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Mentally Ill? Here's a Bus Ticket

A Las Vegas hospital is transporting mentally ill patients via solo trips on Greyhound buses.

Things are screwed up in Nevada, which you probably already knew because things are screwed up everywhere and especially so in Las Vegas. But this, from today's Sacramento Bee, seems more screwed up than most:

Since July 2008, Rawson-Neal Psychiatric Hospital in Las Vegas has transported more than 1,500 patients to other cities via Greyhound bus, sending at least one person to every state in the continental United States, according to a Bee review of bus receipts kept by Nevada's mental health division.

In case you missed that: they're busing mentally ill patients across the United States. Why? Beyond what appears to be, at best, semi-clueless management: money.

In recent years, as Nevada has slashed funding for mental health services, the number of mentally ill patients being bused out of southern Nevada has steadily risen, growing 66 percent from 2009 to 2012. During that same period, the hospital has dispersed those patients to an ever-increasing number of states.

By last year, Rawson-Neal bused out patients at a pace of well over one per day, shipping nearly 400 patients to a total of 176 cities and 45 states across the nation.

These patients are almost always traveling alone, and this past February, a 48-year-old patient discharged from Rawson-Neal "turned up suicidal and confused at a Sacramento homeless services complex." He'd never been to Sacramento before and knew no one there. The paper's investigation discovered a number of other patients arriving in cities without a plan and without knowing anyone.

If this sounds bizarre, it's because it is. The paper contacted mental health officials from 10 other states, and none considered sending a mentally ill patient alone on a bus to be a reasonable thing to do. "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," said Dorian Kittrell, executive director of the Sacramento County Mental Health Treatment Center.

The lack of mental health care in Nevada, and especially in Las Vegas, has long been an issue. The state's mental health expenditures per capita are $68, while the national average is $122. According to the Bee, the state has spent $205,000 on putting patients on Greyhounds over the past five years, while inpatient care runs at a rate of about $400 per day, per patient. “We have a really serious problem,” Senator Harry Reid said, back in January when asked about the state's insufficient mental health services. “Obamacare will be a big help to it because it’s going to allow more mental health care.” Whether or not that turns out to be true, with a number of other investigations currently looking into Rawson-Neal, it doesn't seem like a situation that can wait until 2014.