County Mental Health Clinics Threatened by Funding ‘Crisis’

Tens of thousands of patients served by Los Angeles County’s mental health clinics could be cut off from treatment by summer’s end if additional state or local funds are not quickly pumped into the overloaded system, officials said Wednesday.

The news was delivered Wednesday as about 700 patients, parents, psychiatrists and mental health workers staged a massive demonstration in support of increased mental health funding during Board of Supervisor budget hearings at the Hall of Administration.

The mental health funding “crisis,” as county officials describe it, is the dominant issue in deliberations on the county’s $8.9-billion spending plan for the fiscal year that begins July 1. An $18.2-million cutback--about 8% of the current mental health department budget--is the largest proposed for any area of county government this year.

Growing Population

It comes at a time when the department already is struggling with the demands of a growing mentally ill homeless population, increased referals from police who have stepped up efforts to get dangerously disturbed people off the streets and reports that acutely ill patients are languishing for days on the floors of the county’s psychiatric emergency rooms before treatment beds can be found.

“The number of people turned away who should get served is incredible,” said Richard Van Horn of L.A. Advocates for Mental Health, a support group for the mentally ill.

The cuts, which are politically sensitive for all the supervisors because they could affect a large cross-section of ethnic groups and economic classes, are based on Gov. George Deukmejian’s proposed reductions in funding from the state, which provides most of the money for county mental health programs. A large state budget shortfall, coupled with legislative gridlock in Sacramento over how to solve the problem, have heightened fears that the local programs may indeed have to be cut severely.

“Possibly 30,000 people--one-third of our current (patient) population--would not be served,” Robert Quiroz, head of the county Department of Mental Health, told reporters. Quiroz is developing a plan, which may be released today, that would balance the budget by closing about half of the county’s 18 outpatient mental health clinics, as well as cutting back a number of community outreach programs for the mentally ill.

Clinics Not Identified

The clinics to be closed were not identified Wednesday, but Quiroz said they would be distributed throughout the county. And the cuts would have a major effect on the entire outpatient system because the thousands of seriously ill patients would have to be absorbed by the offices that would remain open. “This system is being forced to treat the most seriously disabled,” Quiroz said. “It can’t (continue to) serve all these people.”

People with no history of mental illness or psychiatric hospitalization, but who are suffering from depression and stress, are among those likely to be dropped, he said. But Quiroz said there may be a long-term price to pay. “The preventive capabilities (of the clinics) are tremendously reduced,” he said.

Supervisor Kenneth Hahn, who like his colleagues repeatedly tried to redirect the blame for the problem to the state capital, complained that it may take a major tragedy involving a mentally ill person to get lawmakers’ attention.

Concerned About Cuts

Los Angeles Police Department Capt. Bob Martin told the board that he is concerned about the proposed cuts at a time when police have developed new procedures to identify and refer to the department potentially dangerous individuals. “The bad things have already happened,” Martin told the board. He cited a shoot-out involving a disturbed man three months ago inside the Van Nuys courthouse and the 1984 blood-bath at the 49th Street School, when a man that officials had identified as having mental problems and a series of run-ins with the law sprayed gunfire across a schoolyard of children. Three people died and several were injured.

It is not clear how the financial tug-of-war in Sacramento may sort itself out, but Van Horn made it clear that his group is not going to let the supervisors off the hook if the state does not come through. Supervisors are meeting legal requirements with the funding they plan to allot to mental health care. “But they are not meeting the challenge,” he said.

Supervisor Ed Edelman said he may push for a change in priorities before the budget is adopted next month. One option, he said, is to trim increases for law enforcement and increase funding for mental health.

Nicholas Brkich, 71, one of those who packed the huge Hall of Administration hearing room, is an outpatient at the mental health clinic at County-USC Medical Center. His therapy sessions have already been cut from once a week to twice a month, he said. He said he attended the meeting because “the importance (of the clinic’s services) can never be measured.”