With long waitlists, counselors in the community are pushed to their limit with client capacity. The increased access and need for mental health care during and in the dwindling stages of the COVID-19 pandemic exposed the gaps in care as more people sought counseling. The demand is still high and growing.
"There is room for improvement in the Northern Nevada mental health care system," director of the Downing Counseling Clinic in the College of Education & Human Development, Adrienne Renwick, said. “In recent years, as a state, we've done well at recognizing the gap in services that exists in schools, and there have been many funding streams released to support initiatives [but] there is still a significant need for more community mental health clinics that can provide wrap-around care."
There are many systemic issues contributing to the shortage of care for Nevada’s most vulnerable populations. These include limited public transportation in the Northern Nevada region, a scantiness of community mental health clinics despite a growing population and the continued stigma surrounding the pursuit of mental health resources.
The deficit of counselors in the region exacerbates the issue. To remove those barriers, the Downing Counseling Clinic, within the College of Education & Human Development, has begun shifting to practice from a modified community mental health model of care. Previously the clinic was structured as a private practice, with longer-term care and a smaller number of clients served.
"We have a goal to shorten wait times, incorporate crisis care, and partner extensively with community providers in the Northern Nevada region to develop a wide referral base,” Renwick said. “We commit to providing counseling at a significantly reduced cost, or we help people get connected to other mental health providers if their unique set of needs falls outside our scope of practice."
The clinic is staffed by 33 pre-Master's level student clinicians completing practicum or internship hours. The number of students in the clinic varies by semester. In the fall, the clinic is staffed with the third-year cohort of students taking an internship course; in the spring, that doubles with the addition of the second-year cohort in practicum.
Student clinicians provide services such as individual, couple, group and play therapy sessions under the supervision of Renwick and other Counselor Education Program faculty. The clinic provided services to around 200 clients in the fall semester. A future goal of the clinic is to have the capacity to provide students supporting the clinic with stipends.
“Many of our students are in the clinic for 20 hours a week, meaning they need to reduce the amount of time spent at their jobs,” she said. “This causes a great deal of financial stress for our students."
The time spent in the clinic is transformative as students develop their counselor and professional identities.
"Because your life is worth my time," Janell Halverson, a third-year Clinical Mental Health Counseling student, said when asked why she and other student clinicians became counselors.
“I have grown so much working here at the Downing Counseling Clinic and have had such great support from staff, cohorts, and supervisors in my counseling journey that I will take with me,” she said. “It has been such an honor to work with and support members of our society and be a part of their journey."
Second-year Clinical Mental Health Counseling student, Clarisa Rivas-Reyes, reflected on her experience as well.
“I am a student intern, and I just saw my first client,” she said. “I am very excited for my journey with the Downing Clinic in helping the mental health community."
Nikki Riley, third-year Marriage, Couple and Family student, said, "The opportunity for hands-on learning in a community clinic has been amazing."
Riley also serves in a leadership capacity pairing student clinicians with clients and integrating problem gambling into our scope of services.
The College of Education & Human Development's counseling program is one of the largest producers of mental health professionals in Nevada, training future school counselors, Clinical Professional Counselors, and Marriage and Family Therapists. They are guided by the standards set by the Council for Accreditation of Counseling and Related Educational Programs, meaning it meets the rigorous standards set to develop and produce highly skilled, ethical and culturally competent counselors.
The Downing Counseling Clinic works in partnership with departments on campus and with schools and agencies in the community. In her new role as director of the Clinic, Renwick is excited about the collaborations that have been created or built upon.
"Some of the initiatives I've focused on this past semester are relationships with campus partners, such as the Center for the Application of Substance Abuse Technologies, Nevada Center for Excellence in Disabilities, and Counseling Services," Renwick said.
Some of these alliances provide possibilities for student clinicians to deliver counseling services to those with a specific subset of needs. Having a wide variety of opportunities allows student clinicians to become trained in working with diverse populations and be able to provide more comprehensive care for clients.
Renwick is also committed to expanding school-based mental health counseling. The clinic recently partnered with Humboldt County School District to begin providing telehealth sessions facilitated by students in the clinic.
"We've been providing mental health counseling onsite for the Churchill County School District for some time, and our collaboration only continues to grow," Renwick said.
School-based mental health programs ensure accessibility for children who might not otherwise receive mental health care. Early interventions are critical to supporting healthy social and emotional development, contributing to academic success.
Renwick became the director of the Downing Counseling Clinic in the summer of 2022. She is a Licensed Clinical Professional Counselor, a Licensed Clinical Alcohol and Drug Counselor and a supervisor for both licensing boards. She also is a doctoral candidate at Oregon State University. Her clinical specialization is trauma, substance abuse, and issues specific to children and adolescents. She teaches clinically oriented classes such as group counseling, pre-practicum, practicum and internship, while also overseeing the Downing Counseling Clinic.
About her new role as the director of the Clinic, Renwick said, "I am honored to work alongside the accomplished and dedicated faculty in the College of Education and Human Development. I look forward to shaping and growing the clinic to better meet the needs of our campus and community in the years to come."
The Downing Counseling Clinic is dedicated to serving the University and the community. A primary objective is to provide a helping environment in which clients feel heard, valued and represented while being engaged in the process of change. Additionally, they seek to foster the ethical development of their counselors-in-training and to facilitate a caring, warm climate for clientele. Services are available 10 a.m.-6 p.m. Monday-Friday. Learn more or request an appointment at the Downing Counseling Clinic.
If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org.