Immediate housing needs don’t trump mental health treatment for homeless people

While I applaud Dave Marlon’s recent article in The Nevada Independent for bringing attention to the need for increased funding for programs to assist those members our community that are in a mental health crisis and/or suffer from a substance use problem, I think it is crucial to not lose sight of the immediate need of housing for this vulnerable population.  

Nevada has a widespread and deepening affordable housing crisis that affects our state in many ways — but by far the largest gap between the number of available, affordable rental units and the documented need for units is for those with Extremely Low Income (ELI) at 20 units for every 100 needed. 

Dave makes the excellent point that mental health conditions and substance use disorders are two underlying factors that contribute to homelessness and that they need access to treatment. However, it is important to recognize that recovery takes both quality treatment and a stable living environment. An individual is less likely to recover, and sustain recovery, if the living environment is unstable.  

While efforts to improve programs for the unhoused has been increasing, attempting to attain and sustain stability when you are concerned for your safety, the safety of your property (including medications), and have no clear path to permanent housing is a challenge that many just cannot meet. The National Alliance on Mental Illness-Nevada (NAMI) is advocating for adequate funding from the American Rescue Act (ARP) of 2021 to make life-changing investments for Nevadans who strive every day for recovery. 

NAMI-Nevada supports a solution that is a three-legged stool approach of buildings, vouchers and services:

  1. Provide ARP funds as capital (via a grant) to nonprofit developers of Permanent Supportive Housing (PSH) and Housing for Extremely Low-Income Nevadans. Given the extremely limited income of the mentally ill, disabled, senior, and working poor for whom they provide a home, these projects have the best opportunity to succeed and minimize other subsidies when they are built without debt. These could be ground up projects or acquisition/rehabilitation of existing buildings. 
  1. Provide a commitment to Project-Based Rental Assistance Vouchers. This can be done by allocating ARPA dollars for operating expenses while simultaneously working with the regional public housing authorities to assign project-based vouchers to these projects over the ARPA timeframe (through 12/31/26).
  1. Provide for supportive services. Residents of PSH and ELI housing need basic skills training, Psychosocial Rehabilitation Services, substance use and mental health treatment, and recovery services in order to help people sustain in housing and stay off the street or out of hospitals and jails. While Nevada is ramping up its ability for Medicaid to pay for these services (via 1915(i) and 1115(i) waivers), it will be necessary to commit APRA dollars to fill the gaps.

If interested, check out further details of the ARP proposal and the many other activities of NAMI-Nevada here

Tom Durante is a native Nevadan and social worker. He earned his master’s degree in social work at UNR and received his clinical social work license in 1993. He sits on the board of NAMI-Nevada and has worked in numerous positions for the state including inpatient and outpatient positions at Northern Nevada Adult Mental Health Services and as former director of Lake’s Crossing Center.