By Kelsey Givens
Combine escaped mental patients with a busy hospital and a sheriff’s office stretched to its staffing and financial limits and you have a recipe for disaster in any community.
And in Pahrump, this ugly scenario appears to be playing out more and more.
This is what prompted the sheriff’s office and local officials at Desert View Hospital to sit down recently with state health officials in an effort to avert a potential disaster.
The group, which has so far failed to reach any concrete solution, met this fall to discuss the procedure for identifying residents in need of mental evaluations and possibly hospitalization and whether there are alternatives available beyond the status quo.
The latest conversation involved Legal 2000 patients, or people who exhibit mental disorders and come into contact with police.
“We’re just all going to work in concert to make sure the best interests of not only the patients, but of the sheriff’s office and the hospital are served. It’s no secret the process, they come in here, they’re evaluated and then if it’s determined they need additional levels of care then they go to the state mental health system,” said James Oscarson, marketing director for Desert View Hospital and a newly-elected assemblyman. “But before they are accepted for a higher level of care, they have to be medically cleared and medically sent.”
That procedure, while simple enough, requires the expenditure of precious law enforcement and medical resources — and lately it seems the number of patients identified in this community has outweighed the system’s ability to deal with them effectively.
A Legal 2000 patient can be taken into protective custody for up to 72 hours if it is deemed they are a danger to either themselves or others. That determination is made by a medical doctor, but not before a sheriff’s deputy is usually involved in the initial contact.
Several recent events have prompted the sheriff’s office to attempt to change the policy regarding such patients as the burden placed on the department has grown.
“What was happening here is they were getting physically cleared, then they would be transported to Vegas. The problem was, a couple weeks ago, out of nine beds they had in the ER in admissions, six of them were filled with the Legal 2000s. And since they have to go to Vegas anyway, what we said is we’re just going to take them to Vegas, and the administration said OK,” Sheriff Tony DeMeo said about the process back in October.
“At one time, the hospital believed they all had to be brought there, but that’s something we’re going to discuss with state mental health officials because we disagree; we believe that for us, the destination, if you have a psychiatric patient and there doesn’t seem to be any other medical issues that are noticed on the scene, that the best place they could be is somewhere where they can get immediate help, and not tie up resources,” he added.
In addition to the incident where the hospital was hit with a large influx of Legal 2000 patients all at once, there were also more than one instance where people in need of mental health evaluations actually left the hospital before they were seen by a doctor, even after hospital staff had told deputies the patients would be watched.
“What the hospital would try to do to help us is they’d say OK we’ve got them, we’ll observe them and when we’re finished we’ll call you,” DeMeo said. “But then they had issues with them, people that have psychiatric issues are not necessarily people that work well in closed environments, especially hospitals, and they can become very destructive and disruptive in the hospital. They had an escape, a couple of escapes, which then we had to use manpower, massive amounts of manpower to track them down and bring them back into custody again. So, whichever way we looked at this, for the Nye County Sheriff’s Office as far as manpower allocation, it was a drain on resources. . . . like I basically said, bed space and their assets became hindered because of the psychiatric individual and the ultimate destination was Las Vegas anyway.”
The other issue the sheriff’s office was running into is they had to pay their deputies overtime if officers had to stay to watch a patient until they could be seen by a doctor, or wait until that person was cleared and then drive them to another facility in Las Vegas.
“For us it’s also a money management thing. We have to be there watching them, or the hospital would have to take custody of them until they get cleared. They weren’t getting cleared right away, and the deputies would either have to stay there or if the hospital cleared them they would have to come back then to take them down to Vegas. If you look at it Vegas was the ultimate destination anyway, us being there cost us overtime and cost us shortages out in the street and then for the hospital it basically caused them not to have enough bed space for people that have other medical needs that they can properly address,” the sheriff said.
So both hospital staff and the sheriff’s office agreed to sit down for a meeting with State Health Officer Dr. Tracy Green to talk about the benefits of going straight to Las Vegas, versus the benefits of having them medically cleared first before being taken over the hill.
Oscarson said after the meeting, it was decided for now the sheriff’s office will continue to bring patients first to the local hospital to be cleared medically before they are taken to Las Vegas.
“They are coming to Desert View before they’re evaluated anywhere else, currently, that’s the current process. There were just some other discussions, some other thoughts, but they need to come here to be evaluated currently. Now that’s not to say that process may not change, but that would be a universal change, not just a change for Desert View Hospital, it would be a change for other entities as well,” he said.
Oscarson added that after their discussion, the hospital is working on ways to streamline the process with everyone’s best interests in mind.
“We’re always working to streamline that process,” he said. “We’re always working together, again, with the sheriff’s department, with the fire and rescue folks, to make sure the patients are here as little time as necessary, if they need to be transferred to a higher level of care, trying to clear them as quickly as possible to get them onto the level of care they need.
“You know the psychiatric facilities are much better equipped to handle the psychiatric conditions of some of these patients,” he said.
Oscarson added the two agencies plan to meet with Green again in the future to continue to discuss the best way to help Legal 2000 patients and get them the help they need quickly.