LA County may let more hospitals detain dangerous psychiatric patients

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When someone with a mental health disorder arrives at a hospital emergency room and staff determine that he poses a danger to himself or others, they can detain him for a 72-hour crisis intervention - but only if the facility has an in-house psychiatric unit that's designated to treat such patients.

On Tuesday, the Los Angeles County Board of Supervisors will consider setting up a pilot program that would change that policy at at one hospital.  The County Department of Mental Health is proposing the experiment at south L.A.'s Martin Luther King, Jr. Community Hospital, which doesn't have a mental health unit.

Since MLK's ER staff don't have the authority to detain psychiatric patients, they have to wait for one of the county's Psychiatric Mobile Response Teams to collect a patient deemed dangerous and transport him to a county or private psychiatric facility.

That's a problem because those teams are "incredibly busy," says Robin Kay, acting director of the Department of Mental Health. In the meantime, she says, the person in crisis is occupying a bed in a busy ER.

Law enforcement and qualified medical personnel can detain a person deemed a danger to himself or others for up to 72 hours for assessment, evaluation and crisis intervention under section 5150 of the California Welfare and Institutions Code.

"What we hope is that we'll find that this [pilot project] helps to alleviate the pressure on that emergency department, by allowing us to more expeditiously attend to the needs of clients that are there," Kay says.

As part of the pilot, MLK emergency department staff would be required to complete a course and pass an examination, both administered by the county mental health department. The hospital would have to comply with all the requirements associated with state law.

The experiment could begin by December and run through June 2017, with an optional one-year extension through June 2018.

If it's successful, the supervisors could authorize other hospitals without inpatient psychiatric units to detain patients, although Kay notes that her department will first "want to have the chance to look at how [the pilot] impacts the inpatient units, the urgent care centers, etc." at MLK.

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