After a series of deaths and other serious events involving local residents with mental illness, a top state official has called a temporary halt to outpatient referrals to Western Psychiatric Institute and Clinic.

Department of Public Welfare Secretary Estelle Richman said she informed Western Psychiatric officials about her decision yesterday.

Welfare Department officials said the temporary halt on referrals would allow time for state, county and Western Psychiatric officials to conduct a service review of its procedures and practices.

Western Psychiatric is being singled out because six of 10 serious incidents, known as sentinel events, that have occurred in Allegheny County in recent months involve people who have received outpatient mental health services from that agency, state officials said.

Three other incidents have involved patients at Mayview State Hospital, officials said, and another occurred in Washington County.

State officials do not cite the subjects of sentinel event investigations by name because of concerns over patient confidentiality. But the latest investigation began Friday, the same day police found the body of 18-year-old Kia Johnson in Andrea Curry-Demus' Wilkinsburg apartment.

Ms. Curry-Demus, a former Mayview patient arrested in 1990 for stabbing a woman and kidnapping an infant, is charged with killing Ms. Johnson and cutting a baby from the woman's womb.

A service plan created for Ms. Curry-Demus in 2006 required her to cooperate with mental health treatment provided by Western Psych.

"Clearly, there has been an increasing amount of concern over sentinel events, particularly in Allegheny County," Ms. Richman said.

The review of Western Psych will focus in part on personnel and training, support for clients, community treatment teams and the "adequacy of adult outpatient and community services," according to a statement from the welfare department. As part of the review process, the state plans to hold weekly meetings with county, Western Psych and other officials.

"I think they're prepared to take a very deep internal look," Ms. Richman said of Western Psych.

A spokesman for the agency, part of the University of Pittsburgh Medical Center, declined to comment.

The temporary moratorium will affect new referrals for Medicaid recipients covered by the state's HealthChoices behavioral health managed care program, as well as patients leaving Mayview as part of the planned closure of the facility by the end of this year, state officials said.

Those referrals will instead be sent to other local providers of community mental health services, officials said. They had no estimate of the number of clients who might be redirected.

Because other providers are available, Ms. Richman predicted no slowing of patient discharges from Mayview, at least for now.

Persons already receiving mental health care in the community from Western Psychiatric will not be affected.

Community mental health care can include medication prescribed by a psychiatrist, employment assistance, case management or other services, generally with the goal of helping recipients live as independently as possible.

While she has had growing concerns about sentinel events in Allegheny County, Ms. Richman said the most recent reported event prompted her to call for the temporary moratorium.

Another sentinel event investigation was opened one day after Shadyside resident Terrence Andrews was arrested for the May 29 stabbing death of 18-year-old Lisa Maas. Officials said Western Psych provided services to Mr. Andrews.

State officials have noted that a number of sentinel events have involved patients who left Mayview before the announcement last August of the hospital closure process. Ms. Richman said patients leaving Mayview since then generally have had detailed plans for their care in the community.

She wants to ensure that other seriously mentally ill people living in the community and supervised by Western Psych have similar treatment plans. And if patients with serious needs are no longer receiving treatment, she wants the agency to find them and prepare a treatment plan.

She did not specify how long the moratorium on referrals would last, saying it would depend in part on the results of the planned review.

"I'm hopeful it's a process that will get to the areas of concern in a very quick manner," said Patricia Valentine, deputy director of the county's Office of Behavioral Health.

About 15,000 county residents with serious mental illness are living in the community, she said, noting that Western Psych and Mercy Behavioral Health are the area's largest providers of community mental health services.