State Needs to Resolve to Fix Mental Health System

The state has long been aware of failings in our mental health system. Is 2014 the year we finally get serious about fixing them?

Illustration by Ryan Olbrysh

Illustration by Ryan Olbrysh

There are more pleasant occasions to take a walk down memory lane than a national public shaming of Nevada’s mental health system. And yet, here I am at the start of 2014 recalling the litany of problem-and-Band-Aid-solution stories that makes up our state’s mental health service history.

As the new year turns, Governor Brian Sandoval is jumping into action after The Sacramento Bee published a series of articles revealing that the state-run Rawson-Neal Psychiatric Hospital in Las Vegas has, for several years, been putting hundreds of mentally ill patients on Greyhound buses and shipping them to other cities to cope—often with little or no treatment plans.

Pressured by that news as it made the rounds in the national media, Sandoval quickly created a mental health council of experts and policymakers to respond, earmarked some money for bolstering the system and created a mental health drop-in center. Almost simultaneously, an independent report by research firm Social Entrepreneurs found Nevada’s mental health funding was “woefully inadequate” when compared with other states, creating a dearth of everything from hospital beds to outpatient care.

Thinking about all of this led me to revisit the Southern Nevada Adult Mental Health Services campus on West Charleston Boulevard, behind which sits the Desert Willow treatment center for youth, as well as Rawson-Neal. The rest of the buildings are aging adobe structures set across a field of grass, which has become home to more than a dozen fat rabbits. A watermelon-size white bunny with red eyes gnawed on the bush next to an empty picnic table as I looked for signs of the drop-in center.

Inside the administration building, which has the old-linoleum-floor-and-vinyl-seating feel of institutional neglect, various people waited for help. Clerks worked from behind a secure plastic window, and a security guard stood by a rack of brochures about mental disorders. I had a quick flashback—I was here to report on a similar set of mental health service issues about 10 years ago.

In fact, there’s no way that lawmakers and community leaders should be surprised by the most recent news from Rawson-Neal. Nevada’s pitiful mental health system has been called out repeatedly by media, activists, patients and mental health professionals for years. Sandoval—who was quoted in December as being “appalled” by the patient-busing from Rawson-Neal—is a longtime public servant in Nevada. He was first elected to the state Assembly in 1994. A quick Google search brings up headlines pretty much every year about the serious problems caused by a perennial lack of mental health funding, infrastructure, beds, well-paying psychiatrist positions, outpatient services and a network of support services.

Our failure to adequately fund and address the mental health needs of our population and our visitors (a responsibility that comes with being Sin City) has cost us in many other ways. It’s caused our emergency rooms to overflow; it’s been the root of innumerable crimes; it has overburdened our homeless shelters and nonprofit social service agencies. A sample of headlines from the last decade:

September 11, 2001: “Hospitals hurt by mental health system problems”– Las Vegas Sun

August 25, 2004: “Crisis continues for mentally ill patients”– Las Vegas Sun

October 21, 2007: “Holes abound in mental health care” – Las Vegas Review-Journal

October 12, 2009: “Safety net for mentally ill youth lacking” – Las Vegas Review-Journal

December 17, 2012: “Las Vegas mental health services overloaded” –

These and other stories—including lengthy reports by the Nevada Disability and Advocacy Law Center in 2005 and the National Alliance on Mental Illness in 2011—have chronicled the state’s consistent underfunding when compared with other states and the national average, and shined a light on the real human consequences.

I reflect on all of this as I walk across the lawn to the pharmacy building, where a room has been designated as the drop-in center. Here, people are encouraged to simply be with others, or “get out of the weather”—a nod to the coinciding problems of mental disorders and homelessness. There’s a young woman sitting outside the center talking on a cellphone, crying, telling someone where she is.

“I didn’t have anywhere else to go, and I don’t want to be alone,” she’s saying through her sobs. It makes me sad, and sick, and grateful that we have what services we have—but disgusted that it’s taken yet another series of shameful stories to prompt leaders to act. Let’s hope that 2014 will be the year we make the thorough improvements in mental health care that we’ve needed for a long, long time.



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