The professionals are calling for a mental health supermarket. Some patients would have to travel considerable distances for treatment, but they would find what they came for when they arrived. : Merger Sought for 4 Mental Clinics

Likening mental health services in the San Fernando Valley to poorly stocked neighborhood mini-markets, representatives of clinics spared by the recent round of Los Angeles County cutbacks are recommending that their sprawling but fragmented operations be consolidated at one central location.

Under the proposal, presented this week to senior managers at the county Department of Mental Health, outpatient clinics in San Fernando and La Crescenta would close, as would two North Hollywood centers offering more intensive, specialized services to the mentally ill. Care to patients from those locations would be delivered at a new multipurpose center that probably would be in Van Nuys or Sepulveda.

“We try to do too much with too little,” said Ron Klein, director of the Crisis Management Center in Van Nuys. “Our preference would be to have well-stocked 7-Elevens all over the place, but we don’t have that.”

The next best thing, mental health professionals say, is one full-service supermarket, a concept being explored in other parts of the county as well. It would force some patients to travel considerable distances for treatment, but they would find what they came for when they arrived. Patients without transportation would rely on a mobile unit that would be part of the new center.

Valley clinics are operating on a shoestring now, sharing physicians and psychologists with other centers. “I don’t know of one facility that is staffed as it should be,” said Kenneth Miya, director of the West Valley Mental Health Center, which closed Sept. 29, the most recent victim of budget constraints. “It is a problem in terms of management and safety issues.”

In addition to Miya and Klein, supporters of the plan for a comprehensive center include the directors of the county’s two remaining outpatient clinics in the Valley area--San Fernando Mental Health Services, which serves 700 patients, and Crescenta Valley Mental Health Center, which serves 150 patients.

Jim Allen, deputy director for adult services for the Valley region, said the proposal “appears to be a very workable approach” that will be considered by county supervisors. “It seems to make sense, given the resources.”

The San Fernando Valley has been particularly hard hit by dwindling mental health funds. Two clinics--East Valley in North Hollywood and West Valley in Canoga Park--have closed since June, taxing other, already overburdened centers throughout the area.

The county contracts with about 14 nonprofit agencies that provide mental health care in the Valley region, but patients must often wait up to five months for an appointment.

About 500 patients from the now-closed West Valley Mental Health Center were referred to the county-operated Crisis Management Center. Under the new plan, many of those patients would receive treatment at the multipurpose center.

The Crisis Management Center was intended to operate as an emergency room for the mentally ill. However, it has been forced to absorb increasing numbers of patients requiring ongoing care as other treatment programs have closed. More than 350 patients were transferred to the center after the East Valley clinic closed in June.

The crisis center now has 1,000 people on its outpatient rolls and sees about 300 to 400 emergency patients a month. Its waiting room is often packed. Patients linger four and five hours, waiting to see a doctor.

Klein said the multipurpose center would reduce waiting periods and offer better, more efficient care than is now available. The services would include those now provided by the San Fernando and La Crescenta clinics, where patients go for medication, crisis intervention and socialization groups that help them learn to interact with others.

Serves Fewer People

The multiservice center would incorporate the Intensive Case Management Project in North Hollywood. That program serves a smaller population than outpatient clinics--about 70 people--but offers more individual treatment and attention to problems such as poor nutrition and vocational skills.

And finally, the new center would include the North Hollywood Continuing Care project, which serves patients in board-and-care homes, helping them to become more independent. It also links patients from state psychiatric hospitals with social services in the community.

The proposal to centralize mental health services counters a trend that began in the late 1960s, when patients warehoused in state mental institutions were released to their communities, where it was believed that they could function independently with help from neighborhood clinics.

But money to do the job didn’t follow the patients, mental health officials said, and the system’s ability to care for people near their homes has eroded.

If the multipurpose center wins approval from county supervisors, proponents say, it could be open in about six months.