Nationally, rates of mental health concerns, including depression and psychological stress, have been rising, but individuals receiving treatment remains disproportionately small. Studies show that more school counselors equate to less student misbehavior in classrooms. Therefore, unmet mental health needs of children and adolescents pose a challenge to the academic success of students in Nevada’s K-12 system.

With fewer than 1,000 school counselors serving Nevada’s nearly 500,000 students, we cannot meet students’ academic, career, and personal/societal development needs. National survey data shows students desire greater access to school counselors, but Nevada’s student-to-counselor ratio, 508-to-1, is less than half of what is recommended by industry experts.

There is a strong body of research pointing to the effectiveness of clinical mental health counseling in treating and school counseling in affecting positive academic outcomes for students and schools. This suggests that these professions could make a much-needed positive impact in Nevada. The shortage of clinical mental health counselors and school counselors in a state where demand for both is rising at a faster rate than the national average, however, creates a culminating crisis for the state.

The experts

Chris Wood, associate professor in the College of Education’s educational and clinical studies department

Ching-Chen Chen, assistant professor in the College of Education’s educational and clinical studies department

Jared Lau, assistant professor in the College of Education’s educational and clinical studies department

These experts authored a policy paper, "Mining for a Nevada ‘Counselor Lode’: Mental Health, Schools, and the need for Responsive Legislation," that appears in the College of Education’s 2017 volume of reports for Nevada lawmakers. To read the full paper, visit the College of Education's policy initiatives site.

A few facts

• In 2014, Nevada was ranked lowest (51st) in the nation for “access to care” regarding mental health, moving from the 2011 ranking of 49th.
• There is a significant shortage of mental health care professionals in the state, with only 1.7 licensed counselors per every 100,000 people in the state.
• Studies show 69 percent of adults 18 and older in Nevada having any mental illness did not receive any form of treatment at any point from 2009-2013.
• Nevada’s rates of mental illness are consistent with national averages, but substance abuse rates are higher in Nevada (12.6 percent) than comparable states.
• Children and adolescents’ mental health needs are even higher at 14 percent, but Nevada has considerably lower rates of access to services than in comparable states (29 percent in Nevada, versus Arizona [54 percent], Colorado [46 percent], and Florida [41 percent]).

Why this matters

What is the current outlook for mental health in Nevada?

Right now, experts agree that Nevada’s outlook regarding access to mental health care is grim. Coming in dead last in Mental Health America’s rating for “access to care,” Nevada’s poor ranking indicates a “continued neglect of the mental health needs of [its] constituents.” While Nevada’s mental illness rates are fairly consistent with national averages, access to care and average mental health expenditures per capita are startlingly lower—with only 1.7 counselors for every 100,000 residents, and a per-capita expenditure of $122 nationally versus Nevada’s $71, respectively.

On the school counseling side, things aren’t much better. Nevada's 508-to-1 student-to-school counselor ratio is half of what the American School Counselor Association recommends. Evidence suggests that in-school counseling has proven an effective tool in treating conduct disorders in youth and curbing disruptive behavior that hinders students’ learning and progression. And even with considerable evidence that earlier (K-8) access to counseling provides significant support for children, Nevada only mandates school counseling in grades 9-12 currently.

Comprehensive access to school counseling in K-12 education has shown to increase preventive efforts against obstacles to educational success including bullying/violence and substance abuse. Further, national survey data show that counseling is a critical and cost-effective intervention strategy in schools, and that students desire greater access to school counselors.

However, given the current shortage of professionals to serve the state, experts say that various counseling professions have been categorized as “bright outlook” occupations to further develop and support Nevada’s workforce. The Bureau of Labor Statistics projects that clinical mental health counseling has a demand and growth rate at 17 percent, and substance abuse and behavioral disorders counselors have an even higher demand at 22 percent, both in the state and across the nation. Demand for school counselors in Nevada (30 percent) is among the highest rating across all states, approximately 115 percent higher than the national average.

How does access to care help support Nevadans?

“There is a strong body of evidence that supports the effectiveness of counseling,” Wood said. A meta-analysis of 375 studies determined that individuals receiving therapy were better off than 75 percent of those who received no treatment. Not only does counseling help individuals, but access to mental health care also supports Nevada businesses and a stronger workforce.

Currently, one-third of all social security disability claims are for mental illness. Given that statistic, experts say that it is not surprising that counseling is associated with increased work productivity. Noted previously that counseling is a proven cost-effective intervention, employers indicate that the cost of treatment for depression, for example, is fully offset by savings from reduced sick days. In addition, research indicates that counseling/therapy is correlated to a decrease in additional physical medical care.

In schools, studies have found that comprehensive school counseling programs correlate directly to higher academic achievement, higher test scores and higher proficiency scores in language arts and math as compared to schools without such programs. In addition, school counseling is noted to have a positive impact on schoolwide academic outcomes, with student-school counselor contact being a positive predictor of college application.

Experts say that lowering student-to-counselor ratios corresponds to a 59 percent decrease in student discipline problems. In regards to effectiveness of clinic-based counseling programs over school-based programs, interestingly, researchers have found no significant difference in positive outcomes regarding treatment youth with depression.

What policies can Nevada consider to better meet the mental health care needs of its residents and students?

Experts say that Nevada, which has rates of mental illness consistent with national averages, but far fewer counseling/mental health professionals, should consider a few mitigation measures to better serve its residents and address the counselor shortage in the state. These include:

• Supporting federal legislation that provides increased mental health treatment.
• Removing impediments to licensure for clinical mental health counselors coming to Nevada from other states.
• Revising state mandates to incorporate counseling programs in K-8 schools.
• Developing innovative state legislation that provides support and stimulus for increased training and education for clinical mental health counselors, school counselors, and human services professionals.

“It has been suggested that a government might be judged by how it takes care of its most vulnerable members,” Wood said. “However, out of [the state’s] conundrum, there is an opportunity for improvement … Nevada could come to be less known for the Comstock Lode but rather the investment in trained professionals it created as infrastructure for care of its citizens.”