TRENTON — The Sen. Garrett W. Hagedorn Psychiatric Hospital in Hunterdon County is closing, and Mary Zdanowicz is frightened. She says her 49-year-old sister, Beth Grojean, diagnosed with severe schizophrenia, has spent three quiet and safe years there at the state's smallest hospital, nestled in the mountains overlooking Spruce Run Reservoir in Glen Gardner. Zdanowicz fought to have Grojean...
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Mary Zdanowicz of Arlington, Va., talks with her sister Beth Grojean, a patient at Hagedorn Psychiatric Hospital in Glen Gardner. Zdanowicz is concerned about the closure of Hagedorn, the result of state budget cuts.TRENTON — The Sen. Garrett W. Hagedorn Psychiatric Hospital in Hunterdon County is closing, and Mary Zdanowicz is frightened.
She says her 49-year-old sister, Beth Grojean, diagnosed with severe schizophrenia, has spent three quiet and safe years there at the state's smallest hospital, nestled in the mountains overlooking Spruce Run Reservoir in Glen Gardner.
Zdanowicz fought to have Grojean transferred to Hagedorn after eight often violent and accident-prone years in the state’s largest institution, Ancora Psychiatric Hospital in rural Camden County.
Grojean’s files, which Zdanowicz obtained from the state, read like a boxer’s medical chart: black eyes, broken bones, bruises, and cuts so deep they required stitches. She lost a toe due to an untreated infection.
Zdanowicz, who is Grojean’s guardian, said she’s sick over the thought her sister may return there or to another large hospital.
"The difference between what she looked like coming out of Ancora and now is night and day," she said. "She looked frightened. She’s happy now."
Grojean is one of 235 patients who will be moved out of Hagedorn — the state's only psychiatric hospital serving mostly geriatric patients, and the only one that doesn’t accept those with criminal offenses — by next June.
In a controversial decision that became final when he signed the state budget, Gov. Chris Christie will close the hospital to save $9 million and reduce New Jersey’s over-reliance on institutions.
State officials say they’re ready to move Hagedorn patients to proper settings. They say one-quarter are clinically ready to leave for supervised community housing, and an assessment of the others is under way.
But a group of relatives say the state is not prepared to move very sick patients into the community in the next 11 months. They suspect officials are overestimating how many patients will be stable enough to live outside a psychiatric hospital.
And they dread the options that remain for the most profoundly ill: the state’s three other psychiatric hospitals, potentially getting bigger with Hagedorn gone; and private nursing homes that generally do not provide specialized mental health care.
"To close Hagedorn in less than a year with new leadership at the helm and no plan is dangerous and irresponsible," said Robert Davison, executive director of the Essex County Mental Health Association. He noted that Deputy Commissioner Kevin Martone, who led the effort to close Hagedorn, resigned last week to take a job in Boston.
State Human Services officials say closing Hagedorn will not lead to overcrowding at the other hospitals because they’ve already added more than 1,500 beds in private facilities such as hospitals and group homes in the last five years.
Ellen Lovejoy, spokeswoman for state Human Services Commissioner Jennifer Velez, who oversees the hospitals, said there will be enough time for each patient’s treatment team to determine their specific needs. The team will consider the patient’s and family’s preference of where to go, and proximity to family, she said.
Patients who can’t safely live in supervised community housing could be sent to Ancora, Greystone Park Psychiatric Hospital in Parsippany and Trenton Psychiatric Hospital — but geriatric patients will not be mixed in with the general population, Lovejoy said.
"All hospitals will be able to treat geriatric patients, though some may receive more than others, depending on the needs. And there is no intention to mix them with patients considered violent," she said.
Hagedorn’s closure divided mental health advocates who generally believe institutionalizing people violates their civil rights and doesn’t give them a chance to get better. The state is obligated to shed hospital beds under a U.S. Supreme Court ruling saying people with disabilities have a right to live in the least restrictive place.
"I can’t say the hospital should never close – that would be demagoguery," said Davison, who chaired a mental health task force six years ago that recommended the state spend more on community treatment and less on institutions.
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Hagedorn Psychiatric Hospital in Glen Gardner, Hunterdon County.At the same time, the same advocates are keeping a close eye on how the state pulls this off.
Closing Hagedorn "is good news to the extent that resources are freed up to develop truly specialized services and more community based placements," said Disability Rights Executive Director Joseph Young, who brought the federal lawsuit. "But the decision was made so late. We’re concerned like everyone else about where the Hagedorn patients will go, and if overcrowding will occur."
Several years ago, New York transferred patients from closed psychiatric hospitals to nursing homes that did not provide the specialized care these patients needed, Young said. "We’ll be watching to see that doesn’t happen here."
From 2006 to 2010, state figures show the roughly 450 patients discharged each year Hagedorn most often went directly to nursing homes, residential care facilities — which resemble boarding homes but provide varying levels of medical supervision — and group homes.
Neither residential centers nor boarding homes, which are often plagued with building code and safety problems, "should be a first-choice discharge option," unless people request it, Young said. Lovejoy said these facilities aren’t the first place the state looks to place these patients, unless they ask for it.
Bill Fallon of Warren said he thinks the push to move people out of hospitals minimizes just how sick institutionalized patients are. His brother, Michael, is among the 10 percent of schizophrenics for whom medication doesn’t help. "Unfortunately, there is no alternative for my brother than a state institution. Private hospitals no longer take patients on a long-term basis.’’
Michael, 50, spent five years at Ancora, which Fallon called "much more a warehouse for the mentally ill." He said "by a stroke of luck," Michael was moved to Hagedorn five years ago.
Human Services officials say for those who need institutionalized care, the remaining state pyschiatric hospitals are now smaller and better managed — and have space for 300 more patients.
While Ancora remains on the watch list for the Department of Justice, which opened an inquiry into civil rights and safety abuses in 2009, Lovejoy said it is vastly improved. The hospital, which held about 700 patients three years ago, has a capacity of 515 beds and serves 471 — and has two geriatric units, she added.
"It's just not the same place it was," Lovejoy said.
Editor's note: An earlier version of the story incorrectly stated that Hagedorn Psychiatric Hospital is next to Round Valley Reservoir. It is next to Spruce Run.
Related coverage:
• Chris Christie to close Hagedorn Psychiatric Hospital, state senator says
• N.J. psychiatric hospitals to release 300 patients under lawsuit settlement
• Task force submits inconclusive report on closing Hagedorn Psychiatric Hospital