Legislators discuss changing treatment for mentally ill

CARSON CITY -- A program to transport mentally ill people from emergency rooms to psychiatric wards could ease an expensive bottleneck in Nevada's general hospitals, state lawmakers were told Tuesday.

But Sen. Sheila Leslie, D-Reno, said the program could be "a bus to nowhere" if it comes with cuts to mental health services and the treatment centers themselves.

"Transportation is a great idea when everything is functioning," said Dan Musgrove, who represents WestCare, which contracts with the state to operate Nevada's Community Triage Centers for mentally ill people. "But we don't know the full impact of the cuts. ... We think the number (of patients) will go higher."

The triage centers, which provide care to people who are mentally ill and have substance abuse problems, face an uncertain future as the proposed budget pulls away the general funds that supply one-third of their funding.

Stakeholders at a meeting earlier this month, including representatives from the triage centers, said they preferred keeping the existing programs in place. Pulling state funding would leave counties and hospitals to pick up the full tab and would likely result in the triage centers closing altogether, Musgrove said. That could overload regular and psychiatric hospitals even further.

Nevada legislators weighed triage centers against the governor's proposed transportation program at a budget subcommittee hearing. The transportation program would address mentally ill patients who end up languishing in emergency rooms for days, because they lack transportation to mental hospitals.

The program would cost about $3 million over the upcoming biennium and provide "medicars," a less expensive version of an ambulance, to usher patients from hospitals in Las Vegas to Rawson-Neal Psychiatric Hospital as soon as they get clearance from a doctor.

Fixing the transportation problem would reduce overcrowding in hospitals, reduce disruptions by mentally ill patients and ensure patients are not waiting 24 to 36 hours for psychiatric treatment, according to Southern Nevada Adult Mental Health Services Director Stuart Ghertner, who conceived the idea.

But the transportation project seemed unlikely after the hearing, where legislators expressed support for triage centers in favor of starting the new program.

"A comprehensive plan needs to be developed," Ghertner said. "We're taking money from this proposal without evaluating whether there's a way to keep both."