Valley was hit with a major blow to existing youth mental health services: Montevista Hospital, the area’s largest inpatient mental health provider for youth and adolescents, was shut down, Frost said. The facility was one of the few local providers for youth with serious mental health problems in need of full-time care. Without it, more youth will be forced to go out of state for those services, which further disrupts their lives, Frost said.
“It’s hard to take a kid who’s been in a very structured situation and transition them back home if the kid has been out of state and the parents have had limited access to the child,” Frost said.
Despite this and other challenges, some improvements have been made in recent years to youth mental health care in Southern Nevada. Southern Hills’ new inpatient behavioral health facility, which can accommodate up to 20 young people a time, is one example.
Since the Southern Hills behavioral health pavilion opened in March, staff have picked up on a growing need for local youth services based on referrals. Originally designed to serve teenagers ages 13-17, the youth unit now accommodates children as young as 11. Southern Hills might lower the age limit even further, said Dr. David Gennis, clinical director of the pavilion.
Most of the young people who use the pavilion’s services have shown suicidal ideations or behavioral challenges. The average length of stay is 3-5 days, during which time youth receive individualized, group and/or family therapy, Gennis said.
“We’re working on determining what led them to feeling so overwhelmed where they felt that suicide was the route they wanted to take at that time,” he said of the intensive program.
In addition to identifying factors that trigger destructive behavior, staff at the youth pavilion help young people develop coping skills and regulate their emotions, Gennis said. When they are ready to be discharged, staff work on a transition plan as well. That almost always involves connecting families to geographically accessible outpatient therapy services, which can be difficult, Gennis said.
“I don’t believe we have enough licensed service providers throughout all of Clark County to meet the therapeutic needs of everyone,” he said.
The behavioral health pavilion will soon be complemented by an intensive outpatient program for adolescents to better facilitate that transition away from inpatient care, Gennis added. Expected to open Dec. 2, the facility will give some patients the opportunity to continue working with their Southern Hills therapists two to three days per week post-discharge.
“A lot of this is consistency. That goes a long way in treatment,” said Jasmine Smith, director of physician and provider relations at the behavioral health pavilion.
Meanwhile, schools in the area have taken up some of the slack when it comes to transitioning students out of intensive care, with the psychological services department having created a mental health transition team for that population, Weires said. But CCSD’s resources are also insufficient.
The district faces a shortage of school psychologists, whose duties include evaluating students in crisis, intervening when students show suicidal tendencies and helping students post-inpatient care. The shortage means that school psychologists sometimes work across three schools — even though they aren’t supposed to oversee services at more than two schools at a time — and that they have little spare time to devote to anything other than crisis situations, Weires said.
“We can’t go as deep, far and wide with any particular skillsets or services for kids if we’re spread out too thin,” he said.
The school district recently opted to spend $350,000 per year to contract with the company Columbus Educational Services, which will provide CCSD with 3.5 full-time equivalent school psychologists. Although Weires would prefer to hire more permanent staff instead, local and national school psychologist shortages have made that all but impossible, he said.
“(This) helps us spread our services a little wider, a little deeper,” Weires said.
In response to a state mandate from the 2019 legislative session, the district is also working to create a suicide prevention plan. All public and private schools in Nevada are required to do so under Senate Bill 204, which Gov. Steve Sisolak signed into law in June.
CCSD’s suicide prevention plan is still at an early stage, Weires said, but it will involve strengthening relationships among specialists in the district, such as psychologists, counselors and nurses.
More collaboration and communication between the school district and community service providers, such as the United Citizens Foundation, could be a part of the plan as well. United Citizens Foundation delivers therapy to students in area schools, said Frost, who manages government affairs at the nonprofit.
By offering those services during the school day, United Citizens Foundation addresses another barrier to care in the valley: For children of working parents, even when care is available, it might not always be accessible financially or time-wise, Frost said.
“(Families) only have so many hours after school that therapists might not work. And that’s cutting into homework time and dinnertime and everything else,” she said.
Parents nonetheless should try to be proactive about teaching their children healthy mental habits and coping skills, Frost said. The sooner parents are able to identify and deal with potential mental health concerns in their children, the better.
“I think there’s an opportunity for us to do a better job with our very young children, to start teaching them how to manage negative or uncomfortable feelings and then how do they express behaviors (and) communicate appropriately,” Gennis said.
While Southern Nevada’s youth mental health challenges won’t be fixed overnight, experts agree that at least one thing has improved: From lawmakers to educators to parents, people seem to be taking youth mental health problems more seriously than ever before.
Reducing that stigma even more and reminding parents that mental health problems are no one’s fault remains key to addressing the issue, Gennis said. As his staff say to the families of children at Southern Hills’ behavioral health pavilion: No blame, no shame.