Las Vegas Sun

December 19, 2014

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Sun editorial:

Crisis in mental health

State should not be content to let Clark County jail act as an ineffective psychiatric clinic

Nevada needs a long-term plan for treating people with mental disorders, as shown by the inmate population at the Clark County Detention Center.

On many days, one out of every five inmates has been diagnosed as mentally ill. Some days mentally ill people come closer to numbering one out of every four in the jail’s 3,000-plus-inmate population.

These facts were disclosed in a story Sunday by Las Vegas Sun reporter Timothy Pratt, who interviewed the jail’s chief psychiatrist, Keith Courtney. The jail, Courtney remarked, is “the largest mental health facility in Southern Nevada.”

As Pratt pointed out, however, because the jail cannot provide sustained treatment, it is also the most expensive and least effective mental health facility in the region. And that includes hospital emergency rooms, whose heavy use by mentally ill patients is also costly and largely ineffective. One day last month, for example, Pratt reported that one in every three area ER beds was occupied by a mentally ill person.

The state-run Rawson-Neal Psychiatric Hospital in Las Vegas has room for 204 patients. Clearly, the state is not meeting its responsibility to care for mentally ill people in Southern Nevada.

Because there is often nowhere to house and treat them, most psychologically impaired people who commit crimes are jailed — and eventually returned to the streets. The streets, of course, offer opportunities for obtaining illegal drugs and for committing more crimes. The chances that mentally ill people on the street will pursue outpatient therapy are virtually nil, so many end up back in jail.

This cycle is one reason why Clark County spends $4 million a year on mental health treatments in its jail, treatments that most of the time do not do any permanent good.

For at least the past 20 years, state government has underfunded mental health care and local taxpayers are paying more because of it — through costly services that are only minimally effective. Even if the recession persists, the Nevada Legislature urgently needs to devise a plan that will reverse this trend.

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