By Elaine Cunningham and Dewey Dirks
This is a follow-up to last weeks article, Rawson Neal Psychiatric
Hospital is truly a prison, to outline a solution as promised.
First, some history. Rawson Neal Psychiatric Hospital is a prison due
to too many people being sent there on legal 2000 petitions, many of
them frivolous. It is understaffed and the staff under trained so they
create a much too harshly controlled environment that makes the
patient more miserable, family overly stressed, as they are not
allowed to see how family is treated or given any information. It is
the only state owned hospital for adults in Southern Nevada and must
accept those who are uninsured. More often than not, the reasons
people are sent there are frivolous. It is the overload that is
causing most of the problems. You must go to a hospital emergency
rooms to get help because you must have medical clearance to get
admitted to any facility in Southern Nevada. It is there that medical
staff starts to either recognize, further or create a problem, as they
are also understaffed and under trained.
The solution is very simple. Follow the law. The law, both state and
federal, is designed to keep the people out of any type of facility,
for as long as practically possible given the circumstances.
Independent, proactive, not reactive ombudsman can achieve that goal.
At the same time, doing the most important job, protecting people’s
civil rights. We have had reactive advocates for years and as you can
tell by the state of the system, this is not working. Change must
The difference between proactive and reactive is that proactive arrive
in the first minutes of a persons arrival at any facility and gather
valuable information promptly (someone hospital employees must call
when a patient first arrives). Reactive ombudsmen wait for a phone
call that may never come. If the patient or family can figure out whom
to call, which seldom happens, the ombudsman arrives hours too late
and the damage is done. It is the law that staff must inform patients
and family about an ombudsman and the grievance process, but seldom
ever do. Medical staff makes the convenient assumption that because
this information is posted in some obscure place in the hospital, you
will see it. Medical staff does not realize that when you are in
crisis or when you have family in crisis, the last thing you do is go
read the walls. Your focus, if you can maintain any, is on the person
you care about on that gurney. The patient is in no condition to, and
not allowed to wander to read the postings. Most people do not know
their rights; do not know there is someone they could call to help.
The ombudsman being attached to the facility creates a conflict of
interest that not many people are aware of. They have mixed
allegiances and try too hard to stay friendly with the administrators
and employees of the facility they are assigned to. There are many
ombudsmen in place and all are trying to do a good job, but another
mistake they make is having too much respect for the system that is in
place. It is dangerous to have too much respect for anyone, much less
the medical profession as many people do. Excesses of anything become
bad for you. The only solution is an independent, prudent, proactive
patient and family oriented advocate.
The ombudsman program that the Adriene Cunningham advocacy foundation
(acafnv.com) has proposed is a better way to handle a system that has
been in profound trouble for years and is a five way win situation.
First, the patient is better protected both legally and physically and
can feel safer and less alone.
Second, the family is crucial to patient comfort, understanding the
situation and listening to them makes them less anxious about the
things being done to help family being right, can and should
participate, saving even more tax dollars.
Third, patient and family civil rights are truly protected.
Fourth, the state and taxpayers save money by cutting millions of
dollars per year in wasted resources by cutting the amount of people
that really cannot benefit from a hospital setting under a frivolous
Fifth, as there are many people that truly need a hospital setting,
these people can get much better treatment with lessened caseloads
By Elaine Cunningham and Dewey Dirks