Nevada is among a handful of states to add a surcharge to all phone bills intended to help support the state's 988 mental health emergency hotline.

A new report by the mental health advocacy group Inseparable found if the surcharge were to increase from 35 cents to 98 cents, it would generate approximately $3 million annually for the Silver State.

Angela Kimball, chief advocacy officer for Inseparable, said the report is a tool to help policymakers and state leaders develop an equitable and sustainable crisis response system. They found Nevada's in-state answer rate sits at 68%, when it should be above 90%.

"We're still a long way from having the kind of system that everybody expects in every ZIP code, in every part of America," Kimball acknowledged.

Kimball pointed out with the implementation of 988, it also brought about changes in the way local jurisdictions respond to mental health crises. The report highlighted Nevada has convened a workgroup to build response processes for collaboration between 988 and 911. While it is a step in the right direction, the report showed Nevada could improve call center capacity, crisis response as well as system financing.

Nevada has the 39th highest suicide rate in the country and also ranks 50th in the nation for overall mental health, according to the Nevada Division of Public and Behavioral Health.

Kimball stressed the figures need to see improvement. She added not having an effective response system in place can make a difference between life and death for some.

"People going without help, being turned on to the streets, being in jail, being in emergency departments, being hospitalized -- voluntarily or involuntarily -- or, tragically, having their life end," Kimball noted.

Kimball added the report lays out policy examples for each of their policy recommendations which come from red and blue states moving the needle in the right direction. She hopes they can serve as inspiration for other states. If you or someone you know is experiencing a mental-health emergency, do not hesitate to call or text 988.

Budding flowers, warmer temperatures and longer days are welcome signs to many after the long, dark months of winter. Some people might believe warmer weather improves mental health after seasonal depression in the winter months, but that's not always the case. Many people experience increased mental-health struggles as spring rolls around.

When people's feeling in the springtime doesn't meet their expectations, said Cynthia Cubbage, director of family and post-adopt service for the Barker Adoption Foundation, it can make mental-health issues worse.

"When people are looking forward to spring because it's a time of renewal, and those expectations don't happen, and then nothing gets better for them because it's deeper than that," she said, "then they get really stressed and depression can really set in. And it's because of the expectations."

Suicide rates rise in the spring and not winter, according to Johns Hopkins Medicine. Researchers find that seasonal allergies play a role. A person with rhinitis, which causes allergy symptoms, is more than 40% more likely to be depressed.

Cubbage said there are many ways people can combat those feelings: Get outdoors as much as possible and get out socially as well. But she reminded folks that sleep is vital.

"Definitely prioritize sleep, even though we're having more daylight," she said. "It makes people want to stay up longer - that they should be doing things - and to remember that's a big transition for your body. They should still prioritize their sleep. If they were still going to sleep at eight or they were putting their kids down at eight, that should continue."

Cubbage added that, if you continue to feel depressed or down even after trying those suggestions, it's best to seek out professional mental-health help.

A bill headed to the Montana governor's desk would qualify post-traumatic stress disorder under workers' compensation for the state's first responders.

PTSD is a mental-health condition that someone may develop after a traumatic event. It can result in a range of symptoms from a negative mood and reactivity to flashbacks and difficulty sleeping. First responders report experiencing PTSD at about five times the rate of the general population, according to Relief Mental Health.

George Richards, who serves as president of both the Montana State Firefighters' Association and the Montana State Council of Professional Firefighters, said suicide is one of the top two leading causes of death among firefighters.

"Firefighters, police officers, paramedics, EMTs, experience - working on a gunshot victim or a fatality wreck or a kid death - major trauma-critical calls that really affect the brain," he said.

Richards said the bill had bipartisan support, although some opponents were concerned with the costs. The bill passed a House vote Friday, just before today's observance of Workers Memorial Day.

Until now, Montana was one of roughly a dozen states without a PTSD-related workers comp policy for first responders. Richards said treatment for PTSD will also help with worker retention.

"We want it recognized so they can get the treatment and return to work as a healthy individual with a clear mind," he said.

Treatment can take different forms, Richards noted, from peer-to-peer support to residential treatment programs.


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A new report finds that Maryland has made progress in providing school mental health services to its students but work still remains. The report by the national mental health advocacy organization, Inseparable, measures states based on 13 policy targets.

Maryland has improved its ratio of social workers to students. There is one social worker for every 620 students - a decline from more than 2,300 students in previous years. But the state has not implemented, or only partially implemented, five policies, such as expanding Medicaid coverage to include school-based mental health services.

Caitlin Hochul, vice president of public policy with Inseparable, said providing mental health services in schools has major impacts on students and parents alike.

"You're reducing the financial strain on parents," she explained. "You're reducing the need for reliable transportation. You don't need to be taking a lot of time off of school to go travel to an appointment, so it really helps give kids the resources and tools they need to get back in the classroom and learn."

Maryland also lacks mental health screenings of students, a tool that advocates say is critical to identify potential mental health issues.

The Maryland state legislature recently passed laws geared toward bolstering the behavioral health workforce. One law made school mental health professionals eligible for the state's loan repayment plan, and another created a state workforce development program for mental health professionals.

Sen. Malcolm Augustine, D-Prince George's County, said a focus of the state legislature has been working to bring - and keep - mental health professionals in the state.

"It's challenging right now for us to attract and retain these folks," he said. "It's a global issue, so we are trying to do our very best to create opportunities for them to have their loans repaid, opportunities for them to grow professionally, in the hopes that we'll be able to retain and grow our own."

Maryland lawmakers also passed laws requiring education and health agencies to provide guidelines for student telehealth appointments on school days.