Nevada has made history by becoming the first state in the nation to create a formal credential dedicated entirely to building a children’s mental health workforce. With the enactment of SB 165 in February 2025, the state established a new profession focused on screening, early intervention, and prevention to catch children’s mental health concerns before they become crises.
It is a bold, structural solution to a problem that has quietly devastated families across the state for years.
The law came as a response to tangible needs from the community. Nevada is ranked as one of the lowest states when it comes to children’s mental health outcomes. The numbers tell part of the story. Roughly 20 percent of youth in Nevada have a major mental health disorder, yet only about 1 in 5 of those children ever receive treatment from a qualified professional. For families in rural communities, the nearest provider can be hours away. For the significant portion of Nevadans without health insurance, cost is a barrier that never comes down. For decades, the state could not grow enough of its own behavioral health professionals because of its lack of doctoral-level accredited residency programs. This meant that those pursuing degrees in child psychology had to leave Nevada to complete their training, and many never came back.
More than two years before SB 165 was introduced, the Children’s Advocacy Alliance of Nevada (CAA) began the process of gathering providers, families, youth, and elected officials to talk honestly about what was happening on the ground. The stories were consistent and heartbreaking. Families could not find care, could not access the right level of care, or simply had to give up trying. One mother described watching her daughter struggle with severe mental illness and the painful decision they made to send their child out of state to receive the care she needed. Another parent, herself a doctoral student in psychology, spoke about the professional sacrifice she faced. Completing her degree would require leaving Nevada, and finishing her training meant leaving her community behind.
These conversations made clear that addressing this crisis would require rethinking how the state provides child mental and behavioral health care from the ground up. The Children’s Mental Health Action Coalition was formed to do exactly that by bringing together stakeholders to move legislation and develop lasting solutions.
Dr. Tara Raines, former Deputy Director of the Children’s Advocacy Alliance of Nevada and current Senior Director of Policy and Advocacy at the Ballmer Institute for Children’s Behavioral Health, was instrumental in shaping what one of those solutions could look like. She organized a legislative field trip to the Ballmer Institute in Portland to show elected officials how a workforce model inspired by the UK approach and focused on screening, health promotion, skill building, and de-escalating crises could work in Nevada. Legislators returned energized, and that enthusiasm quickly turned to legislation.
SB 165 creates a structured pathway for children’s mental health prevention and early intervention by establishing behavioral health and wellness practitioners as a new licensed profession in Nevada. Defined in the bill as a supervised clinical practice focused on identifying mental health risks and achieving individualized mental health goals through prevention and intervention strategies, the credential is intentionally designed with a clear and focused scope of practice, one that Raines hopes will become a replicable model for other states to adopt.
The law funds three bachelor’s-level training programs at the University of Nevada, Las Vegas, the University of Nevada, Reno, and Great Basin College. Each institution is developing its own version of the degree, offering different tracks and levels of specialization. It also requires Medicaid to cover services provided by these practitioners while raising reimbursement rates for child behavioral health services. What sets the training model apart is its emphasis on hands-on preparation. Students complete 700 hours of practicum training as part of their undergraduate degree, allowing them to graduate ready to identify children in distress and connect families to services from day one. The law also secured $2 million in scholarships for students pursuing the new training programs, establishes child mental health apprenticeships to create additional on-ramps into the profession, and supports microcredentials to help those already working with children.
Importantly, SB 165 also establishes Nevada’s first APA-accredited, doctoral child psychology internship program, which will welcome its first cohort of interns in fall 2026. This milestone directly addresses the pipeline problem that has long pushed trained professionals out of state, giving doctoral candidates a reason to complete their training in Nevada and, hopefully, stay to continue their practice. “That will be huge, huge, huge for us,” said Raines.
Getting the legislation passed required casting a wide net and coming to the legislature with solutions, not just problems. Embedding programs across three universities was a deliberate coalition-building strategy, and the result was a broad alliance of psychologists, social workers, insurance companies, community members, and parents linking arms. “By crafting this solution that put programs in each of the major universities, north, south, and rural Nevada, and making sure they had funds earmarked so they could create these programs, we were able to get a very large coalition of folks together to advocate on behalf of this bill, which is not always the way it happens,” said Elisa Cafferata, Executive Director of CAA. The bill passed with a Democratic sponsor and two Republican co-sponsors, a reflection of what the coalition has always insisted—children’s mental health is not a partisan issue.
Funding, however, was the hardest part. The team leveraged Nevada’s state opioid settlement funds and secured a partnership with the Las Vegas Aces Foundation to get the initiative off the ground, a combination of public dollars and private philanthropy that Raines sees as a model for other states to follow. “When there is a clear, strategic, long-term solution, there are private philanthropy partners in your community who may have an interest in supporting these next steps,” she said. “Having those partners can be a spark to getting government, legislative, and university partners on board. So you need to think creatively about funding. It was definitely the hardest part, but it can be done.”
Cafferata and Raines also credit the Alliance Network with supporting this work. For Raines, connecting with peers across the country through the Alliance Collaborative Community for Equity Leaders (ACCEL) program provided resources that helped shape both the advocacy strategy and consider the equity considerations that should be embedded in the new profession.
SB 165 is a profound step forward for Nevada’s children and the future of its mental health workforce. By establishing the behavioral health and wellness practitioner license and creating structured pathways that connect higher education to careers in behavioral health, the legislation opens the door for an entirely new generation of professionals dedicated to children’s mental health. “I think what is great about this legislation is that it gets us further upstream,” said Cafferata. “It is really focused on prevention and giving kids and families the tools they need to get to stability and not just deteriorate into crisis. I hope this creates much more resilient families and communities.”
Nevada is not alone for long. Oregon has already passed legislation to license behavioral health and wellness practitioners, and advocates are actively working to expand it further. “We’re moving our way through the country and hoping to share this model with many more states in the next few years,” said Raines, whose current role at the Ballmer Institute is focused on taking the credential nationwide. “This new profession gives me hope. It feels like a no-brainer solution, and we just have to be willing to do something a little differently than how we’ve done it for the last 100 years. It’s a ripe time to take bold action, because what we are doing now is not enough,” she added.
All children deserve compassionate, qualified mental health support. Nevada, and a growing number of states across the country, are now meaningfully closer to delivering on that promise.
States interested in pursuing similar legislation are encouraged to reach out to Dr. Tara Raines at the Ballmer Institute directly.