Community-based programs work best for mentally illFew...

April 13, 1999

Community-based programs work best for mentally ill

Few would dispute the point made by Brenda Hohman and Carolyn Knight in their April 7 op-ed piece ("Smaller hospitals for the mentally ill") that people with mental illnesses should have hospital beds available to them. Many of us do, however, question why it takes eleven state-run institutions to meet that need.

For those of us who work every day with individuals disabled by mental illness, there is little doubt that most of the people now in state institutions could be supported successfully in the community. Community programs serve not only individuals who are "mildly to moderately mentally ill," as Ms. Hohman and Ms. Knight suggest, but those with severe and long-term mental illnesses.

Maryland's nonprofit psychiatric rehabilitation agencies have been assisting hard-to-place individuals make the transition from hospital to community life for twenty years. With proper support, those with even the most disabling conditions can achieve remarkable levels of independence and productivity when given an opportunity to participate in community life. Homelessness and return to the hospital are rare if rehabilitation, housing, job training and other community services are there for them.

Community programs are also less expensive than institutionalization. Even the downsized state institutions of today are expensive. The average annual cost per bed at the 340-bed Spring Grove Hospital Center is $129,000; Upper Shore Center in Chestertown costs $136,000 a bed

The cost for a comprehensive array of the most intensive community services may approach $50,000. The $80,000 figure Ms. Hohman and Ms. Knight cite for such services is exceptional -- it only applies if additional medical supports are required for people with complicated psychiatric and somatic conditions -- but even that is far cheaper than a hospital bed. And most community services are eligible for Medicaid reimbursement, so the federal government picks up half the cost.

Community service providers are not advocating closing all state hospitals. We are recommending that the hospitals be downsized more aggressively, that the most inefficient ones be closed, and that funds saved by downsizing and closure follow residents into the community as the General Assembly has directed.

Herbert S. Cromwell, Catonsville

The writer is executive director of the Maryland Association of Psyciatric Support Services Inc.

A historic district for Baltimore City

Despite what The Sun reported April 7 ("Amendments appease some foes of downtown development bill"), Baltimore Heritage Inc. and Preservation Maryland have never asked the Baltimore Development Corporation or the City Council for "150 properties to be placed on a historic preservation list and saved from condemnation."

What we have asked for is: the development of a credible revitalization plan that seeks maximum use of existing businesses and historic buildings while meeting other important goals; the inclusion of legitimate stakeholders in development of the plan, and support for the creation of a National Register Historic District. This district would not restrict property owners or guarantee preservation of historic properties, but would make important financial incentives available to owners who want to preserve buildings.

We believe these requests are reasonable and reflect important public purposes which have not been adequately addressed in the bill that is currently before the Baltimore City Council.

William J. Pencek, Jr.

Tyler Gearhart, Baltimore

The writers are, respectively, the president of Baltimore Heritage Inc and the executive director of Preservation Maryland.

Call "ethnic cleansing" what it is: murder

A page one headline in The Sun March 31 read, "Victims of ethnic cleansing flood Albanian border post." The phrase "ethic cleansing" is a disgusting euphemism for deliberate mass murder; the Sun's article, like so much else in the media, repeats this lie again and again, without even putting the phrase in quotation marks to suggest how misleading it is.

I don't know who first used the term "ethnic cleansing," but the irresponsible repetition of this reprehensible phrase makes it appear that mass murder is somewhere within the range of acceptable policies. Anyone who uses this and other similar phrases (for example, "collateral damage" for the killing of civilians, "peace-keeper" for lethal weapons, "Defense Department" for what was accurately called the "War Department" until World War II) should be challenged every time the lie is uttered.

It is much more difficult to kill, exploit, steal, and discriminate if you have to declare accurately what you are doing. The complicity of the media in making such atrocities palatable by mindlessly repeating deliberately deceitful terms is an appalling contribution to the continuation and spread of such atrocities.

Joe Morton, Towson

The writer is director of Peace Studies at Goucher College.

The Kosovars need American help

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