Ten years after Anne Arundel Medical Center closed its psychiatric ward, the county's second major private hospital may follow suit, a move that would force mentally ill people to leave the county for hospital care.
North Arundel Hospital's 15-bed facility in Glen Burnie is the only place in the county where insured mentally ill patients can receive immediate short-term hospitalization. It also serves the uninsured, easing the burden on the crowded state hospital system.
But James R. Walker, the hospital's president and chief executive officer, said his hospital might close its psychiatric ward, which he said is losing money serving uninsured patients squeezed out of the shrinking state hospital system.
He said his nonprofit hospital received the same amount of state funding this year - about $400,000 - to serve uninsured patients as it received when it opened in 1989. But this year, the hospital served twice as many uninsured patients as it did in 1989. A spokesman said the cost was $860,000 this year.
"We feel like we're subsidizing the state," Walker said. "We are working hard to try to keep it open, but we are evaluating."
State officials and advocates are lobbying to avoid this closing at a time when budget concerns make it unlikely that the state will soon expand mental health care programs, said Richard J. Bandelin, a deputy director with the state Mental Hygiene Administration.
"It would obviously be the worst time in the world to us," he said. "It's a resource that would be lost when we're having trouble trying to keep up with the need."
After Anne Arundel Medical Center closed its psychiatric ward in 1992, North Arundel became the only county hospital that accepted both insured and uninsured patients.
Crownsville Hospital Center, a state mental hospital, does not accept insured patients. And the capacity at Crownsville is shrinking - advocates said it is about one-fifth what it was more than 40 years ago. The facility is packed not only with the uninsured but with patients involved in criminal court cases, so there is no guarantee that local patients will be admitted.
According to estimates by the Anne Arundel chapter of the National Alliance for the Mentally Ill, about 4 percent of the county's residents - nearly 20,000 people - suffer from mental illness, a brain disorder or an emotional disorder.
And the number of Anne Arundel residents receiving state-provided mental health services has swelled to about 5,000, from about 4,000 in 1998.
"I can't do my job without [hospital] services," said Frank Sullivan, executive director of the nonprofit, state-funded Anne Arundel County Mental Health Agency Inc. "People have periods where they absolutely have to be in the hospital."