Men­tal health wait list shrinks

State re­leases some pa­tients to make room, but a dozen re­main in jail await­ing beds

Baltimore Sun - - NEWS - By Pamela Wood pwood@balt­sun.com twit­ter.com/pwoodreporter

State health of­fi­cials have sig­nif­i­cantly re­duced a back­log of pa­tients wait­ing for beds in men­tal health hos­pi­tals.

A dozen peo­ple now sit in jail wait­ing for a spot — down from 85 a few months ago, the state’s health sec­re­tary told law­mak­ers on Tues­day.

The state-run psy­chi­atric hos­pi­tals have re­leased dozens of pa­tients who were ready to be dis­charged to make room for court-or­dered pa­tients. And they’re plan­ning to add a few more spa­ces for pa­tients by shuf­fling money and re­sources, said Sec­re­tary Van T. Mitchell dur­ing a brief­ing be­fore mem­bers of four leg­isla­tive com­mit­tees.

Mitchell cau­tioned that more work is needed.

“This is a long-stand­ing com­plex prob­lem that is about more than just beds,” he told law­mak­ers.

State judges called Mitchell into court this year to ex­plain why the state’s hos­pi­tals weren’t ac­cept­ing de­fen­dants who were or­dered into treat­ment af­ter be­ing found not com­pe­tent to stand trial. He called it a learn­ing ex­pe­ri­ence that was “ex­tremely ben­e­fi­cial.”

Mean­while, em­ploy­ees at those hos­pi­tals have com­plained that chronic un­der­staffing makes them un­safe places to work.

Law­mak­ers in­di­cated they were pleased to see Mitchell’s ini­tial steps. But some said they ex­pect the state to de­velop longert­erm so­lu­tions.

Del. Erek L. Bar­ron said more work needs to be done to keep men­tally ill peo­ple out of the courts in the first place.

“We’re talk­ing about a pop­u­la­tion that is about as deep into the crim­i­nal jus­tice sys­tem as you can get, but they don’t nec­es­sar­ily have to get this far,” said Bar­ron, a Prince Ge­orge’s Demo­crat.

Del. Kath­leen M. Du­mais, vice chair­woman of the House Ju­di­ciary Com­mit­tee, said she’s trou­bled that those wait­ing for beds are stuck in jails “that aren’t set up to treat them.”

And be­cause the court or­ders ac­tu­ally com­mit the in­di­vid­ual to the state Depart­ment of Health and Men­tal Hy­giene — and not sen­tenced to the cus­tody of the county or state cor­rec­tional sys­tem — it cre­ates a le­gal li­a­bil­ity is­sue for the jails that might amount to il­le­gal im­pris­on­ment, said Du­mais, a Mont­gomery Demo­crat.

“How do we pre­vent us be­ing in this place where peo­ple are be­ing il­le­gally de­tained?” she asked.

Erik Roskes, di­rec­tor of the state’s Men­tal Health Ad­min­is­tra­tion, likened the ef­fort to turn­ing around the Ti­tanic.

“I’m hop­ing we don’t run into the ice­berg,” he said.

To make room for new pa­tients, 59 of 98 pa­tients who were deemed “ready to dis­charge” were ac­tu­ally dis­charged. Some had re­mained hos­pi­tal­ized be­cause of is­sues such as dif­fi­culty en­rolling them in an out­pa­tient psy­chi­atric treat­ment pro­gram.

The state also set up a 16-bed unit at Spring­field Hos­pi­tal Cen­ter in Elder­s­burg to help pa­tients “step down” from in­pa­tient psy­chi­atric care to out­pa­tient care. That freed up space within the main treat­ment pro­gram at Spring­field.

Mitchell said some mi­nor ren­o­va­tions at Clifton T. Perkins Hos­pi­tal Cen­ter in Jes­sup — which houses pa­tients with the great­est po­ten­tial for vi­o­lence — could add room for16 more pa­tients. The ren­o­va­tions would cost about $300,000, and the money for salar­ies would come from re­duc­ing over­time costs else­where in the state hos­pi­tal sys­tem.

Mitchell also set up a work group that came up with rec­om­men­da­tions, such as adding even more beds to the ap­prox­i­mately 900 in state hos­pi­tals, im­prov­ing cri­sis ser­vices in the com­mu­nity and in­creas­ing out­pa­tient treat­ment of­fer­ings.

Mitchell said he’ll de­velop a mul­ti­year plan for car­ry­ing out the work group’s rec­om­men­da­tions that he will present as part of the next state bud­get. He didn’t say how much money might be needed.

Three judges who tes­ti­fied ex­pressed frus­tra­tion at what they see as a sys­tem fail­ure.

Judge John P. Mor­ris­sey, chief judge of the Dis­trict Court of Mary­land, said too of­ten de­fen­dants are or­dered to treat­ment, put on a bus to a state hos­pi­tal and turned away.

“You need to get them into a fa­cil­ity as quickly as pos­si­ble,” he said. “We don’t ex­pect it to be im­me­di­ately, but we ex­pect it to be prompt.”

Rep­re­sen­ta­tives from AFSCME, the union that rep­re­sents state hos­pi­tal work­ers, said hir­ing more em­ploy­ees and pay­ing them bet­ter would help them of­fer bet­ter qual­ity treat­ment to pa­tients.

And rep­re­sen­ta­tives of pri­vate men­tal health groups said they too need more fund­ing to treat peo­ple when they get out of state hos­pi­tals and to help peo­ple be­fore they end up in the crim­i­nal jus­tice sys­tem.

JOSHUA MCKERROW/BAL­TI­MORE SUN ME­DIA GROUP

The Rev. Jesse L. Jack­son Sr. con­ducts a prayer cir­cle with stu­dents af­ter a voter reg­is­tra­tion and get-out-the-vote rally Tues­day at Bowie State Univer­sity, Mary­land’s old­est his­tor­i­cally black univer­sity and one of the old­est in the na­tion.

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