Busing Analysis

Editorial: Skimpy mental health net leads to dumped patients

In what appears to have been an egregious case of interstate patient dumping, a 48-year-old severely disturbed schizophrenic says he was released from a state mental institution in Las Vegas more than two weeks ago, put on a Greyhound bus to Sacramento and told to call 911 when he got here.

Confused and dazed, James Flavy Coy Brown was taken by police to Loaves & Fishes, the social services facility north of downtown that provides assistance to homeless people. When he arrived, Brown had exhausted his supply of several powerful anti-psychotic medications to control severe depression, seizures, panic disorder and schizophrenia.

Appalled by the story they heard, Loaves & Fishes got Brown's permission to share it with The Bee. It seems the group home where Brown had lived in Las Vegas for several years recently closed. Brown said he and four other mentally ill residents who lived with him were shunted to a state mental hospital, Southern Nevada Adult Mental Health Services. After a couple of weeks there, he said they were all put on buses bound for different cities in California.

An outraged Senate President Pro Tem Darrell Steinberg says he is considering asking the U.S. attorney to investigate what he sees as a clear violation of the mentally ill patients' civil rights, apparently by Nevada mental health authorities. An investigation is clearly warranted.

Whoever is responsible for putting Brown on a bus to Sacramento with a three-day supply of meds and instructions to call 911 when he arrived needs to be held accountable.

But the problem goes beyond patient dumping. Severely mentally ill people, some bused from other jurisdictions and some not, show up regularly at local hospital emergency rooms, at our jails and at major social service agencies. Too often, no one is on hand to assess their condition and refer them to appropriate programs and services.

Even Loaves & Fishes, an agency that deals regularly with the homeless mentally ill, was unable to offer comprehensive assistance to Brown. Officials at Loaves & Fishes put him on a bus to the UC Davis Medical Center, but there is no evidence that he ever arrived. He is now missing, apparently wandering the streets of Sacramento.

At the behest of the California Hospital Association, Steinberg has introduced a bill to create a triage system for mentally ill and helpless people like Brown. It's not been fully vetted yet, but in concept the measure would try to place people trained to make mental health assessments at key points – hospital emergency rooms, social service agencies or county jails – and use them to refer patients to the services they need. And Steinberg says he's not talking about giving mentally ill people a piece of paper or a bus ticket and telling them to show up at a clinic somewhere. He wants a real "warm body referral," where someone trained can take people such as James Flavy Coy Brown, the helpless schizophrenic from Nevada, and shepherd them to the help they urgently need.

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