Depression rate high in Nevada

Nevadans are more depressed than residents of the vast majority of other states, according to a study by a nonprofit that says budget cuts to mental health services would probably worsen the situation.

The study, released Wednesday by Mental Health America, ranks Nevada 47th based on rates of depression among residents surveyed between 2002 and 2006, as well as the number of suicides during that time.

Nevada's poor ranking can be attributed to a shortage of mental health services, said David Shern, president and chief executive officer of Mental Health America. The nonprofit seeks to help people live mentally healthier lives.

The reasons also include the low number of psychiatrists and psychologists in the state.

Because Nevada is in such bad shape, Shern said, someone should probably "advocate for more funding" by calculating the additional deaths expected as a result of the anticipated lack of services.

Shern said Maryland, which ranks fifth in the study, spends nearly three times more than Nevada does on public mental health care.

Maryland spends $131 per person per year, while Nevada spends $54, he said.

Shern said Maryland also has four times more psychiatrists, 10 times more psychologists and nine times more social workers than Nevada does.

The study, "Ranking America's Health," suggests that states can significantly improve the mental health of their residents by adopting policies that expand access to treatment. The nonprofit found that suicide rates are lower in states with more psychiatrists, psychologists and social workers per capita.

"The survey validates what we already know," said Assemblywoman Sheila Leslie, D-Reno. "While we have made a lot of progress -- every year we've added millions more to our mental health budget -- we still haven't been able to keep up with growth. And now we're about to give up $51 million, that's beyond depressing."

Recently, Gov. Jim Gibbons, a Republican, asked each of the state's departments to trim 8 percent from their budgets to offset shortages in state tax revenue. For the state's Division of Mental Health and Developmental Services, that could be as much as $51 million, a figure that includes losses in federal matching dollars.

Mental health officials say anything from staffing to acute psychiatric beds are at risk.

Leslie fears mental health will suffer as it did in 1991 when the state faced a similar budget crisis. In balancing that budget Gov. Bob Miller, a Democrat, cut from mental health services, she said.

Leslie said there also were layoffs within the division.

Since that time, legislators have tried to restore services, adding millions to the mental health budget each year while contending with growth.

"As the governor exempts things from cuts, it puts a burden on what's left," Leslie said. "That's what happened in 1991. As a result of those cuts, we saw increases in the mentally ill occupying our jails and emergency rooms. We don't want that happening again."

Leslie said the problem with Nevada's mental health budget, and the reason it is an easy target for cutting, is mostly that it is supported through the general fund and does not receive much federal funding.

Another factor is the people most affected by the cuts. "They don't complain," Leslie said, "because they are mentally ill."

During a Legislative Committee on Health Care meeting Tuesday, Dr. Lesley Dickson, clinical professor of psychiatry at the University of Nevada School of Medicine, said there are 195 active psychiatric licenses in Nevada. That equates to roughly 7.6 psychiatrists per 100,000 population.

But about one-third of psychiatrists with Nevada licenses live outside the state, and the average age of Nevada's psychiatrists is 55, meaning they're nearing retirement.

Dickson said Nevada has a difficult time recruiting psychiatrists because most must work salaried positions due to poor reimbursement in the private sector and from HMOs. This doesn't appeal to recent graduates, she said.

Dickson also said Nevada has lost several younger psychiatrists to better-paying jobs in California. She said California pays psychiatrists about $100,000 more per year than Nevada does.

"Access is key, and you have to have a work force," Shern said. "I think all of those factors contribute to high rates of depression and suicide in Nevada."

Linda Flatt, suicide prevention trainer for the state's Office of Suicide Prevention, said the fact Nevada's depression rate is high aligns directly with its suicide rate, which trails only Alaska's. Suicide is the sixth-leading cause of death among residents in Nevada.

The study was supported through an unrestricted educational grant from Wyeth Pharmaceuticals.

South Dakota leads the nation with the best depression status while Utah ranked last.

The rankings are based on the percentage of a state's adult population experiencing at least one major depressive episode in one year; the percentage of adolescent population experiencing at least one major depressive episode in one year; the percentage of adults experiencing serious psychological distress; and the average number of days in which the population reported that their mental health was not good.

Shern said the report has two goals: developing a public surveillance system to monitor the mental health of Americans and the impact of depression, and stimulating action by communities and federal and state policymakers to address depression.

Contact reporter Annette Wells at awells@reviewjournal.com or (702) 383-0283.