Proposed cuts to Nevada's rural mental health clinics have prompted concerns.
According to state budget documents, 11 out of 12 psychologist positions would be cut from the state budget to save about $1.25 million.
Of the 21 clinics in the state, 11 would be closed, including the one in Silver Springs.
In September, the Dayton and Fernley clinics closed, and services were consolidated in Silver Springs, then thought to be a more central location.
Other clinics proposed for closure in the state Department of Health and Human Services budget include Stateline, Hawthorne and Tonopah.
Nevada Division of Mental Health and Developmental Services, Rural Clinics will close the Silver Springs clinic if the current budget proposals are approved by the Legislature, according to Susan Haut, regional director of Rural Clinics. If so, the clinic will close in July 2009.
She said that a new "hub and spoke" business model will allow the clinic to close with minimal impact to the patients.
The hubs will be Fallon, Sparks and Carson City, with patients given a choice as to which clinic they would utilize. Haut said transportation will be provided to those who don't have access to a vehicle or public transit service.
"They have the choice of going to any of our centers," she said. "The people that live on the Carson side of Silver Springs would choose to go to Carson and the people on the Fallon side would choose to go to Fallon."
Tahoe's clients would travel to Douglas Mental Health in Gardnerville.
Douglas County Manager T. Michael Brown is seeking authorization from county commissioners on Thursday to send a letter to the state expressing concerns about cutbacks.
In his report to the county, Brown said the waiting time for a new patient to see a therapist is several months. There have been up to 100 people on the list during the last year.
State cutbacks last year reduced access to qualified mental health professionals in Douglas County. On-call and after-hours emergency services were discontinued in September 2007.
"Due to the state's current budget shortfall, it is anticipated that even more severe cuts are imminent," Brown said. "Douglas County shares the unfortunate distinction of having the highest completed suicide rate in Nevada."
Brown said additional cuts will affect the ability of county agencies to do their jobs.
"Cuts from the prior fiscal year coupled with additional cuts will have huge impacts on many county and community services including social services, sheriff's office and the jail, juvenile detention, probation, the East Fork Fire & Paramedic Districts, the school district, Carson Valley Medical Center, public and private counselors and the faith community."
Nevada Psychological Association President Laura Drucker said the number of psychologists being cut seems out of proportion with the rest of the cuts.
"We're very concerned by the disproportionate cut of psychologists," she said. "They seem to be underutilized at some of the rural clinics. We feel it would be better to look at that issue and as they are reorganizing see how we can best use all the different mental health professionals. I don't think we're looking at that same level of cuts in other departments."
Drucker said her organization recognizes the difficult position the state is in due to budget cuts.
"I understand that the budget cuts are affecting everybody," she said. "We're very concerned about both the immediate and longterm impact of these cuts. We need to be able to provide quality mental health to the rural counties."
Drucker, a clinical psychologist, said those effects will be felt more severely in the more isolated communities.
"One of the concerns is that they are eliminating rural clinics far from urban areas," she said. "Those people will have no access to services. We have a chronically mentally ill population that doesn't have a lot of resources. We're talking about doing case management or group treatment with medication, but not a whole lot of support.
That group of people is going to be underserved more than they already are."
Looking past the budget crisis, Drucker said it is important to create a better way to provide psychological help in the rural counties.
"The immediate budget crisis is going to be painful for everybody," she said. "The long term issue is how Nevada is going to be able to provide longterm services, and build toward a better delivery system."
" Nevada Appeal staff writer Karen Woodmansee contributed to this report.