Los Angeles County Health Officials To Present Strategy To Address Overcrowding in Psychiatric Emergency Departments
The Los Angeles County Department of Health Services and the county Department of Mental Health on Tuesday are scheduled to present to the county Board of Supervisors a strategy to address overcrowding in the county's four public psychiatric emergency departments, the Los Angeles Times reports. Patient volume at psychiatric EDs in the county this year has increased by 16% since 2003, and hospitals since May have requested diverting patients from their EDs because of overcrowding about two-thirds of the time.
County Supervisor Zev Yaroslavsky called for a plan to ease the overcrowding after a psychiatric patient at Harbor-UCLA Medical Center committed suicide a few weeks ago. Hospital officials said the patient had to wait several days for care in the ED.
Jim Allen, deputy director for adult systems of care at DMH, said health officials have several ideas they could present to the board. According to the Times, the proposals include:
- Placing psychiatric patients who do not require long-term care in a new "crisis stabilization service" where they could receive 24 hours of care, as well as up to a year of follow-up therapy;
- Using money from Proposition 63, which will expand mental health services by increasing by 1% the state personal income tax on people whose annual incomes exceed $1 million, to make available therapists and other care providers in community settings; and
- Using the new mental health funds to contract for more inpatient beds for psychiatric patients in private facilities.
Yaroslavsky said, "We have a supply-and-demand problem," adding, "There's no financial excuse now not to deal with this," following the approval of Proposition 63.
According to the Times, some officials say the increase in psychiatric ED patients could be attributed to the closure of seven private hospitals in the past 18 months. Others have said that acute psychiatric services generally are not very profitable because of nurse-staffing requirements and the number of uninsured patients psychiatric EDs admit.
Despite the recent closure of several facilities, county DMH Director Marvin Southerd said, "There has always been and continues to be a shortage for persons who don't have" insurance. He added, "It's a rare day in which all of the acute beds are filled for people who have Medi-Cal." Southerd said he is most concerned about providing adequate psychiatric services for children, who generally require "expensive" medical specialists (Chong, Los Angeles Times, 11/23).