Virginia’s mental health care system is “chaotic” and must be addressed, says Sen. Deeds
Jan 14, 2018 | By Alexandria Bursiek
Half of Virginia’s budget for mental health services goes to state hospitals that serve only 2 percent of the mentally ill population.
That needs to change, said state Sen. Creigh Deeds.
Deeds, a Democrat from Bath County, formed a subcommittee known as the Deeds commission in 2014 after the death of his son, Austin “Gus” Deeds, who committed suicide after stabbing his father 13 times at the family’s home. The day before, the senator tried to admit his son to a mental hospital but was turned away when no bed could be found.
In an interview with The Virginian-Pilot last Monday, Deeds described the state’s mental health care system as “chaotic” and said its problems must be addressed.
He said more money needs to be funneled to the local hospitals and community service boards that handle far more of Virginia’s mentally ill patients than state hospitals.
“People are falling through the cracks every day. It’s urgent that we get this done today, but it’s more urgent that we put in place something that will last in the long term,” Deeds said.
He stressed that improving Virginia’s mental health system will take plenty of small changes over a number of years.
“With mental health, it’s kind of a long game,” he said. “It’s not like you can get instant gratification.”
Among the initiatives being proposed by the commission this year:
- Discharge planning to provide mental health care to inmates after they leave jail as they integrate back into society.
- Alternative transportation for those with mental illness in order to free law enforcement time.
- Allowing psychologists to treat patients remotely by interacting with them using cameras and the internet.
- A realignment plan that integrates community service boards with institutions.
Citing the novel “The Greening of America,” Deeds said: “Spring doesn’t happen overnight. It greens up over time and that is kinda what we will do here. We got a few things done in 2014, a few more in 2015, a few more in 2016 and 2017. It was a big step in the legislation last year, and hopefully we will take another big step this year and another big step next year, and then we’ll see.”
Last year, the legislature passed STEP VA, a model that will require community service boards to provide crisis services for individuals with mental health or substance abuse disorders. It also provides psychiatric rehabilitation and other services.
Before 2017, the only services that were mandated were emergency care and case management. The bill requires 10 services that will be phased in by 2021 and are expected to cost around $200 million. Deeds mentioned that it may take even longer to fully integrate all of them.
Looming over mental health care proposals is the possibility of Medicaid expansion.
Deeds said roughly 60,000 mentally ill people would benefit from Medicaid in Virginia. The Affordable Care Act is the only real equity when it comes to money for mental health services, Deeds said, stressing that “we have to take advantage of it.”
Expanding Medicaid would add $130 million to Virginia’s bottom line and already has been factored into former Gov. Terry McAuliffe’s final two-year budget proposal.
“The most important thing we can do in terms of care is Medicaid expansion, and I think we have a real chance to get that done,” Deeds said.
Expanding Medicaid also would take some pressure off state hospitals. The additional insurance coverage would help pay for the care that patients under civil commitments receive at the hospitals. In the long run, the extra dollars also would allow individuals with mental illness to receive care in the community and keep them out of state hospitals and jails, where they often wind up.
Sen. Emmett Hanger, R-Augusta County, who is on the Deeds commission, said last Wednesday in an interview with The Pilot that those additional dollars would go a long way toward offering community services to the commonwealth.
The money would allow for the STEP VA model to offer same-day care to consumers, and speed up the delivery of several other services. Hanger added that more mental health reforms would have been possible if Medicaid expansion had passed in previous years.
“If we had accessed those federal dollars, obviously we would have relieved pressure on some of the rural hospitals that are having difficulty keeping the doors open,” he said. “We would have been able to make more services available more broadly across underserved areas in the commonwealth.”
Deeds and Hanger agree that mental health reforms are not a partisan issue but that Medicaid expansion is. Neither is confident enough to say the latter will happen.
“I remain hopeful that we can see the wisdom in that for the people we represent. For crying out loud, there are as many people in Republican areas as Democratic areas that would benefit,” Deeds said. “I hope we can look past the politics of it, the partisanship of it, and think about what’s going to be good for the people we represent.”