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Commentary: Mental Health Needs Go Unmet

Under provisions of the Code of Virginia that were strengthened after the tragic shootings at Virginia Tech in 2007, an individual who has a mental illness and is likely to cause “serious harm to himself or others” or who has “a lack of capacity” to protect himself from harm or to provide for basic human needs and “is in need of hospitalization or treatment,” may be held under a temporary detention order. For the individual the law provides access to treatment, and for the public the law is intended to enhance safety. As well intentioned as these changes in the law were, there is serious evidence that a lack of services and facilities render the law ineffective in too many cases.

The Office of the Inspector General (OIG) of the Department of Behavioral Health and Developmental Services found in its review of the law that between April 1, 2010, and March 31, 2011, approximately 200 individuals who met the criteria for a temporary detention order were subjected to a process referred to as “streeting.” Because there were no psychiatric facilities that had space or were willing to take them they were released from custody, hence the term streeting. As the OIG stated in its Semi-Annual Report, “Streeting represents a failure of the commonwealth’s public sector safety net system to serve Virginia’s most vulnerable citizens and places these individuals, their families and the public at-risk. The fact that approximately 200 individuals, who were evaluated by skilled clinicians and determined to be a danger to themselves or others and lacking the capacity to protect themselves, were denied access to a secure environment for temporary detention and further evaluation, greatly concerns the OIG,” as it should concern all of us.

For too many who are mentally ill and on the street, the next stop is homelessness or the jailhouse. The Compensation Board is required by law to make a report each year on the number of mentally ill in the jails in Virginia. In its most recent report for the month of July 2012, the board found that of the 26,669 inmates in the system 3,779 were female, and 22,890 were male. Of the female populations, 38.74 percent were mentally ill, as were 21.22 percent of the male populations. By default our jails have become mental health facilities for too many people.

We are not doing enough to respond to the mental health needs of the commonwealth. According to the National Alliance on Mental Illness, the per capita spending for mental health programs in FY 2009 was $122.90. For Virginia it was $93.81. Too many of our mental health needs are going unmet.