Policy Brief

I. Executive Summary

Nevada’s criminal justice system currently lacks statutory requirements to identify veterans, screen for PTSD, and provide treatment-based diversion. As a result, veterans with service-connected trauma are often overcharged, incarcerated unnecessarily, and released without addressing the root causes of their behavior. The PTSD Justice Reform Act (2027) proposes statewide reforms to:
– Mandate early veteran identification and PTSD/TBI/MST screening.
– Codify PTSD as a mitigating factor in sentencing.
– Expand Veterans Treatment Courts (VTCs) statewide, including rural access via telehealth.
– Provide fiscal savings through treatment over incarceration.

II. Historical Context – PTSD in the Military & Society

A. Evolution of Understanding
WWI: “Shell shock” – seen as weakness, stigmatized.
WWII & Korea: “Battle fatigue” – still under-recognized, minimal treatment.
Vietnam: Recognition of post-combat psychological injuries grew.
1980: PTSD formally recognized in DSM-III.
Present: VA is the global leader in PTSD research and treatment.

B. Changing Treatment Protocols
Past: Sedation, isolation, minimal therapy.
Present (Gold Standard):
– Prolonged Exposure (PE) therapy.
– Cognitive Processing Therapy (CPT).
– EMDR.
– Combination with pharmacotherapy (SSRIs, Prazosin).

C. VA’s Role
VA operates the largest integrated PTSD treatment network in the world.
Las Vegas VA Medical Center is a flagship facility offering specialized trauma programs.

III. PTSD and the Criminal Justice System

A. Link Between Trauma and Criminal Behavior
PTSD symptoms — hyperarousal, irritability, emotional numbing, avoidance — can manifest as:
– Aggressive responses to perceived threats.
– Domestic disputes.
– Public disturbances linked to flashbacks.
– Substance abuse as self-medication.
Law enforcement often mistakes these for deliberate misconduct rather than medical conditions.

B. Arrest & Charging Practices
Without mandated PTSD screening:
– Veterans are overcharged (felonies vs. diversion).
– Opportunities for treatment are missed.
– Early intervention is rare.

C. Incarceration Outcomes
– Exacerbates PTSD due to violence, confinement, and lack of privacy.
– Disrupts VA treatment/benefits.
– Raises suicide risk after release.

IV. Legal Gaps in Nevada

1. No mandatory veteran identification at arraignment.
2. No mandated PTSD/TBI/MST screening.
3. Limited VTC access — rural veterans excluded.
4. PTSD not statutory mitigation — left to judicial discretion.
5. Nevada statute reflects outdated stigma — PTSD excluded from automatic mitigation.

V. Lessons from SB 163 (2023)

SB 163 would have expanded VTCs statewide but failed in Senate Finance due to:
– Prosecutorial concerns over discretion.
– Rural infrastructure gaps.
– Fiscal opposition.

Key Testimony:
“We know the treatment works. The problem is identifying veterans early enough in the process.” — Prof. Rachel Anderson, UNLV Boyd School of Law.
“Our rural veterans are not getting the justice they deserve simply because of geography.” — Col. James Porter (Ret.), Nevada Veterans Coalition.

Strategic Adjustments in 2027 Bill:
– Tele-VTC for rural access.
– Allow DA objection only with expert rebuttal.
– Use Medicaid matching funds to offset costs.

VI. Fiscal Impact

A. Cost Comparison
Incarceration (Nevada): $24,000/year.
VA PTSD Treatment: $9,000/year.
Savings: $15,000/year per veteran.

B. Projected Savings
100 veterans diverted/year: $1.5M saved.
Five years: $7.5M saved (excluding reduced recidivism costs).

VII. PTSD Justice Reform Act – Draft Statutory Language (Nevada 2027)

AN ACT relating to criminal justice; requiring the court to inquire whether a defendant is a veteran or current member of the Armed Forces; requiring prompt screening for posttraumatic stress disorder, traumatic brain injury, or military sexual trauma; codifying such diagnoses as statutory mitigating factors in sentencing; expanding access to veterans treatment courts statewide, including through telehealth; and providing other matters properly relating thereto.

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Section 1. Chapter 4 of NRS is hereby amended by adding thereto a new section to read as follows:
1. At the defendant’s initial appearance or arraignment, the court shall inquire whether the defendant has served in the Armed Forces of the United States, including the National Guard or reserves.
2. If the defendant affirms military service, the court shall cause that status to be entered into the record and transmitted to the prosecuting attorney, defense counsel, and the Department of Veterans Services.

Sec. 2. Chapter 176A of NRS is hereby amended by adding thereto a new section to read as follows:
1. Within 7 judicial days after a defendant’s military service is confirmed under Section 1, the court shall order a standardized screening for:
(a) Posttraumatic stress disorder (PTSD);
(b) Traumatic brain injury (TBI); and
(c) Military sexual trauma (MST),
to be conducted by a qualified mental health professional.
2. The screening results shall be provided to the court, counsel, and, with the defendant’s consent, to the United States Department of Veterans Affairs (VA) or other appropriate service provider.

Sec. 3. NRS 193.165 is hereby amended to add:
7. In determining the sentence to be imposed, the court shall consider as a mitigating factor that at the time of the offense the defendant was suffering from PTSD, TBI, or MST related to military service, as diagnosed by a qualified mental health professional.

Sec. 4. NRS 176A.280 is hereby amended to read as follows:
1. A veterans treatment court program must be made available in each judicial district, either in person or through secure telehealth platforms, to eligible defendants diagnosed under Section 2.
2. Participation in a veterans treatment court program shall be offered as a pretrial diversion or condition of probation when the court finds that:
(a) The offense is related to the defendant’s diagnosed condition; and
(b) Public safety does not require incarceration.
3. The prosecuting attorney may object to diversion only upon presenting clear and convincing evidence from a qualified expert that the defendant is not suitable for treatment.

Sec. 5. Funding.
1. The Administrative Office of the Courts shall coordinate with the Department of Veterans Services, the VA, and the Division of Health Care Financing and Policy to maximize the use of federal and Medicaid funds for program implementation.
2. State general funds may be used to cover costs not reimbursed by federal or other sources.

Sec. 6. Definitions.
As used in this Act:
(a) “PTSD” means posttraumatic stress disorder as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
(b) “TBI” means traumatic brain injury resulting from external force to the head or body.
(c) “MST” means psychological trauma resulting from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment occurring during military service.
(d) “Veteran” means a person who served in the Armed Forces of the United States, including the National Guard or reserves, and was discharged or released under conditions other than dishonorable.

Sec. 7. Effective Date.
This Act becomes effective on July 1, 2027.

VIII. Charts

1. PTSD Prevalence by Era
2. Cost: Prison vs. Treatment
3. MST Prevalence by Gender
4. Recidivism Rates

IX. Appendices

Appendix A – Legal Authorities:
– Minnesota Stat. § 609.115: https://www.revisor.mn.gov/statutes/cite/609.115
– California Penal Code § 1001.80: https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1001.80&lawCode=PEN
– Illinois 730 ILCS 167/: https://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=3399
– Nevada Revised Statutes: Chs. 4, 176A, 193: https://www.leg.state.nv.us/NRS/

Appendix B – Academic & Government Sources:
– Anderson, R. Beyond the Battlefield, Nevada Law Journal, Vol. 22, No. 3 (2022).
– RAND Corporation. The Cost and Outcomes of Veterans Treatment Courts (2021): https://www.rand.org/pubs/research_reports/RRA1466-1.html
– VA Health Economics Resource Center. Program Cost Data (2022): https://www.herc.research.va.gov/
– Olff, M. et al. (2014). Gender Differences in PTSD. Psychological Bulletin: https://doi.org/10.1037/a0036608

X. Conclusion

Nevada can lead the nation in trauma-informed justice. The PTSD Justice Reform Act is fiscally responsible, ethically necessary, and backed by proven data. It ensures veterans receive treatment, not unnecessary incarceration, improving public safety and honoring service.