Strengthening School-Based Behavioral Health in Nevada: Policy, Practice, and Funding Insights

Nationally, child and adolescent behavioral health needs have increased over the past decade; and Nevada’s youth behavioral health crisis has been longstanding. Nevada ranks 51st in the nation for youth mental health and has consistently ranked in the bottom five states since at least 2014, according to Mental Health America.

Recognizing that schools are critical venues for providing behavioral health services, the Nevada Department of Education commissioned this report to evaluate the state’s current school-based behavioral health system and to identify strategies to strengthen implementation. The Guinn Center conducted this comprehensive study involving literature reviews, focus groups, and key informant interviews with education and health stakeholders to assess the state’s existing infrastructure and provide actionable recommendations.

Key Data Points

• ‍‍23.51 percent of Nevada youth reported suffering from at least one major depressive disorder episode in the past year.
• 14.09 percent of Nevada youth reported having a substance use disorder in the past year.
• 34,000 Nevada youth have reported experiencing thoughts of suicide.
• 73 percent of youth in Nevada who need treatment for depression did not access care.

Nevada also ranks near the bottom nationally for youth with substance use disorders and suicide ideation.

Access to school- and community-based behavioral health services nationwide—and in Nevada—is uneven, with several factors impacting care. A national survey found that while more than half of white families had access to school-based mental health services, fewer than 30 percent of Black families did. Similarly, 60 percent of high-income families reported access to school-based behavioral health services, compared to 37 percent of low-income families—though low-income families used these services at five times the rateof high-income families. Lack of health insurance also presents a barrier to access. According to the Georgetown University Center for Children and Families’ Children’s Health Care Report Card, 8.5 percent of children without insurance are school-aged (6-18 years old).

One of the most salient factors, however, is a shortage of mental health professionals in Nevada. 91 percent of the state’s population lives in a designated provider shortage area, according to the Nevada Rural and Frontier Health Data Book. Imbalanced ratios of behavioral health professionals to students in Nevada schools further reflect these shortages.

These challenges are compounded by the expiration of temporary federal funding sources, potentially putting existing school-based programs at risk.

Findings‍

Despite a solid policy foundation—including legislation, investment in MTSS (Multi-Tiered System of Supports), and Medicaid reimbursement opportunities—school-based behavioral health implementation across school districts remains inconsistent. Barriers like limited workforce capacity and inequitable access to services persist, making service delivery a challenge for some schools and districts, but schools with well-integrated MTSS and restorative justice frameworks reported improved attendance, reduced behavioral incidents, and better school climate.

• While efforts are underway to address the gaps in access to community-behavioral healthcare for youth and families through Nevada Medicaid’s Children’s Behavioral Health Transformation, there is an urgent need to address children’s behavioral health needs across the population.
• Nevada’s schools could play a critical role in increased access to behavioral health prevention, promotion, and intervention. Decades of evidence indicate that schools can provide a range of evidence-based behavioral health supports and services with demonstrated success.Outcomes include reducing risk factors contributing to youth behavioral health issues and increasing protective factors leading to greater overall mental well-being and healthy development.
• The current Pupil-Centered Funding Plan and At-Risk Funding formula fall short of funding nationally recommended ratios for the professional school and district personnel needed to address behavioral health programming and services.

Recommendations‍

The report outlines four primary recommendation areas:

1. Secure sustainable funding for school-based behavioral health services to implement and use the MTSS framework;
2. Designate publicly funded schools as formal access points for a full continuum of behavioral health services;
3. Support districts and charter schools in building and maintaining comprehensive school mental health systems (CSMHS);and
4. Expand Nevada's behavioral health workforce pipeline to address persistent shortages.

These strategies are aimed at ensuring all students have access to timely, effective, and coordinated behavioral health support.

For a deeper dive into our findings, analysis, and recommendations, read and download the full report below.

Have questions about this study? Email us: info@guinncenter.org.