Maryland’s psychiatric hospitals are running out of room — and the data shows why

Two years of internal state reports reveal falling admissions, collapsing releases, and a system increasingly unable to move patients out — while youth beds sit half-empty.

By Michael Phillips | MDBayNews

The numbers inside Maryland’s monthly psychiatric inpatient reports don’t scream. They accumulate. Month after month, facility after facility, the same quiet signals repeat: more patients on the books, fewer cycling out, and an occupancy crisis at the adult level that the state has not publicly addressed.

A review of nearly two full fiscal years of data — 19 monthly reports from the Maryland Department of Health, spanning February 2024 through January 2026 — reveals a system under structural pressure that predates the current fiscal year and is worsening by measurable degrees. The data spans the final months of fiscal year 2024, all of fiscal year 2025, and the first seven months of fiscal year 2026.

“Month after month, the same quiet signals repeat: more patients on the books, fewer cycling out, and a crisis the state has not publicly addressed.”

The revolving door has jammed

The most important number in these reports isn’t the occupancy rate. It’s readmissions.

Across the full fiscal year 2025 (July 2024 through June 2025), Maryland’s state psychiatric system recorded 234 readmissions — patients returning to inpatient care after a prior hospitalization. That’s down from 300 readmissions in fiscal year 2023, a 22% drop in two years.

By the nine-month mark of fiscal year 2025 — through March 2025 — readmissions had already fallen to 178 from 230 over the same period in FY2023, a drop of 52. That is the steepest year-over-year readmission decline in this dataset at any comparable reporting point.

In any other context, falling readmissions would be celebrated as evidence that patients are doing better in the community and not relapsing. But the rest of the data tells a different story. The average number of patients on the books has not fallen — it has held steady above 1,086 across both fiscal years. Net releases, the measure of how many patients successfully transition out, fell from 1,031 in FY2023 to 985 in FY2025.

The picture that emerges is not one of patients recovering and staying well in the community. It is one of patients staying in the hospital longer, so that the revolving door has fewer rotations simply because fewer people are leaving.

Metric	FY2023	FY2024	FY2025	Change (FY23–FY25)
Total Admissions (12 mo.)	~980	~960	~930	−50
Readmissions (12 mo.)	300	~270	234	−66 (−22%)
Net Releases (12 mo.)	1,031	~1,010	985	−46
Avg. Patients on Books	~1,095	~1,086	~1,093	Essentially flat
Deaths (12 mo.)	6	6	6	Unchanged

Table 1: System-wide trends, FY2023–FY2025. Source: Maryland Department of Health monthly statistical reports.

Where patients are going — and not going

The shift in where admissions flow within the system is striking over three fiscal years.

Eastern Shore Hospital Center has seen the steepest decline: 119 admissions in FY2023, 99 in FY2024, and just 66 in FY2025 — a 45% drop over two years. Its net releases fell in lockstep, from 121 to 67. A facility that was moving more than 10 patients per month into the community two years ago now moves fewer than 6. The nine-month FY2025 data through March confirms the trend: Eastern Shore had just 52 total admissions through March 2025, compared to 87 over the same period in FY2023 — a decline of 35. Eastern Shore ran at or above 98% average occupancy throughout, suggesting the problem is not a low-census facility winding down. It is a facility that has stopped turning over.

Spring Grove, by contrast, saw admissions hold nearly flat at the top of the system — 332 in FY2023, 363 in FY2024, 362 in FY2025 — while its net releases rose modestly from 318 to 369. Spring Grove is the one facility that appears to be moving patients at pace with its intake. But it is doing so while running above 100% of its operated capacity, peaking at 107.3% in the most recent reporting period. In July 2025 alone, Spring Grove admitted 45 patients in a single month — the highest single-month figure in this dataset — foreshadowing the overcrowding that followed through fall and winter.

Perkins Hospital Center, which primarily serves patients from the criminal courts, saw a 21% drop in admissions from FY2023 to FY2025, while its census remained essentially unchanged. Thomas B. Finan Center in Cumberland, meanwhile, is a notable outlier on the positive side: its net releases have risen from 33 in the eight-month FY2023 period to 40 in the same period of FY2025, and its admissions have grown modestly. Finan is taking on more work and moving more patients — but it is also running at 98.5% average occupancy and has peaked at 104.5%.

Facility	FY2023 Admissions	FY2025 Admissions	Change	FY2025 Avg Occupancy
Spring Grove	332	362	+30	97%+
Spring Field	~230	~240	+10	97%
Perkins	~170	~140	−30 (−18%)	96–97%
Eastern Shore	119	66	−53 (−45%)	~99%
Thomas B. Finan	~50	~56	+6	98.5%
RICA Baltimore	~40	~25	−15	~47%
RICA Montgomery	~30	~28	−2	~42%

Table 2: Admissions and occupancy by facility, FY2023 vs. FY2025. Figures approximate from cumulative report tables.

The RICA question

While adult facilities strain, the two Regional Institutes for Children and Adolescents — RICA Baltimore and RICA Montgomery — have run at a fraction of their capacity for two full fiscal years.

RICA Baltimore has a 45-bed operated capacity. Its average daily census has ranged from 17 to 27 patients across the 19 months of this review — never above 60% of capacity, and frequently below 53%. RICA Montgomery, with 50 beds, has averaged 19 to 31 patients. Combined, the two facilities have left roughly 40 to 55 youth psychiatric beds unfilled every month, for at least 19 consecutive months.

The February 2025 data shows RICA Baltimore at an average daily census of 21 — 47% of capacity. RICA Montgomery averaged 21 as well, or 42% of capacity. By March 2025, RICA Baltimore was at 23 patients (51%) and RICA Montgomery at 20 (40%). These figures are consistent with what the reports show month after month.

The April through June 2025 reports — the end of fiscal year 2025 — show RICA Baltimore’s monthly admissions hitting zero in June. Zero admissions to a 45-bed youth psychiatric facility in a single month, in a state with well-documented adolescent mental health needs.

“Zero admissions to a 45-bed youth psychiatric facility in a single month — while adult units were full.”

This is not explained anywhere in the reports. The data does not tell us whether admissions criteria changed, whether the referral pipeline dried up, whether staffing shortages forced bed closures within the unit, or whether youth are being diverted to private or out-of-state placements at greater public expense. But the numbers are consistent and persistent.

The ‘operated capacity’ floor

Every occupancy figure in these reports is measured against “operated capacity,” defined as beds in buildings currently in use. This is not the licensed capacity of each facility — it is the number of beds the state is actually staffing and running at any given time.

The system’s total operated capacity is listed as 1,161 beds across the adult and youth facilities. When the state reports that Spring Grove is at 107% of operated capacity, it does not mean the building is physically overwhelmed. It means the state is running fewer beds than the physical plant could support, and those beds are overfull. The difference between licensed capacity and operated capacity reflects choices — about staffing levels, about funding, about which wings to open.

Those choices are not visible in these reports. MDH did not respond to a request for comment.

A death in the facility — and deaths outside it

The reports document patient deaths across the full dataset. Over the first nine months of fiscal year 2025 through March 2025, six deaths had been recorded in the system — one more than at the same point in FY2023 and FY2024.

Notably, the March 2025 report records one in-facility death at Perkins Hospital Center. This is a departure from the pattern seen across most of the dataset, in which deaths occurred while patients were on conditional release or another form of leave status. The Perkins in-facility death in March is the only confirmed in-facility death in the 19 months of data reviewed.

Over the seven additional months from July 2025 through January 2026, four more deaths were recorded — in October, November, December, and January — all at Spring Field or Spring Grove, and all while patients were on conditional release. The reports record the deaths by facility and month but provide no information on cause or circumstance.

A system holding still while pressure builds

The quietest finding in this dataset may be the most telling. Despite falling admissions and fewer readmissions, the total number of patients on the system’s books has barely budged in two years.

In March 2023, the average number of patients on hospital books systemwide was 1,096. Through March 2025, that figure stood at 1,093. In January 2026, it was 1,094. The system’s population has remained within a three-patient range — above 1,086 — for the entirety of this review period.

The end-of-month census peaked at 1,103 on the books as of March 31, 2025 — the highest end-of-month figure in the full dataset. By January 31, 2026, it stood at 1,088.

The system is not growing. But it is not releasing patients either. Its population has stabilized at a level that keeps adult facilities chronically at or above operated capacity — while the youth units sit largely unused — not through any deliberate policy anyone has announced, but through the slow arithmetic of patients staying longer and fewer moving on.

Whether that reflects appropriate clinical decisions, a failure of community mental health infrastructure to absorb discharged patients, or some combination, the state has not said. The data only shows the result.

METHODOLOGY

Data source: Maryland Department of Health Psychiatric Inpatient Facilities Statistical Reports, February 2024 through January 2026 (19 monthly reports), obtained through public records. Fiscal year data drawn from cumulative tables published in each month’s report. FY2023 baseline figures are drawn from the comparative columns in FY2024 and FY2025 reports. “Operated capacity” is as defined by MDH in each report: beds in buildings currently in use, which may differ from licensed capacity. All figures are drawn directly from official monthly reports; no figures were projected or interpolated except where noted as approximate in tables above.

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