Robbyn Panitch spent her last Sunday with her fellow union members at an all-day workshop, training as a shop steward and organizing others to oppose Los Angeles County's planned closing of eight mental health clinics.
One of her final phone conversations Tuesday morning was with a fellow mental health worker who shared her distress over budget cuts that would have forced Panitch's demotion. She and other protesters believed that the pending cuts would only worsen an already dangerous situation in which years of funding cuts by federal, state and county officials had increased tensions for both patients and mental health workers.
Shortly after that phone call, the 36-year-old psychiatric social worker was dead--brutally stabbed, allegedly by the homeless, mentally ill man she had been counseling in the county's Santa Monica clinic.
Her family and her fellow union members believe that those cuts directly contributed to Panitch's death. But county officials, although they mourn her death, say the answer is not so simple and insist that the state and federal governments should shoulder part of any blame after greatly reducing their share of mental health dollars in recent years.
Family and union colleagues contend, however, that the cuts have fostered an unsafe atmosphere. For example, they say, reductions in services have meant that fewer people can be helped, leaving only the sickest patients with access to the clinics. Staffing reductions also have meant bigger caseloads and less security for staff members who found some safety in numbers. Pending cuts, the union says, foreshadow an even more dangerous future.
"We're not talking about just what happened in that room with that man," said Edith Pollach, president of Local 2712 of the American Federation of State, County, Municipal & Municipal Employees, which represents psychiatric social workers.
"We're talking about the lack of support services for people who don't have the help they need," said Pollach, who was the woman with whom Panitch spoke on the morning of her death.
County officials staunchly reject the idea that the budget cuts are to blame for the attack.
"I feel that we've got to take this for what it was: It was a tragic, tragic incident," said Roberto Quiroz, the county's mental health director. "But when people say these cuts contributed to this incident, they're (wrong)."
In fact, Quiroz insisted, the attack underscores the county's need to consolidate clinics and improve security by concentrating more staff members at fewer places. With the county facing as much as an $18-million annual loss, Quiroz says the consolidation is the only alternative left if any clinics are going to remain.
"We can no longer be all things to all people," Quiroz said. "We have to target our resources to the most severely chronically mentally ill. And when we no longer have the funds to keep all the clinics open, that means closing some down."
Quiroz, who has been the county's front man in the budget cuts, said Wednesday that he intends to proceed with plans to shut down eight clinics from the South Bay to the San Fernando Valley starting Monday. Services at five other outpatient clinics, including four at county-run hospitals, would also be sharply curtailed.
As a result, more than 20,000 patients who had relied on county services will be left to find treatment at private clinics or to do without help. Another 10,000 patients will be transferred to other county-run clinics. According to a report last month to the Board of Supervisors, nearly 300 mental health workers will be laid off and 150 other employees will be demoted or transferred to other jobs.
More Money Sought
Supervisor Ed Edelman said Wednesday that he intends to ask his fellow board members next week to scrape up $3 million to $4 million to save at least some of the clinics until the state can step in with more funding.
But Supervisor Deane Dana, long an advocate of mental health services, said there is nothing more the county can do.
"There is no way to get the money to save the clinics," Dana said. "We have been stringing this along all the while, and we have just come to the end of the line."
For Los Angeles, like other California counties, it has been a steady financial decline for mental health funding.
The state, which provides 90% of the funding for local mental health programs, has substantially reduced its support over the last 15 years.
An illustration of the effect of that reduction was provided by the Mental Health Assn., composed of parents and other supporters of the mentally ill. The association said that if services were to be maintained at the 1974 level, more than $258 million would have to be added statewide to the present $575 million earmarked for community mental health programs.
At the same time the services were being cut, the county's homeless population--which includes a sizeable number of mentally ill--exploded, providing more patients for an overworked staff. And the federal government, which had paid to open community mental health centers, abandoned many of those programs to state and local officials who were struggling for money.
"What has happened is that the county has been stretching itself over the years, and the chickens have come home to roost," said Bryan Jones, staff director for the Los Angeles Advocates for Mental Health, a lobbying group for mental health activists.
State mental health director Michael O'Connor, who met with county officials on Wednesday, sought to assuage some of their fears of even further reductions in state funding and told them that the Deukmejian Administration is still exploring ways to send more mental health money to Los Angeles.
But those words were of little solace to Quiroz.
"It will only get worse before it gets better," he predicted after the meeting.
Nor are Panitch's union colleagues comforted. They announced Wednesday that they will hold a candlelight ceremony tonight at Palisades Park in Santa Monica and will show up in force next Tuesday to protest the mental health cutbacks.
"We have pledged that in Robbyn's memory, we will continue to fight and try and prevent these closures, cutbacks and layoffs," said Pollach. "Those cuts can only worsen the situation, and we don't want another incident like Robbyn's."