Costly Status Quo

We've been warning of this for some time. And now, we are beginning to see the consequences. Nevada's largest psychiatric hospital, Rawson-Neal in Las Vegas, has faced disturbing allegations of mental health patient dumping since April. And today, an independent investigation of Rawson-Neal concluded that while many of the discharges were proper, quite a few were not.

The state hired Dr. Kenneth Appelbaum, a professor of psychiatry at the University of Massachusetts Medical School, and Joel Dvoskin, a clinical psychologist and faculty member at the University of Arizona College of Medicine, to examine the hospital's practices.

The two spent a week at the hospital earlier this month. Among their findings:

• Hospital staff often feel pressure to discharge patients quickly to make room for more.

• The hospital relies too heavily on treatment with medications and not enough on psychotherapy or behavioral therapy.

• Staffing levels are not adequate for the large volume of patients seen at the hospital.

The consultants recommended that the state increase the number of staff positions at the hospital by about 5 percent. They also recommended that the hospital "increase the amount of high-quality, evidence-based treatments beyond the provision of psychotropic medication."

Boosting staff levels, along with ensuring each patient has a clear treatment plan upon discharge, may reduce the number of patients improperly bused out of state without housing or treatment waiting at their destination.

"Every single state has seen massive budget cuts in their mental health system," Dvorkin said in an interview. "Billions of dollars nationally. It isn't just Nevada. In my opinion, we are starting to see the impact."

Surprise! Chronic underfunding of our state's social safety net is leading to ghastly consequences. Who could have guessed this?

As we've explained before, Nevada is finally experiencing a rude awakening. We can no longer afford lulls of complacency. The strained economy and tattered social safety net won't allow for any more.

At least Governor Brian Sandoval (R) has finally agreed to address the problems with Nevada mental health care. Yet with that said, is he ready to truly fix the systemic ills behind this latest scandal? His latest actions cast doubt. And it's not as if the Legislature now has the appetite to do something.

So for now, we're mostly stuck with the status quo. Look at how much it's already costing us. How much more can we afford?