Mental Health Care Linked to Prop. 134 : Services: Officials are ready to close major clinic and transitional residence unless voters approve ‘nickel-a-drink’ initiative.

Los Angeles County officials are prepared to close the major government-operated clinic for the impoverished mentally ill in the San Gabriel Valley and shut down a transitional home in El Monte for patients released from mental hospitals if a tax initiative on the November ballot is defeated.

A contingency plan drawn by the Los Angeles County Mental Health Department also proposes slashing grants to private, nonprofit organizations that help care for hundreds of the mentally ill throughout the valley.

Psychologists and social workers warned last week the proposed reductions threaten “a complete meltdown” of psychotherapeutic services for the poor in the San Gabriel Valley that would send some psychotic and schizophrenic patients into the streets and land others in already overcrowded jails and hospitals.

County officials blame the proposed cuts, which countywide would total $40 million, on reductions in state funding. Only a significant increase in the state alcohol tax, proposed in Proposition 134 on the statewide Nov. 6 ballot, can stave off the drastic reductions, said Roberto Quiroz, director of the Mental Health Department.

The so-called “nickel-a-drink” measure would raise about $760 million a year for a variety of social and health programs.

The initiative has been opposed by a well-financed ad campaign. Opponents say it should be defeated because it would lock into the state budget higher levels of spending than the increased alcohol tax would raise. Thus, they warn, it could lead to other tax increases.

If Prop. 134 is defeated, the cuts in the county’s mental health budget could be adopted as soon as Nov. 15.

The contingency plan circulated last week among county employees and private mental health providers estimates that about 22,000 of the 52,000 mostly low-income patients who receive mental health treatment in the county would be turned away from county and private clinics.

“Those people are seriously in need of some agency to help them meet the crises in their lives,” said Ann Brand, president of the 42-member Assn. of Community Mental Health Agencies. “And those people are going to end up on your doorstep and on my doorstep and in much worse shape than they are now.”

Susan Mandel, director of the Pasadena-based Pacific Clinics, said the San Gabriel Valley would be particularly hard hit because it already has too few services. The valley has about 19% of the county’s population, but receives only about 13% of the money spent on public mental health services, Mandel said.

The plan to cope with the county’s projected cash shortage contemplates closing 12 of the county’s 23 mental health clinics and drastically reducing grants to private, nonprofit agencies that serve the mentally ill poor.

Under the proposal, clinics closed in the San Gabriel Valley would be the Arcadia Crisis Management Center and the Therapeutic Residential Center in El Monte. The Arcadia facility provides medication, counseling and other services to more than 1,200 clients. The El Monte center is home to 238 people, helping them to prepare for independent living after stays in mental hospitals or board-and-care homes.

The county contingency plan is designed to shift many services to private, nonprofit agencies. But many of these groups in the San Gabriel Valley would have their funding cut under the county proposal, as well.

Pacific Clinics, one of the largest private providers of mental health services, would have several programs reduced or eliminated under the proposed budget reductions, Mandel said.

It would have to close its outpatient clinic for adults in Duarte--which serves about 300 people--and drop about two-thirds of the 250 adults it serves at its Pasadena clinic, she said. Additionally, almost all outpatient services for children at the Pasadena clinic would be closed, and about 10 of the 50 slots in a Duarte program for disturbed children would be eliminated.

“Everyone we see is quite sick,” Mandel said. “They are schizophrenic or manic-depressive and they can’t function in a normal setting. And there is nowhere else for them to go.”

Nor would Pacific Clinics have any money left to coordinate Project IV, a program in which counselors work with hundreds of troubled Pasadena schoolchildren in an effort to keep them in school, Mandel said.

In place of the closed clinics, the county plans to operate an emergency system: Ten regional offices would provide medication and track 3,000 of the most disturbed patients, and Psychiatric Mobile Response Teams would respond to calls for emergency psychiatric care.

The proposed reductions follow several years of cuts. Last year, the county closed five clinics and reduced services at seven others, including the Arcadia clinic.