A reorganization of patients at the Springfield Hospital Center was designed to alleviate overcrowding, but has come under criticism by area mental health advocates.
The change eliminates geographic separation of patients in the two main buildings to which they first are admitted, said Dr. Bruce Hershfield, hospital superintendent.
Until this month, patients from northwest Baltimore City all wereadmitted to one building and patients from Carroll, Frederick, Howard and Montgomery counties were admitted to the other.
Hershfield said city admissions have been going down, while the county admissionshave been rising, leading to a lopsided arrangement of the total 196patients. There was room in the city building, but patients from thecounties were crowded, he said.
Members of the Carroll County Alcoholism, Drug Abuse and Mental Health Advisory Committee sent a letter to Hershfield asking him to reconsider the changes because of the effect they might have on patients as they are discharged.
Each building has eight social workers who help coordinate services in the patients' home counties, once they are released.
The changes mean social workers no longer specialize in one geographic area, said HowardHeld, director of the county Health Department's Mental Health Bureau.
Patients who need more than a one- or two-month stay eventuallymove to smaller buildings on the campus, Hershfield said. Patients who can be treated while living in the community link up with programsrun by county health departments or by private agencies.
Such community services are arranged ahead of time by social worker teams in each of the two large admission buildings.
Held said the advisory committee members felt that social workers on the county units have gotten to know the services in their particular communities.
By putting patients in units where the social workers might not be familiarwith that particular county's services, "There is some concern this might dilute that working relationship," Held said.
"The problem Ihave with this is it's taken a good while to establish a link between the hospital staff and the community agencies in the individual counties," said Janice Becker of Berrett, an advisory committee member and a mental health advocate who had an adult relative treated at Springfield.
Such a relationship between the workers can mean the patient, when he or she is discharged to a community program, gets those services sooner, Becker said.
Some of the things that take social workers a while to learn can be as small -- but important -- as what time of day is best to catch workers in the community programs, Becker said.
Hershfield said he understands the members' concerns, but believes relieving the overcrowding is a more pressing matter. He said he has offered to meet with them to explain his decision.
He also said the change will be gradual. "We've moved almost no patients," he said, noting the change will be with those admitted.
He said the difference is that a worker in a community program gradually will deal with a larger pool of 16 instead of eight social workers, and thesocial workers will deal with more than one county.