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# City’s psychiatric patients have few long-term options
- URL: https://www.smdp.com/citys-psychiatric-patients-have-few-long-term-options/
- Published: 2005-09-14T15:00:00.000Z
- Updated: 2026-10-23T07:46:54.000Z
- Author: Guest Author
- Tags: Health, Santa Monica, #archive-import, Homeless

*Down, out and mentally ill in SM*

*By ROBERT FATURECHI Special to the Daily Press*

For many of Santa Monica’s mentally ill homeless residents, finding adequate, long-term health care can be a rocky road, as the few wards equipped to handle their disorders often are filled to the brim.

Though the emergency rooms at area hospitals — St. John’s Health Care Center and Santa Monica-UCLA Medical Center — do meet the immediate needs of the mentally ill, they’re not equipped for long-term care, a personnel pitfall that, combined with packed psychiatric wards, often results in those in need returning to the streets.

“Most psychiatric patients feel gratified to come to the emergency room, get medication and have their stories heard thoroughly,” said Russ Kino, medical director of emergency services at St. John’s. “But there needs to be more psychiatric beds in the county and private sector, specifically in the county sector, for us to be able to transfer to.”

Los Angeles County is home to some 90,000 homeless, nearly 2,000 of whom live in Santa Monica at any given time. Officials say many of them are mentally ill and often drain local hospitals’ emergency resources.

Barbara Browning, associate director of organizational performance improvement at Santa Monica-UCLA hospital, said many of the mentally ill who end up at the center are among the city’s most down-and-out.

Though the immediate medical needs of those mentally ill patients are met, that’s not often the end of the line for them. Many homeless hospital-goers can’t afford long-term care, don’t take their medication or simply can’t find room at a health care center equipped to care for them.

“We’re not a psychiatric facility, but we certainly do make referrals. But it’s difficult to place people,” Browning said. “Sometimes they don’t have money; they’re non-compliant.”

Though many find fault with the long-term health care system, hospital officials say initial emergency room care is near perfect.

“They feel like we’re an island in an angry ocean, a beacon they come to and we save them,” Kino said.

Patients’ ailments are addressed, they’re stabilized, then they meet with a psychiatric evaluation team.

That is where the disconnect often occurs, hospital officials said.

If deemed appropriate, some are sent to better equipped institutions; many of the uninsured end up at the nearby Venice Family Clinic, but only if there are open spaces, Browning said.

For those who end up on the streets, much of the post-E.R. pitfalls are self-inflicted.

Some refuse to take their medication, some fail to return for scheduled follow-up visits, and some refuse care altogether, which is an option as long as patients are neither a harm to themselves nor to others, Browning said.

Barbara Hold, clinical director at Step Up on Second — a local nonprofit organization that helps the mentally ill — said even emergency care for those in need of psychiatric attention is not up to par.

Because emergency rooms are equipped for the general public, they often fail to meet the special needs of the mentally ill, thus turning off such patients, Hold said.

“They’re not geared toward people with mental illness,” Hold said. “It can be very intimidating. They may not be able to navigate the system and talk to someone at the desk.”

To meet the need, Step Up on Second recently applied for a grant that would fund an on-site nurse.

In the health care system today, Hold said, a lot of the mentally ill are not getting their annual checkups and appropriate life-stage screenings, such as mammograms.

Another gaping hole, according to hospital officials, is care for an unsung minority of the mentally ill: children and adolescents.

“There are so few resources in the community,” Kino said. “Nobody wants to take ’em.”

Because mentally ill kids and teens make up a small number of the total population, most hospitals — even those capable of caring for the mentally ill — aren’t equipped to meet the special psychiatric needs of youth.

*Originally published in the Santa Monica Daily Press print edition on September 14, 2005.* [Read the original PDF.](https://s3.us-east-1.amazonaws.com/smdp%5Fbackissues/091405.pdf?ref=smdp.com)