Since mid-2008, as the economy worsened and Nevada slashed mental health spending, the number of psychiatric patients getting one-way tickets out of Rawson-Neal steadily rose, ……
Nevada psychiatric hospital's busing of mental patients was disturbing to workers
By Cynthia Hubert and Phillip Reese - email@example.com
Sunday, May. 05, 2013 | 01:00 AM
LAS VEGAS – In the darkness of early mornings during his graveyard shift at Nevada's primary state psychiatric hospital, Gilbert Degala regularly walked patients outside and watched them climb into taxis bound for the Greyhound bus station on Main Street.
The scene made him uneasy.
Many of the patients, burdened with mental illnesses that caused them to become delusional, suicidal or violent, were being discharged from Rawson-Neal Psychiatric Hospital in Las Vegas to buses that would ferry them hundreds of miles away. They carried their discharge paperwork, enough medication to last them a few days, and up to a case of Ensure nutritional supplement for the journey.
Some of the men and women knew why they were traveling to places like Miami or Sacramento or Los Angeles, Degala said. They were returning to family or friends. But for a troubling number "there was no one to pick them up," he said.
Some patients, he and other current and former workers told The Bee, appeared disoriented or unstable and not ready to leave the hospital.
"I felt bad for these patients," said Degala, who as a mental health technician helped social workers and nurses manage clients. He wondered whether the men and women ever got on their assigned buses, he said, and what happened to them if they did.
He resigned last year along with many of his colleagues, he said, as working conditions became more stressful.
Patient care at Rawson-Neal – and its discharge practices specifically – have come under scrutiny in recent weeks amid revelations that the hospital has bused roughly 1,500 patients to states across the nation over the past five years, a third of them to California.
Since mid-2008, as the economy worsened and Nevada slashed mental health spending, the number of psychiatric patients getting one-way tickets out of Rawson-Neal steadily rose, according to a Bee review of Greyhound bus receipts purchased by the state agency that oversees the hospital. By last year, Rawson-Neal was busing patients out of Las Vegas at a pace of more than one per day, shipping nearly 400 patients to 176 cities in 45 states, according to The Bee's review.
The sheer scope of the busing program has raised questions in California and elsewhere about whether Nevada was systematically "dumping" indigent mentally ill patients across state lines, prompting criminal probes in Los Angeles and San Francisco, as well as federal regulatory investigations.
In the weeks since The Bee published its findings, Nevada health officials have both revised and largely defended the unusual busing practice, saying Las Vegas is an international destination that attracts more than its share of visitors. They maintain the vast majority of the patients transported out of state were being sent back to their "home communities," where they had support systems or family to meet them.
Nevada's Health and Human Services chief has said that the increased pace of busing over the five-year period was not related to state funding cuts, and instead stemmed from a change in the hospital's internal approval process that has since been remedied.
Several current and former Rawson-Neal staff members interviewed tell a different story.
Though the employees offered different perspectives on the wisdom of sending psychiatric patients alone on bus trips across state lines, most described increased pressure in recent years to move patients out. And budget cuts, they said, were a driving factor.
"There is so much pressure now to get people out as soon as possible," said one longtime Rawson-Neal nurse, who requested anonymity for fear of losing her job.
Read more here: http://www.fresnobee.com/2013/05/05/3286736/nevada-psychiatric-hospitals-busing.html#storylink=cpy