Nevada ranks 51st in youth and overall mental health metrics in 2025 — again — and ranked 49th in adult mental health metrics, according to an annual report assessing mental health access and care in the U.S.
The state has owned dismal rankings in the annual report published by Mental Health America for several years.
Specific areas the report singled out as securing Nevada’s bottom-dwelling rankings included the portion of youth with one or more major depressive episodes, the portion of adults with substance abuse disorder, and the prevalence of youth receiving no preventative care.
Using data in the Mental Health America report, Brookings Mountain West at UNLV breaks out some of the findings with a more regional emphasis in its report on the “State of Mental Health in the Mountain West.”
The Brookings analysis included metrics for major depressive episodes, mental illness, substance use disorders, suicidal idiation, and unmet treatment for both adult and youth population.
About 23% of Nevada youth experienced at least one major depressive episode last year, compared to less than 19% nationwide.
Nationwide, 51% of youth with one major depressive episode didn’t receive mental health services compared to nearly 60% in Nevada.
The state’s rate of adults with mental health disorder was 23%, about the same as the rate nationally.
About 32% of adults reported not receiving treatment. The national average was 25%.
There is one mental health professional for every 400 Nevada residents, “the second-lowest mental health workforce availability among Mountain West states,” the Brookings analysis noted.
Arizona ranked 50th in overall mental health ratings – 39th in adult mental health and 49th children’s mental health – and has 550 care providers for every one person.
‘Support is getting harder to come by’
Access to treatment could be even more difficult in the future due to federal changes to health insurance.
Although Nevada state lawmakers have taken some steps to improve mental health care in the state, children advocacy groups warn recent and pending changes to insurance could further exacerbate the gaps in receiving treatment.
“Just as we’re getting a better understanding of the challenges young people face and the ways to help and support them, that support is getting harder and harder to come by,” said Elisa Cafferata, the executive director for Children’s Advocacy Alliance.
President Donald Trump signed a multitrillion-dollar domestic spending and tax cut package that imposes steep cuts to the social safety net including Medicaid.
Insurance rates have already gotten more expensive due to the expiration of the enhanced Affordable Care Act premium tax credits. Changes to Medicaid, which includes new work requirements, are still expected to go into effect by 2027.
Under the new federal law, the standards for obtaining Medicaid will become “more stringent” even as people’s financial situations haven’t improved, Cafferata said. That will reduce the number of people accessing mental health treatment.
By implementing new requirements, families “are going to have to spend a lot more time going through paperwork and basically resigning up for Medicaid twice a year,” she said.
Prior to this year, it was already hard for some treatments to get approved by insurance, said Amy Novak, the founder of Playbloom Therapy, which provides therapy and family support.
Applied behavioral analysis (ABA), a widely-used but expensive therapy that experts say improves outcomes for children with autism, has generally been paid for by insurance.
In previous years Novak said she saw “maybe 50 to 60% success in having that coverage approved for the child.”
But an unknown number of children with autism in the state have been denied ABA benefits, or were required to pay more for the services they need, such as one-on-one help from an aide — a registered behavior technician — during school hours since the beginning of the year according to the Governor’s Council on Developmental Disabilities.
Less than 30% of coverage for ABA benefits has been approved by insurance since the policy change at the beginning of the year, Novak said.
A representative with UnitedHealth Care previously told Nevada Current in January that the company would investigate the concerns of providers and the Governor’s Council.
If UnitedHealth Care “still continues to profit even though they said they were losing so much money on children with behavioral and mental health challenges” then they need to be held accountable, Novak said.
Though all insurances have denied coverage claims for ABA benefits, the “writings on the wall that it’s coming,” Novak said.
“If that’s coming for private insurance, is that going to impact Medicaid as well?” she added.
Nevada most recently took steps to address one problem with the gap in access in mental health services for children.
Senate Bill 165, passed during the 2025 Legislative Session, creates a profession of licensed behavioral health and wellness practitioners by the Board of Psychological Examiners for the supervised clinical use of prevention and early intervention strategies relating to children’s mental health.
By increasing its mental health workforce for children, the state could do more to help preventative care and catch youth in need before the point of a crisis, Cafferata said.
“Those degrees are being created, and we haven’t even gotten them established yet,” Cafferata said. “It’s going to take a little bit of time in the pipeline before we actually are turning out folks with those credentials and degrees.”