The three state psychiatric hospitals in Central Maryland should remain open but continue reducing caseloads by placing more patients in suitable community-based treatment, according to a new report prepared by state mental health officials for the General Assembly.
This is a shift from the conclusions of a two-year study that recommended closing one of the three hospital centers -- Crownsville in Anne Arundel, Spring Grove in Catonsville or Springfield in Sykesville -- by 2000.
State health officials reviewed the issue at the request of the legislators who are most directly involved with finance and policy decisions relating to state psychiatric hospitals.
"Our goal is to provide quality care in an appropriate setting," said Del. Samuel I. Rosenberg, chairman of the House Appropriations Subcommittee on Health and Human Resources.
"The question is, 'Do three smaller facilities meet that test better than two somewhat larger facilities?' " said Rosenberg, a Democrat whose district includes part of Baltimore and Baltimore County.
In 1995, the task force studying the consolidation of state psychiatric hospitals decided that two hospitals could effectively serve the Central Maryland region, if additional funding for community-based services were made available. However, the task force said it could not identify "definitive factors" to determine which hospital should be closed.
Based on recent data, the new report recommends keeping all three hospitals to serve inpatient populations ranging from 150 to 250. Currently, Springfield is the largest of the hospitals, with an average daily population of 350. Spring Grove has 290 patients, and Crownsville has 210.
The report proposes reducing the number of adult inpatient beds from 1,250 to 1,000 throughout the state mental health system over the next two years.
"I think generally, we'd like to see all three [hospitals] stay open and accept the reality that there's going to be continual downsizing," said Carolyn Knight, president of the Maryland chapter of the National Alliance for the Mentally Ill.
Some providers of psychiatric services and mental health advocates maintain that the recommendations in the new report are politically motivated.
"It's really apparent that the report and its timing are election-year politics at its very worst," said Scott Graham, president of Revisions, a community-based provider of psychiatric services in Catonsville.
Peg Sullivan, who served on the hospital task force formed in 1993, also questioned the need for a second report.
"We all know that state hospitals do not have that many people in them anymore, but they take a big chunk of the mental hygiene budget," said Sullivan, executive director of On Our Own, an information and education organization run for mental health services consumers.
Rosenberg said the joint budget committees will review the new report and seek comment from mental health providers, patients and patient advocates during budget hearings. He said the committee members hope to make a decision before the end of the legislative session.
The superintendents at Crownsville and Spring Grove hospitals applauded the report's recommendations.
"I believe a community requires these inpatient services and they should be provided close to the patient population, so we can provide good community liaison and family support," said Ronald Hendler, superintendent at Crownsville.
As caseloads continue to decrease, Knight said it's critical for the state to develop more crisis services, such as mobile response teams, to help individuals in the community who may experience temporary psychiatric problems, but don't need to be hospitalized.
Pub Date: 1/16/98