Las Vegas Sun

May 27, 2015

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Sun Editorial:

An outrageous case

Nevada needs to clean up its act after claims of patient dumping

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A damning series of stories published this year in the Sacramento Bee accuses Nevada of systematically dumping mental health patients on other states, particularly California. According to the Bee’s analysis, the Rawson-Neal Psychiatric Hospital in Las Vegas over the past five years discharged more than 1,500 patients to the Greyhound bus station with one-way tickets out of state.

The details of some of the cases are awful. Consider what happened to James Flavy Coy Brown, who had spent three days in the Las Vegas hospital being treated for schizophrenia and other mood disorders. He says he was told there was no place for him in Nevada and sent by taxi to the bus station.

Brown had a ticket to Sacramento, a few days’ worth of medication, some crackers, bottles of Ensure and not much else. He didn’t have identification, had never been to Sacramento and didn’t have any friends or family there. He had no follow-up treatment plan besides a verbal instruction to call 911 when he arrived.

He was set up to fail. He told the Bee that he wondered whether he was destined to die in Sacramento. Thankfully, people in California were able to help Brown, and he eventually found a place in a halfway home.

Good for California.

Nevada, however, should be appalled and ashamed.

A state investigation into the allegations is ongoing, and so far state officials admit they “blew it” in Brown’s case, but they don’t think this is widespread. The state has given people one-way bus tickets and sent them packing, but state officials say the idea has been to reunite people with families and support networks back home.

As Mike Willden, director of Nevada Health and Human Services, puts it, Las Vegas is a “mental health magnet,” and people from all over the world end up here without the support they need. Willden said 2,400 of the 31,000 people admitted to the Rawson-Neal hospital over the past five years had out-of state addresses.

Logically, it would make sense to reunite people with their families, assuming the patients will find support when they arrive. But that’s not what happened in Brown’s case — his daughter lives on the East Coast — and there was nothing in place to help him. Brown’s case is the picture of patient dumping.

State officials this past week said they have tightened procedures to make sure that anyone bused out of state has an escort, but the question still remains about how other cases were handled.

Perhaps Brown’s case is an anomaly, and as proud Nevadans, we would like it to be so. Still, it’s not difficult to understand why people would accuse Nevada of dumping mental health patients. The state, as a whole, has been negligent when it comes to mental health care, much less social services. Mental health budgets have been sparse and have repeatedly been targeted for cuts. Given that, were one-way bus tickets the best the state could do? Was “Greyhound therapy” a way to ease an overcrowded system?

That would be a crass and cynical view that we hope isn’t true, but Nevada’s attitude toward the mentally ill has been awful. At best, it’s an attitude of benign neglect; at worst, it’s cold-hearted and mean. There’s a prevailing belief that people should pull themselves up by their bootstraps, and the taxpayers aren’t responsible.

But what about the people who don’t have the ability, means or support to pull themselves up? People such as James Flavy Coy Brown.

It has been said that a society is measured by the way it treats its weakest members, and Brown’s case speaks volumes. It’s not acceptable that even one person was treated this way.

Nevadans need to do some soul searching. Brown’s case and the allegations of patient dumping are symptoms of a state that has ignored problems and left the most vulnerable in jeopardy. That has to change.

The Bee’s stories have left a deserved black eye on the state. Improving social services and mental health care are issues that won’t win much applause, much less elections, but political and civic leaders have to take on the task. Nevada has to be better than this.

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