Governor Urged Not to Close CMH : Supervisors Say Mental Patients Have No Place Else to Go

The San Diego Board of Supervisors on Wednesday issued a “formal and urgent” letter to Gov. Deukmejian asking him not to close the county mental health (CMH) facility in Hillcrest.

The board warned Deukmejian that closing the hospital would possibly release “aggressive” mentally ill patients into “parks and other public places” where they could hurt others. It said the patients could not be adequately cared for in other facilities.

The letter, signed by each supervisor, expressed confidence that the county could correct the “serious program and administrative problems” at the hospital.

The mental health facility has been roundly criticized during the last six months by a number of state and local agencies, which launched investigations into the quality of care and administration at the facility after a former staff psychiatrist blamed three recent deaths at the hospital on poor medical judgment.

Last week, the controversy came to a head when Assemblyman Larry Stirling (R-San Diego), a frequent critic of the county’s health services programs, called on Gov. Deukmejian to immediately close the facility, saying the situation was serious enough to pose a “life-threatening danger” to patients there.

Stirling acted after receiving copies of 33 reports by the state Health Services Department about deficiencies at the facility. Recommendations from the department for improving mental health care in the county will be included in a report due by early next week--a report that will discuss the possibility of closing the hospital.

On Monday, Stirling met with Deukmejian, who ordered the state Health and Welfare Agency to advise him whether the hospital should be closed. Meanwhile, the agency will review a proposal by Stirling that the state send psychiatrists to bolster the staff at the county mental health facility, a move that dovetails with the county’s own request for temporary staffing help from the state.

While several supervisors have joined in the criticism of the hospital, they took a strong stand in asking the governor to keep it open.

“We are as aware as you are of the problems” at the hospital, the letter said, “but closure is not presently the solution for the patients or citizens of San Diego County.”

The letter stressed that the patients in the 61-bed facility could not adequately be cared for--and probably would not be welcome--at other hospitals. Many have been sent to the hospital by the criminal justice system.

“It is this board’s firm and documented opinion that similar acute inpatient services for the type of involuntary psychiatric patients the county serves are not available elsewhere in this county,” the letter said.

“Clearly, these are young, aggressive, severely mentally disabled clients who are difficult to place. If (the facility) were closed, these individuals would most likely be placed in state hospitals or jails, live in parks and other public places inhabited by the homeless, and would likely injure others, since they are, by and large, gravely disabled and unable to care for themselves as a result of a mental disorder,” the letter said.

Stirling, citing a recent report by the state Health Systems Agency that said that a surplus of psychiatric beds existed in the county, has said that closing the hospital would pose no hardship on other facilities.

Responding to that assertion, the board said in its letter that while vacant beds exist in the county, they are located in facilities that do no offer the type of care provided at the county hospital.

“Recent negotiations with local facilities for backup psychiatric care . . . have elicited responses that hospitals will take our patients only with the proviso that they reserve the right to transfer them back if the patient interferes with the private facilities’ therapeutic milieu, as many of our patients so often do,” the letter said.