At least five mentally ill patients from a Nevada psychiatric hospital took a one-way ticket to San Jose, arriving homeless and un-medicated at the Greyhound Bus Station in downtown.
That’s according to a series of disturbing reports, titled “Leaving Las Vegas,” this week by the Sacramento Bee, which investigated Rawson-Neal Psychiatric Hospital’s apparent practice of “patient dumping.” The state-run mental health hospital in Nevada reportedly bused out more than 1,500 patients to various major cities across the country during the past five years, according to records of Greyhound bus ticket purchases reviewed by the newspaper.
The hospital sent at least one patient to every contiguous state in the U.S., including more than 200 to Los Angeles, 19 to Sacramento, 36 to San Francisco and, according to interactive maps published with the Bee’s report, five to San Jose.
Bee reporters investigated the trip taken by James Flavy Coy Brown, 48, who wound up suicidal, confused and out of much-needed antipsychotic meds at a Sacramento Loaves and Fishes soup kitchen in February. His story about being discharged from Nevada’s primary mental health care facility and put on a 15-hour bus ride to the California capital prompted reporters to file records requests for all of the clinic’s Greyhound bus receipts in the past five years.
Similar scenarios presumably played out here in San Jose, as a mentally ill person arriving by Greyhound would show up at a station in downtown. In one of the Sac Bee stories, a Nevada official calls busing patients “Greyhound therapy,” which might be amusing if this wasn’t a true story.
The investigation into the practice found that busing patients is out of line with safe, standard care. Every California county interviewed for the Bee story, including Santa Clara County, insisted that they would never send a severely mentally ill person on a bus unattended with only a limited supply of medication.
The San Francisco Chronicle balked at the number of patients sent to S.F., saying it’s long suspected this one-way busing was a problem, considering it houses one of the highest concentrations of homeless people of any major U.S. city.
“Some San Francisco officials have suspected for years that they were locked in an unfair fight on homelessness, hearing anecdotes that other communities were giving their vagrant and mentally ill populations one-way bus tickets to the city by the bay,” the Chronicle reports.
Does San Jose have a similar, if smaller-scale, problem?
The city doesn’t have anything comparable to the Tenderloin, but San Jose has had numerous homeless encampments in downtown. One became a big news story earlier this year when the city ordered a clean-up of the 100-person “tent city” by the Guadalupe River.
The New York Times has covered poverty in high-tech’s shadow, and the newspaper estimates that many of San Jose’s 4,000-plus homeless are mentally ill and from out of town. Like in most major cities, the homeless tend to flock to urban centers because of better access to public help.
Los Angeles and San Francisco are considering legal action against the Nevada hospital. City spokesman Dave Vossbrink says San Jose just learned of the problem, so it’s not likely to pursue anything at this point, especially since the extent of the problem is still unknown.
The city’s homeless coordinator, Ray Bramson, took a break from helping the Santa Clara Valley Water District clear out a homeless tent settlement at Coyote Creek to say that it could be the Nevada patients sent to San Jose knew someone in town. He doubts a hospital would send someone unattended without a safe place to discharge them. But the Bee’s accounts found otherwise.
County-hired mental health expert Paul Taylor says he’s shocked but not surprised.
“It’s amazing to me that anyone in Nevada is admitting that this is happening,” says Taylor, CEO of Momentum Health, a county-contracted mental health care provider. “There have been rumors about this for as far back as the 1970s, that other states were sending mentally ill here because we have large progressive cities with good public health programs. It isn’t just Nevada. We suspect a lot of states do this.”
Never in his 30 years of working in the field has he seen a mental health clinic send away patients like described in the Bee, Taylor says. California’s public health care system is broken up by county. Each jurisdiction cares for its own residents or gets reimbursed through Medi-Cal for services provided to residents of another county, based on declared addresses. For this reason, it would be rare that homeless people in California are sent further than some other county in-state.
Nevada, hard-hit for decades by budget cuts to mental health services, is also home to a disproportionate number of mentally ill who flock there because of the bright lights, promise of quick riches and whatever other temptations might lure someone with a fragile impulse-driven psyche.
“As the whole country no doubt knows, Vegas is a pretty unique place,” UC Davis emergency room psychiatrist Dr. Lorin Scher tells Bee reporters. “Many bipolar patients impulsively fly across the country to Vegas during their manic phases and go on gambling binges. Vegas probably attracts more wandering schizophrenic people.”