EDITORIAL: More shame for Nevada’s awful mental health system

Nevada’s disgraceful mental health system is back in the news for the wrong reasons. The Sacramento Bee, which previously uncovered improper patient discharges and out-of-state transports from the Rawson-Neal Psychiatric Hospital in Las Vegas, reported more troubling findings this week: some patients were bused out of town despite facing criminal charges in Southern Nevada.

When the state is simultaneously prosecuting suspects and helping them evade prosecution, it’s a serious problem. Nevada might as well fill a fleet of charter buses at the Clark County Detention Center and ask the inmates where they’d like to go.

Gov. Brian Sandoval was justifiably “appalled” by the newspaper’s report and said a new investigation was underway. After the Bee reported hundreds of patients had been bused out of Las Vegas unaccompanied, and sometimes to places where they had no ties and no family (one such transport to Sacramento triggered the inquiry), Gov. Sandoval ordered an investigation that resulted in major discharge policy changes, the termination of two doctors and a requirement that transported patients have a chaperone.

On Thursday, Gov. Sandoval announced 18 appointments to the new Governor’s Behavioral Health and Wellness Council, which is charged with making recommendations to improve the delivery of mental health services. Their first recommendation is a no-brainer: Require Rawson-Neal and other mental health institutions to conduct criminal background checks on patients upon admission. This week’s Bee report noted hospitals aren’t required to do so, which is, well, insane, considering the severely mentally ill have frequent contact with police. In the interest of public safety, institutions must know if a distressed patient is a suspect in a crime, has a history of violent crime or is a sex offender.

Not surprisingly, the Bee also determined that some patients bused out of Las Vegas went on to commit crimes. No state has the resources to keep the severely mentally ill out of trouble forever. Dialing the clock back several decades and reopening the asylums that served as prisons is not an option. No one should want that, even if they could afford it.

The difference between Nevada and other states, however, is that Nevada lacks the resources to treat its own residents, let alone those who drift into town from somewhere else. Adequate mental health treatment is expensive, and the state has cut tens of millions of dollars from its mental health services in recent years. Are we willing to rebuild those programs at great expense for the benefit of a tiny, vulnerable, volatile share of the population?

As the governor’s panel is sure to conclude, we can pay now or pay dearly later.


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