Friday, May 20, 2005 | 3:53 a.m.
WEEKEND EDITION
May 21 - 22, 2005
Officials at Montevista Hospital, a private facility for the mentally ill, say they have taken advantage of advancements in technology and medications to shorten hospital stays and get stabilized patients back into society quicker.
As for criticisms of the general health care for the mentally ill in Southern Nevada, Montevista officials maintain that improving post-hospital care of patients from both the private and state facilities will vastly improve overall care.
"I would not say the (mental health) system is broken, but rather there needs to be more coordination of services in facing the challenges," said Ingrid Whipple, chief executive of Montevista at 5900 W. Rochelle Ave., which celebrates its 20th anniversary in Las Vegas on Monday.
"There needs to be a better transition from the health care facility, whether it is us or the state, to (outpatient) psychiatrists and therapists."
Montevista serves mentally ill adults, teens and children who have health insurance; substance abuse adult patients with insurance; or self-paying patients. All other mentally ill people, including the homeless and otherwise uninsured, go to Southern Nevada Adult Mental Health Services.
While the care offered by both hospitals is comparable -- Montevista's facility is a little fancier, including having a swimming pool -- access to treatment has long been the big difference between the two hospitals.
Insured mentally ill patients in crisis generally go to quick care facilities that assess their condition and get them into the 80-bed Montevista facility within a few hours.
The uninsured go either to the county-funded University Medical Center's emergency room or the WestCare-operated triage center to be evaluated. But it has taken as long as two days for those patients to get admitted to the state hospital.
One day this month, there were 48 people waiting for beds at the 131-bed state facility to open up.
Last year Montevista treated about 3,000 inpatients, hospital spokeswoman Lauri Carlson said, noting there has been a 9 percent increase so far this year.
By comparison, the state facility also admitted about 3,000 patients to its crisis observation unit last year. About half of them later were admitted to the state psychiatric hospital for more extensive treatment.
Carlson says, however, that comparing the two hospitals is apples to oranges because Montevista's count includes mentally ill adults, children and adolescents in crisis, as well as adult chemically dependent patients, while the state's count is for adult psychiatric patients only.
Officials of the state-sponsored psychiatric hospital on West Charleston Boulevard say they are glad Montevista exists and wish there were more private facilities like it.
"We serve two different populations, but if Montevista didn't exist to serve the insured, we would have to serve everyone," said Dr. Jonna Triggs, director of Southern Nevada Adult Mental Health Services.
"One reason we are experiencing an emergency bed crisis is because there are not enough private beds. Charter Hospital closed a few years ago and Lake Mead Hospital, which is now North Vista Hospital, in North Las Vegas, closed its Medicaid psychiatric unit. We need all the players we can get."
Montevista's planning stage began in 1981 when then-owner Hospital Corp. of America searched for a Las Vegas site based on a 1977 study that determined Southern Nevada could use 285 private psychiatric beds.
"We don't have that many psychiatric beds in the entire valley now, and our population today is so much higher," said Dr. Harold Orchow, a psychiatrist who has been with Montevista since it opened and today is the medical director with a staff of 16 privately contracted doctors and 185 employees.
"That demonstrates how long the need has existed here for so many beds."
After HCA divested itself of its psychiatric division in the early 1990s Behavioral Healthcare Corp. took over Montevista and ran it until 1998, when Ardent Health Services took over.
Ardent has since decided to drop its psychiatric division and Psychiatric Solutions Inc. will take over as Montevista's owner. To date, each change of ownership has been a smooth transition, Whipple said.
Of all of the factors that have gone into health care treatment for the mentally ill, Whipple and Orchow say the advanced technology and improved medicines of the last 20 years have perhaps played the biggest role.
"Twenty years ago it was not uncommon for a patient to be in a psychiatric hospital for a few weeks to several months, while today, we get patients stabilized and back in their homes and on with their lives in a matter of a few days," Orchow said.
Montevista officials also point to other areas that have brought their program success:
One Las Vegas woman, a nurse and mother of three, credits Montevista's one-week inpatient treatment, six-week outpatient program and its ongoing alumni project for enabling her to overcome addictions to alcohol and the drug OxyContin nearly four years ago.
"Betty," who asked that her real name be withheld, lost one job for stealing drugs from a hospital where she worked.
"The programs made me take a real good look at what my addictions had done to my life and identified what I needed to do to stay drug and alcohol free," said Betty, 50. "The people at Montevista cared about me and made me feel my life was worth saving. I learned to face my lifelong disease as a day-to-day battle."
Betty said her addictions began before she moved to Las Vegas in 1998 and escalated from there, in part because of low self-esteem, which she said was boosted by the treatment she received at Montevista.
Today, Betty is back working as a local nurse.
Montevista officials say they are looking forward in the next 20 years to even newer technology and more improved medicines that will further increase their ability to meet patient needs.
But Whipple says the hospital's goals also must remain compatible with the grim reality that mental illness is not going to go away and may even get worse.
"We know there will always be people in need of care for mental illness," she said. "No ultimate drug will come along to cure all of the ailments associated with mental illness. To meet patients' needs, this facility may eventually have to expand."
archive
