

Once Suicidal and Shipped Off, Now Fighting Nevada Over Care - tvladeck
http://www.nytimes.com/2013/09/22/us/once-suicidal-and-shipped-off-now-battling-nevada-over-care.html

======
phren0logy
Psychiatrist here. The mentally ill and the homeless (often not coincidentally
related) are often treated poorly by our Emergency Room system. Before
Californians get too mad at Nevada, know that California doesn't have a
sterling track record here either (though not as specific to mental illness):

[http://www.cbsnews.com/8301-18560_162-2823079.html](http://www.cbsnews.com/8301-18560_162-2823079.html)

Sadly, hospitals get little reimbursement for treating mental illness,
therefore many inpatient psychiatric wards are closed. I don't know the
details, but places I have worked claim these units lose money. In many states
and in many hospitals, patients may wait for days and days in the ER before a
bed opens there or somewhere else. Supply and demand are grossly mismatched,
and reimbursement has not responded to demand. Therefore, units continue to
close.

Now much of the care of the mentally ill happens through the correctional
system or related venues. See prior HN discussion here:

[https://news.ycombinator.com/item?id=6182507](https://news.ycombinator.com/item?id=6182507)

It's possible some parts of the Affordable Care Act may help with this:

[http://www.usatoday.com/story/news/nation/2013/09/21/law-
pus...](http://www.usatoday.com/story/news/nation/2013/09/21/law-pushes-for-
parity-in-mental-health-coverage-/2847889/)

I don't know why so many stories about mistreatment of the mentally ill have
been on HN recently, but it makes me happy that smart people are taking an
interest.

~~~
jmspring
Yep, and living in a central coast region where the weather is great, the
benefits are plenty, and most "petty" crimes are a revolving door parade,
things are just peachy.

Ignoring the local business owner murdered due to the accidental release by CA
state psychiatric recovery facilities @ Atascadero [0]; Murder of two police
officers due to the military looking the "other way" while discharging an
individual without a record of his sexual assaults [1]

Two "minor" _local_ incidents speak well of our mental health and criminal
justice systems in this state.

[0]
[http://www.santacruzsentinel.com/localnews/ci_20573683/suspe...](http://www.santacruzsentinel.com/localnews/ci_20573683/suspect-
identified-fatal-stabbing-santa-cruz)

[1] [http://www.contracostatimes.com/ci_22776195/former-
defense-s...](http://www.contracostatimes.com/ci_22776195/former-defense-
secretary-leon-panetta-military-ought-be)

------
jevinskie
> But what makes it “even more tragic,” Mr. Herrera said, “is that on top of
> the inhumane treatment, the State of Nevada was trying to have another
> jurisdiction shoulder the financial responsibility for caring for these
> people.”

Sigh... that isn't the tragic part, not by a long shot. The tragic part is the
human souls involved. That statement is so telling towards San Francisco's
true motives in the lawsuit. I just hope the people that Nevada neglected get
justice and change Nevada's course.

The gentleman seems to be very happy with the city of SF though, from his
quote at the end of the article.

------
balloot
As a resident of SF, this makes me furious. I hope our city attorney just
demolishes them in court. WTF Nevada.

~~~
WalterSear
Sadly, I think whoever cooked up this scheme will never be uncovered, and the
tax payers of Nevada will pay the bill.

~~~
sliverstorm
That's the golden rule, isn't it. The tax payers will foot the bill. All that
is at stake here is whether it will be Nevadans or Californians that get stuck
with the check.

------
anigbrowl
Although it may seem off-topic I'm glad to see this on HN. Many people here
have commented on the 'homeless problem' in SF, often being critical of both
the homeless themselves and of city policy. Not bigoted, mind - just critical,
and often with a solid basis in fact. but it's also a fact that other places
have been systematically dumping mental patients on California and SF in
particular.

~~~
rdtsc
Whenever I hear these stories I always wonder, why California. Why not Kansas,
Vermont or Arizona? What makes California, especially SF a target? Presumably
if Nevada wanted to wipe the traces of their scheme better they would just
pick random locations every time.

~~~
jonnathanson
The weather is more stable and less seasonal than in most other states. And
California has richer cities and municipalities than most other states, so
maybe there's a belief that the homeless will at least have a better shot at
getting care here.

The cynical/realist motive: California is a really big state -- so it's an
easy dumping ground for people to get tossed into and disappear.

~~~
rdtsc
Ah makes sense. I can see why some homeless given a choice would prefer SF.
But I guess from Nevada's point of view I am not sure if they really do want
to help or just want to get rid of them. Maybe if they sent them to Chicago in
the middle of the winter, whoever made that decision could in theory be
criminally prosecuted somehow.

------
VladRussian2
doesn't it sound like an FBI matter - basically kidnapping (as it was against
their will - i.e. they didn't give informed consent) and transfer across state
lines? One can only wonder there are all the overzealous federal prosecutors
when their services are really needed.

~~~
refurb
He was given a bus ticket somewhere and some food. I don't think that falls
under kidnapping.

~~~
VladRussian2
>He was given a bus ticket somewhere and some food. I don't think that falls
under kidnapping.

Was he free to leave the bus? No (and physical presence or absence of an
officer of the State on the bus isn't necessary and isn't material here -
that's is the nature of the Force of the State) Thus we have illegal
imprisonment/kidnapping at least until the moment the bus left Nevada.

------
Spooky23
This isn't incredibly uncommon, and isn't limited to psychiatric patients.
Southern states for decades encouraged poor blacks to enjoy the better
benefits available in the north, for example. Cops in many places shipped off
"frequent fliers" to bigger cities.

Even today, it's a common practice to make sure that troublesome social
services clients are aware of better benefits available in other
jurisdictions.

------
ck2
Can you image the gall of the decision maker who said to someone "well we're
not going to deal with this, ship them to another state".

Wow, just wow. I am sure they sleep perfectly fine at night. I hope they lose
their pension somehow.

