Officials Warn Clinic’s Closure May Cause Mental-Care Crisis

More than 1,000 mentally ill patients could be left without treatment and hundreds of emergency calls may go unanswered each month when expected budget cuts close the San Gabriel Valley’s only publicly run mental health clinic, county officials say.

Health professionals, advocates, police and patients worry that the area could face a mental-care crisis--causing a rise in crime and homelessness--when the Arcadia Mental Health Center is closed Sept. 1.

The county-run clinic employs about 25 doctors, nurses and counselors and is the largest public mental-health facility in the San Gabriel Valley with a $1.8-million annual budget. Current state and county budgets have not earmarked any funds to keep it operating.

“We’re making plans to close right now,� said Dr. John S. Wells, district director for the county Department of Mental Health and head of the Arcadia clinic since 1969. “We’ll hope our legislators put a few more bucks in the pipe, but it doesn’t look likely.�

State Funds Cut

The county Department of Mental Health is faced with budget cuts of $18 million because of a drop in state funding, according to the agency’s director, Roberto Quiroz. To meet that disparity, officials have targeted nine of the department’s 25 facilities, including Arcadia, for closure.

The clinics are funded on a ratio of nine state dollars for every dollar of county money. So unless state officials change their plans when the Legislature reconvenes in August, there will not be nearly enough money to keep the clinics operating.

A psychiatric emergency team run by the Arcadia center would also fall victim to the shortfall. It is the only 24-hour emergency mental-care service in the San Gabriel Valley. Team members answer about 250 calls each month from people who need immediate counseling and respond with police to emergencies involving mentally ill people, such as would-be suicides.

“It’s a very depressing, angry feeling for myself as well as the patients that we may not be here in a month,� Perry Horowitz, a psychiatric social worker on the emergency team, said just before answering a call about a woman who had swallowed 90 tranquilizers. “The politicians just see these people as statistics. We see them as people.�

The Arcadia clinic--which provided extensive counseling after the October earthquake--was included on the “curtailment list,� Quiroz said, because it was judged less necessary than others. There are a few smaller San Gabriel Valley clinics that might be able to absorb some of Arcadia’s regular patients, he said.

Many Turned Away

“We will try to accommodate the most severely disturbed clients if we can,� Quiroz said. “But there will be some that won’t be seen. We have to face that. We have to wonder how many people will need help in later years because we couldn’t help them now.�

Dr. Christopher Amenson, head of Pacific Clinics, a private nonprofit mental health center with branches in Duarte, Pasadena and Rosemead, said his facilities are already struggling to serve 3,000 people each year. The clinics turn away half of those asking for help because they are not “seriously enough disturbed,� Amenson said, and still average a monthlong waiting list even for suicidal patients and abused children.

Both the Arcadia clinic and Pacific Clinics serve people with a monthly income of less than $1,500. About 80% earn less than $600 each month.

When the Arcadia clinic closes and patients there look for care elsewhere, Amenson expects to start turning away nine of 10 people asking for help. He also predicted a sharp increase in suicide attempts, homelessness and the number of mental patients arrested and hospitalized against their will.

“These people have serious, serious problems,� Amenson said. “These are not people who are going to be OK with no treatment.�

Bill, an articulate 44-year-old Temple City resident who asked that his last name not be used, has been a patient at the Arcadia clinic for nine years. In the eight years before that, he had attempted suicide, gone into extreme depression and was committed to private and state mental institutions a dozen times.

Attends Group Therapy

Bill said calmly that without professional help, he is afraid that he will revert to his suicidal tendencies and might harm others. He now attends weekly group therapy at the clinic and receives individual counseling and medication there. But Bill does not have health insurance and does not know what he will do if the clinic shuts down.

“The one thing that makes me comfortable and has kept me out of more mental institutions are the services the clinic offers,� Bill said. “The threat of having that pulled away is frightening, terribly, horribly frightening.�

If mental patients do not receive professional help, health officials and police are afraid some will become unstable and commit crimes or take to the streets.

Quiroz said the department has not decided whether any of the Arcadia center’s employees will be laid off if it closes. But because most have seniority, Wells said he expects many would be reassigned to other facilities, where they might force other employees out of jobs.

To Arcadia clinic employees, severe budget cuts are nothing new--for each of the past five years the facility has been faced with cutbacks, reducing its work force and services. But this is the first year those cuts have come so close to actually shutting it down.

Staff Frustrated

Doctors and counselors say they are frustrated, knowing they will not be available to help patients much longer, and not knowing what to tell patients to do when the clinic closes.

“We’ve got to say we’ve got nowhere else to send them,� said Eugene Marquez, a mental health technician who has worked at the clinic for five years. “That’s really scary, because if someone’s in a bad jam, you can’t keep saying wait till tomorrow.�

Local police departments are also worried about the effect of the clinic’s demise. Officers can now contact the emergency psychiatric team to defuse a situation, possibly avoiding involuntary commitment, or can transport a mentally ill person to the Arcadia center.

But if the center is closed, the only choice for police would be to arrest unstable people and transport them to a hospital in downtown Los Angeles, diverting precious manpower from the streets.

“I’d hate to see that shut. Any cop will tell you that center makes our lives much easier,� said Capt. Jim Strait of the Monterey Park Police Department. “It’s going to reduce our amount of officer time on patrol and reduce the effectiveness of what we can do for these people because we have only one option: to arrest and hospitalize.�

‘Sad Commentary’

“It’s a sad commentary on our entire health system,� said West Covina Police Chief Craig Meacham. “I don’t know what the people who make these decisions can be thinking about.�

A spokeswoman for county Supervisor Pete Schabarum, who represents the area where the Arcadia center is located, said the facility has a high priority for reinstatement if reserve funds should become available.

Patients at the center and advocacy groups have been lobbying public officials heavily, pointing out that regular treatment at the Arcadia clinic costs taxpayers less than a patient’s commitment to a mental hospital, and is also more humane.

“There’s nobody who knows about the situation who’s not very much up in arms,� said Sara Shatford, president of the San Gabriel Valley Alliance for the Mentally Ill. “Those with mental disorders will wind up in jail or prison with real tragic results instead of getting the help they need. It will be devastating not just to the people and their families, but the whole community.�