By Dina Sokal, MD
[Winter 2005; Vol. 31, No. 2; Pg 1-2]
After serving the state psychiatric inpatient population for over ninety years, Crownsville Hospital Center closed on June 30, 2004. Two hundred patients were transferred to Spring Grove and Springfield Hospitals, and clinical staff was transferred with them.
Currently, there is a skeleton crew at Crownsville to maintain the buildings and provide security. An environmental firm is investigating the land to determine if chemicals are buried there. Anne Arundel County is being offered the land for free as it has the first right of refusal before the state offers it to others.
The MHA budget for Crownsville for fiscal year 2006 is now $1.6 million, down from $27 million in fiscal year 2005. Four million of these savings will be available annually for a five county collaboration (Anne Arundel, Prince George’s, Charles, Calvert, and St. Mary’s) to provide community services. These services will include in-home support services for children and adolescents to maintain them in their communities and the development of Assertive Community Treatment models for adults with persistent and serious mental illness. The rest of the savings will be used to reduce the state budget deficit for the Mental Hygiene Administration.
For many employees, the transition period was a sad time as many had worked there for years. Sheilah Davenport, Crownsville’s Acting CEO since March of 2003, acknowledged that Crownsville staff were like family, with some employees having had parents who worked there before them. Paul Lurz, Director of Performance Improvement, retired after working there for 40 years. He regrets that Crownsville has closed, noting that its history was marked by a commitment to patients’ rights beginning with its inception in l912 to serve the African American population needing psychiatric care. In the l950s, Crownsville’s Superintendent, Dr. Morgenstern, refused to allow lobotomies, and he was the first director to hire African American staff. In the l960s, Charles Ward, the superintendent at that time, released African Americans who were hospitalized simply because they were demonstrating for civil rights, sending a letter to the papers denouncing their hospitalizations. Paul Lurz also describes Crownsville as being the hospital known for its reluctance to put patients on the streets without post hospital arrangements.
According to CEO Sheilah Davenport, the first inquiry into closing a state hospital occurred in December 2002 when a State Legislative Analyst recommended closure to help resolve the State’s budget deficit. Legislators asked the Department of Health and Mental Hygiene (DHMH) to choose one to close and withheld $2 million from the their budget until a final report was presented to the Legislature. The recommendation was to close a facility which would have the least impact on patients, their families, and staff while ensuring that all state beds would be maintained within the system. The recommendation was to close Crownsville-- it was the smallest hospital, and its patients could be more easily transferred to the two larger facilities, keeping the number of beds intact.
In October 2003, Nelson Sabatini, Secretary of the Department of Health and Mental Hygiene, went to Crownsville to inform staff that their hospital was being considered for closure and to reassure them the Department would ensure a smooth transition and attempt, to the best of its ability, to find placements for staff. For the next several months, staff awaited a final decision by the legislature. CEO Sheilah Davenport met on a regular basis with staff to keep them informed and the CEOs of the three hospitals held ongoing meetings to determine where and when to transfer patients and staff with the least disruptions to continuity of care. The decision was made to move the Adolescent and Geriatric units to Spring Grove as this location was more accessible to families while the long term unit went to Springfield as the impact on families was less for this patient group. The Intermediate Unit and the Forensic Admissions Unit went to Spring Grove while the Civil Admissions Unit went to Springfield. Staff placement notifications were made in February, followed by patients and families being informed in April of their transfer location. Everyone was reassured that staff on the unit was accompanying the patients being transferred from those units and further reassurances were given by providing tours of the other hospitals for staff and patients.
Despite these efforts, some staff continued to be anxious about their duties at the new hospital while others were pleased with how the transition was handled. Ms. Davenport acknowledged that this was a difficult time for Crownsville staff and complimented them on their dedication to their patients during and after the transition. Currently, most staff has remained in their new positions though some are still adjusting to their new environments at Springfield and Spring Grove.