What’s being done to address Nevada’s dire mental health care workforce shortages?
This story is the sixth and final installment of the KUNR series Mental Health in the Silver State.
Nevada ranks last in the country in overall mental health, according to a 2022 report released by UNLV that looks at the prevalence of mental health issues and access to care, among others.
The state has faced long-standing issues of provider shortages for years, said John Packham, associate dean for the University of Nevada Reno’s School of Medicine’s (UNR Med) Office of Statewide Initiatives.
“Close to 3 million Nevadans reside in a mental health professional shortage area. That translates to about 86% of the population,” Packham said. “All 14 of our rural and frontier counties are, so the problems are acute.”
While there have been improvements in public and private insurance coverage, the number one barrier is the lack of providers, Packham said.
“If you have an insurance card in your pocket and you don’t have a provider, that barrier [is] still pretty substantial,” he said.
Another workforce barrier is that these types of jobs are emotionally taxing on providers, said Dr. Takesha Cooper, the chair of psychiatry and behavioral sciences at UNR Med and the chief of behavioral health at Renown.
“We really do work to train health care providers, really talking about how we can support each other through our day-to-day when we have difficult times,” Cooper said. “And help people feel like, ‘Wow, this is tough work, but it’s meaningful work.’ ”
The health impacts can be severe if there is a lack of providers, Cooper said. Community members can suffer alone, have long wait times, or even end up in the hospital.
She would like to see more graduate medical education opportunities, residency programs, and fellowships. The UNR Med program graduates six psychiatry residents annually, and her goal is to increase that to 10. However, many have to leave the state due to the limited number of residency slots available.
“We have to really get young people interested early, helping students, particularly first-gen students, students that are underrepresented in medicine, really letting them see that this is something that is an option for them,” Cooper said.
Efforts are also being made to ensure that the current workforce accurately represents the Nevada community it’s serving. High Sierra Area Health Education Center (AHEC) offers a 9-hour cultural competency training. Health care providers in Nevada are required to take this type of program every two years to renew their licenses.
The training addresses intersections of race and ethnicity, sexual orientation and gender identity, and what it means not to have adequate access to health care. This is crucial for mental health care workers, said Ricardo Rubalcaba-Paredes, program coordinator for AHEC’s diversity department, Nevada Cultural Competency.
“If a mental health care worker understands, or is open to understanding, what it means to exist in the sort of intersection of queerness, and being brown, and also being a first-generation Mexican American, then that makes me more comfortable as a patient,” Rubalcaba-Paredes said.
AHEC can also be found in the classroom – teaching students about careers in the medical field. Sara Hunt, assistant dean for behavioral health sciences at the Kirk Kerkorian School of Medicine at UNLV, is working to support that.
A new state law that passed in spring will establish a behavioral workforce development center under the Nevada System of Higher Education. Initially, it will be based at UNLV and will provide outreach to students and adults looking to enter the field. The Behavioral Health Education, Retention, and Expansion Network of Nevada, coined BeHERE NV, could be up and running as soon as this spring.
Hunt said this is important because mental health is often skipped over.
“When we look at mental health careers compared to other health care disciplines, we just have not shown up in that K-12 space to get students to start thinking about the options of working in mental and behavioral health,” Hunt said. “Not like our colleagues in nursing. They do a really good job of that.”
That’s partially due to stigma, something Hunt sees improving as more people talk more openly about mental health.
“That can still be an issue with workforce development,” she said. “The awareness that mental health is health care, and that being able to talk about emotional, mental difficulties and struggles, it’s still not widely accepted or openly discussed, like we talk about physical care and primary care.”