Where I Stand — Jerry Keller: Better care helps us all

Friday, Aug. 23, 2002 | 9:22 a.m.

Editor's note: In August the Where I Stand column is written by guest writers. Today's columnist is Jerry Keller, sheriff of Clark County. SERIOUS, UNTREATED mental illness has reached a crisis level in Southern Nevada. Among our estimated 8,000 to 10,000 homeless people, up to 60 percent suffer from serious mental illness, substance abuse or a combination of the two. A much larger group of mental illness sufferers are less visible because they are scattered in private residences throughout the valley.

Untreated mental illness increases the incidence of suicide and attempted suicide and leads to a variety of criminal offenses, including assault, theft and public disturbance. For the past 10 years, Nevada has led the nation in suicides, double the national average. In two recent months, the Las Vegas Metropolitan Police Department responded to 789 calls reporting suicide attempts, probably a fraction of the actual number of such attempts.

The deficiency of our mental health system is seen in our overcrowded jails and in the backlog of mental health patients in our hospital emergency rooms. Nationally, approximately 16 percent of jail and prison inmates have serious mental illness. Many of these are "frequent fliers," who are recycled repeatedly through our jails for low-level criminal conduct because of lack of access to mental health treatment.

For example, Las Vegas Metro has identified 25 people in the downtown area who have accumulated 8,113 arrests among them since 1985. Local jail administrators rank mental illness among inmates as their top challenge in managing their facilities.

Las Vegas Metro has undertaken major steps to enhance its response to the community's mentally ill. Every uniformed officer receives additional training in identifying and effectively dealing with mentally ill individuals whom they encounter. In addition, a corps of volunteer police officers will receive 40 hours of specialized training to respond to people in crisis.

The Clark County Detention Center is piloting an aftercare program to help mentally ill individuals receive continued treatment once released from the jail to help prevent repeat offending, and Metro is supporting the establishment of a mental health court to help mentally ill offenders remain in compliance with their treatment programs.

The efforts of our police officers will have little effect, however, if there is no place to take people in need of mental health services. Our hospital emergency rooms are overcrowded with acutely mentally ill people who are held for hours or even days until one of the few emergency beds at the state hospital becomes available.

On a typical day, as many as 20 people are strapped on gurneys waiting for one of those beds. Holding mentally ill patients for long periods without treatment is unfair to the patient and also ties up resources that could be better used for individuals with acute physical ailments.

Southern Nevada Adult Mental Health Services currently has only 88 beds. Until very recently, only 10 of these beds were available for emergency care. By comparison, Reno has a state-of-the-art public mental hospital with a capacity for 80 patients to serve a population that is less than half that of Clark County.

Southern Nevada's mental health crisis is directly related to two factors -- the explosive growth of this community in the past 10 years and the impact of dramatic budget cuts made to the state mental health budget in 1992, from which the state is still recovering. And while we have been struggling to regain our funding losses, our community population has virtually doubled.

During his administration, Gov. Kenny Guinn has undertaken significant steps to remedy the situation. His recently announced plan to transfer funding from prison expansion to improved mental health facilities in Clark County is another major step forward. There is also growing support for a crisis triage center where people with mental illness can be dropped off and receive prompt, appropriate treatment.

With proper access to care, people with mental illness can lead responsible, productive lives. The National Strategy for Suicide Prevention cites the availability of basic mental health services as a primary factor in suicide prevention, and the absence of such care as a major risk for high suicide rate.

Spending public funds for mental health care is also a sound fiscal decision. Inadequate funding has placed a significant burden on our hospital emergency rooms, police, fire department, emergency medical technicians, jails and prisons, at a cost of hundreds of thousands of dollars a year.

Providing treatment before crisis or criminal conduct occurs can reduce the drain on emergency services and criminal justice resources. It is foolhardy to think that the community saves money by denying adequate mental health care when the cost of untreated mental illness carries such a hefty price tag.