Experts Cite Budget Cuts, Predict More Violent Acts

Mental health workers and other experts predicted Tuesday that the kind of violent attack that killed Robbyn Panitch died is likely to happen more often after dramatic budgetary cutbacks in the county mental health system take effect Monday.

A dozen mental health workers and their representatives interviewed Tuesday said they had already been concerned about increased potential for violence under the planned cutbacks. The killing of the 37-year-old veteran social worker Tuesday seemed to confirm their fears.

“When I hear something like this, it confirms my worst nightmare,” said Julie Ann Hargaray (cq), a psychiatric technician at El Camino Mental Health Center in Santa Fe Springs. “I’ve been kicked in the head, spat at, punched in the stomach... I’m concerned about what’s going to happen with the clinic cuts.”

Official View

County officials, however, said there was no reason to believe the attack was related in any way to the cutbacks.

“This is a tragic incident and it’s important to note that people who have not had mental illnesses have committed such violence,” said Mental Health Director Roberto Quiroz. He said he saw no reason to believe that clinics should be less safe for workers or the public after the cutbacks.

County officials said the most severely and chronically mentally ill will continue to get treatment and medication, and that many other patients will seek care at private clinics.

Richard Van Horn, executive director of the Mental Health Assn., which represents patients, their families and workers. agreed that Tuesday’s assault was an isolated case. But he expressed fear that some mentally ill people who are being deprived of care might respond violently.

Such patients “are getting frustrated and angry, and things are escalating,” said Van Horn. “The real tragedy is that the state is not recognizing the level of the problem that we’ve got.”

Because a lack of state funds for mental health programs, the County of Los Angeles ordered $18 million in budget cuts, which will force the closure of eight mental health outpatient clinics, affecting some 20,000 patients from the San Fernando Valley to the South Bay. Services will be drastically reduced at another five clinics.

Because of the cutbacks, mental health workers said, patients with borderline psychoses will be shoved out of the outpatient system to make room for the most seriously ill. Consequently, more mentally ill people will either have no care at all, or be forced to be hospitalized during their worst episodes.

“It is extremely likely that an identifiable percentage of these patients will become violent,” predicted Melinda Bird, a staff attorney with the Western Center on Law and Poverty that represents indigent mentally ill patients.

“And they will direct that violence against those who are close to them. That will definitely include county mental health staff, and family members and people they bump into in the community as well.”

A dozen mental health care workers interviewed Tuesday said that most have been exposed to dangers routinely. But now, they stressed, they will have to deal with a greater percentage of seriously ill patients with fewer workers. About 280 mental health workers have been laid off under the cutbacks.

“Our clients do not deal with stress and change very well,” said Paul Schettler, director of the San Pedro Mental Health Center. “Our concern is we’ll see more and more crises similar to this...This is the only fatality, but we’ve had many other situations come close.”

Most of the clients come through the front door of the county mental health clinics quietly depressed or disoriented. But others draw knives tucked under pant legs, hurtle ash trays at receptionists, and threaten to kill the very people who are trying to help them. In one case a few years ago, a distraught patient followed a worker into a clinic coffee area and tried to strangle her.

County officials in charge of security for clinics were busy investigating the assault Tuesday and could not be reached for statistics on previous attacks.

Security provisions vary from clinic to clinic, workers said. At some, workers have silent alarms under their desks. Because of the patients’ need for privacy, most interviews are done in private offices. In some clinics, not all, there is a security guard; But in most clinics, including the site of Tuesday’s slaying, staffers must call police if they need help, workers said.

Because the drop-in clinics must remain open to serve clients who need help, the ranks of mental health workers on duty after hours is likely to drop, reducing the protection workers feel from other staffers.

In the past, workers said, the County offered workers optional self-defense courses.

“We’re going to be turning down sex offenders, we’re going to be turning down wife-beaters, we’re going to be turning down all sorts of people who needed help,” said one veteran psychiatric worker who asked his name not be used. “How would you like to be a woman working late at night with only a receptionist between you and the front door?”