Devote more resources to mental health and innovative mental health treatments

Rochelle and Dustin Hines

UNLV Neuroscience professors and directors of the Hines Group

Comprehensive Neuroscience Lab

•Nevada ranks 51st in access to mental healthcare in the U.S. Despite this grim statistic, Rochelle Hines, who holds a PhD in neuroscience — as does her partner Dustin Hines — sees promise in the state’s burgeoning institutions, such as the Lou Ruvo Center for Brain Health, Clark County Children’s Mental Health Consortium, and UNLV. “It’s just figuring out how we can better support these institutions and connect them even more with our communities… and also remove barriers to access,” Rochelle says. “If a patient really wants to try an innovative therapy, you have to look at the barriers that might be preventing them from being able to access that.”

Both Drs. Hines have seen a more integrated model for mental healthcare during postdoctoral fellowships at the Tufts University School for Medicine in Boston. “In Massachusetts, you could go to one of these massive clinics, and you could see your primary care physician,” Rochelle says. “And if you needed behavioral health support, you could go two floors up and see that person; if you needed an MRI, you could go two floors down and see that person. That really removes barriers for people, when they know where to go, they know what providers are there, and their primary care provider can link them in with the specific person, who may even be in the same facility.”

Dustin Hines adds that integrating mental healthcare with other health services is tantamount to improving patient health. “We understand very well that mental health and cardiac diseases, say, are comorbid. So, if you have mental health issues, it’s very likely that

Nevada's U.S. ranking in access to mental healthcare

later in life, you’ll die of a heart attack,” Dustin says. “A lot of places are looking at this, but we don’t have the resources to really connect all the doctors at a giant hospital, to pull in the mental health expert with a cardiologist.”

Beyond holistic integration, both Dustin and Rochelle Hines emphasize that mental health treatments need to be updated to be more effective. Dustin says, “The treatments that we have for depression largely came out in the 1950s and have not been improved upon other than things like toxicology … Fluoxetine and other common SSRIs (selective serotonin reuptake inhibitors, used for treating depression) work in about 20 to 30 percent of patients. So that means, generously, 70 percent of the people are treatment resistant.” Conversely, he points to psychedelics as a form of treatment that has been shown to be effective at an earlier rate in around 70 percent of patients. In patients with PTSD, one dose of psychedelic therapy has proven to be effective, which, Dustin says, “is something I haven’t seen in my entire career of working with AstraZeneca.”

Rochelle adds that SSRIs can take two to six weeks to take effect. “Oftentimes, patients need to wait that six weeks and find it’s not really working, or it has negative effects,” Rochelle says. “Then they have to try another medication. It can take months before the person starts to see benefits, and in the meantime, maybe they could also be better supported by having access to behavioral healthcare.”

“We’re not saying (SSRIs) aren’t good treatments,” Dustin says. “It’s just time that we innovate on mental health and come up with new treatments.” — NB