Daily Record
By Abbott Koloff
March 18, 2007
Greystone faces patient overload
New hospital falls short by 75 beds
Relatives of Greystone Park patients and advocates for the mentally ill, even as they anticipate an improved new building opening this fall, say they have some concerns about what's going to happen to 75 patients who won't fit into the new facility.
The capacity of the new Greystone Park Psychiatric Hospital in Parsippany, scheduled to open in October, is listed at 510 patients with 450 beds in the main building and room for another 60 patients at hospital-run cottages. The old hospital, most of which is expected to be demolished, presently has about 585 patients.
"I know the hospital is studying the issue," said Bill Albrecht, of Belvidere, a member of Concerned Families of Greystone, a group composed of relatives of present and former Greystone patients. "They know there is a serious problem. If their census exceeds capacity, I don't know what will happen."
State officials say they expect to get the number of patients down to 510 by the time the new building opens in about seven months, as more beds in group homes become available. They expect to have at least 36 additional beds at cottages to be run by a private group on the hospital grounds. They anticipate other patients leaving for other group homes or supported housing.
But they also say they were hoping to have fewer patients in the old buildings by now. The hospital presently holds about 30 patients more than it did in 2004. And despite an infusion of money into community housing, state officials say many Greystone patients are ready to be discharged but have no place to go.
"I wish it was a little lower," Kevin Martone, the state's assistant commissioner for the Division of Mental Health Services, said of the present census. If necessary, he said, the hospital would keep one of the old buildings open as a temporary measure, but added that he didn't expect that to happen. "We're moving ahead as if that's not going to happen."
Martone responded last week to some concerns being expressed by behavioral health experts who have been saying a smaller Greystone might present problems to the mental health system. Local hospital officials worry that they won't be able to discharge as many patients to Greystone, creating a bottleneck in the system. Behavioral health experts say the state isn't spending enough money on community housing to reduce the population at Greystone.
Martone said the state spent $15 million over the past two years to create more than 500 community housing opportunities. Yet, he acknowledged Greystone's population has not been getting smaller.
"It was preventative," he said of the housing efforts. "The census (at Greystone) could have been higher."
He said the population has remained the same partly because more people need psychiatric services as the overall population grows. Almost half of all patients at the state's psychiatric hospitals could be discharged right now, he said, if there were openings in group homes or other types of supported housing. He said he expects more community beds to be available this year, although he did not have a number.
Local hospital officials also have expressed concerns about a smaller Greystone, saying they depend on it to relieve pressure on their limited number of psychiatric beds.
"When Greystone downsizes, we're anticipating major backups in the system," said Jean Zaccone, vice president of behavioral health and chief nursing officer for St. Clare's Health System.
St. Clare's has 18 short-term psychiatric care beds that are usually full, she said. Some patients who need long-term care are sent to Greystone, which allows patients being held in the St. Clare's emergency room to be moved to the short-term beds. Patients who can't be moved to Greystone, Zaccone said, might have to be sent to hospitals in South Jersey, which would be a burden on their families.
"You don't want that to happen," she said.
Martone said he expects the state to come up with money to fund more short-term care beds at local hospitals, but added that he was unaware of a specific plan. Zaccone said St. Clare's has talked to state officials about such funding and hospital officials still are waiting for a response.
Martone also said that Essex County Hospital, a newly opened psychiatric facility in Cedar Grove, likely will take some of Greystone's admissions.
Patient advocates say they welcome the new Greystone, that it will allow for better care and oversight of patients along with more comfort, with each room having its own bathroom instead of one being shared by an entire ward. But they also worry about the potential for overcrowding even as the new building is under construction. And they say some patients are ready to be discharged, and have been waiting for community housing for years.
Albrecht said one of his sons lives in a halfway house, and life has improved since he was discharged from Greystone. That son is now busy all the time, Albrecht said, going to sports events, museums and taking shopping trips to the mall. He said he has another son still waiting to be discharged.
"When that will occur is not known," he said. "I'm hoping he'll be discharged before the new hospital opens."
Some behavioral health experts say the problem is money, with too little being spent on community housing to make up for lost beds.
Michael Armstrong, executive director of Community Hope, which helps run group homes on Greystone's property, said the state may have underestimated the need for beds. His organization is involved with an organization called Care and Hope At Morris Plains, or CHAMPS, in housing 25 people in group homes on Ruth Davis Drive at Greystone. It will house another 36 people in cottages being renovated on the hospital grounds. The state, Armstrong said, has been putting money into community housing.
"It just hasn't been enough," he said. "The mentally ill continue to be an underfunded and underrepresented constituency."
His group originally was supposed to get 10 cottages at Greystone but he said that number has been cut to eight. Armstrong said he was still hoping to get the other two cottages in the future.
Martone said state officials decided to keep the two cottages when they decided to continue funding the group homes being run by CHAMPS. Albrecht, whose son lives in one of those homes, said he never heard they were in danger of closing.
"I absolutely never heard that before," Albrecht said.
Michelle Borden, associate director of NewBridge Services, which offers various mental health services and runs group homes, said the state has stopped offering money to help fund group homes. Her organization's group homes are full, she said, as are most others. She said she's been waiting for the state to issue requests for group home proposals, but that hasn't happened.
"It's very frustrating because we don't have enough group home beds," she said.
Instead, state officials say they are spending money on supported housing. Clients are given rent subsidies for apartments and also receive free or subsidized mental health services. Martone said such housing costs less than half the estimated annual $50,000 for one person living in a group home. Some patients' advocates say it's also what most people want.
"We're looking to make a big shift in the system," Martone said.
Some experts said the state seems to be neglecting a segment of the population, those not ready to live on their own. But Martone said the state is not trying to get rid of group homes. As more people move into supported housing, he said, more group home beds will open up and more Greystone patients will be discharged.