Help for Depressed, Distraught : Counselor at Hospitals Tackles Mental Crises

Three years apart had not diminished Tom’s love for his wife. Just as he had done on other trips to Bellflower to visit the couple’s two children, Tom made a play to win back her affection.

Only this time his obsession became Reno Galassi’s problem.

A marriage and family counselor with College Hospital in Cerritos, Galassi is a member of the facility’s Crisis Response Unit. He is one of 14 counselors who work around the clock providing emergency psychiatric treatment and referrals free of charge to nearly 50 hospitals in Los Angeles and Orange counties.

This night it was Galassi who was dispatched to Bellwood General to calm Tom--not his real name.

Sobbing and Shaking

The man had become distraught when his ex-wife refused to give the marriage another go. He had come south from his Northern California home hoping this time she would agree to mend their differences. She didn’t, and Tom, a carpenter in his mid-30s, began sobbing and shaking uncontrollably. The ex-wife and a friend took him to Bellwood, where Galassi arrived a short time later to find Tom curled up on a gurney in the emergency room. It would take Galassi and a minister friend of the family nearly four hours to settle Tom and convince him to leave the hospital and go home with the minister.

It was a victory of sorts for Galassi. He helped defuse a crisis, and the hospital was relieved of a patient who does not fit into its medical care program.

In fact, most hospitals are not equipped to handle patients like Tom. “If you’re bleeding or your arm is broken, they know what to do,” Galassi said. “But a guy like (Tom) is a mystery. He’s obviously upset, in some kind of trouble, but there’s no blood, no sign of a medical problem. . . . They really can’t admit him because they don’t know what’s wrong.”

In recent years, a growing number of homeless, depressed, chemically dependent and mentally disturbed people have begun showing up in emergency rooms at neighborhood hospitals, said George Orras, director of Outreach Services at College Hospital. Government-subsidized treatment for these people is disappearing, he said, because of state and federal budget cuts. The burden, therefore, falls on the private sector to provide care for the mentally ill and others, Orras said.

Few Special Units

While some hospitals have opened special units to treat disorders like alcohol and drug addiction, as well as abuse victims, the vast majority still do not take such cases. And those that do are sometimes hard to find or get to. So Orras, a psychiatrist, approached College Hospital in 1983 about setting up a 24-hour hot line for emergencies and referrals. In the first month, Orras received 12 calls. Today, the crisis unit is averaging about 140 calls a month. Hospitals from eastern Orange County to Long Beach to Pico Rivera are part of College Hospital’s crisis response network.

The hospitals are not charged when Galassi and other counselors make a call there. For College Hospital, a privately owned and operated facility, the payoff has been an increase in patients. About 5% of those who are seen through the Crisis Response Unit wind up at College Hospital, both an inpatient and outpatient institution. But Orras said it’s not the business he is after. “It is not how many we can bring to this hospital, but how many we can place somewhere in some kind of program. . . . Treatment is our goal.”

When the program began, it was Orras and a secretary. Today, his staff has grown to 50 full- and part-time employees, and the number of programs has grown too. Besides the Crisis Response Unit, he also oversees “Hospital Helpline,” a phone referral service, and a program aimed at educating young people about problems like drug and alcohol addiction, all of which are offered free of charge.

Despite the growth in his programs, Orras does not believe there is more mental illness today. “People are simply more aware of psychological problems,” he said. “The media has made it OK for people to have a problem, to talk about schizophrenia, abuse or neglect. In the long run this can only help us understand what makes us tick.”