Governor proposes mental health reforms

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McDonnell’s plan provides $38 million as part of mental health system overhaul

By Landmark News Service

RICHMOND — Gov. Bob McDonnell plans to revamp Virginia’s mental health system by lengthening the time a person in crisis can be held for evaluation, providing $38 million more for support services over two years, and creating a task force to recommend changes in the aftermath of a shocking tragedy.
He announced those plans Tuesday during a news conference held weeks after the son of state Sen. Creigh Deeds stabbed his father before taking his own life at their Bath County home on the morning of Nov. 19.

Austin “Gus” Deeds, 24, reportedly received a mental health evaluation hours before the incident but was released without further treatment when no hospital beds were found to accommodate him by the time an emergency custody order expired.
It was later revealed that some hospitals in the region had open beds the day the Rockbridge Area Community Services agency sought accommodations for the younger Deeds.
Some of the governor’s proposals seemed to be aimed at addressing systemic issues magnified by the Deeds situation. They include extending the maximum duration of custody orders from six to eight hours; increasing funding so temporary detention orders last 72 hours instead of the current 48; and expanding crisis intervention services to assist in holding people while placement is sought.
In addition, the governor raised the idea of establishing a statewide inventory of public and private psychiatric beds. Also up for review is a state practice of first seeking private hospital beds for psychiatric patients when public space might be available.
McDonnell billed his proposals as an effort to provide clarity to a system that can be complex for patients and practitioners alike.
“These are important things that we do to take care of people in need in our society who, through no fault of their own, have mental health situations that just cry out for treatment and intervention and support of loving families and of health care providers,” he said Tuesday.
Virginia last modified its mental health laws during the General Assembly session following the April 16, 2007, shooting at Virginia Tech that claimed 32 lives and was carried out by a gunman with a history of mental health problems.
This latest push appears to be a continuation of those reforms as well as an outgrowth of a state school safety task force McDonnell created after last year’s elementary school shooting in Newtown, Conn.
The Deeds incident remains under review by the McDonnell administration and the Office of the State Inspector General. State officials say no conclusions have been reached, though Deeds in a recent interview with a newspaper in his district assigned some blame to the local mental health agency involved in assessing his son’s condition.
“Does anyone here believe what happened was a good thing?” Dr. Bill Hazel, Virginia’s health and human resources secretary, said Tuesday when asked about the state inquiry. “It was clearly a very bad outcome for the Deeds family and for all of us. So I would not say it was a success. What we don’t know yet was whether it could have been prevented or not and how it could have been prevented.”
Asked whether he had spoken to Deeds, a Democrat he defeated for attorney general in 2005 and governor in 2009, a somber-sounding McDonnell said he had:
“My purpose was to call him as a dad and say, ‘Hey, we really care about you.’ And to tell him we’re going to do everything we can to try to make improvements in the system.”
Under McDonnell’s plan, the 300-bed Eastern State Hospital in Williamsburg would receive an extra $7.2 million annually to maintain its current capacity and expand bed availability by opening a vacant 20-bed geriatric unit for other adult patients.
Its counterpart, Western State Hospital in Staunton, would also get a funding boost for operational support. Capacity at that 246-bed facility, which just moved into a new complex, would not be increased, however.
Statewide, the network of licensed private psychiatric beds numbers 1,388. Capacity for an additional 1,550 patients is available through Virginia’s seven adult mental health facilities.
Gaps exists in the safety net, Hazel conceded Tuesday, though he insisted bed availability is a problem in less than 1 percent of mental health detention cases. Proposals to address them are part of the outgoing two-year budget McDonnell will present to legislators for consideration in next month’s General Assembly session. Some of his ideas would require changes to the law.
State mental health spending has fluctuated over the years. A high point was a $42 million infusion of new mental health funding after the Virginia Tech shooting, but much of the extra money was washed away during budget cuts made in response to the recession. Overall, state expenditures on community mental health services have risen in recent years — the difference between spending in 2005 and 2013 is $71 million — as has related Medicaid spending.
Current-year spending totals $205 million for state mental health hospitals and $183 million for community services boards.
Kay Ashby, president of the Virginia Beach chapter of the National Alliance on Mental Illness, applauded the funding but questioned the need for another task force:
“I think we know what needs to be done. Start with funding housing, that’s one of the best preventive services. I don’t think we need a task force, but rather continuous adequate funding.”