Las Vegas Sun

October 20, 2014

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Sun editorial:

Nevada has to do better than this

With treatment still subpar, the state needs leadership on mental health issues

A federal judge on Wednesday dismissed a lawsuit alleging that Nevada dumped mental health patients on other states.

The lawsuit came after a string of damning news stories about Nevada’s mental health system, and it says officials at the Rawson-Neal Psychiatric Hospital in Las Vegas regularly discharged patients with one-way bus tickets out of Nevada.

The Sacramento Bee reported that since 2008, more than 1,500 patients had been discharged and sent out of state.

The plaintiff in the lawsuit seems to be the picture of patient dumping. James Flavy Coy Brown, a homeless man who was hearing voices, was discharged from Rawson-Neal after two days of treatment and sent to the Greyhound bus station with a ticket to Sacramento. He said he had never been to Sacramento and didn’t know anyone there.

Judge James Mahan dismissed the suit, saying the arguments Brown’s attorneys made didn’t support allegations that Brown’s constitutional rights were violated. The ruling leaves the door open for Brown’s attorneys to rework their arguments and file the case again, which they plan to do.

For Nevada, it was a technical win, but it is hardly a victory.

The state’s defense was about the legal issues raised in the case, and the judge ruled, as he was supposed to, on the law. The larger issue is a moral one, and that lies outside of the courtroom. It’s an issue that the governor, state leaders and lawmakers will have to deal with.

The question for them isn’t whether this is legal but whether it is right to treat people this way.

Nevada’s track record on mental health issues is terrible. It wasn’t until 2006 that the Rawson-Neal hospital opened, and that was only after local emergency rooms were overwhelmed with mental health patients.

Mental health funding has been tight for years. The Kaiser Family Foundation found states on average spent $120.56 per capita in 2010 on mental health agencies; Nevada spent $68.32.

The result is that Nevada’s mental health care has lagged behind the rest of the nation. According to the National Alliance on Mental Illness, Nevada has among the fewest psychiatric hospital beds per capita in the nation, and it says that between 2009 and 2012, the state cut general fund spending on mental health by 28 percent.

The lack of resources, from money to facilities able to treat the mentally ill, may be why Rawson-Neal relied on “Greyhound therapy.” In Brown’s case, after two days on psychotropic medicine, he was sent to the bus station with enough medicine for the 15-hour bus trip and a few bottles of Ensure. His care plan essentially consisted of the advice to call 911 in Sacramento.

Federal reviews have criticized Rawson-Neal, and the hospital just closed a walk-in clinic that was found to be out of compliance with federal standards. The clinic’s closure will only further stress mental health services in Southern Nevada.

The governor and his staff have said they are moving to address the problems, and the Interim Finance Committee this past week pledged $4 million more to improve staffing at the hospital.

But that sounds like too little too late. The state needs real leadership on mental health issues, but we’re not holding our breath. Mental health issues don’t drive voters to the polls. But the story of Brown and others should.

For years, state lawmakers and governors have shrugged their shoulders and complained of tight budgets, but they should realize that budgets have real-world implications. It is unconscionable that the state treats the most vulnerable of society this way.

In Brown’s case, the state failed, and the failure could have had catastrophic consequences. How many more chances are we willing to take?

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