Cain said Helsel wasn't always responsive to the organization's concerns. "There are other facility directors who welcome our observations and our concerns and what we hear from patients, and we have not had that relationship with Dr. Helsel," she said.

Representatives from the American Federation of State, County and Municipal Employees union said they hope Helsel will talk with the workers at Perkins. But they, too, said they had little direct contact with Helsel at Spring Grove. His staff was less than responsive, said Patrick Moran, director of AFSCME Maryland.

"I have not seen much engagement from this individual, if any, in the past," said Moran. "His underlings have not shown a willingness to work with the employees. It's been quite the obstacle at times."

Moran said the union has pushed Spring Grove and other hospitals to improve employee training and to help create a safer work environment. "The best advice we have for [Helsel] is that he is going to need to talk to the people who do the front line work — the people who are out there dealing with the clients on a minute-by-minute, hour-by-hour basis," he said.

Cain also said she was concerned that the salary for the new position wasn't enough to attract candidates, particularly given the troubles at Perkins. Helsel will earn $194,792 at Perkins, the same salary he got at Spring Grove.

Others said he'll bring valuable assets to the Perkins post.

"Dr. Helsel is one of the most experienced and accomplished administrators and psychiatrists in our state," said Dr. Joshua M. Sharfstein, Secretary of the state Department of Health and Mental Hygiene, who had asked Helsel to apply for the job, along with Dr. Brian Hepburn, executive director of the Mental Hygiene Administration. "His steady hand will help guide Perkins through this difficult time.

Dr. William T. Carpenter, director of the Maryland Psychiatric Research Center at the University of Maryland School of Medicine, called Helsel "remarkably devoted to Spring Grove and its patients."

Carpenter, whose research and treatment facility shares a campus with Spring Grove and often relies on the hospital for space and resources, said he saw Helsel deftly handle the evolving demands of a large state psychiatric institution.

"These hospitals are very, very old, and it's very hard to get them to meet accreditation standards," Carpenter said of the national certification required by the federal government for payments and by states for licensure.

"And now these places are flooded with [court-referred] cases. These are extremely challenging jobs — any hospital with 300 beds will have … a propensity for violence and suicides within. … You almost never hear bad stories, and these places are almost designed for bad stories."

Helsel graduated from the University of Cincinnati College of Medicine and trained at the University of Maryland. He is a board-certified psychiatrist.

Helsel will start at Perkins on Nov. 14. Cheryl Heilman will become the new interim chief executive of Spring Grove.

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