Thursday, May 30, 2013 | 2 a.m.
No one is more intimately aware of the gaping holes in our mental health safety net than Marilyn Rogan-Smith.
She retired as a captain at the Clark County Detention Center, where she oversaw medical and psychiatric treatment in what is Southern Nevada’s largest de facto mental health facility.
Her son Adam was born with a birth defect in 1985 and had skull surgery when he was 4 months old. Unbeknown to the family until years later, the surgery left Adam with brain damage that seems to have manifested itself as mental illness, including schizophrenia, obsessive-compulsive disorder and attention deficit disorder.
“Because my son needed services so badly, I was driven to be an advocate and find the best mental health services out in the community. Unfortunately, in Nevada, that’s a struggle,” she said this week.
Adam got caught in a common cycle beginning around age 13 — when he was faithful about taking his medication, he was healthy and productive. Then he would consider himself cured — wanting to free himself from the stigma of mental illness — and stop taking meds. When problems quickly arose, he self-medicated with drugs and alcohol. Jail, emergency rooms, institutions.
In April 2012, Adam died of cardiac arrest, though his untreated mental illness was the real cause, Rogan-Smith said.
“The death of my son nearly killed me,” she said. She isolated herself and began raising Adam’s 4-year-old daughter Alayna, whom she and her husband have adopted. Alayna’s mother, who also suffered from mental illness, took her own life after Adam died.
Then Rogan-Smith got a call from Jeff Iverson, a local business executive who also runs sober living facilities.
His proposal: Take over a recently shuttered facility for the homeless and mentally ill on the Owens Avenue Salvation Army campus and start their own program of housing and treatment.
Today, Adam’s House has its grand opening.
“It’s like Adam’s life has meaning,” Rogan-Smith said.
“I couldn’t help him, but maybe another parent doesn’t have to go through the pain of losing a child to this disease,” she said. “And hopefully we can help them live with dignity and self-respect, and they’ll be productive members of society.”
The facility has room for 42 people, with an additional nine separate studio apartments for residents who gain independence.
The goal is a family environment and immersion in all the necessary services in one place, including a consistent team of caregivers who will provide continuity of treatment.
The need is so great in the Las Vegas Valley that nearly all the spots are already taken, with more referrals coming every day.
While I was interviewing Richard Holligan, another co-founder and a psychiatric nurse, he received a call from a doctor at a hospital looking to place a patient. She is no longer a threat to herself or others, but where does she go now?
“There’s no place to discharge her to, so the cycle starts again,” Holligan told me.
Luckily, with the opening of Adam’s House, he could head to the hospital and evaluate her to see if she’s a good candidate. Turns out, she was, and now she’s at Adam’s House.
But Adam’s House is a drop in the bucket. There are scattered group homes in the valley, mostly full and some better than others, but for the most part, a lack of transitional housing with services is a big problem and a key reason our mental health system operates in perpetual crisis. Patients bounce around from emergency room to the state-run Rawson-Neal Psychiatric Hospital, to the jail and back to the streets, in a never-ending vortex.
“Nevada waits until the person is in crisis,” Holligan said.
In 2010, our per-capita mental health spending was 57 percent of the national average, and we’ve cut around $80 million from mental health since the start of the recession.
Of Adam’s House, Rogan-Smith said, “It’s a start.”
Indeed it is. And kudos to this plucky team for its efforts.
But I find the timing of the opening of Adam’s House bitterly ironic, coming as it does in the closing days of a legislative session that will once again be known for its inaction when it comes to protecting the state’s most vulnerable citizens.