ELKO – Living in a remote community has its positive aspects: the air is clean, the great outdoors is right next door and life runs at a slower pace. The downside is the scarcity of medical care and facilities, especially when it comes to mental health.
“I got my associates degree at Great Basin College a long time ago,” psychiatric mental nurse Roberta Andreozzi said. “I always told Margaret Puccinelli that I would be interested in the BSN [bachelor of science in nursing]. When she was getting that started I threw my hat in. I was lucky enough to be out of six or seven of us to be selected.”
After graduation, she took a year off and then entered a master’s program offered through Gonzaga University. She is only 31 credits shy of doctoral degree.
Andreozzi is from a four-generation Battle Mountain family. She has lived in Elko since 1992 and raised her children here. She has served as a psychiatric nurse since 2002. She worked for the State of Nevada and the Vitality Center.
“What made me pursue my graduate degree is that there is a lack of psychiatric services in Elko. Even with rural clinics our psychiatrists started doing telemedicine. Most of the physicians were out of Las Vegas. Most of them had never been north of Las Vegas.”
She explained that when she worked at a satellite office in Ely she realized doctors did not always understand the difficulties some patients went through in order to get help.
“You’d have someone riding their bike in from McGill in maybe 10 degrees below zero in a T-shirt. They did not think much of that in Vegas. They did not realize how important this visit was or how sick this person was. Rural to them is completely foreign.”
Andreozzi also explained that her patients would often have to see a different doctor each time, complicating the treatment process.
“In psychiatry that’s very hard because they have to tell their life stories,” Andreozzi said. “These can be very deep, hard stories about trauma and addiction, stuff they do not want to repeat telling every few months.”
Andreozzi’s goal has always been to get her education and support the rurals. She even moved to Salt Lake City to complete her residency because she had to study under a psychiatrist or psychiatric nurse. That option was not available here.
Besides having her own office, Andreozzi also works at the jail through Medallus Health. She does medication-assisted treatment for substance use disorder with specialty courts. She travels to Winnemucca twice a week to serve the community there.
Andreozzi works in therapy with people as young as 8 years old. She does not do medical management with anyone under age 11. However, she will work with very young patients if their pediatrician supervises the medication.
Andreozzi has always seen the need for a local source of psychiatric care. She realized many Elko mental health patients have been traveling to Twin Falls, Salt Lake City or Reno for treatment and therapy.
“It’s expensive and hard and when you are in a crisis you are not always safe to drive,” Andreozzi said. “You can’t just go on down to the local clinic and be seen.”
Andreozzi said her practice is not yet set up to take insurance but she is in the process of being paneled for that and Medicaid.
“What most clients are doing is using their Flex cards,” Andreozzi said. “I will work with people. As long as I see you we will worry about the bill later.”
Andreozzi recognizes that about 30 percent of her clients do have excellent local counselors. In such cases, she can work with the patient and therapist by using what she considers her stronghold, medical management.
During Andreozzi’s career she has noticed that the stigma of mental illness is still prevalent in our area but things are changing.
“I often have to educate new patients at least 10 minutes normalizing that this is OK,” Andreozzi said. “This is no different than if you had diabetes.”