No ‘Meat Ax’ on Mental Health Clinics, Judge Rules

A Los Angeles Superior Court judge Tuesday barred county officials from shutting down eight mental health outpatient clinics and curtailing services at five other psychiatric centers, calling the plan a “meat-ax approach” that would harm thousands of indigent mentally ill.

Judge Barnet M. Cooperman issued a preliminary injunction halting the closures--which were scheduled to begin Wednesday--after ruling that the county Board of Supervisors had failed to fully study the effect the cuts would have on clinic patients and employees.

The judge, delivering a soft-spoken but tough-worded message to the supervisors, said he sympathizes with the budget squeeze that led to the curtailments but expressed deeper concern for the patients who depend on the threatened mental health clinics.

“I hate to use the vernacular but the board took a meat-ax approach,” Cooperman said of the decision to cut a third of the county’s outpatient clinics to save more than $18 million.

The threatened clinics included outpatient programs in Wilmington, San Pedro, South-Central Los Angeles, Arcadia, North Hollywood, Canoga Park and Carson. All had been scheduled to close on Wednesday, their patients left to find other facilities or go without care.

Another Threatened

Another clinic in Bell Gardens had been targeted to shut down late next month and outpatient services at five other psychiatric centers, all but one at county-run hospitals, were also slated for service reductions as part of the county cuts.

Attorneys representing indigent patients in a class-action lawsuit had won a temporary delay of the county order before a different judge on Aug. 11. On Tuesday, they argued that just the threat of closings had forced some mentally ill to seek help at overcrowded psychiatric emergency rooms or at private clinics that are not equipped to treat the more severe cases.

Referring to county projections, they estimated that more than 23,000 patients would be denied mental health treatment in the aftermath of the clinic cuts and another 10,000 patients would be forced to transfer to other outpatient programs.

County officials disputed those numbers and said that a total 20,000 patients would be affected by the clinic cuts.

But Cooperman said the precise numbers of patients are less important than the fact that the closings would have a “drastic effect” on patients who may be cut off while in “midstream of their mental health treatment.” Such an abrupt loss would increase the risk of suicide or anti-social behavior that could mean an even greater financial burden on law enforcement, he added.

In stopping the closures pending further court action, the judge called on the supervisors to conduct “a systematic study” of the effect the cuts would have on patients and on workers in the endangered clinics. He also suggested there may be other ways to save money, including improving the efficiency of the mental health department.

County Aide Surprised

Mary F. Wawro, senior assistant county counsel, said she was surprised at the judge’s decision and that the county intends to file “an expedited appeal” with the state Court of Appeal or state Supreme Court.

But board chairman Deane Dana said late Monday that no decision to appeal has been reached.

“No member of the Board of Supervisors wants to close any mental health programs. The judge’s characterization that the county used a meat-ax approach is unfortunate and, given the facts, ill-informed. Those cuts were a last-resort step by the county. We were out of realistic options,” Dana said in a prepared statement.

Roberto Quiroz, the county’s mental health director, meanwhile, warned that further delays in cutting clinics will cost the county $1.5 million a month. “Unless we find the funds, we’ll be facing an even greater crisis later,” he said.

In contrast, James S. Carroll, an attorney for San Fernando Valley Neighborhood Legal Services Inc., one of four public-interest law firms representing patients, called the court decision a victory and said that the mental health community breathed “a collective sigh of relief.”

A 52-year-old patient at the San Pedro Mental Health Center had said Monday she was fearful that her clinic would close, threatening the treatment she needs to combat bouts of major depression and suicidal thoughts.

“I’m elated. To me this was so vital,” she said. “The people at San Pedro had become my family. If they closed I would have to leave my family, and I couldn’t handle that.”