Before we tear off the remaining couple of pages on the May calendar, I want to address the important recognition of May as Mental Health Awareness Month. While Virginia is credited with having the first mental health hospital, or asylum as they were called in the 18th century, the Commonwealth has had difficulty in recent times coming to grips with the enormity of the need and the provision of funds to respond to those needs. In fact Virginia is ranked 40th in the nation in mental health care according to the results of a national study of the issue. It took a state senator’s mentally ill son attacking his father with a knife to shock the state to greater action. That father now chairs the Joint Subcommittee on Mental Health Services in the 21st Century, or the Deeds Commission, that includes Sen. Janet Howell as a member and has made critically important recommendations on which the state has made significant progress.
Special thanks go to The Commonwealth Institute for documenting recent progress and remaining opportunities in behavioral health in a recent edition of The Half Sheet. The Institute, which is a nonprofit organization focusing mostly on human service needs, used the term “behavioral health” to be more comprehensive than “mental health” to include mental health services and supports such as substance abuse treatment. The Institute recognized accomplishments this past year to include a 21 percent increase in Medicaid reimbursement to encourage more licensed mental health professionals to accept Medicaid thus increasing access to services for people with low income. Additional funding for emergency opioid kits will expand the access to and availability of Naloxone, which is used to reverse the effects of an opioid overdose. The General Assembly also passed and the Governor signed my bill to expand the health care providers authorized to dispense Naloxone to make it more readily available.
Increased funding was provided to increase staffing at state mental health facilities that are struggling to keep up with demand. Funding was also approved to replace the aging mental health facility Central State Hospital. In addition, monies have been made available for transportation of persons needing mental health hospitalization from having to be transported by law enforcement.
The Department of Behavioral Health and Developmental Services indicates that there is a need for 5,000 permanent housing units for those who need supportive housing in the state. This year’s funding along with an increase last year will provide 1,300 units of supportive housing. Obviously, there is a severe need to do more in this area with a price tag of about $47 million.
Challenges remain to be addressed in providing greater access to programs and services for those who live in rural areas and to those who have experienced the trauma of having been exposed to the immigration and refugee system. A task force is looking at ways to increase the number of mental health professionals in the state.
Our awareness of mental health needs cannot end with the month of May. More needs to be done!
The recent tragic stabbing of State Senator Creigh Deeds by his son, who then took his own life, brings to attention the importance of the mental health system and its very fragile condition in Virginia.
While the young Deeds son was evaluated the day before the tragedy by staff of the local mental health board, he was discharged without being held for treatment. Early reports indicated that there was no facility available to accommodate him. Subsequent information seems to indicate that there were several hospitals within reasonable distance that could have taken him, but there is no system for coordination of available facilities and patient needs. At least two investigations are underway to find out what went wrong and why.
Regardless of the facts that are found surrounding this terribly tragic event, there remains a concern that the mental health system in Virginia is inadequate to meet the needs. Clearly the mentally ill are no more violent than the rest of society, and some statistics suggest that a smaller percentage of the mentally ill are violent than in the population at large. At the same time, however, violent people have their own needs for mental health treatment for themselves as well as for the safety of family and society.
The tragic slayings at Virginia Tech demonstrated the consequences of an untreated disease and the faultiness of the system that is supposed to take care of them. The immediate response in Virginia was to provide an instant transfusion of about $40 million to meet the need. Unfortunately with the economic recession and the cutback on spending, that money has mostly disappeared from
Mental health services had a budget of $424.3 million in FY2009, but that amount had decreased to $386.6 in FY2012. The adoption of a state budget for the 2014-2016 biennium must recognize the continued need and restore and supplement lost funding.
The same Inspector General who is looking into the circumstances of Deeds’ son being released without treatment earlier had looked into this problem system wide. In 2010 the Inspector General found that approximately 200 individuals were returned to the streets in Virginia that year even though there was agreement among mental health professionals that they needed to be hospitalized.
In the view of these professionals, either these individuals were sick enough to harm themselves or others, or they were unable to defend themselves. This is referred to as the “streeting” of individuals with mental illnesses. It occurs when either there is no space for mentally ill people in public facilities or no private facility will take them. About one-third of the persons in local jails are in need of mental health services
My continued prayers are with Senator Creigh Deeds and his family. May time bring about merciful healing. For legislators, may this tragic event spur us to action without the need for more lives lost and communities shattered. The need is clear; we must act responsibly.
Ken Plum has represented Reston in Virginia’s House of Delegates since 1982. He writes a weekly column for Reston Now. He can be reached at [email protected].