Psychiatric ER at Los Angeles Public Hospital Crowded, Unsafe, Report Finds

Perpetual overcrowding at the eight-bed psychiatric emergency room at Los Angeles County-USC Medical Center, which often holds more than twice its capacity, has created "unsafe conditions for patients, visitors and staff," putting them at "serious risk" for injury, according to a new report from the Los Angeles County Grand Jury oversight panel. The Los Angeles Times reports that the study "generally echoes the concerns of staff members" at the facility and is the "latest in a series of warnings to county officials about conditions in the psychiatric ER." Several factors have contributed to the hospital's problems: the 1994 Northridge earthquake resulted in the closure of a separate county psychiatric hospital facility at the medical center, leaving County-USC to "ma[k]e do with a tiny suite." In addition, the county health department faces an $884 million deficit in five years, prompting hospital administrators to rule out building a new psychiatric ER or upgrading the current facility because of cost concerns. According to Catherine Ehrlich, a psychiatrist at the ER, "patients who need sensitive treatment are jammed together indiscriminately"; she cited an example of a "young psychotic man" who climbed into a ceiling through a loose tile and fell into a nearby trauma patient holding area. Dr. Marius Campeanu, the ER's director, said, "No one can deny that there are instances in the psychiatric emergency room where we maybe aggravate the conditions that place (patients) there."

The report recommends that the county's Department of Mental Health provide funding for additional beds at the ER. According to Roberto Rodriguez, County-USC's former CEO who stepped down last week, the "immediate solution ... would be to create more treatment centers for mentally ill patients" outside the hospital. While insured patients "quickly" move out of County-USC's psychiatric ER because "there is a surplus of private hospital beds in Los Angeles willing to take them," the Times reports that a "shortfall" of beds still exists for the uninsured. County-USC currently contracts with other county and private hospitals to reserve 100 beds for uninsured patients and is trying to obtain 25 more. Of the current "cramped" conditions at the ER, Rodriguez said, "It is nuts, and it's unacceptable," but he noted that the issue "is something over which hospital officials have little control" (Riccardi/Rohrlich, Los Angeles Times, 7/2).