County Mental Centers Reject 50% of Cases, Study Finds

The Los Angeles County Grand Jury reported Tuesday that the county’s psychiatric hospitals are so crowded and their medical staffs so overworked that at least 50% of those seeking admission are routinely turned away.

The grand jury also confirmed reports by county medical authorities that patients who are admitted are sometimes forced to sleep on emergency room floors because of the lack of available bed space. Other patients have been “detained for days in the emergency room due to a lack of acute beds,” the jury panel reported.

The panel also said that county hospitals have severe manpower shortages, running as high as 50% in some county Department of Health Services facilities. The lack of staff and bed space also forces some adult units to admit juvenile patients.

The grand jury urged the Board of Supervisors and state health officials to find a way to fund an additional 335 acute-care and 315 subacute-care mental health beds in the county, which would bring the county’s mental health bed total to 1,730.

Homeless Population

The panel also recommended that a full range of health services be made available to adolescent patients and to a mentally ill homeless population estimated at 12,000 people scattered throughout the county.

“The elected leadership on the state and local levels needs to be concerned about the mentally ill and provide for them,” said grand jury foreman Manuel A. Gallegos.

Gallegos was critical of state officials, whom he said were not supportive enough of local attempts to ease the critical bed and staff shortage at psychiatric hospitals.

“The county is dependent on the state for additional funds, and the state is saying they are giving all they can,” he said. “There’s an attitude that needs to be changed.”

The state Department of Mental Health has declined support for more acute-care beds in the county, “claiming lack of funds and the possibility of local mismanagement,” the grand jury report says.

The grand jury said that the county’s shortage of mental health beds appeared even more onerous when compared to mental health facilities in New York City. The county has only one-fourth the number of acute-care beds that New York has, despite the fact that “both systems serve populations about the same size and with similar demographic characteristics.”

Took Up Issue

The jury took up the mental health shortage as an issue last September after its Health and Hospitals Committee noticed the effects of the shortages during visits to county medical facilities.

In recent months, county health officials have given graphic examples of some of those effects. In April, Dr. Milton Greenblatt, chief of psychiatry at the Olive View Medical Center in Sylmar, testified that 130 “patient nights” were spent on the floors of the facility last January, nearly double the number recorded in January, 1987.

The other county mental health facilities are Harbor-UCLA Medical Center, Martin Luther King Jr./Drew Medical Center’s Augustus Hawkins Mental Health Center and County-USC Medical Center.