Once Suicidal and Shipped Off, Now Fighting Nevada Over Care | Hacker News Reader

Once Suicidal and Shipped Off, Now Fighting Nevada Over Care

nytimes.com

28 pointstvladeck23 comments

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

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

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...

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.

Official or not, many of the homeless around Vancouver say they were given a bus ticket by their respective provincial governments.

It's sad to see, but it does seem like this is becoming a hot issue. Alec Baldwin's radio show [1] had an interesting episode with Martin Horn, former New York City Commissioner of Correction and Probation. He touches on the issue of how to appropriately address people wrestling with mental illness in the context of corrections.

[1] http://www.wnyc.org/story/289924-martin-horn/

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...

[1] http://www.contracostatimes.com/ci_22776195/former-defense-s...

> 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.

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

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

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.

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.

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.

The weather is a factor. It doesn't rain much in large parts of Cali. In those same areas, you are generally at low risk of freezing to death and in SF and a few other areas you also won'tbe dealing with excess heat. SF in particular has very homeless friendly policies. I took a class at SFSU years ago on Homelessness and Public Policy. That detail was highlighted during the class.

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.

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.

Exactly, it's the same reason for the large homeless population in Vancouver, BC. It's the one major city in Canada that has a relatively mild winter.

I believe it's a combination between of San Francisco's homeless support services (which aren't great, but are something), and Nevadan bigotry.

Compared to the rest of the US, they're pretty good.

- California has great weather

- San Francisco is really quite amenable to the homeless compared to most of the rest of the country

Weather, as stated, plus SF is a pretty liberal town that at least tries to match wrods with actions. Arizona? So they could end up in one of Sheriff Joe Arpaio's concentration camps? (His term, not mine - http://en.wikipedia.org/wiki/Joe_Arpaio#Tent_City)

But presumably in this case it is Nevada who is buying the tickets. That doesn't strike me as they particular care for the well-being of the homeless. Sending them to Arpaio certainly decreases the chance of them returning to Vegas.

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.

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

>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.

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.

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.

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