Cuts to mental health funds concern suicide specialists

At a time when more Nevadans are despairing, those who help the mentally ill worry proposed cuts to mental health spending could add to the state's notoriously high suicide rate.

Less funding means less access to mental health services for the unemployed and uninsured who, hit hard by the recession, might become despondent or even suicidal.

"You're going to see services disappearing and money for prevention going away at the same time we need increased services," said Debbie Gant-Reed, hot line coordinator for the Crisis Call Center in Reno, which serves as Nevada's suicide hot line.

Suicide calls to the hot line have increased since the recession began as people who have never needed help are losing everything, she said. Last year, the hot line received 4,007 suicide-related calls, compared with 3,824 in 2009 and 2,669 in 2008.

Meanwhile, Gov. Brian Sandoval's plan to reduce mental health spending by about 9 percent would mean a cut to the number of Nevadans receiving state-funded outpatient mental health services. That number would drop from 4,075 to 2,765, said Harold Cook, administrator of the state's Division of Mental Health and Developmental Services.

"We will have to provide more group therapy instead of individual therapy," he said. "Some people probably will choose not to do that and may drop out of services and deteriorate."

The number of beds available for in-patient mental health services also would be cut. Recent studies have shown that Nevada already has fewer public psychiatric beds per capita than nearly all other states. Nevada's spending on mental health agency services is seventh lowest in the nation.

Nevada ranked fourth nationwide in suicides in 2006, the most recent year statistics were available from the state Office of Suicide Prevention. Suicide rates in Clark County have fluctuated but trended upward the past several years, according to the coroner's office. In 2006, 350 people committed suicide in the county. In 2007, that number was 349, then climbed to 384 in 2008. In 2009 the number dropped again to 367. In 2010, 404 people committed suicide in the county.

Researchers at Texas A&M University and Loyola University Chicago have found a strong link between suicide and unemployment. Local police have anecdotally linked some recent murder-suicides to the economy, including an August case in which a man shot and killed his wife and then himself after the couple, heavily involved in the real estate business, had been financially crippled by the recession.

Access to mental health services "has usually been difficult in our community but it's going to be more difficult" with the expected cuts, said Linda Flatt, a state suicide prevention trainer and network facilitator based in Las Vegas. "A protective factor for suicide is access to treatment."

Connecting service cuts to a potential spike in suicides is a "no-brainer," she said.

As services disappear, "we don't have anywhere to refer the suicidal," said Gant-Reed. "If they can't get their medications and services, they could deteriorate and become more suicidal."

Sue Gaines, president of the Southern Nevada chapter of the National Alliance on Mental Illness, said she, too, worries about that.

"As they cut funding, people have to wait longer for services," she said, adding that it's already difficult to get appointments in the state's mental health system. "People who are in crisis, if they're not getting their meds or the services they need ... they could absolutely carry out that suicide that they've been thinking about for a long time."

If you know someone who is in imminent danger of suicide, Gaines said, you should call 911 and ask them to send a crisis intervention team.

Local police teach officers how to handle calls involving suicidal people through crisis intervention training programs. They frequently conduct welfare checks after friends and family members call the suicide hot line or dispatch and voice concerns about a loved one's safety.

But police are limited to what they can do. Nevada Revised Statutes allow the police to conduct what is called a Legal 2000 during such calls. It does not allow them to commit a person to a psychiatric facility. Rather, the procedure compels subjects to receive a mental health evaluation within 72 hours, and they are taken from the scene by ambulance to a hospital. Whether a person needs that kind of intervention is assessed by the officers who respond to the call.

People must be medically screened in local hospital emergency rooms before they can receive state mental health services, Cook said.

Contact reporter Lynnette Curtis at lcurtis@review journal.com or 702-383-0285.