Grim picture painted of mental health care in Nevada
CARSON CITY — Nevada mental and behavioral health officials presented a bleak picture Wednesday of the state’s ability to find quick and appropriate care for mentally ill people.
Dr. Tracey Green, the state health officer, said there is not enough space in the Rawson-Neal Psychiatric Hospital in Las Vegas and other hospitals, so mentally ill people wait and wait in emergency rooms for the next available beds. In January alone, an average of 139 people have been waiting each day on Legal 2000 three-day holds. She noted additional beds soon will open, but not enough to deal with the total problem.
“Either they wait or go to jail,” she told the members of the Nevada Behavioral Health and Wellness Council, an 18-member board that was created by Gov. Brian Sandoval by executive order in December. The council includes members of law enforcement, judges, legislators, mental health and budget experts.
Often mentally ill people are released to the street and then are readmitted to emergency rooms a day or two later, said Green. She added half did not need to be admitted in the first place, but there is no “clearinghouse” to determine initially what should be done with them.
The council, created in part because of patient dumping problems at Rawson-Neal, on Wednesday held its first meeting, which was teleconferenced between Las Vegas and Carson City. Its charge is to develop recommendations to improve the system that might be acted on by the 2015 Legislature. From Wednesday’s presentations, it is clear the recommendations will include requests for money.
“We are not going to get a significant increase to what we have (now) to work with,” said Clark County Sheriff Doug Gillespie, a council member.
Mike Willden, the director of the state Department of Health and Human Services, presented information that spending at the Southern Nevada Adult Mental Health Services dropped to $87.7 million in 2013 from $116 million in 2009. Rawson-Neal funds are part of this budget.
He said the cuts were made by the Legislature because of the recession and also his own lack of managing the spending. He said some funds were not spent and reverted back to the state general fund.
“We left money on the table,:” Willden said.
But he also said his agency is “getting back on track fiscally.
He noted that the spending authority for this two-year-budget period has been increased by $21 million.
But he also said national rankings that place Nevada 40th ($68 per person versus a $120 per person national average) in mental health are not correct since Nevada does not include federal Medicaid dollars in its accounting as some other states do. Medicaid spending on behavioral health in Nevada last year was $259 million versus $105 million in 2007.
“No one has a clue where any state ranks,” said Joel Dvoskin, the council chairman and a staff member at the University of Arizona medical school.
State Sen. Debbie Smith, D-Sparks, said the Legislature looked at the “least expensive” ways of making cuts. The cuts included limiting the amount of diapers available for patients.
Willden said his agency is processing 45,000 applications for Medicaid, which offers free health care to low-income people and families, and 100,000 more applications might be approved over the next year. The federal funds might be used to help Nevadans with behavioral health problems.
The Associated Press contributed to this report. Contact Capital Bureau Chief Ed Vogel at evogel@reviewjournal.com or 775-687-3901. Follow him on Twitter at @edisonvogel.
