Virginia’s mental health system needs an overhaul, legislators say
State Sen. Emmett Hanger, R-Mount Solon, urges the state to come up with a plan to shrink the state’s network of mental hospitals at a Joint Subcommittee to Study Mental Health Services meeting on Dec 4 2018 (Dave Ress/ staff)
Virginia needs a plan to shrink its network of state mental hospitals, according to a key state legislative panel.
The term the panel used is “right-sizing” the state system of nine hospitals.
“We’ve got to get to the point where we’re not spending 50 percent of our money on hospitals,” said Sen. Creigh Deeds, D-Warm Springs, chairman of the Joint Subcommittee to Study Mental Health Services.
Virginia should move in the direction of most other states, which spend about three quarters of their mental health funds on community services, he added.
Sen. Emmett Hanger, R-Mount Solon, who proposed asking state officials to develop a right-sizing plan, said he knew doing so “could open a can of worms.”
But he said the federal government’s effort to claw back $58 million in Medicaid money from the state’s Piedmont Geriatric Hospital and Catawba Hospital, disputing the way those facilities characterized their services, might be a signal that Virginia needs to rethink its system.
“We say right size but we all understand we are going to have to move away from heavy reliance on institutions,” Hanger said. Instead, the state needs to boost its community services, he added.
Del. Nick Rush, R-Christiansburg, initially said he was not sure the timing was right for a new plan since state hospitals are at near-maximum capacity.
But he, Deeds and Sen. George Barker, D-Alexandria eventually said working on a right-sizing plan made sense as long as it did not set a firm timeline for action.
A surge in the number of people going to state hospitals under temporary detention orders for evaluations has added to the strain.
Although the number of orders issued by courts and magistrates has declined in the past two years, the number of people going to state hospitals under such orders has increased from 3,498 in fiscal year 2016 to 5,356 in fiscal year 2018.
One big reason is that private psychiatric hospitals are taking more patients who are admitted willingly, University of Virginia law professor Richard Bonnie told the panel.
Other challenges include the admission of people with complicated medical problems in addition to psychiatric issues, and a backlog of people who are ready to leave the hospital but are unable because the community services and housing they need aren’t available, Bonnie said.
The panel also voted to establish minimum standards for mental health care in jails, developed and enforced by the Board of Corrections.
Del. Rob Bell, R-Albemarle, told the panel that a Newport News effort to divert people with mental illness from jail when they face only minor charges could be a model for the rest of the state.
December 4, 2018
By Dave Ress