On top of the horror that Las Vegas has already experienced this week, Nevada is facing another potential crisis: the state “may be uniquely ill-prepared to deal with the emotional aftermath of the deadliest shooting in modern history,” Michael Easter writes for Science of Us.
Nevada’s mental health care system was already stretched thin prior to Sunday’s shooting, where 58 people were killed and more than 500 were injured. “There’s a crisis-level shortage” of psychiatrists in Las Vegas, Dr. Gregory P. Brown told Easter. “Nevada has just 190 licensed psychiatrists and just 390 psychologists,” Rebecca Robbins writes for STAT. That translates to about 6 psychiatrists per 100,000 residents and 13 psychologists per 100,000 residents. Easter points out that most similarly-sized urban areas have double those figures, and the Dartmouth Atlas of Health Care shows that in 2011, San Francisco, California, and the Bronx, New York, had 29 and 21.2 psychiatrists per 100,000 residents, respectively.
After a traumatic event like a mass shooting, it’s normal for people who were there to be psychologically affected by what they experienced, especially those who were already dealing with mental health conditions. Post-traumatic stress disorder (PTSD) is a particularly big concern.
The best way to treat PTSD, Easter writes, citing the National Institutes of Mental Health, is to work with a mental health professional—which Nevada, as already mentioned, doesn’t have many of. And as Robbins points out, many of the counselors in Las Vegas specialize in treating gambling, drug or alcohol addiction, not trauma.
In recent days, volunteer mental health professionals have been traveling to Las Vegas to help survivors and their families, Robbins writes. This is encouraging news, and the number of mental health care professionals there now exceeds the demand for them. But Robbins poses an important question: “What happens when the volunteers go home?”
In order to to handle the continuing mental health crisis after the volunteers leave, “it’s certainly going to take us above and beyond what we were already capable of managing before, which was: We were barely making it,” Michelle Paul, a clinical psychologist and director of a mental health care clinic at the University of Nevada, Las Vegas told Robbins.
Franci Crepeau-Hobson, an associate professor at the University of Colorado, Denver, who has studied how mass shootings impact people psychologically, told Easter that it’s common for some survivors of mass-shootings to experience bad dreams and flashbacks, and to become easily startled or depressed. “Research suggests the psychological weight survivors carry will be heavy,” Easter writes. He points to a study in the American Journal of Psychiatry that found following a mass shooting that left 23 people dead in Killeen, Texas, 20 percent of male and 35 percent of female survivors experienced mental health issues. And of course, survivors probably don’t live in a bubble: they likely have friends and family who are also affected by the mental health challenges they’re going through.
Even before the shooting happened, Nevada was already faring poorly in terms of providing access to mental health treatment. Mental Health America, the largest national mental-health nonprofit, put Nevada last on their list of mental-health rankings by state in 2014, Easter writes. That ranking is calculated using 15 measures including mental health workforce availability, adults with dependence or abuse of illicit drugs or alcohol, adults with disability who couldn’t see a doctor due to costs, how many citizens have considered suicide and how many have struggled with depression.
Nevada also ranks “36th for prevalence of mental illness,” based on the same findings from Mental Health America, but ranks 50th in access to care. Meaning Nevada “offers the least access to mental-health care compared to every other U.S. state,” Easter writes.
Then of course there’s the policy side of things: “the Nevada legislature cut $60 million in funding from mental-health programs,” in 2014 Easter writes, during a time when mentally ill patients were being shipped out of Las Vegas via bus in order to be closer to their families.
While there are obviously large changes needed to fix Nevada’s mental health care system in the long run, in the immediate aftermath of the shooting, Las Vegas needs safe spaces to help those affected heal, Crepeau-Hobson told Easter. She said that these spaces should exist outside of traditional mental health centers: “Faith-based institutions and schools are good locations to set up trauma centers because people feel safer and more normal going there.”
Part of healing from events like Sunday night’s shooting can come from communal catharsis. Even if you weren’t personally affected, these events ripple through our collective consciousness. One of the best ways to feel useful and lend support is to get involved: you can donate money to the Las Vegas Victims’ Fund here, or look up your local Red Cross blood donation center here.