State officials have offered to promote the chief physician at a troubled state-run psychiatric hospital in Fairfax County in an effort to halt his resignation and those of dozens of other staff members who have threatened to leave the facility if he does, according to an official close to the negotiations.

An emergency meeting between mental health officials and staff members of Northern Virginia Mental Health Institute is scheduled for this morning to discuss what could become a new crisis for the 148-bed hospital if the medical director, Mohamed El-Sabaawi, does resign.

By late afternoon, El-Sabaawi had not accepted the state's offer to make him interim director of the Northern Virginia Mental Health Institute, the official said.

The hospital, which treats Northern Virginians with severe mental illness, has been in turmoil since a 26-year-old patient died there last year. The facility is under Justice Department scrutiny for alleged poor patient care, and has seen a succession of medical directors.

Last week, 39 physicians, psychologists and social workers threatened to resign after El-Sabaawi, the facility's third medical director in 14 months, told staff members that he planned to leave to take a job in North Carolina.

El-Sabaawi had been on the job barely four months, but staff members said they had great hopes that he could put the hospital on an even keel and improve conditions there.

Employees complained of personality conflicts among senior staff members, a lack of communication between nurses and the clinical staff, poor management and high staff turnover.

"The continued instability of this institute and the conditions that remain unchanged that precipitated Dr. El-Sabaawi's resignation, are unacceptable to us, to the degree that many of us are now pursuing other career opportunities," employees said in a letter to Virginia's medical director.

The letter was signed by six physicians, eight psychologists, 14 therapists and 11 social workers, accounting for nearly two-thirds of the clinical staff. In the letter, sent to the state medical director Friday, the staff members threatened to resign if El-Sabaawi goes, and they asked for a meeting with state officials.

An employee who signed the letter but would be interviewed only if allowed to remain unnamed said many clinical staff members were "fed up" with the way the facility was being managed and believed El-Sabaawi could turn things around. "I've never seen morale this low," the employee said. "It's got to change. We're hoping he can take charge and improve communications."

El-Sabaawi did not respond to several phone messages left with an aide.

The hospital is next to Inova Fairfax Hospital near Falls Church.

Reed Boatright, a spokesman for the state Department of Mental Health, Mental Retardation and Substance Abuse Services, said state officials responded quickly to the letter to avert another major exodus. A year ago, virtually the entire staff of psychiatrists and psychologists resigned shortly after the death of Skander Najar, a 26-year-old patient who suffered pancreatic hemorrhage while in the hospital's care. An internal investigation found the death was a result of human error.

When Najar's death occurred, the hospital was already under orders to improve from the U.S. Justice Department, which had been investigating the entire state mental health system.

The continuing turmoil at the institute has prompted several advocacy groups to press state officials to resolve problems more swiftly. Robin Edge, president of the Virginia chapter of the National Alliance for Mental Illness, said the group has scheduled an emergency meeting Saturday to consider urging Gov. James S. Gilmore III (R) to appoint a high-level official to oversee the hospital.