The Novel Method Nevada Uses to Reduce Mental Illness in its State: Patient Dumping

Treating people with mental illness takes time, effort, money and resources. People with chronic serious mental illness — such as schizophrenia — sometimes find themselves homeless and reliant upon the state’s public health system for care.

And sometimes that public health care is a little… how shall we say? Lacking.

So last week it shouldn’t have been much of a surprise when Nevada was accused of patient dumping. A psychiatric hospital in Las Vegas, Rawson-Neal, apparently discharged a patient to a bus station to catch a bus to Sacramento, California with a one-way ticket. The patient was under the care of the Southern Nevada Adult Mental Health Services.

The only problem? The patient had no contacts or family in Sacramento, California. He knew absolutely no one there.

While it’ll be a few weeks before we know the full story (after a hastily-called state investigation into the practice), we do know this. The patient, James F.C. Brown, arrived Feb. 12 in Sacramento after a being given a one-way ticket to take a 15-hour bus ride from Las Vegas:

He told social workers he was forced to go to Sacramento, where he had never been and knew no one. […]

In Brown’s case, the discharge paperwork from Southern Nevada Adult Mental Services had no detail about who or what organization might help him in Sacramento. The paperwork, signed by Brown and a discharge nurse on Feb. 11, lists his address on discharge as “Greyhound bus station to California.”

“Discharge to Greyhound bus station by taxi, with 3 day supply of medication,” the handwritten instructions said. “Follow up with mental health, NA (Narcotics Anonymous) meeting in California. Follow up with medical doctor in California for any medical concerns.”

Somebody clearly dropped the ball here. Brown was staying at Rawson-Neal psychiatric hospital in Las Vegas, a 190-bed acute-care psychiatric hospital. It apparently has a 30-bed observation unit which Brown was staying on, after being thrown out of his group home in Las Vegas, due to the group home’s closure. Annie’s Place was a 10-person assisted living home.

According to KLAS-TV Las Vegas, since July of last year, some two percent of patients with Southern Nevada Adult Mental Health Services were discharged to California — most of them by bus. An internal review by the Nevada Division of Mental Health Services is under way, along with external reviews by both the state Division of Healthcare Quality and Compliance, and the U.S. federal Centers for Medicare and Medicaid Services.

The real question is — is this a one-time accident, a situation where a lone patient fell through the cracks? Or is this a symptom of a more serious and chronic practice in Nevada that has been, perhaps, going on for years?

Hey, it’s one way to improve the mental illness statistics in your state — ship people with mental illness to a neighboring state. And hope they don’t come back (or don’t talk to a concerned social worker who takes their story public).

Read the coverage

Sacramento Bee: Federal probe sought of alleged ‘dumping’ of mental patient in Sacramento

Las Vegas Review-Journal: State to investigate report of mentally ill man dumped in California