Mental health staff relying on police

Alarmed by reports that Los Angeles County mental health staff -- hobbled by a countywide shortage of beds for the mentally ill -- are increasingly forwarding emergency calls to police, commissioners overseeing the department on Thursday asked that a plan to end the practice be presented by early next month.

Department of Mental Health workers have turned to law enforcement officials because hospitals are required by law to take emergency mental health patients transported by police. If a county mental health worker brings a person in for treatment, facilities are not compelled to accept them.

According to department records, mental health staff responded to 10,003 calls this year, down 20% from 12,722 calls answered last year.

“Not only do we use police who might be doing other things, but we’re also taking more people than need to go” to hospitals, Dr. Roderick Shaner, the department’s medical director, said during a meeting of county mental health commissioners. Shaner said his office is looking for a better option than relying on police to get patients admitted to hospitals.

The increased police response to mental health emergencies was first reported this month in the Los Angeles Daily Journal, and mental health commissioners cited the article in calling for immediate fixes, despite the shortage of hospital beds.

“That should be no excuse for not taking someone with a mental health issue,” said commissioner Barry Perrou, a former Los Angeles County Sheriff’s sergeant. The department “says we’re running out of bed space -- well, we’re running out of back seats. We want these patients to be somewhere they can be managed, not the back of a police car.”

The department began shifting emergency calls to police in March 2006, Shaner said, as hospital bed space tightened countywide. As of last month, there were 2,562 beds available for mental health patients in Los Angeles County, he said, and only about 200 of them were at county hospitals, which are required to admit poor and uninsured patients.

County staff monitor bed space hourly, and Shaner said “they’re never empty. There is a huge, pent-up demand.” The average patient stays about two weeks.

Although some departments have created hybrid teams of mental health staff and police, there are only a dozen in Los Angeles and a handful in Long Beach and Pasadena. Advocates for the mentally ill and the homeless say that there are not enough hybrid teams to go around and that police who respond alone can aggravate emergencies.

“Folks who are trained to deal with people who are having mental health issues have the experience to calm things down,” said the Rev. Andrew Bales, chief executive of Union Rescue Mission on skid row. “Somebody who’s distressed is probably going to panic when they see the police. I’ve been in that situation where I’ve been trying to help someone and they became upset when the police arrived.”

One way to alleviate demand is to expand the pool of 100 mental health staff trained to respond to emergency calls and treat patients where they live. Shaner said he is looking at that option, but 40% of emergency calls would still probably require hospitalization.

County leaders could also try to change state law to compel hospitals to accept patients transported by county mental health staff as well as police. Another possibility, officials said, would be to expand available bed space for the mentally ill at county hospitals.

Advocates for the mentally ill say the county should be providing many more services given an influx of $130 million in state income-tax money since the passage of Proposition 63, the Mental Health Services Act, in 2004.

“It seems like all the money . . . got absorbed into the bureaucracy rather than meeting the need,” Bales said.

But Shaner said the Proposition 63 money came with strings attached, including rules that bar spending on involuntary treatment programs such as emergency hospitalization.

Shaner’s office is scheduled to report back to mental health commissioners with proposed solutions Dec. 4.

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molly.hennessy-fiske@ latimes.com