Las Vegas Sun

March 28, 2024

Hospitals hurt by mental health system problems

CARSON CITY -- The problems of the state mental health system in Las Vegas have spilled over to create a crisis at University Medical Center and other hospitals in Southern Nevada.

Dr. Dale Carrison, director of emergency services at UMC, says mentally ill patients are backed up in hospital emergency beds for several days because the state's acute care hospital has only 10 beds and it can't take any more patients.

"We've been having problems for two to three years but it's slowly gotten worse," Carrison said Monday. "This year it's become a disaster."

Carrison says mentally ill patients are not getting immediate attention from a psychiatrist. They are filling beds in emergency centers throughout Southern Nevada that should be used instead for the physically ill, he said.

Because of a declining number of psychiatrists, the state is drafting plans to cut back services to the mentally ill in Southern Nevada. Those reductions probably would come in outpatient services.

Dr. David Rosin, medical director of the state Division of Mental Health and Developmental Services, acknowledged the state acute care hospital was at capacity. He agreed that mentally ill patients confined to emergency wards represents a problem throughout Clark County.

Rosin said he is trying to put together a team of a psychiatrist and a social worker to visit the hospitals to provide therapy. "We're seeing how we can stretch things," he said, referring to his limited staff.

He said he has talked with Carrison about getting a psychiatrist privileges for UMC.

"This would ease the crunch," Rosin said, who added this was a national problem, not only one in Las Vegas. He said he was working on this problem early Monday before Carrison made his public complaints.

Rosin said the division submitted a request to double the number of acute mental health beds in Las Vegas to 20. But it didn't get the recommendation of the state Public Works Board. Had it been approved, it would have taken some of the strain off of the hospitals.

More than 20 percent of the 53 beds in the emergency wing at UMC are being taken up by patients with mental problems. And they stay for several days.

For instance, Carrison discharged three persons Monday who were admitted with mental health problems. One was psychotic but whose problem was exacerbated by drugs and alcohol. The patient dried out in two days and the immediate problem evaporated. But there was no therapy provided to deal with the long-term cause.

Two people were admitted because they were suicidal. These two eventually contacted their families and the depression was relieved.

"But they really didn't get what was needed at the time -- emergency psychiatric evaluation," said Carrison.

"I'm an emergency room physician, not a psychiatrist," he said.

He isn't blaming state mental health officials. The state, he said, has not kept up with providing mental health programs to an exploding population in Southern Nevada.

Other hospitals have three to four mentally ill patients who are filling emergency room beds.

The problem has worsened because Valley Hospital has closed its psychiatric unit. And Monte Vista Hospital, which provides psychiatric care, is filled, Carrison said.

If those beds were vacant at UMC, Carrison said he would fill them with three times the number of physically ill patients.

Rosin is also working on a plan to curtail services in Las Vegas because of a declining number of psychiatrists. It will be several days before he has the final details, he said.

Rosin appeared before the state Board of Medical Examiners in Reno on Saturday asking for help. But the board said its hands were tied.

The division has been relying on out-of-state psychiatrists to temporarily come into Las Vegas to take care the growing caseload. On July 1, a new law went into effect, requiring these doctors to take a competency test if they had not taken the examination in the last ten years.

Rosin, who took over his position in February, told the board he has 18 positions available in Las Vegas. But there are only six psychiatrists on the job and another three are on sick leave.

And three of the temporary psychiatrists are leaving in the next two months with only one replacement coming to Las Vegas.

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