Now, back to governing
My deadline prevents me from writing about this week’s election, but no matter the results, it’s time for the winners to move beyond campaign promises and prepare to govern.
Nevada’s late state Senator Bill Raggio was a master at behind the scenes maneuvers to benefit his party and patrons. He certainly did all he could to ensure the Republican party controlled the state Senate, masterfully gerrymandering districts in Washoe County to produce three safe Republican seats, leaving just one for the Democrats, despite the closeness of voter registration. But he often chastised legislators of both parties for attacking each other outside of the campaign cycle, saying, “The campaign’s over. It’s time to get things done.”
As the Tea Party grew more powerful, Raggio became increasingly isolated, rejected by younger Republican senators who were willing to jettison his wisdom and experience for a political philosophy that devalued across the aisle collaboration and instead, favored constant confrontation.
During Governor Sandoval’s tenure, supported by the leadership of Chief of Staff Mike Willden, there were several meaningful bi-partisan initiatives that succeeded, the expansion of Medicaid and full-day kindergarten. Both policies were long-supported by Democrats, who proved willing to work with the covernor when he showed interest in adopting these concepts as his own. Nevada is better for it.
Regardless of who leads Nevada in 2019, there is one policy area that seems ripe for the same consideration, the diversion of those suffering from mental health issues from the criminal justice system. There has been a quiet revolution over the past decade in how law enforcement officials view this concern, with growing recognition by chiefs and sheriffs that incarceration of those living with a severe mental illness doesn’t usually change behavior and, in fact, often makes things worse.
Programs like the mental health court and assisted outpatient treatment have achieved incredible savings in jail days and associated law enforcement, prosecution, defense and court costs. Recidivism decreases sharply when diverted clients are provided with affordable housing and wrap-around services, including medication and case management. When law enforcement officers are provided with crisis intervention team (CIT) training, there are fewer violent incidents in the jail and fewer law suits. And when mentally ill people access consistent high-quality treatment, the results can be miraculous.
The Washoe Regional Behavioral Health Policy Board will be advocating for the creation of crisis stabilization centers (CBCs) in 2019 to immediately address mental health and/or substance use problems and prevent escalation to an acute crisis, such as suicide or incarceration, by providing effective support and treatment to improve symptoms of distress. These services include 23-hour crisis stabilization/observation beds, medical detox, short-term crisis residential services and crisis stabilization, mobile crisis services, 24/7 crisis hotlines, warm lines, psychiatric advance directives, and peer crisis services.
To be effective, the CBCs must also be able to connect clients to community-based residential care, ongoing intensive outpatient treatment and affordable housing, services often in short supply in Nevada. Our new political leaders must overhaul our mental health system, starting with the community-based living arrangement homes which were in the news again last week due to a scandalous audit showing about $1.5 million in overpayments to the same private for-profit operators which a January audit determined were housing severely mentally ill Nevadans in “filthy” and “unsafe” conditions.
Nevada desperately needs a new housing model for this vulnerable population using non-profit organizations or state staff. We need our elected officials to demonstrate interest in mental health and support new approaches. The campaign’s over. Let’s get to work.