Dan Morain: Nevada sets itself apart with ousting of mentally ill

April 16, 2013 

Nevada Gov. Brian Sandoval unveiled a cheery little ad that displays the Silver State's sunny side set against a toe-tapping version of "Don't Fence Me In," the sort of tune that can worm its way into your head. The governor proudly displayed a new slogan: "Nevada: A world within. A state apart."

Funny, but Sandoval can't bring himself to talk about a policy that truly sets Nevada apart: busing patients from Rawson-Neal Psychiatric Hospital in Las Vegas to every state in the continental United States.

"We are going to decline to comment," Sandoval's press secretary, Mary-Sarah Kinner, emailed, before she stopped bothering to respond at all.

Those snappy 30-second commercials started airing Monday in Los Angeles, San Francisco and Phoenix, which send the most tourists to Nevada.

Nevada also buses many of its psych patients to those areas, 240 to the Los Angeles area, 48 to the Bay Area and 71 to the Phoenix area since mid-2008.

"We're not amused by what they're doing," said Orange County Supervisor John Moorlach, who, like other California officials, hadn't known of Nevada's practice.

As Nevada quietly carried out its policy, it failed to inform mental health care professionals on the other end of the bus rides. But in February, Rawson-Neal's staff stumbled by giving James Flavy Coy Brown a three-day supply of anti- psychotic medication, four bottles of Ensure and some "cheesy peanut butter crackers," and sending him on a 15-hour bus ride to Sacramento, where he has no family and no connections.

Brown, who has schizophrenia, made his way to the Loaves & Fishes shelter where a social worker listened to his story and got his permission to call reporter Cynthia Hubert. She has been writing about Brown ever since.

We used Nevada's public records act to get receipts of all bus tickets purchased by the Nevada mental health department back to mid-2008 and found that the state bused 1,500 people from its Las Vegas psychiatric hospital to cities in every corner of the country. It recently bused two people from Rawson-Neal's inpatient wing 2,200 miles to Miami and three people 2,400 miles to Boston -- presumably with no escort, but with 18 bottles of Ensure each.

As governor, Sandoval presided over cuts in mental health funding as Nevada stepped up its out-of-state busing program. In 2010, the year before he took office, Nevada bused out 290. In 2011, it was up to 361, and in 2012 it was 388. This year, 81 have been dispatched, putting Nevada on track to bus out more than 400 people in 2013.

Nevada authorities were cavalier in their care of James Brown. But they are strict about the privacy of those they bused, careful not to release any names. That leaves questions. How ill were those being bused? Did they make it to their destinations? Did any harm themselves or others along the way?

Mike Willden, director of Nevada Health and Human Services, explained that when out-of-towners deteriorate, he said, "we're using our funds, our resources, to treat that mentally ill patient. ... We're going to attempt to get you connected with your family, your friends and your resources in your community. So if you look at most of the bus transports we've done, that's what we've done. We've connected them to their community."

If Nevada authorities truly want to reintegrate those individuals, rather than dump them, case workers probably would have called ahead to mental health workers in target counties.

"I have not received any communication from anyone in Nevada," Orange County behavioral health director Mary Hale said, echoing other non-Nevada officials.

Willden explained: "I don't know that the county would know about it. But the family, friends and the treatment program we're sending them to should know about it."

The governor, meanwhile, portrays himself as a family man, with three children and a first lady who works "to advance awareness of children's mental health issues." How nice.

A former Nevada attorney general and federal judge, Sandoval is mentioned as vice presidential timber. And Willden said Sandoval has been reading about Brown and "is very concerned. ... You'll have to ask the governor beyond that what his opinion is."

I tried during my day in Carson City. But Sandoval was busy unveiling Nevada's "awesome" new brand. Nevada: A world within. A state apart. One that has a cold-blooded policy born of a lack of compassion for people who cannot care for themselves. Think of it when you hear the catchy new rendition of "Don't Fence Me In."


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