Emergency Treatment Services Ets provides psychiatric assessment and crisis intervention to adults, children

For the months of March and April 2009, ETS interviewed more than 1,700 patients. The only existing triage area, with its two interview rooms, is inadequate to handle the volume of patient interviews. This situation appears to be inconsistent with Welfare and Institutions Code Section 5325.1 (b), relating to patient confidentiality. RCRMC executive administration has shared with the 2008-2009 Grand Jury the proposed plans for expansion of the AC. As of the date of this report construction has not commenced. (The patient confidentiality issue was also a finding of the 2006-2007 Riverside County Grand Jury.)

During a February 2009 visit to ITF, it was observed that one of the monitors surveilling a patient room in Unit A, (Intensive Treatment) was not functioning. It was also noted that the images provided by the monitors surveilling other patient rooms were grainy. In October 2008 there were monitors on order with county Facilities Management to replace Unit A monitors, as well as those in ETS and the restraint room in Unit D. In February 2009 the requisition was modified to include additional monitors to cover blind spots in Units B and C. As of this report none has been received.

Psychiatric patients are released with a 14-day supply of medication. Because of the minimal number of outpatient clinics available, upon release there can be a lengthy time interval before their scheduled follow- up medical appointments. This lag creates a recurring situation where the patients exhaust their supply of medication before they are seen. Staff refers to this situation as a “revolving door syndrome,” in which patients will return to emergency services for additional medication multiple times in the interim. Of the more than 1,700 ETS patients seen in March and April, 142 of them had returned only for medication. Because they are not acute patients, some wait up to 12 hours before they are evaluated by staff.

There is a need for RCRMC and the Department of Mental Health to provide outpatient clinics for patients suffering from chronic mental illness.

Other than at the AC, uninsured psychiatric clients countywide do not get served unless they are in crisis. When these patients frequent the hospital emergency rooms on a recurring basis, they may become eligible for coverage from Proposition 63 monies. (These state funds are provided to counties to expand mental health services.) 2

There is a lack of services in the Coachella Valley for uninsured mentally ill individuals not in crisis.

Interviews revealed that almost daily, patients in the inpatient facility are ready to be released to the next level of care with no immediate place to go. Meanwhile, there are patients in emergency services that have already been evaluated for placement in the inpatient facility with no available inpatient beds.