The psychiatric emergency room at Los Angeles County-USC Medical Center is so crowded that it violates patients' rights and puts them and staff members at serious risk for injury, according to doctors, nurses and a county grand jury report to be released this week.
Hospital officials acknowledged that they have been aware for at least a year that the eight-bed psychiatric emergency room at the West's largest public hospital regularly houses more than double the number of patients it is designed to accommodate. But these administrators contend that they haven't been able to fix the problem because the remedies are too costly and remain largely outside their control.
"It is nuts, and it's unacceptable," said County-USC chief executive Roberto Rodriguez, who discussed the cramped conditions in an interview before stepping down from his post last week.
Mental patients are left dangerously unsupervised, staff members say. Amid the chaos in the ER, one young psychotic man recently noticed a loose acoustic ceiling tile, hoisted himself into the crawl space above and fell through the ceiling into a nearby trauma patient holding area, said psychiatrist Catherine Ehrlich.
Psychiatric patients who need sensitive treatment are jammed together indiscriminately, Ehrlich added. She recalled a suicidal 17-year-old girl who had been raped cowering in the corner in a room full of older male mental patients who were there because police or relatives had judged them dangerous.
The grand jury report, obtained by The Times, finds that patient rights were violated and that the ER creates "unsafe conditions for patients, visitors and staff."
The report generally echoes the concerns of staff members such as Ehrlich. It is, in fact, the latest in a series of warnings to county officials about conditions in the psychiatric ER. The hospital was recently cited by state monitors and even the county's own Department of Mental Health for violating psychiatric patients' rights.
The grand jury findings arrive at a difficult time for the county's cash-strapped health system. The county's health director, Mark Finucane, departed last week after a tumultuous five-year stint. Rodriguez left as well. At the same time, County-USC, the system's flagship hospital, has been hit with complaints from doctors and nurses that patient care is compromised by dangerous delays in critical services and by poor leadership.
