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Long-term costs to state could outweigh budget savings in mental health funding


By Andrew Doughman, Nevada News Bureau: The state may save more money by spending rather than cutting.

Advocates for mental health funding advanced that seemingly nonsensical argument in a plea to save the state’s mental health courts, which are designed to rehabilitate mentally-ill criminal offenders.

Gov. Brian Sandoval’s budget outlines about $100 million in cuts to the state’s Mental Health and Developmental Services Division, cuts that are supposed to save money and help balance the state’s budget.

At a legislative subcommittee hearing, advocates for the courts said that closing them would lead to more crime, increases in homelessness and overcrowding in jails and hospitals as mentally-ill people go untreated on the streets.

The courts handle cases of mentally-ill people who have committed felonies and oftentimes have a substance abuse problem. Judges mandate that they treat their illnesses and attend to drug or alcohol addictions in a safe living environment provided by the state.

All of this is supposed to reduce the chance that people might fall back into their old ways.

“The people who are in [the system] trust us,” said Judge Peter Breen, who serves in the Mental Health Courts and testified in support of the courts. “They know we are going to deliver on services, medicine, improve the safety of their lives and help them get better.”

In his budget, Sandoval has pushed the $7.4 million funding responsibility for the mental health courts onto the Clark County, Washoe County and Carson City governments. The cash-strapped counties then decide whether to fund or eliminate the specialty courts.

Breen said that shifting the funding burden onto the counties would be a “death sentence for our mental health courts” because many counties are already starved for revenue.

Since 2003, the mental health courts have “graduated” hundreds of people. The courts are also one of the few Nevada programs that serve as models for other states to copy.

In some cases, the program does appear effective.

Kathleen O’Leary, chief deputy public defender for Washoe County, said that the county has tracked 106 people through its mental health courts.

Together they had accumulated 5,011 days in jail prior to entering the court system. After leaving the state’s programs, that number dropped to 295 days, she said.

The Washoe County Sheriff’s Office estimates that it costs the county about $126 per day to house someone in jail.

That means the 106 mentally-ill offenders cost the state a total of $631,386 in the time they spent in jail before entering the mental health courts and $37,170 after exiting the program.

Supporters say there are more intangible savings that offset the cost of the court’s services: Less homelessness, less crowding at hospital emergency rooms and less crime.

Should the courts go away, mentally-ill people charged with felony offenses could go the more traditional route and serve prison sentences.

That, however, would also cost the state money. The Nevada Department of Corrections estimates it costs about $68 per day or $24,820 per year to house an inmate in one of the state’s prisons.

If the courts were eliminated, mentally-ill people would still have state programs available to them.

“All of the people are eligible for services anyway,” said Sen. Sheila Leslie, D-Reno, who is an advocate for funding mental health. “The mental health cost stays the same.”

Mike Willden, director of the Department of Health and Human Services, said that mentally-ill people could receive services, but these would be generic services unlike the targeted, specific care provided through the mental health courts.

Plus, these generic programs are also slated to have their funding cut in the upcoming biennium, he said.

When it comes to the cost, $7.4 million isn’t that much money in a $5.8 billion budget. But the complexities of even this tiny slice of the budget suggest that balancing the state’s ledger isn’t as zero sum game of  saving this program and cutting that one.

The budget games begin Feb. 7 when the Legislature convenes for the first day of its 120-day session.

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