When Theresa Talavera was plagued by suicidal thoughts, she headed to a familiar spot in Boyle Heights.
“They took care of me right there and right away. And I never went back,” the Highland Park resident said.
Seventeen years later, the 73-year-old continues to attend the outpatient mental health clinic at Los Angeles General Medical Center, a county-run public hospital.
The therapy and groups there have helped her deal with her ups and downs. She said she has known some of her fellow patients for years as they struggle with depression.
“Now that they’re shutting down, I’m going through a lot. I’m on a roller coaster,” she said.
Long-term patients like Talavera are worried about moving to other locations as the Los Angeles County Department of Health Services prepares to close its outpatient psychiatric clinic on July 1.
The county’s mental health department estimated the move would affect about 1,000 adult patients and 160 children and teens. County officials said adults can go to the mental health department’s facility less than two miles away in Lincoln Heights or to its other clinics, including locations that may be more convenient for them.
Dr. Curly Bonds, the department’s chief medical officer, acknowledged the move could be more complicated for children, who often have more limited options for psychological care. Still, Bonds estimated last week that more than half of the children at the L.A. General clinic had already received appointments to continue care elsewhere.
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County officials said the Boyle Heights clinic has long been an exception in the mental health care provided by Los Angeles County: They said such psychiatric services are not typically provided at county-run hospitals, but rather at facilities run by the Department of Mental Health and its network of providers.
In a joint statement, the mental health and health services departments said the move is aimed at “centralising outpatient specialised mental health services” under the mental health department.
He said doing so would give patients access to a wider range of specialized mental health professionals and resources; ensure “consistent and streamlined care” under one department; and make it easier to access care through the Mental Health Department’s network of clinics across the county, among other benefits.
“The goal of this change is to incorporate these clinics into the existing model of care,” L.A. General Chief Executive George Orozco said at a meeting held at the hospital on Friday.
At the meeting, Bonds said the Department of Mental Health is “doing everything possible to ensure no one is left behind” during the transition. County officials said a care coordinator from the department will be embedded at L.A. General to assist with handoffs to other clinics.
“With such a major change, it’s inevitable that not everything will go perfectly,” Bonds said. “But our commitment is to make sure we address these concerns as they arise.”
Orozco said “this is a decision that has been under discussion for at least five years.” But the plan is very new to patients like Talavera, who have only begun to learn about the impending closure in recent weeks.
Griselda Avendano, 65, was worried about joining a therapy group elsewhere.
After going to the L.A. General clinic for eight years, “Am I going to start all over again?” she asked.
“I don’t think so. I would rather stay at home.”
Kelly Muhonen, a foster parent whose children have received care at the outpatient clinic, said her family has had to wait up to six months for a psychiatrist who specializes in children with developmental disabilities such as autism.
“If this has been in the works for so long, why are we only being told about it a month before the transition?” Muhonen asked during Friday’s meeting via Zoom.
Bonds said he didn’t want to dismiss their concerns, but “there is a standard that the minimum time for notification is 30 days.” Dr. Talen Keshishian, L.A. General’s chief of psychiatry, said staff are trying to notify patients “in real time at their appointments, through letters, through outreach, through phone calls. … One approach is not one size fits all.”
“If we haven’t reached you, we will continue to reach out to you,” Keshishian told those present at the meeting.
Muhonen said in an interview that despite being a trauma therapist herself, “I had to turn the world upside down to find the care I needed for my kids,” particularly given their developmental needs.
She drives from Arcadia to the L.A. General clinic because the care there has been “really exceptional,” she said. One of the benefits of the Boyle Heights clinic, she said, is that mental health providers had access to other medical records for her children — including primary care — to get a full picture of their complex needs.
As the L.A. General outpatient clinic prepares to close, “they referred us to clinics within the community,” said Benito Tambunga, 53, who said he has been going there for more than two decades.
But the advantage of the L.A. General clinic is that during a mental health episode, “you can go immediately to the hospital and they have your records, your history,” Tambunga said. “It’s all in-house.”
Officials from the two county departments said their goal was to share health records so that “clinicians from both departments can have a complete view of patients’ medical history, needs and ongoing treatment,” according to their joint statement. Keshishian said Friday that they aim to provide a summary with key information, including patients’ medical conditions and what medications they are taking, before they visit the mental health department.
Los Angeles General Medical Center’s outpatient psychiatric clinic will close July 1.
(Myang J. Chun / Los Angeles Times)
Los Angeles County Supervisor Hilda Solis, whose district includes the hospital, said she is closely monitoring the outbreak. She said, “It is important to avoid any significant disruption in care,” and that departments contact affected residents directly to ensure quality care remains accessible.
The LA General clinic is also linked to a residency program with USC that gives medical school graduates experience in psychiatry. After the transition, medical residents working with adults will be housed at the Lincoln Heights facility, while those working with youth will be housed elsewhere, the Department of Mental Health said.
In their joint statement, the two departments said moving psychiatry residents to the Lincoln Heights site would “give them more exposure to the public mental health system” and help with recruitment efforts at the Department of Mental Health. In addition to the residency program, county officials said some personnel from the L.A. General Clinic would be relocated to Lincoln Heights, including two psychiatrists and a registered nurse.
Rosa Hidalgo said she struggles with any kind of change — and not going to the LA General Clinic anymore is a big one. The 32-year-old started seeking help there about six years ago after spiraling into depression. Hidalgo said while she was expecting the move, the anxiety disrupted her sleep and she had stomach problems.
“I fell in love with that clinic because it felt like home,” he said.
Hidalgo took some comfort in the fact that she might find some familiar employees at the Lincoln Heights site. Still, she said, “I’m taking this very seriously.”
