Neighborhood Relives Tragedy : Ventura: Woman’s stabbing death renews debate over how to care for the mentally ill.

It was a typically quiet morning on Agnus Drive in Ventura when an agitated hospital patient named Kevin Kolodziej slipped from Ventura County Medical Center and eluded two hospital staff members in pursuit.

Within the hour, police had found a 90-year-old woman stabbed to death in a nearby house and arrested Kolodziej.

The tragedy has hit hard in the Ventura neighborhood, bringing renewed attention to a matter debated across the state for 25 years: How should health officials handle the thousands of mentally ill no longer confined in mental hospitals?

Today, the victim’s family and friends will hold a neighborhood meeting at St. Paul’s Episcopal Church on Loma Vista Road and presumably renew their calls for tighter security at the county’s mental hospital. They say disoriented, pajama-clad patients frequently shuffle through their neighborhood in leg restraints.

Nevertheless, county officials who plan to attend the meeting say the brutal death of Velasta Johnson will not bring dramatic changes to the county’s meager mental-health program.

The best they can hope for, they say, is that it will increase visibility of the longstanding problem that seems to command little public interest and few public dollars.

“What we do with our population that have mental problems is a big issue, but it hasn’t been a crisis,” said Ventura County Supervisor Maggie Erickson Kildee. “Whether this pushes it into a crisis mode, I don’t know.”

County health officials are quick to point out that Kolodziej escaped from the county hospital, not the mental-health facility nearby. He was being treated for presumably self-inflicted knife wounds and the county hospital had no legal power to restrain him for psychiatric evaluation.

Furthermore, they say, the vast majority of mentally ill patients pose no danger to others even if they walk away from the mental-health facility, which cannot be locked without violating fire codes.

“We’ve never had someone leave the mental hospital and commit an act of violence against another person or property in 24 years,” said Randall Feltman, the county’s mental health director.

Yet mental-health authorities, reacting to the homicide, plan to increase security personnel at the mental hospital to ease the fears of neighbors and assign a mental-health team to fetch runaways at any time of the night or day.

“We want to make sure we are as secure as possible, but we want a reasonable reaction to this,” said Supervisor Susan Lacey. She said some neighbors of the county hospital complex agree with her view that last week’s homicide was an aberration.

“They want a reasonable reaction to this,” she said. “They don’t want an armed camp.”

Ultimately, county officials say the problem of AWOL mental patients should end in the Agnus Drive neighborhood when a new mental hospital with lockup quarters is built in the same area sometime next year.

“We need a locked facility,” said Supervisor John K. Flynn, who added that he has been pushing the idea for several years. “The architect is working on it now, and the money is there to build it. We hope it will be operating next year.”

Other than Flynn, no other supervisor is pressing mental health officials for quick solutions.

“I’m waiting to see what the experts tell me,” said Lacey, who sometimes takes the lead on mental-health issues.

Supervisors Erickson Kildee, Maria VanderKolk and Vicky Howard said they have a wait-and-see attitude.

Although a new mental hospital will better secure the 44 patients in greatest need of acute psychiatric care, it will not provide the bulk of care for the department’s other estimated 2,000 mentally ill clients scattered throughout the county.

All told, Ventura County has 6,700 people with serious mental illness, roughly 1% of the population, according to mental-health experts. Many of these mentally ill people seek treatment from private sources or get no care at all.

Flynn is pushing for a new housing project off Lewis Road in Camarillo to supplement the county’s mental health program. It would accommodate 130 people in independent apartments or supervised dormitories and provide outpatient treatment for others.

“I’m not advocating going back to the Middle Ages in treating patients,” Flynn said. “But people who have mental illness need treatment and a controlled environment.”

Most public-health officials acknowledge that the system for delivering care to the mentally ill is woefully inadequate.

The problem dates back more than 25 years, when a nationwide effort was undertaken to reduce the population of state mental hospitals that had become notorious for their wretched conditions.

Thousands of mentally ill people were “deinstitutionalized,” or discharged into the community with the expectation that they would find economical and humane treatment in outpatient clinics that offer counseling and mind-stabilizing psychotropic drugs.

In California, the number of patients at state mental hospitals has plunged from 37,500 in 1959 to fewer than 5,000 today.

But the plan was a disaster, mental health officials now concede, because government money did not follow the patients into the community.

“In the 1960s, Camarillo State Hospital had 9,000 patients at its peak,” Flynn said. “Today, it has 700 people. So where did they go? They went into the community, into the river bottoms, under the bridges and, for the most part, under no one’s care.”

Mental-health experts estimate that a quarter to a third of homeless people are certifiably mentally ill. About 500 homeless people in Ventura County have been treated by county workers, Feltman said.

A decade ago, Ventura County was 56th out of 58 counties in California in spending per capita on mental health, Lacey said. “Because of special demonstration projects,” she said, “we are certainly at or above average in our spending on mental health. Unfortunately, the average is not so great.”

In addition, the county’s budget problems continue to limit mental health programs. “The problem is how do we care for all these people at the same time mental health has to cut back 2% from its budget,” Erickson Kildee said.

Kolodziej, the 25-year-old drifter now facing murder charges, was released by police officers minutes before the killing because hospital officials said they had no “legal hold” on him as a patient.

The officers said they asked Kolodziej if he wanted a ride back to the hospital. He declined and indicated he would walk back by himself. Prosecutors have charged him with committing a murder a short time later.

County health authorities said they were planning to transfer Kolodziej to the nearby mental-health facility and hold him 72 hours for psychiatric evaluation as soon as he was medically cleared from the county hospital.

Unlike Los Angeles County-USC Medical Center, Ventura County Medical Center does not have state authorization to place a 72-hour hold on patients being treated in the county hospital.

To get such authority, county health officials said the hospital would have to employ its own team of psychiatrists and renovate portions of the hospital to meet state requirements designed to protect patients’ rights. It could not rely on psychiatrists who work in the adjacent county mental hospital.

The apparent hole in the system has angered the victim’s family, neighbors and members of some mental health groups.

“There is no meaningful law that ensures treatment for the ill person and protects both that person and the public,” said Lou Matthews of Ventura, a member of the California Alliance for the Mentally Ill.

“The law,” she said, “allows many of the most severely ill to go untreated and protects the Mental Health Department in its decisions of neglect.”

But Assemblywoman Cathie Wright (R-Simi Valley) said she has discovered the difficulty of designing laws to meet every contingency and still preserve the delicate balance between patients rights and public safety.

“Every once in a while you will have someone slip through the cracks,” she said. “You cannot tailor any piece of legislation to cover every incident.”