Plan for mentally ill is questioned

By Emily Richmond (contact)

Monday, Aug. 19, 2002 | 11:18 a.m.

A proposal by Gov. Kenny Guinn to put $15 million in unused prison funds toward a new psychiatric hospital in Southern Nevada would be a small drop in a deep bucket, mental health professionals say.

"We're talking about a system that has been underfunded for decades," said Kathryn Landreth, chairwoman of the Southern Nevada Mental Health Coalition and the head of policy and planning for Metro Police. "We should look at this money as a stepping stone we can build on for future successes, not as the solution to an ongoing crisis."

Mental health officials were careful not to criticize the governor's plan unveiled last week, saying the money would be useful and a new facility is needed because of long waits for psychiatric beds in the Las Vegas Valley.

But many officials question whether the money will have an immediate impact in solving the crisis of inadequate mental health care.

Guinn's plan, unveiled last week, would use money left over from a prison expansion plan to build a mental health hospital with up to 150 beds in Southern Nevada. The governor said he hopes to see the project through in the next two years.

The $15 million in prison funds would probably pay for half of the costs of a facility, similar to a new 90-bed psychiatric facility, said Carlos Brandenburg, administrator for the state's Mental Health and Developmental Services Division.

It's unclear where the additional money would come from. But some mental health advocates said any money for mental health would be better spent on treatment, rather than hospital space.

Davette Shea, director of Emergency Trauma and Transport at University Medical Center, said more preventative services are needed to help mentally ill people before they reach the point of requiring hospitalization.

Many of the mentally ill patients who show up in the ER are repeat visitors, Shea said.

"This is an issue of recycling," Shea said. "We don't just need more beds, we need outreach programs that will monitor patients once they're released, so that they don't wind up back with us again a day or a week or a month later."

Health-care officials said that a hospital is a great idea, but they would rather have money to put more psychiatric workers in hospitals to make the best use of the beds available now.

The problem is that under state law the money the governor is offering can only be used for building projects.

Greg Bortolin, Guinn's spokesman, said that the $15 million should be considered "seed money" toward a larger goal of improving mental health services overall in Southern Nevada.

It's too early to speculate on where additional funds might be found for the project, Bortolin said.

"We're at the beginning of the process," Bortolin said.

The only state-run mental hospital in Southern Nevada, located on West Charleston Boulevard, is outdated and inadequate, Brandenburg said.

A new 90-bed psychiatric facility in Reno has made a "world of difference," in the treatment patients receive, Brandenburg said.

Lawmakers will hear suggestions for improvements from a coalition of citizens and mental health professionals at a legislative hearing later this month.

"We are way behind the curve when it comes to taking care of our citizens with mental health and disability issues," said Assemblywoman Ellen Koivisto, D-Las Vegas, chairwoman of the Health and Human Services Committee. "It's absolutely essential that we do something."

Mentally ill patients cost area hospitals $6 million last year in emergency room care, Shea said. Some patients languish for days in the emergency room, because a psychiatrist cannot be found to do an evaluation or there are no beds available, Shea said. UMC, the county-run hospital, has no psychiatrists on staff to do assessments.

Brandenburg acknowledged the need for more immediate services and programs, including crisis teams to evaluate mentally ill patients who show up at emergency rooms. Since January, Brandenburg said, he has filled eight vacancies for psychiatrists assigned to Southern Nevada, bringing the roster to 16. There are still two positions open, he said.

The staffing shortage made it difficult to meet requests for assessments, Brandenburg said.

"Ideally, we'll now be able to get in more quickly and move folks out of the ER to the appropriate setting," Brandenburg said.