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Recession lls areaÕs ER beds with mentally ill

On Thursday, nearly one-third of the patients in Las Vegas Las Vegas (läs vā`gəs), city (1990 pop. 258,295), seat of Clark co., S Nev.; inc. 1911. It is the largest city in Nevada and the center of one of the fastest-growing urban areas in the United States.  Valley emergency rooms were awaiting psychiatric psy·chi·at·ric
Of or relating to psychiatry.

psychiatric adjective Pertaining to psychiatry, mental disorders

That morningÕs tally — 117 people whose minds had unraveled to a point where they were considered a danger to themselves or others — was higher than the number cited when Clark County Clark County is the name of twelve counties in the United States of America:
  • Clark County, Arkansas
  • Clark County, Idaho
  • Clark County, Illinois
  • Clark County, Indiana
  • Clark County, Kansas
  • Clark County, Kentucky
  • Clark County, Missouri
 declared a mental health emergency in 2004. The resurgence re·sur·gence  
1. A continuing after interruption; a renewal.

2. A restoration to use, acceptance, activity, or vigor; a revival.
 has health care officials concerned that the stress of the economic collapse could be fueling another communitywide psychiatric crisis.

A coalition formed to address the issue five years ago stopped meeting in 2007. But its members regrouped Thursday to try, once again, to reconcile an increasing demand for psychiatric care with a dwindling dwin·dle  
v. dwin·dled, dwin·dling, dwin·dles

To become gradually less until little remains.
To cause to dwindle. See Synonyms at decrease.

ÒThere are more people in crisis, we still have overcrowding overcrowding

overcrowding of animal accommodation. Many countries now publish codes of practice which define what the appropriate volumetric allowances should be for each species of animal when they are housed indoors. Breaches of these codes is overcrowding.
 and a lack of services, bringing us kind of back to square one,Ó said Janelle Kraft Pearce, a retired Metro Police official and chairwoman of the Southern Nevada Mental Health Coalition.

She was speaking to a group that included directors of hospital emergency rooms, psychiatrists This list includes notable psychiatrists.

Individuals listed below are all physicians, and are board certified by the American Board of Psychiatry and Neurology, or are members of the American Psychiatric Association, or the Royal College of Psychiatrists in the United Kingdom, or
, drug and alcohol abuse counselors, and state mental health officials. Many of them had come together in years past to talk about the same problem.

It starts with a Nevada law that requires every person seeking psychiatric care from the state to get a physical examination first. But the stateÕs mental health campus doesnÕt have the resources to perform those exams, so the patients wind up in hospital emergency rooms. And because the state has a limited number of beds, the patients wind up waiting in emergency rooms — currently, for 2 days on average.

The more psychiatric patients, the worse the problem, particularly when so many of them are deemed dangerous.

Their warehousing at the valleyÕs 15 hospitals is not good for those patients, the hospitals or other people who need emergency medical care, officials at the meeting said.

They also allowed that an immediate solution remains elusive.

When then-Clark County Manager Thom Reilly declared an emergency in July 2004, 104 psychiatric patients filled the valleyÕs hospitals. The coalition and others prepared a number of proposals to address the issue, including seeking about $13 million from the state for building a separate triage triage

Division of patients for priority of care, usually into three categories: those who will not survive even with treatment; those who will survive without treatment; and those whose survival depends on treatment.
 center where patients could get physical and psychiatric evaluations psychiatric evaluation The assessment of a person's mental, social, psychologic functionality. See DSM-IV-table multiaxial assessment, Personality testing, Psychiatric history, Psychiatric interview.  in the same place. But that proposal failed in the most recent legislative session, another victim of the economy.

Unfortunately, the same collapse appears to be taking its toll on the mental health of people across the valley, officials said.

ÒThe combined stresses are causing people to become distraught dis·traught  
1. Deeply agitated, as from emotional conflict.

2. Mad; insane.

[Middle English, alteration of distract, past participle of distracten,
,Ó said Stuart J. Ghertner, agency director at Southern Nevada Adult Mental Health Services health services Managed care The benefits covered under a health contract . Ghertner, who was at ThursdayÕs meeting, oversees outpatient care at the stateÕs Las Vegas campus, at 6161 W. Charleston Blvd. He has seen as many as 1,000 patients seeking outpatient help in recent months, twice as many as a year ago.

ÒThe economy is playing a role. People are losing jobs, health insurance, homes,Ó Ghertner said.

The resulting psychological chaos is what Lesley R. Dickson, past president of the Nevada Psychiatric Association, called Òthe domino See Lotus Notes.  effect of losing jobs.Ó

Dickson, who was also at the coalition meeting, noted that some of the patients crowding hospital emergency rooms probably are there because they had stopped taking their medication, a result of losing health insurance.

Jim Osti, administrative analyst at the Southern Nevada Health District, said the number of hospital emergency rooms had increased by three since 2004, and the number of beds at the state campus had more than doubled to about 230 — but those amounts still donÕt meet the need. Not only that, most of the private and public agencies represented in the room had taken steps backward recently because of the economy. Southern Nevada Adult Mental Health Services, for example, is losing four psychiatrists next month, reducing GhertnerÕs staff from 22 to 18, even while the number of patients continues to increase.

The coalition will continue meeting in the coming months, at the least to share information and ideas for making wiser use of the resources that do exist. But the frustration was evident Thursday.

ÒThe thing is, everybody knows the solution — a single facility for medical clearance and psychiatric evaluation,Ó Ghertner said. ÒAnd this community has been unable to make this happen.Ó

Timothy Pratt can be reached at 259-8828 or at
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Author:Timothy Pratt
Publication:Las Vegas Sun
Date:Jun 8, 2009
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