Nevada lawmakers approve $2.1M for mental health

LAS VEGAS (AP) -- State lawmakers unanimously approved a plan Tuesday to fast-track $2.1 million to improve southern Nevada mental health programs, although some say it's not enough to get the system on track for the long term.

The shot of money — which will help bring on 23 new staff members and expand a hospital by 22 new beds, among other things — comes amid months of criticism about the state's patient discharge policies and shortly after Rawson-Neal Psychiatric Hospital in Las Vegas lost accreditation from the nonprofit Joint Commission.

"The governor is determined to find long-term solutions to help the mental health community throughout Nevada," said Gerald Gardner, chief of staff for Gov. Brian Sandoval, who requested the special Interim Finance Committee meeting after the Joint Commission pulled accreditation.

At the meeting Tuesday, state officials outlined a variety of problems plaguing Nevada's mental health programs, including a ballooning number of patients lingering in emergency rooms instead of psychiatric facilities, a long waiting list for inmates destined for a Sparks psychiatric center and difficulties hiring staff on low pay.

The problems have led to lawsuits, including one from the Clark County public defender's office. That suit takes issue with the waiting list for the maximum security Lakes Crossing Center, which swelled from six inmates in November to 36 in July.

Mike Willden, Nevada's chief of health and human services, also cited an "alarming" surge of people taking up the Las Vegas area's estimated 500 emergency room beds while they wait for longer-term psychiatric treatment. In March and April, mentally ill patients occupied about 65 of those beds on any given day. In July, that figure jumped to 144.

There were no easy answers to what's causing the surge. Willden said some of the growth comes as patients are staying longer at Rawson-Neal, and he suggested some doctors hesitated to release people from the ER after a recent incident in which a discharged patient committed suicide.

Willden also told the committee that relatively low state wages were making it difficult to hire psychiatrists and other mental health staff.

"We can recruit them," he said. "We can't close the deal."

While Willden noted that the state's budget has rebounded from the depths of the recession, he cautioned that lawmakers would need to continue putting money toward mental health to maintain the program's quality.

That's something the state's been too slow to do in the past, according to several legislators who spoke at the meeting.

"I have a lot of frustration for this," said Sen. Debbie Smith, D-Reno. "Over the past couple of cycles we've failed to acknowledge that yes, this is about money, because it's money that provides beds and money that provides staff."

Deficiencies in the state's mental health system came into stark relief in March, after The Sacramento Bee published the story of a patient who was discharged from Rawson-Neal to a bus bound for Sacramento, where he had no support system.

Within three days, the state requested three separate investigations on the topic and commissioned two consultants to recommend improvements at the hospital, Gardner said.

Problems with discharge procedures were one of the reasons Joint Commission officials said they'd pull the hospital's accreditation in July.

State officials aren't appealing that decision, which was based on an inspection in May, but want to seek the voluntary accreditation from the Joint Commission again soon and plan to be ready for an inspection by December.

The hospital can still operate without accreditation, but the demerit has consequences, including making it difficult to bring in medical students who are completing their residencies.