Appeal Court Ruling Clears Way for Closing Mental Health Clinics

In a stunning blow to Los Angeles County mental health advocates, a state Court of Appeal has ruled that county officials may proceed with the planned closures of eight mental health outpatient clinics and sharp cutbacks in service at five others.

The appellate court, in a ruling county lawyers received Friday, sided with mental health officials who had argued they had no choice but to act against the clinics because of a shortage of money for mental health programs.

The closures alone would affect more than 20,000 patients in clinics from the San Fernando Valley to the South Bay. The closures were scheduled to begin last summer, but lawyers representing half a dozen mental health patients obtained a Superior Court injunction in August blocking the move. But in the ruling, issued Thursday, the 2nd District State Court of Appeal dissolved that injunction.

“This court appreciates (that) mental health services in many instances can be as vital as other forms of health care,” the appellate court order said. “Unfortunately, there are insufficient funds available to meet all the perceived needs, requiring a prioritization of public expenditures.”

The court added that state law limits the county’s mental health obligations and that any changes in that requirement should be enacted by the Legislature, not the courts.

Because the decision cannot take effect until 30 days after the Jan. 26 ruling date, attorneys for both sides said the earliest the county can begin closing clinics will be at least a month plus an additional 10 days during which time an appeal can be filed.

“We believe that the Court of Appeal reasoning is not consistent or logical, and we’re going to seriously consider a petition of review with the California Supreme Court,” said Melinda Bird, a staff attorney for the Western Center on Law and Poverty, one of the law firms representing indigent mentally ill patients in the court case.

“If the clinics finally do close,” Bird added, “we want to be sure that the procedures are fair and reasonable and that those who need services will continue to receive it.”

County officials have said that in closing the clinics, only those patients who are severely and chronically mentally ill will continue to receive treatment at county facilities. As a result, seriously mentally ill patients at clinics that are on the cut list would be assigned to other clinics which, in turn, could jettison patients who require less psychiatric attention.

In the wake of the court ruling, mental health advocates said they fear such a ripple effect will not only undermine the mental health system but threaten patients who rely solely on the county for treatment.

‘Devastating Effect’

“If the cuts go through with the magnitude they talked about last August, it will have a tragic and devastating effect on our clients,” said Bryan Jones, director of public policy for the Mental Health Assn. of Los Angeles County, an umbrella organization for mental health patients, their family members and professionals.

“I would hope that the supervisors could find some way to continue to provide the funding for mental health that would prevent further cuts,” said Jones, who added that many patients forced to transfer to unfamiliar clinics would face long lines or difficult commutes for treatment.

However, Roberto Quiroz, the county’s mental health director, said Friday that his staff would immediately begin evaluating how to proceed with the clinic cuts.

“We’re waiting for the county counsel to review the wording of the decision,” Quiroz said. “We will be meeting with county counsel on Monday and then proceed with whatever decision we have to make.”

Quiroz said he hopes to make the cuts, which would also include layoffs, as painless as possible. “I think it’s been a time of great uncertainty for staff, patients, administrators and board (of supervisors) and somewhere along the line we had to get a decision made, and this was a responsible decision,” he said.

Other county officials were not so sure.

Paul Schettler, executive director of the San Pedro Mental Health Center, one of the threatened clinics, said while everyone was relieved that a decision had been made, his patients and staff are still in limbo.

“We still don’t know what the extent of the cuts will be, and we don’t know how much curtailment of staff it will be,” he said. (But) it’s certainly clear that there’s still going to be a tremendous impact on loss of services to the severely mentally ill and to the homeless mentally ill,” he said.

In addition to the San Pedro clinic, outpatient programs in Wilmington, South-Central Los Angeles, Arcadia, North Hollywood, Canoga Park, Bell Gardens and Carson are scheduled to close.