EDITORIAL: Nevada takes a step toward humane care of mentally ill

Nevada Gov. Brian Sandoval still has plenty of explaining to do about his state's cavalier policy of busing mentally ill patients unescorted to all corners of the continental United States.

But his administration announced a significant change in that practice last week for which it deserves credit. Nevada officials said they would no longer bus patients without an escort.

The change likely will result in far fewer patients being bused out of Nevada. In a state that doesn't spend much on mental health care, costs will quickly add up if Nevada must pay state employees to accompany patients on bus rides hours or days away, and back to Las Vegas.

Nevada has bused 1,500 patients out of state since mid-2008. A third of the people were bused to California. But 1,000 others were bused as far away as Boston, New York and Miami -- rides that take three days.

During Sandoval's years in office, Nevada bused patients at a rate of more than one a day. The use of escorts will strain staffing, and probably limit the practice.

Nevada officials thought they were getting off cheaply by releasing James Flavy Coy Brown after three days from Rawson-Neal Psychiatric Hospital in Las Vegas, and buying him a $60 one-way Greyhound bus ticket to Sacramento, a city to which he had no connection.

But Sacramento Bee stories about Brown and his plight prompted the city attorneys in Los Angeles and San Francisco to announce last week that they were investigating the busing of Rawson-Neal patients into their cities.

Also last week, federal authorities gave Nevada 10 days to correct problems at Rawson-Neal or face termination of the hospital's Medicare provider agreement.

The federal action came after Senate President Pro Tem Darrell Steinberg called for an investigation into alleged patient dumping by the psychiatric hospital.

There are no easy solutions to severe mental illness, least of all employing "Greyhound therapy" to move patients to other states.

Nevada, and all states, must understand that they have a fundamental obligation to care for people who through no fault of their own cannot care for themselves.