Mental Hygiene

The state of Maryland is seeking doctors willing to practice in needy areas of the state, in exchange for up to $50,000 to repay student loans. The Maryland Loan Assistance Repayment Program was launched in 1996 and 157 primary care doctors have gone through the Program. Currently, 30 are employed in Baltimore city and county and Anne Arundel, Garrett and Worcester county. “Having a sufficient supply of primary care physicians across the state is critical to improving the health status of Maryland citizens,” said Dr. Joshua M. Sharfstein, secretary of the state Department of Health and Mental Hygiene , in a statement.

In their battle against climbing health-care costs, medical insurers have increasingly turned to "utilization review" as a means of defining necessary and unnecessary treatments.The process is coming under fire because of the way the reviews are done and because no Maryland agency has the power to review these decisions, which often involve crucial medical questions.While there are some regulations governing utilization review, they are inadequate, says Del. Joan Pitkin, D-Prince George's, chair of a subcommittee of the House Environmental Matters Committee, which is studying the issue.

Dr. Paul V. Lemkau, pioneer in mental hygiene, dies at 82Dr. Paul V. Lemkau, the first chairman of the Department of Mental Hygiene at the Johns Hopkins School of Hygiene and Public Health, died Sunday of pneumonia at his home in Lusby. He was 82.He headed the department from its creation in 1961 until 1975. He was named professor emeritus of mental hygiene in 1978.He began teaching at the school as a part-time professor of public health administration in 1939. He was named a full-time faculty member two years later and a full professor in 1953.

State licensing officials are taking the unusual step of moving to revoke the license of a residential care provider that treats troubled teen-agers at six homes in Baltimore County.The Maryland Department of Health and Mental Hygiene alleges that Residential Care Network of Pikesville altered records, did not properly report runaways, failed to give adequate dental care to one client and violated clients' rights by taking their shoes and coats and restricting access to the refrigerator and telephone.

At a state mental hospital, it costs an average of $100,000 a year to keep an indigent patient. The same person could receive adequate assistance while living in the community for less than one-third of that cost under a pilot program announced yesterday by the Department of Health and Mental Hygiene.The project, outlined at a news conference, will pay $29,000 per person, enabling 200 chronically mentally ill people to stay out of state hospitals. Another 100 patients, identified as "high cost" Medicaid recipients, also will get certain services, in hopes of cutting down their emergency room visits and hospital stays.

Community mental health providers who deliver services to some of Maryland's poorest psychiatric patients say the state's new reimbursement rates are too low and could force some clinics to close.Providers say they have had to lay off employees and eliminate critical services that are not covered under the new public mental health system. The rates took effect July 1."The fees that have been set up for psychiatric clinics are absurdly low," said Spencer Gear, director of Granite House, a psychiatric rehabilitation center in Westminster.

An age discrimination suit filed on behalf of a 72-year-old woman claims that state mental health officials routinely ignore the elderly when selecting residents for community-living facilities.Many elderly people who would otherwise remain active members of a community are being inappropriately "warehoused" in nursing homes, according to the suit, which was filed in U.S. District Court in Baltimore.A woman identified only as Hattie J. of rural Dorchester County prompted the case. Sociable and outgoing, she likes bingo, music, romance novels and vegetable gardening, her lawyers said.

The Maryland attorney general filed suit yesterday seeking $73,481 from the former director of the Crownsville Hospital Center, who quit in August after state officials found that he faked his resume.The suit was filed in Baltimore County Circuit Court against Haroon R. Ansari, 33, whose last known address was the first block of Heatherton Court, Woodlawn. It accused him of breach of contract and misrepresentation for lying to state officials when he applied to be director of the Crownsville Hospital Center in 1992.

The directors of the county's newest nonprofit mental health agency, meeting for the first time yesterday, assumed control of $8 million in state money targeted for residential and outpatient treatment.The takeover marks the end of a three-year push by mental health care providers to create a private, nonprofit core agency to coordinate services for as many as 22,000 mentally ill county residents.In the past, that coordination and the allocation of money has been left up to the state Department of Health and Mental Hygiene in Baltimore.

PERHAPS BECAUSE the stigma has faded, more mentally ill Americans are seeking care. That is good news. But there's a price to pay. Demand outpaces mental health budgets, forcing community clinics to close, pushing people into emergency rooms, jail cells or the streets. The pattern has been apparent for several years, but the state government has been, to use the jargon, in denial. Once again this year, state government predicted a leveling off or even a decline in cases. That kind of low-balling allows inadequate budgets.