Homeless Community Mental Health in Las Vegas, Nevada

Introduction: Las Vegas and Its Homeless Population

Situated in a hot, dry desert valley, Las Vegas has experienced phenomenal growth in recent years, including large influxes of retirees and Latino immigrants searching for work. This population surge is primarily driven by the casinos located on Las Vegas Boulevard — commonly known as "the Strip" — which is actually situated in an unincorporated township within the city borders called "Paradise," an area that also contains the city's airport and convention center (Ventura, 2003). According to Ventura, "The story of Las Vegas is inextricably bound to the story of the Strip. Its casinos spur the area's unprecedented growth by providing jobs for working people while creating a backdrop of activity for the retired and others who relocate to Las Vegas Valley as a lifestyle choice" (2003, p. 97).

Despite the glamour of the Strip, many jobs in Las Vegas are unskilled and minimum wage — or even lower for undocumented workers — and the large influx of newcomers means that homelessness in the United States can affect even those who are employed. Rothman and Davis emphasize that "the mismatch between decent-paying occupations and affordable housing increased the estimated number of homeless people from 2,000 in 1990 to more than 18,000 in 1999, one-fifth of whom hold regular part- or full-time jobs" (2002, p. 141).

Community Assessment and Demographics

Although a large number of exclusive gated communities exist in the suburbs of Las Vegas where the affluent enjoy lush green lawns and air-conditioned luxury, other parts of the community are far less fortunate. North Las Vegas and West Las Vegas in particular remain characterized by large percentages of minorities, including thousands of undocumented Latino residents in the former and a predominantly African-American population — approximately 15,000 residents — in the latter (Ventura, 2003). Las Vegas is approximately 131 square miles in size and is situated in Clark County, which contains approximately 97,000 African-Americans and just over 7,000 Arabs (Abdullah, 2009). According to Abdullah, "Among African-Americans, conservative estimates put the number of Las Vegas Muslims at 2,000. Among Arabs, the census lists Lebanese (2,857), Syrians (967), and Egyptians (772). The remaining Arab population is comprised of Palestinians, Jordanians, Moroccans, Iraqis, Yemenis, Algerians, Saudi Arabians, Tunisians, Kuwaitis, Libyans, and people of 33 other Middle Eastern ancestries" (2009, p. 26). In addition, approximately 11,182 Filipinos live in Las Vegas (Clarin, 2009).

The City of Las Vegas cites the most recent U.S. Census Bureau figures for the city (not including Clark County as a whole) as shown in Table 1 below.

Table 1: Demographic Breakdown of Las Vegas

Total population: 564,484 | White: 399,848 (70.8%) | Black or African-American: 57,945 (10.3%) | American Indian or Alaska Native: 3,286 (0.6%) | Asian: 30,769 (5.5%) | Native Hawaiian or Other Pacific Islander: 2,856 (0.5%) | Some Other Race: 49,417 (8.8%) | Two or More Races: 20,363 (3.6%) | Hispanic or Latino (of any race): 169,573 (30.0%) | Veterans: 46,179 (11.3%)

Source: City of Las Vegas Census Data, 2011

Population estimates for the larger Las Vegas–Paradise–Henderson metropolitan area in Clark County grew from 852,646 in 1990 to 1,563,282 in 2000 and 2,282,708 by 2010 (World Gazetteer, 2011).

A community genogram for Las Vegas highlights the following characteristics across four dimensions:

Healthcare Access: 13 major hospitals and numerous community-based resources serve the city.

Psychosocial Health: An extensive homeless population — currently estimated at 13,338 for Clark County — lives at poverty levels commensurate with national averages.

Environmental Health: Consistently hot weather creates exposure risks for the homeless; city statutes prevent feeding homeless individuals in city parks.

Population Profile: 564,484 residents (Las Vegas proper), predominantly white (70.8%), with large contingents of Hispanic/Latino (30%) and Black/African-American (10%) residents; median age 35.5 years.

Community Diagnosis: For the dimensions assessed, there remains a paucity of effective interventions for the wide range of healthcare and mental health problems that characterize the homeless condition in Las Vegas. More effective use of community-based resources through partnerships with local hospitals, clinics, and mental health services must be developed to address these needs.

Health Concerns: Mental Health and Substance Abuse

Among the goals of Healthy People 2020 is the objective to reduce the incidence of substance abuse in the United States (Healthy People 2020 objectives, 2011, p. 305). As elsewhere, substance abuse — together with gambling addiction — is a major problem for the homeless in Las Vegas. One community health center counselor in the city reported: "Ninety percent of my clients have gambling and alcohol problems. Drugs, meth, cocaine. Heroin is starting to come back. Gambling is one of the ways to raise money for this. Just being around the casinos they have access to free alcohol" (Littlejohn & Gran, 1999, p. 24). As noted in the demographic data above, approximately 46,000 veterans live in Las Vegas; Healthy People 2020 indicates that about 7.1% of this population — roughly 3,266 veterans — will likely have a substance abuse problem as well (Healthy People 2020 objectives, 2011).

According to the U.S. National Library of Medicine (MedlinePlus), health issues can create a downward spiral for the homeless from which escape is difficult or even impossible without intervention. MedlinePlus (2010) emphasizes that "poor health can contribute to being homeless, and being homeless can lead to poor health. Limited access to health care can make it worse. That is why the health of homeless people in the United States is worse than that of the general population" (Homeless health concerns, para. 2).

Common health problems among the homeless population include:

1. Mental health problems; 2. Substance abuse problems; 3. Bronchitis and pneumonia; 4. Problems caused by prolonged outdoor exposure; 5. Wound and skin infections; 6. High rates of domestic or sexual abuse among homeless women; 7. High rates of emotional and behavioral problems among homeless children, often resulting from witnessed abuse (Homeless health concerns, 2010).

Current data on gender, age, socioeconomic status, and education levels in Las Vegas are presented below.

Table 3: Education, Age, and Income Levels in Las Vegas

Male: 285,298 (50.5%) | Female: 279,186 (49.5%) | Median Age: 35.5 years (U.S.: 36.7) | Under 5 years: 45,818 (8.1%; U.S.: 6.9%) | 18 years and over: 410,555 (72.7%; U.S.: 75.5%) | 65 years and over: 65,155 (11.5%; U.S.: 12.6%) | Bachelor's degree or higher: 21.3% (U.S.: 27.4%) | Per capita income (2008 dollars): $27,988 (U.S.: $27,466) | Median household income: $55,113 (U.S.: $52,175) | Median family income: $63,589 (U.S.: $63,211) | Families below the poverty line: 8.7% (U.S.: 9.6%) | Individuals below the poverty line: 11.7% (U.S.: 13.2%)

Source: City of Las Vegas Census Data, 2011

According to Costello and Bouras, "Mental health problems are socially defined and, as a result, they are highly interactive with the context in which the person lives and the social expectations placed upon him/her. In defining mental health, a whole range of factors needs to be taken into consideration, encompassing not just the individual, but also the wider ecology within which the person lives" (2006, p. 241). This observation is especially salient for the homeless, whose living environment is itself a source of ongoing psychological stress.

The official website for the City of Las Vegas emphasizes that "thousands of homeless individuals and families can be found on the streets, in parks, and other locations throughout the city of Las Vegas on any given day" (City of Las Vegas homeless services, 2011, para. 1). The homeless census data are shown in Table 4 below.

Table 4: Las Vegas Homeless Census

Street count of unsheltered homeless (streets, vehicles, makeshift shelters, encampments): 3,747 (2007) / 3,027 (2009) | Shelter count (emergency shelters, transitional housing, domestic violence shelters): 3,844 (2007) / 7,004 (2009) | Hidden homeless estimate (based on telephone survey of 1,001 Clark County households): 3,826 (2007) / 3,307 (2009) | Total homeless in Clark County: 11,417 (2007) / 13,338 (2009)

Source: Homeless census, 2011

Although a number of community resources are available to assist the homeless population in Las Vegas (discussed further below), city officials have adopted an "out-of-sight, out-of-mind" approach in many cases to keep panhandlers away from the Strip where they might be visible to tourists. Baker reports that "in Las Vegas a person can be jailed for up to six months for handing out food to homeless people in the city's parks. The law has been used against charities that operate mobile soup kitchens" (2009, p. 4).

References

Abdullah, A. (2009, May/June). The other Las Vegas. Islamic Horizons, 38(3), 25–27.

Baker, D. J. (2008). Constitutionalizing the harm principle. Criminal Justice Ethics, 27(2), 3–6.

City of Las Vegas census data. (2011). City of Las Vegas. Retrieved from

City of Las Vegas homeless services. (2011). City of Las Vegas. Retrieved from

City of Las Vegas Neighborhood Services Department. (2011). City of Las Vegas. Retrieved from

Clarin, D. (2009, January). Living Las Vegas. Filipinas, 18(201), 25–26.

Costello, H., & Bouras, N. (2006). Assessment of mental health problems in people with intellectual disabilities. The Israel Journal of Psychiatry and Related Sciences, 43(4), 241–243.

Healthy People 2020 objectives. (2011). HealthyPeople.gov. Retrieved from

Homeless census. (2011). City of Las Vegas. Retrieved from

Homeless health concerns. (2010, November 23). U.S. National Library of Medicine. Retrieved from http://www.nlm.nih.gov/medlineplus/homelesshealthconcerns.html

Las Vegas population. (2011). World Gazetteer. Retrieved from

Littlejohn, D., & Gran, E. (1999). The real Las Vegas: Life beyond the strip. Oxford: Oxford University Press.

Rothman, H. K., & Davis, M. (2002). The grit beneath the glitter: Tales from the real Las Vegas. Berkeley, CA: University of California Press.

Ventura, P. (2003). Learning from globalization-era Las Vegas. Southern Quarterly, 42(1), 97–99.

Appendix A: Hospitals in the Las Vegas Area

The following Las Vegas Valley hospitals serve the region's healthcare needs:

Boulder City Hospital, 901 Adams Blvd, Boulder City, NV 89005 | Centennial Hills Hospital, 6900 N. Durango Dr., Las Vegas, NV 89149 | Desert Springs Hospital Medical Center, 2075 E. Flamingo Rd, Las Vegas, NV 89119 | Lake Mead Hospital Medical Center, 1409 East Lake Mead, North Las Vegas, NV 89030 | Montevista Hospital | Mountainview Hospital | Southern Hills Hospital & Medical Center | Spring Valley Hospital | St. Rose Dominican Hospital | Summerlin Hospital Medical Center | Sunrise Hospital and Medical Center | Valley Hospital Medical Center