Nevada Sends Hundreds of Mentally Ill Patients to California, Other States

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Nevada's primary mental health hospital has put hundreds of patients with mental illnesses on buses and sent them to cities in California and other states, according to an investigation by the Sacramento Bee.

Details of Nevada's Practices

In recent years, Nevada has reduced spending on mental health services.

According to the Bee's review of bus receipts kept by the Nevada Division of Mental Health and Developmental Services, the number of patients with mental illnesses sent by Rawson-Neal Psychiatric Hospital in Las Vegas to other cities via Greyhound bus increased by 66% from 2009 to 2012.

The review found that since July 2008, the hospital has sent more than 1,500 patients to other cities.

According to the review, about one-third of such individuals traveled to California, including:

  • 200 who arrived in Los Angeles County;
  • 70 who arrived in San Diego County; and
  • 19 who arrived in Sacramento.

California officials began criticizing Nevada's practices after a patient who was confused and suicidal arrived at a Sacramento homeless services facility in February.

The hospital sent the patient to Sacramento without making arrangements for treatment or housing. In addition, the patient did not have identification, medication or access to Social Security payments.

California Officials Respond

None of the 10 California mental health agencies surveyed by the Bee recalled being contacted by Rawson-Neal officials to make arrangements for patients coming from Nevada.

In addition, none of the California agencies considered placing a patient with a mental illness on a commercial bus to be a permissible action.

David Wert -- public information officer for San Bernardino County -- said, "We don't do it, we never will do it, and we haven't done it in recent memory, meaning at least 20 years."

Dorian Kittrell -- executive director of the Sacramento County Mental Health Treatment Center -- said, "Putting someone whose mental illness makes them unable to care for themselves alone on a bus for a long period of time could be absolutely disastrous."

Kittrell said patients could suffer relapses and potentially harm themselves or other bus passengers.

Nevada Officials Respond

Tracey Green -- Nevada's health officer -- told Nevada lawmakers during a March hearing on the issue that Las Vegas is an international travel destination and that patients who become ill while in the city have the right to return home if they wish.

She added that most of the patients being discharged and transported are mentally stable and have family members and treatment programs waiting at their destinations.

Michael Wilden -- director of the Nevada Department of Health and Human Services -- said during the hearing that policies have been changed and disciplinary actions taken to ensure that patients only are discharged after the hospital confirms care and treatment at their planned destinations.

He said that an internal investigation of Rawson-Neal's discharge practices found no pattern of misconduct (Hubert et al., Sacramento Bee, 4/14).
Robert Forster
Third party vendors managing Nevada's medicaid population in medical and mental health for over a decade have openly complained about the abusive (costly)mental health "system" in Nevada where providers provide unnecessary expensive care and dumping is used to mitigate costs. Budget constraints (reality) are often the root cause of immoral human behavior. Rob MD
Catherine Mone
Tracey Green should, by now, have confirmed how many of her bus passengers actually made it to family or friends. If she has not done so, journalists should keep asking until all are accounted for. Unfortunately for Michael Wilden, he will need to step down from his position, as he is the responsible leader. If he didn't know, that's simple incompetent management, and if he did know, he should be charged with endangerment. But the comment that people who become psychotic in Vegas should be returned home is true. Just not quite this way. Home counties might have to pay for safe transport.

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