Chasing Blues Has Hospitals in Black

Sure, you can use my name, said Zackery Drew, a 20-year-old former high school valedictorian, with the handsome features of a movie star and, until now, the ugly habits of a drug addict.

“I come from an alcoholic family,” Drew said last week. “I started drinking at the age of 10. I started using marijuana at the age of 12, and I was under a psychiatrist’s care for four years from the age of 12 to 16.”

A special school got him “clean and sober” for a while. But by age 18, he was hooked on cocaine. “I was afraid to go to sleep at night because I didn’t think I would ever wake up again.”

At times he said, he lived on the streets, was unemployed, had no money and no food. “The one thing I had was medical insurance,” he said.

So, a few weeks ago, “I came here because I felt I was dying,” Drew said. “And I knew the problem wasn’t physical.”

As Drew spoke in a conference room at Charter Hospital of Long Beach, he sat flanked by five other men, ages 18 to 50, who are fighting similar drug addictions. Each was eager to talk about his experience. And most, like Drew, were unafraid to see their names in print.

“Nowadays,” said 21-year-old Kevin Koren, “it’s becoming much more socially acceptable to deal with mental illnesses, one of them being chemical dependency. I think young people are more cautious of their drug use, alcohol, narcotics and so on, and people are interested in correcting those problems.”

Facing Problems Easier

Medical experts agree that more people are finding it easier to confront problems ranging from drug use and emotional stress to classic conditions such as depression and schizophrenia. And as they do, Long Beach hospitals are scrambling to provide new psychiatric services that will not only help their patients but also bolster corporate profits.

“I’ve been in this professional field for many years,” said Thomas Mesa, administrator of Los Altos Hospital, “and today’s climate is helped by the fact that several celebrities have sought (psychological) treatment. Hollywood has helped. Television shows, even on regular dramatic series, talk about alcohol and chemical dependencies.”

Several Long Beach-area hospitals, including Memorial Medical Center and Dominguez Medical Center, have long maintained emergency psychiatric units. But other programs have recently gone through a rush of renovation and even transformation. For example:

Charter, already the largest private psychiatric hospital in the West with 227 beds, recently completed a three-year, multimillion-dollar expansion that increased its floor space by one-third, added classrooms, a gymnasium and a re-landscaped campus to develop what it considers the most modern child and adolescent mental health center in the nation.

The expansion includes a new 40-bed adult unit for patients struggling to cope with a life-crisis depression such as divorce, stress from traumatic experiences such as rape, drug dependencies, eating disorders, even so-called “love addictions” that can hamper someone’s ability to develop a healthy relationship.

Last October, Los Altos Hospital converted to an 80-bed psychiatric center from a 97-bed general facility after having trouble attracting patients in the hotly competitive Long Beach medical-care market. Now it has as many as 60 beds filled at any one time. Like Charter, it offers services to children, adolescents and adults.

Compared to larger hospitals, Mesa said, Los Altos tries to “give more attention to detail with smaller programs, which means patients get more direct care, and we’re able to specialize.” While Los Altos doesn’t operate a chemical dependency unit, Mesa said, it can treat the psychological problems usually found at the root of drug addition.

At Long Beach Community Hospital, the success of its year-old, 18-bed Center for Mental Health has prompted the opening this Thursday of a 10-bed addition designed to accommodate more severely disturbed patients. “It will be a locked unit,” explained Dr. Ronald T. Silverstein, “so that we’ll be able to offer patients security” until they are able to control their distress.

Because it is also a general hospital, Community is sometimes able to offer a more complete service to its psychiatric patients, Silverstein said. “Most people generally have to have their (overall) medical issues paid attention to,” he said. “I feel that the experience people get (at a full-service hospital) helps them recover more quickly.”

Since the psychiatric center was opened, added Janet Parodi, vice president of patient services, “we’ve been 80% filled, which really speaks to the need” for such services. In contrast, Community’s general care wards are usually about 65% full, she said.

Parodi and other hospital executives acknowledge that the trend toward more psychiatric care has been more cost-effective than providing general care, which in turn has brought them higher profits.

Insurance Pays Quicker

For one thing, government regulations have eased in recent years so that it is less difficult for a hospital to open such a facility, officials say. But more than anything, most of the patients who seek psychiatric care--such as Drew at Charter--have private insurance policies that provide quicker payment with less red tape than government programs such as Medicare.

But at Community, which operates as part of the HealthWest chain of nonprofit hospitals, money wasn’t the sole motive.

“I think we identified a service and a need and it’s self-supporting,” said Parodi. “It’s a community service which has backing and provides us with a viable product.”

“It doesn’t make a lot of sense to leave those beds empty,” she added, “especially when there’s a demonstrated need for the service.”

At Los Altos, which is owned by the for-profit National Medical Enterprises Inc. (NME), administrator Mesa said its conversion took place “not so much because it was a hospital decision but because it was an analysis by the company.”

NME Senior Vice President Gerard A. Smith said that “not just our company but many others” see psychiatry services as a growing consumer market. According to a study by the National Institute of Mental Health, Smith said, about 19% of the nation’s population over 18 suffers from some psychological disorder.

Doctors like Long Beach psychologist Robert Butterworth, who practices at four area hospitals, welcome the expanded services but say it is no cure-all.

“There’s a whole push now about drug rehabilitation,” said Butterworth, and a lot of companies “are getting behind their employees” who need help. Yet, many insurance companies won’t cover treatment for chemical dependencies because “they don’t feel drug abuse is a serious enough (mental) problem.”

And apart from those patients who have private insurance or can otherwise afford hospital charges that range from $100 to $700 a day, Butterworth said there are too few facilities for poor people who suffer at the hands of a drug addiction or mental disease.

Long Wait for the Poor

Some patients can only turn to county-owned facilities that have “long waiting lists” that typically stretch from 90 days to 120 days, he said. The reality often is that “If you have no money you have no treatment, and it seems to be getting worse.”

The expansion of psychiatric programs here and nationwide has produced many programs that are “excellent,” Butterworth said. But, “when you have hospitals spending millions of dollars on advertising, you don’t always get the most humanitarian care.”

Finally, despite what some hospital commercials might imply, people who confront psychological problems may find treatment more accessible, but won’t find it any easier.

“If anyone feels they can go in (a hospital program) and 30 days later go out and kick the habit,” Butterworth predicted, “I would say they would have a 90% fail rate. It’s a lifelong struggle.”

Doctors at Charter agree that deep-seated psychological problems and drug addictions cannot be cured in a short period, and have counseled Drew and other patients to keep attending Narcotics Anonymous sessions and other support groups after being released from the hospital.

Drew said he knows that “everyday is difficult.”

“I cannot say that tomorrow I won’t use drugs or the next day I won’t use drugs,” said Drew. “But I can say that today I haven’t used drugs.”