BATH COUNTY, Va. -- Since his son died by suicide and attacked him during a mental health emergency seven years ago, State Senator Creigh Deeds has called reforming mental health services in the Commonwealth a “life’s work.”
He said that he wasn't surprised when behavioral health officials announced a pause in admission at five of eight state-run mental health facilities because of safety and staffing concerns.
“We’ve made dramatic strides the past few years, but they simply aren’t enough,” Deeds said. “We’ve been at crisis, a breaking point, for a lot of months. This pandemic exacerbated every problem we had. The reality is, we have people in distress sitting in the emergency room for days because there wasn’t room for them in hospitals.”
On Friday while announcing the temporary pause in new admissions, Alison Land, Virginia's behavioral health and development services commissioner, said there have been more than 60 injuries at state mental health hospitals since July 1 because of the staffing shortage and surge in new patients.
“The challenges faced by the state hospitals are now an immediate crisis for two reasons,” the commissioner said. “First, the level of dangerousness is unprecedented and second, recent admissions are occurring in an environment that is no longer adequately staffed.”
Sen. Deeds said Virginia must fund worker pay increases to make these kinds of jobs more attractive and find ways to get more mental health services workers in the job pipeline.
“We’ve been in distress, we’ve been trying to figure a way out of it, now we are forced, our hand is forced. Some of the other things that were priorities have to take a back seat to this,” he said.
Virginia mental health advocates and law enforcement groups both worry the admissions pause will lead to more families having to call 911 when their loved one is experiencing a mental health crisis.
“When that call to 911 is made and they cannot get a bed, then the options are either the emergency room or jail, depending on how the call comes in. The biggest thing is the pain it is causing to the person who is sick and needs hospitalized medical care and cannot get it,” said Kathy Harkey, the executive director of NAMI Virginia. “For a lot of individuals, the state facilities are the only option.”
Harkey said more funding is critical but the investment in more crisis stabilization units, which provide short-term evaluation, support and treatment for those in crisis, could help ease the burden on hospitals.
“They will look to deescalate the crisis, and they will link them to additional services, whether that be community services or even if they need a longer hospital stay,” Harkey said.
The Virginia Chiefs of Police said law enforcement officers will be put in a tight spot now when transporting patients. Miles Turner, a retired police officer who runs a consulting firm now, said departments could be thin when carrying out temporary detention orders.
“Where are these people going to go?” Turner asked. “I don’t want to leave any county with just one officer working. I don’t want to leave anyone going through a mental health crisis without the help they need. But at some point, it’s a breaking point, and you can’t put two people in one place.”
Deeds agreed the moment marks a turning point for mental health services in Virginia. He backs ideas similar to crisis stabilization units as a way of modernizing the system.
“Drop-off centers or crisis stabilization units or psychiatric emergency rooms, they’re all a little bit different, but they’re all about the same thing. They’re something short of hospitalization where people can go when they’re in crisis,” Deeds said. “We have to adopt one of those approaches in the long run because I think that will take considerable stress off our existing system.”
Deeds said some of this work is already being done in certain Virginia communities, but the level of care remains disparate across the Commonwealth. He said centering emergency mental health care within local communities is something Virginia must speed up.
“This crisis is telling us, or ought to be telling, it’s telling me certainly, that we aren’t phasing it in fast enough,” Deeds said.
Virginia lawmakers meet next month to prioritize spending of billions of dollars from the American Rescue Plan Act, and Deeds said he is confident lawmakers will start to address the staffing shortage issue then.
However, he said the process of reforming the mental health services system in Virginia is still years in the making.