State places psychologist at UMC to help with influx of mentally ill patients

State officials on Thursday placed a full-time psychologist at University Medical Center to help deal with the overflow of mentally ill patients coming through the emergency room.

The move follows a call for help from hospital officials, who earlier this week declared an “internal disaster” because of the high volume of mental patients they’re seeing in the wake of controversy and two physician terminations at Rawson-Neal Psychiatric Hospital. The upheaval at Rawson-Neal, a state-run facility in Las Vegas, followed an investigation into improper patient discharges.

Dr. Dale Carrison, UMC’s chief of staff and head of emergency services, said he appreciated the state’s assistance.

“I’m so glad we finally got someone’s attention,” Carrison said. “I’m glad state government has decided to address the problem. My nurses have been beside themselves” trying to address the needs of patients with physical problems as well as mental health problems.

Psychologist Dean Nelson will be at UMC from 9 a.m. to 5 p.m., Monday through Friday, said Dr. Tracey Green, the state’s health officer. He will help evaluate patients, help determine if they need to be transferred to Rawson-Neal and assist with the transition.

“We did it because they have a lot of our patients,” Green said. “To help them and help the patients.”

Southern Nevada Adult Mental Health Services, which oversees Rawson-Neal, also has a mobile crisis team that rotates among area emergency rooms, but UMC doesn’t participate in the program.

State and UMC officials are still working out the details of Nelson’s placement in the emergency room. Green said it could be a short-term measure or it could become permanent. “We’ll see how the flow of clients goes,” she added.

Carrison said it’s too early to know whether the additional resource will be enough to meet the increased demand at UMC.

“I’m hoping that it will, but I have to wait and see,” he said.

The move isn’t an additional cost to Rawson-Neal because Nelson is a current employee, Green said. Dr. Linda White, a medical director at Rawson-Neal and a psychiatrist, will oversee Nelson’s placement at UMC and the mobile crisis team. White will also assist at UMC if needed.

Mary Woods, spokeswoman for the Nevada Department of Health and Humans Services, said officials don’t have enough information to make a definitive determination as to what’s behind the high volume of patients in Clark County emergency rooms. She pointed out that the number was much higher in March.

However, Carrison said he’s never had 21 mentally ill patients at any one time at the UMC emergency room, as he did earlier this week.

Amanda Powell, spokeswoman for Sunrise Hospital and Medical Center, said the hospital is able to care for a variety of patients and is prepared for an increase of mentally ill patients.

“However, the emergency department is not the appropriate place for mentally ill patients to receive long-term care,” she said “Therefore, our community needs a lasting solution to a much larger problem.”
The Rawson-Neal physicians who were fired in the wake of the state’s investigation into improper patient dumping, Dr. Anurag Gupta and Dr. Rao Puvvada, were listed as senior psychiatrists in the hospital’s organizational chart.

Two more doctors planned to resign, according to a Rawson-Neal employee who asked not to be identified

Rawson-Neal has implemented a plan to address its physician shortage, Woods said. It includes expanding the residency program and contracting outside psychiatrists.

Rawson-Neal came under scrutiny after allegations of cross-border dumping of mental patients grew out of a Sacramento Bee report on a mentally ill patient who had been discharged and bused to Sacramento, Calif., with no support waiting for him.

A state review of 1,473 cases in which patients were bused out of state in the past five years found 10 that may have involved an improper discharge.

In addition to the two doctors fired this week, three other Rawson-Neal personnel face discipline for their roles in the 10 cases. Nine employees in total were involved in improper patient discharges, but four no longer are employed at the hospital.

Contact Yesenia Amaro at yamaro@reviewjournal.com or 702-383-0440.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.