Officials Cite Severe Shortage of Beds for County’s Acutely Mentally Ill

A hospital administrator and a psychiatric nurse, decrying the lack of psychiatric beds in Los Angeles County hospitals, described Friday how mentally ill patients are forced to sleep on floors and mattresses in local emergency rooms while they await available beds.

The patients, who are in need of acute psychiatric care, often wait for several days before obtaining bed space in what has become a worsening crisis in the county’s mental health system, said the witnesses, who appeared at a public hearing organized by Supervisor Ed Edelman into the needs of the acute mentally ill.

“I’ve never seen a situation more severe, more critical and more crying for a solution than we have here in Los Angeles,” said Dr. Milton Greenblatt, chief of psychiatry at Olive View Medical Center, the first of seven witnesses at the Hall of Administration hearing.

Similar responses came from other local and state officials expressing alarm at the dwindling number of hospital beds for acute psychiatric care.

Dr. Greenblatt, who also represented directors of emergency and inpatient psychiatric departments at three other county facilities, echoed Edelman’s complaint that “there is a crisis that needs our attention.”

Greenblatt said that as the number of emergency room patients has grown, the number of mentally ill patients has also mushroomed, but now with fewer beds to place them. He portrayed his own emergency rooms at Olive View as overflowing with mentally ill patients who must either sleep on the floor and on mattresses while awaiting beds or return to the streets.

With the lack of beds, Dr. Greenblatt said, Olive View officials have recorded a sharp increase in the number of patients who actually sleep on the floor. In January, officials recorded 130 “patient nights” spent on the floor, nearly double the same figure during January, 1987, Greenblatt said.

Thomas Hayes, a psychiatric nurse at County-USC Medical Center, told a similar story. He said psychiatric patients often cram into an emergency room “the size of a living room” and sprawl on couches and sleep on the floor “with only a sheet between them and the floor” because of the lack of beds.

“It’s not unusual for our patients to wait two or three days before a bed is found for them,” said Hayes, who described his patients as often times depressed, drugged, suicidal and threatening to others.

The sparsely attended hearing was part of an effort by Edelman to press for more federal, state and county funds to pay for additional hospital beds for the acutely mentally ill.

“We have a serious problem that we all should be concerned about,” Edelman said. “Many of these people are children, and many are in desperate condition when they arrive. . . .”

The supervisor said Los Angeles County presently has about 800 public psychiatric beds, and there is an immediate need for at least 300 more beds for “acute” care as well as 330 additional beds for patients who need other psychiatric care.

It would cost the state nearly $17.7 million and the county $1.8 million to add those beds, according to county mental health officials.

Faced with tight state and county budgets, Edelman suggested a possible bond issue to help finance additional beds. He added that he also will be asking his fellow board members to provide additional money during the forthcoming budget deliberations.

Roberto Quiroz, the county’s mental health director, said his agency has sought to ease some of the overcrowding problems but added, “We continue to have a serious inpatient acute care bed crisis in Los Angeles County.”