ANNAPOLIS -- A commission reviewing Maryland's psychiatric hospitals recommended last week that the state launch a four-year pilot program using private and community-based facilities to treat some mental patients.

Commission members said the state faces spending millions of dollars to maintain its psychiatric hospitals, which care for only about one-quarter of the people who need treatment.

"If we don't do anything, we are going to have to spend an additional $30 million to $35 million a year on staff in order to bring the staffing ratios up to where we ought to be for quality care," said Jim Howe, who headed the study. "That's not a luxury standard, but it will meet federal requirements."

In addition to increasing staff costs, the state is facing spending up to $50 million for capital improvements for the buildings, he said.

Two state hospitals, Springfield and Spring Grove, have lost their certification by the Joint Commission on the Accreditation of Hospitals, Howe noted. "It's clear we are out of balance," he said.

In a report to be forwarded to Gov. William Donald Schaefer, the commission recommends a four-year program that would rely more on community or private programs to treat the mentally ill.

The commission does not recommend that the state shut down its hospitals -- some patients continue to be better suited for psychiatric hospitals -- but it urges relying less on institutions, Howe said.

The pilot program would help the state estimate how much it could save by eventually closing some of its hospitals, he said.

"The idea of moving from public facilities to private facilities -- a few states are experimenting with that," he said. "There hasn't been enough of a body of experience to be a reliable guide. That's why we're being so cautious about closing state hospitals.

"At the end of three or four years, if it works out, we would anticipate there would be some pretty radical changes" in the state's approach to psychiatric care, he said.