Editor's Note: The realities of unmanaged growth

I didn't intend to go off on a tirade this week. I just returned from a short trip to western North Carolina. Tromping around the Blue Ridge Mountains, I saw some of the most beautiful country I've ever set foot in. I wanted to tell you all about it, employing the colorful language of poets to describe the gushing waterfalls, trickling streams and towering forests. But returning to good ol' Las Vegas, I soon found more pressing matters to write about.

The anger stems from state legislators' casual disregard for the mental health crisis in Las Vegas. Hospital emergency rooms are crowded with mentally ill people who should be cared for in facilities dedicated to their needs. But we don't have any such facilities. Unchecked, chaotic growth in the Las Vegas Valley is the primary reason for this crisis, in which growing needs far outstrip practically nonexistent services. Everybody knows this is a severe problem, but the burgeoning anti-government crowd seems to have the upper hand at recent legislative hearings on the issue.

To be fair, the Nevada Legislature has approved construction of a 150-bed psychiatric hospital in Las Vegas, for which it plans to break ground in January. However, there are two problems. First, the need for mental health hospital care exists now. The word crisis is not being thrown around lightly. And second, everybody seems to agree that on the day the planned hospital opens in 2006, it will be full with a waiting list.

In the meantime, the state has allocated funding to open 28 beds for psychiatric patients in an unused building at the Southern Nevada Mental Health Center. This, however, represents less than half the number of beds needed to treat the mental health patients occupying local emergency rooms.

Carlos Brandenburg, director of the state Division of Mental Health and Developmental Disabilities, seems to have a good handle on the scope of the crisis. He's looking anywhere and everywhere for extra money to address the problem. For example, he has asked the state Public Works Board for an additional $5 million to add a 40-bed wing to the planned hospital. And he plans to ask the Legislature's Interim Finance Committee again for permission to use $1.2 million in savings on the hospital, either to offset the rising price of steel or to help build the additional wing. The committee has rejected this proposal once.

Meantime, state lawmakers have repeatedly balked at allocating funding for a mental health triage unit operated by WestCare. Local governments and area hospitals have supported the program, but the state legislators have resisted. Gov. Kenny Guinn recently stepped up with a funding plan for the triage center.

All in all, it's clear that state legislative leaders, who generally have jurisdiction on mental health matters, either do not appreciate the magnitude of the crisis or just don't give a crap. The Darwinian philosophy seeping into political thinking these days seems to be infecting legislative debate on this issue.

You don't have to be a raving liberal to believe that a culture is measured by how well it cares for those who cannot help themselves. The reality of mental illness is not in dispute. Most Nevadans can say they know a family member or friend with one kind of mental illness or another. It is not a problem exclusive to the poor or homeless, old or young, black, white or brown.

Yet funding for mental health programs often seems to get lumped into the same category as welfare--that much-despised "handout" for "lazy" people who, according to conservative mavens, simply ought to get smarter and work harder and they'd make better wages and be able to buy nice homes in the suburbs.

But it's not accurate or fair to equate psychiatric care with welfare. People with mental illness can't help the way they feel or act. It is the result of a chemical imbalance or other mental trauma or ailment. They need proper and sustained treatment in order to lead conventional and productive lives. They aren't "lazy" or "feeding from the public trough," they simply require help or their conditions will worsen. At the extreme level, the mentally ill resort to antisocial or even criminal behavior, endangering themselves and those around them.

We certainly don't want our mentally ill citizens to descend to this level, and we don't want them taking up space in hospital emergency rooms where they do not get specialized treatment and they occupy space and staff time that should be available for those with nonpsychiatric illnesses and injuries. This crisis affects not only the hospitals but the police officers and paramedics who must deal with the mentally ill, and the other patients waiting hour after for emergency care.

State legislative leaders must accept the fact that the Las Vegas Valley has a mental health crisis that's growing by the day and that requires a substantial financial commitment from the state to properly address it. This is the reality of unmanaged growth. The small-government advocates who are giving the mentally ill low priority should be shouted down by those who believe in the necessity, wisdom and morality of helping those who can't help themselves.

--GEOFF SCHUMACHER