SHORT-TERM MENTAL-HEALTH FIX? COUNTY MULLS SPENDING TILL STATE CASH COMES.

Byline: Troy Anderson Staff Writer

Facing an onslaught of psychiatric patients and costs for hospital emergency room visits, Los Angeles County supervisors want to spend $7.2 million on short-term fixes until a new tax for mental health programs kicks in next year.

The money is expected to temporarily ease the ``unrelenting demand'' that more than 8,000 psychotic, suicidal, homicidal, bipolar and schizophrenic people place each year on the system, county documents say.

``It is a crisis,'' said Jim Preis, executive director of Mental Health Advocacy Services. ``The situation is at a stage where people are being detained in the psychiatric emergency rooms but there are no beds available so they are sometimes strapped to gurneys.''

Psychiatric emergency rooms last year saw a 10 percent jump in the number of patients - many of them suffering the effects of illegal street drugs or various prescription drugs.

``In the past, it was pretty easy to tell a heroin addict from a mentally ill person,'' Department of Mental Health Director Marvin Southard said. ``But it's not so easy to tell a methamphetamine addict from a mentally ill patient."

The Board of Supervisors is expected Tuesday to approve the $7.2 million allocation, which would be used to hire nearly five dozen clinicians and to pay for patients' treatment in private hospitals.

Southard said the extra funds will help stop the ``revolving door'' of patients returning to emergency rooms again and again for treatment.

``We know what it takes,'' Southard said. ``It takes providing people housing and employment opportunities, as well as medication and treatment.''

That would serve as a bridge until next year, when the county expects to get $83 million from voter-approved Proposition 63, which will fund mental-health programs through a 1 percent tax on personal incomes above $1 million.

The measure is projected to provide $231 million annually to the county beginning in 2005-06, vastly improving services to the more than 686,000 children and adults in the county suffering from severe mental illnesses.

The mental health department currently provides services to more than 220,000 children and adults.

Dr. Roderick Shaner, medical director of the Department of Mental Health, said the system of outpatient clinics, locked residential facilities, transitional housing and hospital psychiatric wards is overwhelmed by the large numbers of people in need of help.

``If there is a kink anywhere in the system, it all backs up,'' Shaner said.

The crisis has been building since the late 1980s, when the county began closing mental health clinics because of budget cuts. Then Camarillo State Hospital was closed in 1997, and money woes continued to whittle away at the system.

The 2000-01 county grand jury warned that crowding at County/USC Medical Center's psychiatric emergency room was creating unsafe conditions for patients, visitors and staffers.

In June, the supervisors voted to cut $28.6 million from the Mental Health Department's $1 billion budget, reductions that impacted primarily uninsured mentally ill people. All but about $10 million of those cuts have since been restored.

And in August, Gov. Arnold Schwarzenegger vetoed nearly $20 million from the nationally renowned Children's System of Care program, which helps thousands of severely mentally ill children in the county.

As a result, about 15 percent of the severely mentally ill children served by the Mental Health Department - about 600 children - will lose all of their mental health services because they are ineligible for other programs and do not have private insurance coverage.

Paul Frese Jr., director of litigation and advocacy at Public Counsel, said Proposition 63 will help alleviate many of these problems, particularly treating mentally ill people at psychiatric emergency rooms and then often discharging them to the streets.

``The lack of apparent discharge planning is certainly an area of major concern in terms of feeding into the homeless population, whether it's discharging them from a hospital or jail,'' Frese said.

Sheriff's Correctional Services Division Cmdr. Marc Klugman, who oversees the nation's largest mental health institution - the Twin Towers Correctional Facility - said about 2,000 of the county's 17,500 jail inmates are mentally ill and taking psychotropic medication.

Klugman said he expects Proposition 63 to help reduce the number of mentally ill people housed in the jails and the homeless population.

``The crimes they commit that bring them to our attention might not occur,'' Klugman said. ``If an officer or deputy comes into contact with someone who has committed an offense, but it's clear they are acting out because they are mentally ill, or are not on their meds, then the option may be available to take them to a treatment facility instead of the jail, in certain select situations.''

Troy Anderson, [phone]

troy.anderson(at)dailynews.com