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Members of an advocacy group for the mentally ill will put on their walking shoes Saturday to picket the Erie County Medical Center in an effort to end what they contend is "grossly inadequate" emergency and admissions facilities for mentally ill patients.

The complaints of the Erie Alliance for the Mentally Ill include an overcrowded waiting room for emergency psychiatric patients, delays that can leave patients and families waiting for up to 12 hours and cramped quarters that force families to hear the screams of their loved ones being placed in restraints.

The situation is so bad that patients sometimes are "doubled up" in examining rooms, and shackled prisoners escorted by police officers share the same waiting room with families that include small children or mentally ill adolescents, according to Lynne Shuster, the group's president.

In the last 18 months, the local Alliance for the Mentally Ill has met with medical center officials four or five times to seek remedies to those deficiencies, Ms. Shuster said.

"Yet nothing has been done," Ms. Shuster said. "The hospital and the county can come up with money and plans to take care of firemen who need to be hosed off once every 10 years, but no one can find the political will or the dollars to remedy a situation that is intolerable and goes on day after day."

So Ms. Shuster and her group plan to picket the hospital from 11 a.m. to 3 p.m. Saturday, the day before Mental Illness Awareness Week begins.

Medical center officials contacted this week did not dispute the deficiencies. They said interim steps are being taken to improve the situation by late this year or early next year.

"We have been very sympathetic to their needs," Fraser M. Mooney, the medical center's associate administrator, said of the issues raised by members of the group. "We're not fighting them on this issue. We can certainly appreciate their frustrations. We're sorry we're not proceeding as quickly as they would like it to happen."

Needed long-term renovations would require money from the county's capital budget. But in the meantime, Mooney said, steps can be taken to enlarge the waiting room, add more examining rooms and create separate entrances. Such plans are being drawn up and are expected to be done in six weeks, Mooney said.

"I hope we could have it almost finished, or at least well under way, by the end of the year," Mooney said in reference to the interim improvements.

All parties, including Erie County Legislator William A. Pauly, R-Amherst, who has taken an interest in the matter, seem to agree that the demand for treatment at the medical center has outstripped the physical capabilities of the psychiatric emergency-room area.

Three years ago, the medical center treated 4,686 patients in its psychiatric emergency room. This year, that figure is expected to exceed 6,000.

"I think the situation warrants priority attention, no question about it," Pauly said. "The argument is well made that we need to invest some more dollars."

That could include additional funding for physical renovations and more staffing, he said. Pauly, who said he wants to learn more about the interim plans, suggested that the timetable could be speeded up.

The Erie Alliance for the Mentally Ill, an advocacy group consisting mostly of relatives of the mentally ill, is no stranger to grass-roots political activism.

The group has taken its case to Albany in seeking wholesale revision of the state mental-health system, it has tangled with Buffalo Psychiatric Center officials over the quality of care there, and it has spoken out on issues such as the recent WMJQ-FM radio ads that used actors in straitjackets.

"I want to see the hospital provide a standard of care and treatment that is humane, that does not traumatize families who are already in crisis and that matches the caliber of care given to people suffering from any other illness," Ms. Shuster said.

"Our loved ones are first-class citizens," she wrote in the group's newsletter. "They deserve better than third-class services."

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