As Sykesville residents and officials question the move of nine forensic residents from Owings Mills' Rosewood Center to Springfield Hospital Center, some acknowledge they were unaware the Springfield campus is already home to about 200 forensic patients.

"I recently learned that there were forensic patients here," said Rose Topper, a Sykesville resident. "It is not highly publicized."

A forensic patient is one who is undergoing treatment and is charged with a crime, but is found not competent to stand trial or not criminally responsible, according to Susan Steinberg, director of the State Department of Mental Health and Hygiene forensics office.

This month, the Department of Health's Developmental Disabilities Administration is scheduled to transfer nine forensic patients from Rosewood to Springfield's Muncie Building in Sykesville. An exact date has not been set for the transfer.

Gov. Martin O'Malley ordered Rosewood to close by June 30, 2009.

Residents have raised concern about security for those new patients, but some who spoke at two forums on the transfer had no idea that Springfield already has existing forensic patients.

But state officials say the existing patients are no cause for alarm.

"We are doing everything possible to make sure the security measures are in place and that we have sufficient and adequate staffing so that the unit is safe for the residents, for the staff and the community," said Arlene Stephenson, state deputy secretary for public health services.

Increase in forensics

Fifty-eight percent of Springfield's 349 patients are considered forensic, according to Paula Langmead, chief executive officer of Springfield.

The hospital is seeing more forensic patients mostly because of the establishment of the drug court system in surrounding counties, Stephenson said.

"The courts are put there to determine what they need to do with these individuals," she said. "Increasingly, the courts are deciding the best thing they can do is to provide treatment."

Other options would be to send people to detention centers and refer people for outpatient treatment, she said.

Currently, Springfield Hospital is at capacity, she said.

"With the difficulty of hiring nurses, it's hard to increase the number of beds if you can't staff them," she said

Springfield staff is seeing more demand due to the increased number of court-ordered patients, said Stephenson, who worked at Springfield for more than three years.

"It puts more demand on staff to be available to take the residents or their patients back and forth to the courts," she said. "The staff has to be available to escort and drive them."

Staff also has become more concerned about safety having to deal with more forensic patients. To help address those concerns, staff members are registered in the Prevention, and Management of Aggressive Behavior program at the hospital, Stephenson said.

"They are taught methods to identify when (patients') behavior begins to escalate and methods to help de-escalate the patient ...," she said.

The majority of the forensic patients at Springfield have been charged with crimes such as theft and trespassing, Langmead said.

The hospital did recently began receiving patients from Jessup's Clifton T. Perkins Hospital, which is a maximum security hospital. Patients at Perkins may face more "egregious" crimes, Stephenson said.

However, Langmead noted that Perkins patients sent to Springfield are deemed stabilized and are allowed to be housed in a level below Jessup's maximum security.

Security and 'elopements'

Residents should not be concerned about security at existing Springfield facilities, Stephenson said. That's because the risk of escape, or "elopement," is chiefly with patients who are allowed to walk the grounds.

The Department of Health defines an elopement as someone who is not where they are supposed to be, but not necessarily an escape, she said.

That could mean the patient walked off to do something and came back.

Since fiscal 2005, the hospital has had 55 elopements, according to data provided by Langmead. That includes forensic and non-forensic patients.

The elopements have held fairly steady for the past few years with 16 being the highest (2005) and 12 to 13 for the past three years.

All except two patients returned to the hospital, according to the data. The two who did not were placed in another health care facility, the data states.

The hospital completes surveys with eloped patients to find out why they walked off. Since fiscal 2005, 19 patients have been found at a convenience store or went somewhere else to do shopping. However, 16 had no destination and intended to leave, according to data provided by Langmead.

To help reduce elopements, the Springfield Hospital Center Police Department has increased staff from seven guards to 15 since 2004. The department includes certified officers and security guards, all of whom are unarmed, Stephenson said. All psychiatric hospitals have had gunless officers since the mid 1990s.

"These are patents that are here to get better," Stephenson said. "They are not prisoners. There are staff who are trained to know how to deal with them when their behavior is out of the norm, and guns are not necessary."

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