Members of the Washoe Board of County Commissioners and Reno City Council last week, during their regularly scheduled meetings, heard updates on mental health services that are available or will soon be coming to the Truckee Meadows. These include an integrated crisis response system (CRS), the revamping of West Hills Hospital and a 24/7 crisis center.
The services build upon existing behavioral health programs and efforts already in place at the county, local law enforcement agencies and at the state.
“When they get that 911 operator, the 911 operator is going to say something along the lines of, ‘Is this police, health or fire?’”
Washoe County Behavioral Health Administrator Julia Ratti presented to both governing bodies on the county’s crisis response system, something she said the region has been working on for “quite some time.” The Board of County Commissioners in October 2023 identified behavioral health as one of their top priorities and tasked Ratti with working on efforts with regional significance.
“The crisis response system in our current world is if somebody is having a behavioral health crisis, they’re gonna call 911,” Ratti said. “When they get that 911 operator, the 911 operator is going to say something along the lines of, ‘Is this police, health or fire?’ And we’re going to roll the appropriate response, which will generally not be a behavioral health response.”
Ratti said if things go badly, that person is going to end up in an emergency room or jail. “This is not a good behavioral health response,” she said. “And so the behavioral health crisis response system is work that’ been going across the nation to build an alternative behavioral health response for somebody experiencing a behavioral health crisis.”
The coalition to bring CRS to the region began in 2021 with the forming of two groups. One is the Partner Agency Team and is made up of providers who are now or will be providing behavioral health crisis services. The second is called the Children’s Crisis Collaboration which deals with children experiencing behavioral health crises as well as their families.
Ratti said that when it comes to CRS, the first aspect is having someone to call when a person is in crisis. In July 2022, the 988 phone number went live nationally.
“In our community, Crisis Support Services of Nevada, a small but mighty nonprofit, has been running the lifeline for decades,” Ratti said. “And they now take the 988 calls and they can call, text, and chat with somebody who’s in a behavioral health crisis.”
That’s the first step of diverting individuals out of the EMS system, Ratti said, and she said she hopes that the community will continue to be educated on the 988 system so individuals can receive the correct services they need, and to not overburden 911.
Ratti said a 988 fee on phone lines started in June 2023 and brings in about $15 million annually to support statewide health crisis response. She said those funds will be used to improve the system’s technology with data collection, dispatch and a bed registry for in-patient care.
Ratti, when speaking with county commissioners, said existing data can track call volume, but doesn’t provide any details on call types, responses or outcomes.
Mobile response teams
The most challenging piece of providing resources toward mental health, Ratti said, are mobile crisis response teams, adding, “And it will likely also be the most impactful.”
A mobile crisis response team would be used the way an ambulance would be dispatched to a car accident, a fire engine to a fire, or a police officer to a crime. None of those, however, are the correct fit for someone experiencing a mental health crisis that does not include violent behaviors.
What it boils down to, Ratti said, is healthcare and the Medicaid system, which is the health payer system for low income individuals. There has now been a Medicaid state plan amendment passed which now creates a rate for designated mobile crisis teams, allowing the region to expand its offerings.
“So this is the first step in getting towards a viable, sustainable business model where we can realize mobile crisis at some point in our community,” Ratti said.
For Washoe County, they’ll be seeing their mobile crisis team much sooner than other counties. For over a decade, the state has run a mobile crisis response team program, but their resources were limited and they experienced challenges with vacancy rates, which recently hit around 49% vacancy.
As part of a county-state collaboration, the state agreed to provide their budget to the county to fund and run the children’s Mobile Crisis Response Team, which was officially transferred from the State Division of Child and Family Services to Washoe County Human Services in July 2024.
“Just in the first several months, we’ve already doubled the amount of calls that we were able to run on,” Ratti said.
There are other nonprofits in the area who also have response teams and crisis centers up and running, but more still needs to be done to be able to help those experiencing mental health crises.
Crisis Care Center
Another update to the mental health system in the region is the new Renown Crisis Care Center, which is set to open early 2025 and will feature a warm, living-room like environment for short-term crisis care for adults. It will be open 24/7 and staffed by multiple medical professionals, according to Steve Shell, vice president of behavioral health at Renown Health.
There will be 25 chairs and 10 short-term beds for people experiencing a behavioral health crisis, Shell said. The center is housed at the Northern Nevada Adult Mental Health Services campus at 480 Galletti Way, in a portion of the campus that has been left vacant for the past decade.
After going to the center, patients will be assessed and either transferred to an inpatient psychiatric or detox facility, if needed, offered outpatient referrals or appointments, and will receive access to community resources like case management, the Cares Campus or other temporary housing options, if needed.
A major reason for creating the center is to provide somewhere other than emergency rooms and law enforcement agencies for individuals experiencing mental health crises to go.
“ERs are not the right place for people in crisis, and neither is jail,” Shell said. He said the center will allow for an efficient drop-off process modeled after a similar program in Phoenix, Arizona, in which law enforcement officers can return to their duties within minutes after dropping off a person in crisis.
More importantly, the center will be staffed by medical personnel, social workers and individuals who have lived experience with mental health or substance use crises.
Washoe Behavioral Health Center
Since the closure of West Hills Hospital, there has been a major gap in services for individuals needing in-patient behavioral health treatment. Now, the former West Hills has been converted into Washoe Behavioral Health Center, which is meant to become a “critical asset in addressing the region’s behavioral health needs.”
Washoe County allocated $4.5 million in ARPA funds to purchase the vacant facility, and then secured an additional $14.5 million in state funding for its renovation.
The center should be opening around July 2026, with half of the building dedicated to youth services and the other for adult services. The center is slated to include a psychiatric residential treatment facility for youth, a crisis stabilization center and a respite center for foster families. Plans also include a specialized facility for youth victims of sex trafficking and a live-in treatment program for adults.
“This will be a significant asset for our community once it is built,” Ratti said.
Mayor Hillary Schieve said this has been in the making for a decade, and said she is grateful for the progress in establishing a 24-hour crisis response system.
“Soon, we will have a system that is fully operational,” she said.
