New Approach to Mental Health

New Approach to Mental Health

Reforms in wake of tragedy involving state senator's son.

Advocates for mental health services have been calling for improved services and increased funding for years, although the issue has been pushed aside year after year. But now that the son of state Sen. Creigh Deeds (D-25) committed suicide after stabbing his father, a new sense of urgency is emerging in advance of the upcoming General Assembly session. This week, Republican Gov. Bob McDonnell proposed adding $38 million over two years to the existing $250 million budget for community service boards across the commonwealth.

"It makes you wonder why a crisis was needed to initiate the type of funding that we need," said Pamela Barrett, a member of the Fairfax-Falls Church Community Services Board. "We are so far behind other states in mental health crisis response funding as it is, and it's something that the CSBs have been lobbying for and begging for for years."

McDonnell also issued an executive order 68 to convene a task force on improving mental health services and crisis response. The governor described his task force as a group of leaders in the mental health and law enforcement as well as the judicial system and private hospitals. Within minutes of McDonnell's announcement, Governor-elect Terry McAuliffe issued a statement commending the governor, an indication he intends to follow through when he assumes the reins of power next year. But advocates for mental health remain skeptical.

"But the governor's budget proposals are just that — they are proposals. The General Assembly will have to approve them," said James Mack, chairman of the Arlington Community Services Board. "So while this is a step in the right direction, the General Assembly will have to act and Governor McAuliffe will have to continue the executive order."

FOR NOW, the issue seems to have newfound momentum — the result of a series of events that unfolded last month, when an emergency custody order was issued for the senator's son but a psychiatric bed could not be located before the order expired. That's why one of the reforms proposed by the governor is allowing magistrates to extend the orders by two hours. Another proposal would extend temporary detention orders to 72 hours, a proposal that would cost about $1.6 million a year. Funding is also proposed for the Western State Hospital, where Northern Virginia jurisdictions send patients, which would be about $680,000 a year.

"These proposals will make a dent, but this is certainly not going to solve the problem," said Judith Deane of the Arlington Community Services Board. "Northern Virginia jurisdictions put a lot of their own money into this, so in that sense we are better off than many other counties in Virginia. But we still have a lot of need."

Alexandria Community Services Board director Michael Gilmore said when he was director of the community services board that serves rural Bath County and Rockbridge County, the local funding for community services was about $5 per capita when he left a decade ago. In Alexandria, by contrast, the local funding for community services is $125 per capita. That's why a psychiatric bed might be much more difficult to find in the rural stretches of Virginia, where services are few and far between.

"Much of the state is dependent on billing Medicaid to cover the cost of the serves they provide," said Gilmore. "But all five of the community services boards up here have much more local funding."

THE PROPOSALS INCLUDE expanding programs for child psychiatry and children's crisis response services as well as crisis intervention team programs, crisis stabilization services and discharge assistance programs. Other proposals include expanding mental health first aid programs, secure assessment centers and suicide prevention efforts. One initiative would spend $1.8 million to create six secure crisis intervention team assessment centers where people can be held safely for evaluation and finding a bed without tying up law enforcement personnel.    

"That's only $300,000 a center," said Gilmore. "I think it's going to cost a lot more than that."