A small crowd was already waiting in the psychiatric emergency department at the L.A. County-USC Medical Center when Los Angeles police Det. Jim Hoffman arrived early on a Saturday morning in March.
Sitting in a narrow hallway just outside the locked psychiatric unit, two police officers from LAPD’s Central Division waited with a man and woman in handcuffs. Both patients were brought to the hospital overnight and placed on 5150 holds, a 72-hour detention and mental evaluation for patients who are considered a threat to themselves or others.
The ward was full as usual. The man — as well as rotating shifts of officers with him — had been waiting for an excruciating 11 hours, while the woman had been waiting for more then eight.
Hoffman recalled the male patient was “psychotic, but in a calm way,” while siting quietly on the bench. The woman, who was resting on the floor with her hands free and her ankle shackled to the bench, quickly became agitated shortly after waking up. The officers took her outside and back in again in an attempt to calm her.
“Quite frankly, I empathized with her,” said Hoffman, a supervisor with the LAPD’s special mental health team. “At that point, I probably would have been cursing too.”
Despite Hoffman’s best efforts, which included going as far as to call the head of psychiatric emergency unit on his personal cellphone, the male patient waited an additional hour to be seen while the woman waited another two.
According to department records LAPD officers transported 15 psychiatric patients to county-operated hospitals on that day, spending more than 64 hours waiting with patients until they were admitted to unit.
While it was an unusually bad day, officials agree it happens all too often and has become a common problem. Overburdened and short-staffed psychiatric emergency departments are taking patrol officers and firefighters away from the streets as they continue to get stuck in backups. At L.A. County-USC, the typical psychiatric patient count per day has jumped by 60% during the last years.
“The emergency rooms aren’t really a great place for treating people who are in psychiatric crisis,” says Marvin Southard, director of the L.A. County Department of Mental Health.
In order to address the ongoing struggle to keep the mentally ill off the streets and police out of hospitals, L.A. county has built five mental health urgent care clinics, with plans to build more. In total, the clinics see an average of 25,000 patients per year.
More than half — 57% — of patients wait 15 minutes or less to been seen at urgent care clinics, and roughly 80% of all visits are an hour or less according to a survey by the Urgent Care Association of America. L.A. County’s new psychiatric urgent care clinics hope to follow a similar model, while ensuring patients leave with continued mental health services.