CALIFORNIA ELECTION / INITIATIVE : County to Close Clinics If Prop. 134 Loses : Mental health: Without the tax measure, more than 4,000 vulnerable patients will be turned out altogether, with hundreds more affected by cuts in spending for private agencies, county officials say.

Los Angeles County officials are prepared to close four clinics serving more than 4,000 mentally ill patients in Long Beach and the Southeast section of the county if a tax initiative on the November ballot is defeated.

The county plan also calls for cutting spending on several private mental health agencies that serve hundreds of other mentally ill people in the same areas.

Psychotherapists and social workers said last week that the proposed reductions threaten a further crippling of an already-thin supply of psychotherapeutic services for area poor people, sending some psychotic and schizophrenic patients into the streets and landing others in already-overcrowded jails and hospitals.

County officials blame reductions in state funding for the proposed cuts, which countywide would total $40 million. 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 Los Angeles County Mental Health Department.

P roposition 134--the so-called “nickel- a-drink” measure--would raise about $760 million a year for varied social and health programs.

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

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

A 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 now receive mental health treatment in the county would go without care.

“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.”

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

Under the proposal, the Southeast would lose two Long Beach facilities: the Long Beach Adult Mental Health Service, which serves 1,888 patients, and the Long Beach Continuing Care clinic, with a caseload of 646. The Compton-Downey Mental Health Center, with 1,228 patients, and the El Camino Mental Health Center in Santa Fe Springs, with 800, would also be shut.

“The population we have has been coming in here for years,” said Lee Forte, head of adult programs for Long Beach Mental Health Service. “They are going to be thrown completely into turmoil and crisis by this. A lot of them will end up in emergency rooms or be picked up by the police.”

About two-thirds of the clinic’s clients depend on medication to control their moods, Forte said. Most of those depend on public transportation and, Forte said, would probably find it too difficult to navigate their way to Rio Hondo Community Mental Health Services in Cerritos, the closest county facility that would remain open if the county cuts take effect.

He predicted that without medication and treatment, some clients will end up on the streets. “We don’t need an increase in the homeless population down here in Long Beach,” Forte said.

The county plan calls for services to be shifted to private clinics and programs. But many of those would also be hurt by the budget cuts.

The La Paz residential center in Paramount, for example, would lose $1 million and might have to cut its patient load of 127 by as much as one-third, said Ross Peterson, a vice president with Telecare Corp., which operates the facility.

Peterson said the patients would be hard to place in other facilities, because La Paz is the only residential program in the county specializing in geriatric care. Many of those who live at La Paz have been committed for treatment by court order, he said.

The Mental Health Assn. in Los Angeles County would lose funding for two programs serving the Long Beach area.

The group’s Long Beach Social Center on Elm Street provides group counseling and social programs for about 100 mentally ill people. Many of those live in board-and-care homes but become part of the “daytime homeless” if they don’t have programs like the Social Center during the day, said Richard Van Horn, director of the Mental Health Assn.

The organization would also lose funding for its Homeless Outreach Program, which has placed about 150 people in permanent homes in the last three years, Van Horn said.

The United Cambodian Community mental health program in Long Beach, which provides therapy for 300 Southeast Asian refugees, would be closed by the cuts. Director Kayte Deioma said the program’s workers also train other therapists unaccustomed to working with Southeast Asians, many of whom have been traumatized by oppressive regimes in their home countries and years of living in refugee camps.

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 closures would continue a pattern of reductions in the county’s mental health services. Last year, the Board of Supervisors closed five clinics: the Hubert H. Humphrey Mental Health Center in South-Central Los Angeles, the West San Fernando Valley Mental Health Center in Canoga Park, the East San Fernando Valley Clinic in North Hollywood, the Coastal Community Mental Health Center in Carson and the Wilmington Mental Center.

The county also reduced staffing and service at seven other locations, including the Cerritos clinic and another clinic in Bell Gardens.