A Mother’s Nightmare

Heather Rawlyk and Timothy Pratt

Friday, Nov. 19, 2004 | 4:59 a.m.

WEEKEND EDITION

November 20 - 21, 2004

Henderson resident Jeanine Blackwood couldn't help but notice that all eyes were on her when she clocked in at work on Sept. 15.

With newspaper in hand, a co-worker approached Blackwood and asked her if she'd seen the news: 23-year-old Richard Lentino had been arrested in connection with the deaths of his mother, sister and infant nephew.

The co-worker quickly pointed out that Lentino was bipolar, according to his father and his roommate, and had allegedly strangled his mother to death.

"I immediately felt my stomach drop and had to sit down," Blackwood said. "(Because) the first thing I thought was this boy sounds just like my son. Everything, all the mannerisms, they're identical.

"This family died, and I'm going to be next if my son is not put away somewhere."

Her 31-year-old son, Jason Blackwood, who has been diagnosed as schizophrenic with bipolar tendencies, has slipped through the cracks in the Las Vegas Valley's overburdened mental health care system for the past two years, just as Richard Lentino apparently had before he allegedly killed his relatives.

"It's like a revolving door -- he (Jason) is in and then he's right back out again -- does this sound familiar?" she said. "The mental health system and Henderson Police, no one's doing anything about my son, not even after the Richard Lentino thing.

"You'd think they'd be trying to be more careful and see the warning signs, but no one's going to do anything until he shoots or stabs me. No one's going to help me until it's too late and he has strangled me."

Mental health officials say the system -- which was declared to be in a state of emergency by Clark County officials on July 9 -- is overloaded, and it often takes a major incident before something is done.

"The system is so inundated that there is a tendency for some of these cases to fall through the cracks," said Maurice Silva, director of the Program for Assertive Community Treatment, a state program which helps the mentally ill -- often homeless -- who don't get the proper care.

Blackwood sees a system that has had its chances with her son but hasn't acted.

She moved to Henderson from California with Jason, who has lived with her all his life, because she could afford a house in Southern Nevada. Since moving, she has called Henderson Police more than 25 times because of her son, she said. Her repeated efforts to get the mental health system to pay attention and take care of her son have failed, she said.

Gaps in the system

A Sun investigation found that a lack of communication between police, civil court and mental health workers has put Jason back on the streets several times without psychiatric care. He has been arrested for domestic battery twice, once for allegedly choking his mother and leaving visible red marks around her neck, according to an arrest report.

He has been cited for arson for building a bonfire in his mother's yard, the fire fueled by her possessions.

And after neighbors called police the day Jason flooded his mother's house by stopping up all the sinks and toilets and running water incessantly on Sept. 12, police took him to a hospital for evaluation because he appeared to be mentally ill, Officer Todd Rasmussen, Henderson Police spokesman, said.

In that case, within days, despite promises from a mental health advocate that her son would be admitted into the state psychiatric hospital, Jason was back on his mother's doorstep with a hammer in his hand, she said.

He is now in jail on an arson charge awaiting a hearing next month to determine if he is mentally competent to stand trial. His mother says he isn't. One psychiatrist has agreed, and Jason is waiting for a second evaluation before a judge decides if he should be hospitalized. Blackwood has been down this road before. Psychiatrists have previously disagreed, and her son was found competent, after which he continued the behavior that landed him in trouble. She said Jason told her he thinks he'll be found competent and be back home soon.

A recent court hearing didn't help assuage her fears as Jason sat in court chained to Richard Lentino.

Blackwood is afraid and is letting people know that. But she fears her concerns are lost in the system.

She has repeatedly spoken to police and mental health officials to protect herself and others and to get help for her son. The police look to mental health workers to take care of the problem, while mental health workers say they need police cooperation.

While Henderson Police officers get basic training in dealing with the mentally ill, they do not have a specially trained team to respond to such problems.

And, Rasmussen said, depending on the circumstances, there could be little for police to do.

"It's not illegal to be mentally ill," he said. "Not everything that scares people is illegal."

If a person is an immediate danger, police can make an arrest or take the person to get help from mental health officials, Rasmussen said.

In Jason's case, police have done both.

For nearly two years, he was one of 6,800 outpatients at the state's four mental health clinics. Outpatients live in the community and go for regularly scheduled visits with state psychiatrists.

These patients are different from those who wind up in the state's backlogged psychiatric hospital at 6161 W. Charleston Blvd. Called "6161" by authorities and patients alike, it is the destination of many currently clogging up the valley's emergency rooms while they wait for a bed to open.

Outpatient clinics are also overburdened, in some cases ill-equipped and often not coordinated with law enforcement -- problems that make it difficult to zero in on patients who are potentially violent.

Poor communication

Jonna Triggs, director of Southern Nevada Adult Mental Health Services, said "there's a lot of stress on the system" because the nine psychiatrists are assigned about 755 patients each.

The state budgeted them to handle 345 patients each, she said.

Based on patient load and their work hours, psychiatrists would have about an hour and 45 minutes to spend with each patient over the course of a year -- if they spent no time on paperwork, meetings or anything else.

That leaves little time to follow up or catch cases before they fall through the cracks.

Add to that the communication difficulties that appear to exist among different systems -- for instance between the mental health system and the legal system -- not to mention the problems within the mental health system in Clark County.

Despite nearly two years of regular visits to an outpatient clinic on East Lake Mead Drive in Henderson, it took until Aug. 18 for an "intensive service coordination" assessment to be scheduled for Jason, according to state records.

The assessment was slated for Sept. 15 at 6161 -- but Jason never made it.

Intensive service coordination is case management intended for patients with "serious mental illness and (is) usually (for) people coming out of prison," Triggs said.

"But there are cases where it's used as a preventive measure to keep people from going to prison. It may be (suggested) when something starts to give doctors a red flag," she said.

Triggs said it is difficult for employees of the mental health system to find out about patients' run-ins with the legal system unless the police, patients or someone else volunteers such information.

Blackwood, however, said she had been telling workers at the Lake Mead clinic all along of her son's numerous run-ins with the police, including convictions for domestic battery.

Before Jason could make the Sept. 15 appointment, police were called by neighbors to his mother's Henderson home on Sept. 12 and he was taken to Summerlin Hospital's emergency room, where a bed was open. There, he received a physical examination as required by law and waited -- for a week -- for an open bed in the state's psychiatric hospital.

While he was in the emergency room he missed his assessment appointment at 6161, and wound up at the intake section of the state hospital on Sept. 19. He was released a day later.

Triggs said it is hard to say if state hospital personnel ever knew of the pending appointment on Sept. 15 when he was admitted.

Blackwood said she tried to tell 6161 personnel of the appointment, information that cannot be verified because her son's contact with the state is protected by federal privacy laws.

If 6161 personnel had received notice of the appointment, Triggs said, the assessment could have been done there, and "it could have resulted in more intensive care," although there is a waiting list for that category of care.

Part of the problem, she said, is that there is no electronic database shared by the different parts of the state mental health system. That allows for "gaps in the information."

"Keep in mind that Henderson is 20 miles away from here (6161), and they may not have information from there," Triggs said. "It may not have ever been faxed."

Revolving door

The troubles don't end with poor communication and missed appointments.

Just one day after getting a Family Court judge to issue an order to have Jason picked up for a psychiatric evaluation, he was arrested by Metro Police for fourth-degree arson. That means that, yet again, because of the disconnect between the judicial system and the mental health system, Jason is not getting the help he needs, Blackwood said.

"This really just makes things worse," Blackwood said. "Now I'm not guaranteed anything. He could be let right back out. And that's probably what will happen now. He'll go back through the system, and I'll be back where I started."

The civil petition Blackwood obtained to have Jason taken to a hospital expired four days after she received it, about the same time as his first scheduled court appearance on charges of starting a fire inside a glass on top of a garbage can in Mandalay Bay.

Triggs said now that Jason has been arrested, the civil petition is "a moot issue."

"A civil petition does not take precedence over an arrest for a crime," she said. "So now I would imagine he would have a competency evaluation at the detention center, and then it would be up to the judge whether he sees us (at 6161) or not."

Jason remains jailed, awaiting his arraignment. Blackwood said her son was banging his head inside a holding cell before the most recently scheduled hearing, and the arraignment was postponed until this month.

The court will still have to decide on whether he's competent to go forward. In the meantime, he'll be at the jail.

Dr. Craig Essex, chief psychiatrist at the Clark County Detention Center, said inmates are screened for medical and mental health issues. But whether the person is found to be mentally ill is not presented to the judge during the hearing.

"I evaluate them to consider prescribing medication or special housing in the detention center," he said. "But everything we find is treated as confidential medical records and it would be up to him (Jason) to sign to have them given to the judge. So unless his mother or someone presents this information to the judge, the judge wouldn't know about what's been going on and could let him out.

"It sounds bad, I know. Sounds like people really aren't communicating and they don't know about this man's past and problems with police, which seem to be important."

The gaps caused by such poor communication have Blackwood frustrated by the system and its seeming inability to help her, even so soon after the widely publicized triple-homicide for which Lentino is charged.

"My son is obviously a danger to me and a danger to the community," Blackwood said. "Compare their mannerisms. My boy is the mirror image of Richard Lentino."

Jason, interviewed by phone from his room at the Happi Inn -- across from Mandalay Bay -- the day before his arson arrest, said he doesn't know why his mother wants him institutionalized.

When asked about his relationship with his mother, Jason abruptly ended the conversation and said, "I have to go take a bath." Water could be heard running in the background during the several-minute interview.

Blackwood said one of the manifestations of her son's illness is that he likes to run faucets and sprinklers constantly. He also sometimes walks around with a hammer in his hand. She believes that's similar to Lentino's reported habit of carrying a butcher knife around with him.

Often wandering

Jason is often seen wandering around outside, talking to himself, looking from side to side and grinning, just as Lentino allegedly did prior to his arrest, Blackwood said.

But arguably the most important similarity, and perhaps the most terrifying, is the way the two allegedly were so easily discharged from state psychiatric care and supervision, Blackwood said.

Lentino's roommate said he had taken Lentino to 6161, but was surprised by Lentino's release just three days later.

Soon after, Lentino killed his three relatives, police say.

Officials with Southern Nevada Adult Mental Health Services, the state agency that runs the psychiatric hospitals and some valley outpatient clinics, said they could not discuss any specifics about Lentino or Jason's case because of health care confidentiality laws.

"With this on their hands, you wouldn't think they'd let a boy who is just like Richard Lentino leave just one day after being admitted," Blackwood said. "They have a chance to prevent another ... crime, and they're not going to."

She said she is taking the warning signs very seriously, even if no one else is.

"I'm not taking any chances," she said.

Given her son's history with the system and how he has been in and out, Blackwood has put a deadbolt on her bedroom door and keeps in her bedside table a can of mace -- which she takes with her wherever she goes, she said.

She also recently filed a restraining order against her son, she said, and is looking for a house in Pahrump so she can get away from him.

Blackwood's neighbor, Gordon Johnson, who has a degree in psychology from Stanford University, also believes Jason "has slipped through the cracks."

"This is the worst blatant passing of the buck I've ever seen in my life," Johnson said. "Police, mental health, judges, doctors -- no one wants him.

"Somebody better start taking this seriously, or we're going to have another Richard Lentino incident on our hands here. If he's back out on the streets and he's allowed to be coming back over here, that lady (Blackwood) is going to be dead in less than a year."

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