Hospital to study psychiatric options Arundel center plans to close unit

July 11, 1993|By Deidre Nerreau McCabe | Deidre Nerreau McCabe,Staff Writer

Four days before a final decision was expected to allow Anne Arundel Medical Center to close its psychiatric unit, hospital officials have asked state regulators for a postponement while they consider other options.

Hospital administrators want time to study whether to move psychiatric services to their new Pathways facility, a free-standing drug and alcohol treatment center for adolescents Riva Road.

Fran D. Counihan, vice president of public relations and marketing, said the hospital still plans to close the 12-bed psychiatric unit in its building on Franklin Street in Annapolis, which administrators say was inefficient and under-used.

But rather than doing away with the beds, the hospital now is willing to consider other options for psychiatric services, such as opening a unit for people diagnosed with both addiction problems and mental illnesses.

Mental health advocates who opposed closing the psychiatric unit say the decision is good news.

"I've been suggesting this all along," said Arthur M. Warwick, an Annapolis psychiatrist and the former director of the hospital's Inpatient Psychiatric Unit. "I'm glad they're studying it. Whatever they can offer will be useful."

The controversy began in April, when the hospital asked the state's Health Resources Planning Commission for permission to close the 15-year-old unit, which had been running about half full for at least two years. The last patient was discharged May 10, and the unit has remained empty since.

"We've been running at about 5.3 patients average, or about 42 percent capacity. We thought other hospitals could pretty easily absorb the patients," said Betty Schweitzer, vice president of Patient Care Services.

But during a public hearing May 18 before the health commission, former patients, their families and mental health professionals turned out in force to say the unit should not close because Anne Arundel County needs more psychiatric services.

Opponents raised enough "serious questions" that the commission postponed its decision until the hospital could respond, said commission spokeswoman Susan Panek. Some charged that the hospital had kept admissions artificially low by accepting only patients who wanted to be hospitalized. The greatest need is for involuntary admissions, they said.

Several said the hospital could have done more to save the unit, altering services to meet community needs and making it financially viable, if it had been committed to serving the mentally ill.

Despite community protest, the commission staff was satisfied with the hospital's response and released a report Friday recommending the unit be allowed to close.

Richard J. Coughlan, director of the commission's Certificate of Need Program, which oversees opening and closing of hospital services, said he could not speculate about what the commission would have decided Tuesday, but staff members clearly felt the hospital should be allowed to close the unit.

"We believe it would be more cost effective for [the patients] to use other hospitals," he said. "That unit was inefficient and not productive."

But, he added, there are other services the hospital could consider, and "we're very gratified they are meeting with us to discuss them."

"I'm happy the hospital is thinking about alternatives," said Dr. Herbert S. Gross, director of Anne Arundel's Division of Mental Health and Addictions. "They are interested in what's going on in the community. They are a responsive group."

Dr. Gross said a unit that would be less expensive than a hospital psychiatric ward but could treat mentally ill people in crisis would be a useful service for the hospital to consider.

"If there could be a lower-cost facility we could use, less intensive than a hospital but with crisis beds, that would be very helpful," he said. Anne Arundel's unit, which had become the most expensive in the state, cost about $650 a day. Most other facilities, including North Arundel Hospital's 19-bed unit in Glen Burnie, cost about $500 a day. Dr. Gross said a facility costing about $250 a day would allow patients to get treatment who might not be able to afford it otherwise.

Ms. Counihan said the hospital will now determine how to conduct the study of what psychiatric services might be feasible at Pathways, which has 40 beds and has been running less than half full since opening in October.

She did not know when the hospital would decide which services, if any, it would ask the state to approve. The study probably will not be completed until September or later, she said.

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