Closing Mental Health Clinics

I write on behalf of the Southern California Psychiatric Society, a district branch of the American Psychiatric Assn. We represent 1,500 psychiatrists in Southern California, most of whom practice in Los Angeles County.

We are concerned and disturbed by plans to end inpatient psychiatric programs at the county hospitals, to close the Department of Health Services mental health clinics and to simultaneously radically restructure the clinics operated by the Department of Mental Health (Aug. 11). We fear that the chronically and severely mentally ill, who are the least able to take care of themselves, will be lost or abandoned. Moving clinics to Alhambra or Hollywood without a clear plan to connect the current patients to these new sites is dangerous.

We are skeptical that private contractors for inpatient beds will suddenly develop the expertise to deliver the range of services needed for the chronically and severely mentally ill, who include many patients with associated conditions such as chronic physical illness, substance abuse and of course who are without the financial resources and support systems to help them in times of greatest need. Having emergency room programs or emergency room and consultation/liaison programs only is dubious. Any system needs a backup. What will happen to the agitated and violent patients in the community?

We are also deeply disturbed by the threat to end or severely modify the residency training programs operated through the county hospitals. These residencies have historically trained many of the current leaders of the Los Angeles County mental health system, both public and private. Without the current educational infrastructure--libraries, computers, supervisors--residents will provide service but receive less education. Residents at USC are already calling other programs looking for openings. Faculty members are demoralized and senior investigators, many with federal funds, may leave for more promising venues.

We know that Los Angeles County has an awesome budgetary shortfall. We ask for a hard look at alternatives, and compassion for the weakest among us.

MARC D. GRAFF MD

President-elect, Southern California

Psychiatric Society, Los Angeles

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* Millions are being cut back on mental health and other health services to save taxes. “Thousands of the county’s most seriously mentally ill will be cast adrift,” according to your story.

Millions of our tax dollars are being spent to prosecute one wealthy man--O.J. Simpson. Millions of our tax dollars are being spent so that Gov. Pete Wilson can sue the government over affirmative action so that one man can increase his visibility as a presidential candidate.

What’s wrong with our priorities?

SUSAN SCOLASTICO

Woodland Hills