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According to Mental Health America's most recent data, Nevada is ranked fifty-first in the country in mental health services and availability.
That's not a big surprise, considering that state auditors earlier this year found bug and rodent infestations, human waste and other problems in 35 of 37 groups homes examined.
Around the same time, a mentally ill woman in Las Vegas died after being transferred to one of the homes.
Meanwhile, mental health is on the minds of many urban residents in both Reno and Las Vegas as homeless populations keep growing.
But what's behind these problems?
“We do treat people who live with a mental health condition as disposable,” Robin Reedy, executive director of the Nevada chapter of the National Alliance on Mental Illness.
Reedy said so much of the problem comes back to the stigma that most people have about people with a mental health condition. She said people need to understand that a mental illness is just like cancer or diabetes but it is impacting a patient's brain.
Reedy also said people are not open about needing help for loved ones or for themselves.
And when they do ask for help, she said there are often not enough mental health providers to give that help.
“We have a ton of people clamoring to get services but we don’t have a ton of people that a lot of people can serve and still survive,” she said.
With such a large problem, she believes the state needs to be doing a lot more to fix it.
"We need to throw education, we need to throw money, we need to throw staffing, at all levels of government," she said.
She said the federal government needs to increase how much they're reimbursing doctors for Medicare and Medicaid. She said there needs to be more help for housing because it can be difficult for someone to become stable and stay stable without proper housing.
Stephanie Woodard is the senior advisor on mental health services for the State Department of Health and Human Services. She painted a much rosier picture of the state's efforts to improve mental health services.
Woodard said the study that ranked Nevada last in the nation is from 2015 and significant changes have been made since then to improve services for people with a mental health condition, including better oversight of group homes, more spending on behavioral and mental health programs and the establishment of Regional Behavioral Health Boards that will specifically address problems at the local level.
"I do anticipate over the next year or so when we can look at the trends for 2016 and 2017 what we're going to see is a shift in those numbers," Woodard said.
Marilyn Rogan, whose son suffered from a mental illness and died because of it, disagreed that significant improvements have been made.
Rogan pointed out that there are only four psychologists in the state that accept Medicare. She said that is not enough to care for a large population.
Besides dealing with her son's mental health condition, Rogan was also a captain at Clark County Detention Center, which she - and others - called the "de facto mental health facility" in the state.
Rogan said when she was at the jail about 30 percent of the population was being treated with psychotropic medications.
“I think that we could do a whole lot better as far as service wise with getting them out of jail into programming, paying for that programming,” she said.
She said more money should go to alternative programming for people with a mental health condition and for more targeted education for police.
Rogan used her son's death as an example of one of the things wrong with how police react to a crisis situation involving someone with a mental illness.
Her son called police from the bathroom of a grocery store asking for help, but instead of providing help, Rogan said the sergeant on the scene decided it was a full barricade situation and eventually called in SWAT.
When police eventually blew the door to the bathroom down, they found Rogan's son dead. He had died hours earlier. The coroner ruled the death as excited delirium.
She wants more education for first responders, but she would like that education to be targeted to first responders who really understand mental illness and have a passion for helping people who have a mental illness.
Woodard said the state has been working closely with first responders to provide Crisis Intervention Training and establish Mobile Outreach Safety Teams.
“Really recognizing that there is value in having behavioral health providers actually at the ready and to assist in response to issues or concerns or emergencies in the community for individuals who may be having behavioral health related issues or crisis,” she said.
Reedy and Rogan agree that many people with a mental illness can't ask for the help they need and it is up to society to provide that help.
“Mentally ill people can’t advocate for themselves,” Rogan said.
Robin Reedy, executive director, Nevada chapter of the National Alliance on Mental Illness; Stephanie Woodard, senior advisor on mental health services, Department of Health and Human Services; Marilyn Rogan, mother of a child who suffered from mental illness