Outcry blocks move to close mental center

State committee had advised shutting Upper Shore hospital

Community `very adamant'

Reversal comes amid debate on best way to provide treatment

July 18, 1999|By Timothy B. Wheeler | Timothy B. Wheeler,SUN STAFF

Bowing to political pressure, state mental health officials have dropped plans to close one of Maryland's eight psychiatric hospitals, as advocates and experts argue over how best to care for the mentally ill.

Oscar L. Morgan, director of the state Mental Hygiene Administration, said that a committee studying ways to reduce costs at Maryland's psychiatric hospitals no longer recommends closing the Upper Shore Community Mental Health Center at Chestertown.

The Hospital Beds Needs Assessment Committee, made up of mental health professionals and state officials, had drafted a report last month calling for the shutdown of the relatively small 36-bed Chestertown facility, rather than one of the system's three big psychiatric hospitals in Central Maryland.

The panel called for eliminating 350 psychiatric beds over the next five years, leaving about 1,100 beds for the mentally ill statewide. About 1,350 patients are hospitalized in the state system.

The panel's final report, requested by the General Assembly, is to be submitted by Aug. 1. But Morgan said Friday that, after meeting recently with Upper Shore legislators and patients' families, the committee would recommend "reconfiguring" rather than closing the Chestertown facility.

"The Upper Shore community met with us and was very adamant they didn't want the hospital to be changed, and we concurred," Morgan said.

Instead of eliminating the 36 psychiatric beds at Chestertown, Morgan said, the state now wants to use the facility for a 24-bed unit for patients with more than one illness.

Del. Ron Guns, a Cecil County Democrat and chairman of a committee overseeing mental health, said closing the Chestertown facility would have moved Upper Shore patients to the new Eastern Shore Hospital Center being built near Cambridge. Families would have had to drive "almost 90 to 100 miles" more to see their loved ones, which Guns said was too far.

"We look for state policy to have some fairness," Guns said.

`Sacred cow'

But word of the reversal upset advocates who contend that more of the state's mentally ill could be helped by closing or consolidating costly psychiatric hospitals and shifting funds to community care programs.

"Everybody talks about hospital closure, but no politician wants to close one in his or her district," said Lori Doyle, public policy director for the Maryland Association of Psychiatric Support Services. "It's like a sacred cow."

It costs Maryland taxpayers an average of $125,000 a year to keep a patient in one of the state psychiatric hospitals, compared with $35,000 per patient annually in group homes, supervised independent living and outpatient clinics.

About one-third of the state's budget for mental health is spent on the eight hospitals, even though they treat only about 5,000 of the more than 80,000 people who seek state-paid psychiatric care every year.

State officials defend that expenditure, arguing that the hospitals treat those who are most severely ill, most at risk of hurting themselves or others, and for whom community programs have failed.

Two other commissions in the past 12 years have called for closing one of the three big hospitals -- Crownsville Hospital Center outside Annapolis, Spring Grove Hospital Center in Catonsville or Springfield Hospital Center in Sykesville. But state health officials have yielded to opposition from patients' families and hospital staff members who stand to lose their jobs.

Looking for savings

The latest committee envisions saving $22 million by shrinking the number of beds in the system, eliminating through attrition about 600 hospital employees and, according to Morgan, "making better use of the hospital campuses" by leasing or selling unneeded buildings or land. That money would be shifted into providing more community-based mental health services.

With the Chestertown center's retention, the number of psychiatric beds proposed for elimination over the next five years would be 330 rather than 350, Morgan said.

Brenda K. Hohman, executive director of the Maryland chapter of the National Alliance for the Mentally Ill, said she was pleased to hear that the committee, on which she serves, would not recommend closing the Chestertown facility. She contends that the state has not made a case for shrinking its psychiatric hospitals at all.

Rising admissions

Hospital admissions have risen 14 percent in the past 18 months, an upswing state officials say they cannot yet explain.

"How can you reduce beds when the admissions are up?" Hohman asked.

She said the state ought to do a more thorough study of the public's mental health needs, particularly of the homeless and jail inmates, before deciding to downsize its hospitals.

Her argument has won support from Upper Shore legislators.

Guns said he worries that community-based treatment programs may not be adequate to care for those released from hospitals. He noted a national report recently that found many mentally ill being jailed in lieu of getting treatment.

"I think the challenge is not having the jail system being the proxy for the mental health community," Guns said.

Del. Wheeler R. Baker, a Queen Anne's County Democrat, also said he feared the push for cost savings in mental health may go too far. "I sit on a budget committee, and we have to look in every nook and cranny to save a buck," he said, "but sometimes the juice isn't worth the squeeze."

The House Environmental Matters Committee, of which Guns is chairman, will hold a hearing on the state's mental health programs Aug. 3. A House budget subcommittee, which had asked for the hospital-reduction report, plans a hearing Aug. 10.

Pub Date: 7/18/99

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