Community mental health care provided to some adults by the Western Psychiatric Institute and Clinic is the target of a state-ordered probe that includes a temporary halt on new referrals to those services.

Western Psych expects to lose 12 to 15 referrals a week until the moratorium is lifted, said Dr. Claudia Roth, the agency's president. The referrals are being directed to other service providers.

Concerned about a series of deaths or other serious events involving local residents with mental illness, some of whom received care from Western Psych, the state announced the moratorium last week, saying the suspension would allow time for officials to conduct a review of agency services and procedures. Officials have since provided more details about the moratorium and the review.

Dr. Roth said Western Psych, part of the University of Pittsburgh Medical Center, is providing information requested by the state as quickly as possible.

Joan Erney, deputy secretary for the state Office of Mental Health and Substance Abuse Services, declined to speculate on when the moratorium might end, but said she did not expect it to last for a lengthy period.

The temporary ban applies to new referrals to community treatment teams and to specific case management services -- Intensive Case Management/Resource Coordination and Acute Case Management -- for adults in certain public-funded programs such as Medicaid.

Patients already receiving care from those programs or other Western Psychiatric services are not affected.

Case managers work to assess clients' needs and help them solve problems and connect to outpatient psychiatric or other community support services. Community Treatment Teams are mobile groups of mental health professionals that include a psychiatrist and provide an array of services, in part to minimize the need for referrals to other community programs.

Western Psych was singled out for the moratorium and review process, according to the state, because six of 10 serious incidents, known as sentinel events, that have occurred in recent months in Allegheny County involved adults who have received outpatient mental health services from that agency.

Those totals don't include three other sentinel events at Mayview State Hospital and another in Washington County.

Department of Public Welfare Secretary Estelle Richman called for the moratorium on new referrals and outlined other expectations in a July 25 letter to Dr. Roth.

Besides suspending referrals, it calls for Western Psych to cooperate with a review of policies and procedures related to case management and community treatment team services.

It also stipulates a records review for high-risk people "stepped down" to a lower level of service, or who have had their cases closed, in the past six months.

The review, which will assess risks associated with those actions and whether services were appropriate, could involve face-to-face contact with patients and input from psychiatrists.

Western Psych also cannot close any cases involving high-risk adults in the programs under review, or step down services, without the approval of state and county officials. Weekly updates also are called for to assess progress in completing the review.

State officials want to "feel satisfied that all policies and procedures and clinical oversight and areas we've identified in the letter are really working well," Ms. Erney said.

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

State officials, who do not comment on specific cases, said an investigation of that event began July 18, 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.