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'People are hurting:' Report says VA not meeting goals for implementing essential mental health services

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RICHMOND, Va. -- A recent performance review of a program designed to expand access to public mental health services and improve their quality found that the initiative has not fully met those goals over the years.

Virginia mental health leaders said the state hasn't fully set the program up for success, but they expressed optimism that Governor Youngkin's 'Right Help Right Now' initiative will accelerate progress.

Tuesday morning during a 'Right Help Right Now' forum in Henrico, Governor Youngkin called on faith leaders to help members of their communities who may be in crisis.

It was a message that resonated with Pastor Valerie Coley, who sees firsthand the challenges that her congregation faces.

"Oh, it's a lot. It's a lot," Coley said. “Mental health is definitely a major challenge in the inner-city communities and as a whole in this nation.”

Coley attended the forum, where Governor Youngkin announced the availability of $800,000 in micro-grants that local churches and non-profits can access.

Youngkin said organizations could use the funds for training or direct care for those struggling with behavioral health and substance use issues.

Individual organizations may receive up to $15,000.

“We need to jump on this ASAP," Coley said, adding that she plans to apply for a grant to support her ministry's leaders. “If I’ve noticed and identified that there might be some challenges in some type of mental health condition, they have to go and get a therapist. I also connect them with a community resource so that they can get an assessment because before you can lead, your mind itself has to be clear.”

But barriers still remain in accessing help.

Virginia has 40 Community Services Boards (CSBs) across the state which serve as the entry point into the system of publicly funded mental health resources. CSBs are responsible for overseeing, ensuring, and delivering mental health services in localities.

In 2017, the state launched a program called 'Step-VA' which aimed to provide oversight and accountability of CSBs, expand the types of services offered by CSBs, and improve the quality of those services.

However, according to a new report presented to the Behavioral Health Commission, 'Step-VA' has not fully achieved its goals.

“I think there's a lot of opportunity to improve the program," Youngkin's Secretary of Health and Human Resources, John Littel said on Tuesday, adding that the program launched only a couple of years before the pandemic.

'Step-VA' established a set of nine essential core services that each CSB would be required to provide, such as same-day assessments and primary care screening.

According to the report, only six of the nine service components have been implemented at CSBs statewide. The scope of those services has been constrained, limiting the breadth of access, due to limited resources.

Implementation of three service components including psychiatric rehabilitation, care coordination, and case management has not begun at all and is behind schedule due to delayed funding and a shortage of qualified providers.

Sen. Barbara Favola, a Democratic lawmaker in Northern Virginia who sits on the Behavioral Health Commission, said case management is one of the most critical services for people in need of wraparound support.

However, she said the state historically has not provided the appropriate funding and resources to CSBs in order for them to be well-positioned and well-staffed.

The General Assembly has dedicated more than $420 million in funding to 'Step-VA' since 2017, but a 2020 evaluation found that the funding was not sufficient to meet the need.

Littel said he was not satisfied with the pace of the efforts to boost CSBs.

“No. No. We could always be faster on this," Littel said. "The need is so great. We hear all across the Commonwealth that people are hurting."

However, Littel said he expected efforts to accelerate with $155 million in new spending for mental health services included in the state budget. Favola said she agreed.

Parts of Youngkin's 'Right Help Right Now' plan aim to build on the strategies of 'Step-VA' and contribute to the program's goals, such as expanding crisis call centers, mobile crisis centers, and crisis stabilization centers.

However, 'Right Help Right Now' funds are not subject to the same monitoring and oversight requirements as 'Step-VA,' according to the report to the Behavioral Health Commission.

“We know that the CSBs have a huge workload, and they're really working hard in their communities," Littel said. “Our focus is really trying to help the CSBs bring those services up to make sure that all elements of 'Step-VA' are covered and then to build on it with 'Right Help Right Now.'”

It's a mission faith leaders said they can get behind.

“It doesn’t matter about the party. It matters about the purpose," Coley said.

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