Five of Virginia’s eight state-run mental health hospitals remain closed to civil temporary detention order (TDO) admissions due to dangerously low staffing levels. That’s increasing pressure on other pieces of Virginia’s mental health care system. On Tuesday, the Virginia Association of Chiefs of Police (VACP) led a press conference where speakers called for the General Assembly to use American Recovery Plan Act (ARPA) funds and long-term budget increases to help address the crisis.
“The mental health system in Virginia is clearly broken. We’ve seen the slow degradation of available resources in the state over time, and what we have also seen is the need for mental health resources has continued to grow,” VACP President and Herndon Police Chief Maggie DeBoard said.
She said Virginia law enforcement is often involved in intervening in mental health situations even though they are not mental health professionals.
Marion Chief of Police John Clair said that in one situation in his jurisdiction, officers had to wait with a mental health patient for 50 hours while waiting for a facility that had space for the patient. He asked the audience to imagine they had a mental health crisis.
“Maybe you’re not someone prone to these things, and you actually had [a crisis,] and you reach out for help, and 50 hours later you’re still waiting, in handcuffs, in police custody. We’re not therapists. I mean, we’re going to do the best that we can, but we can’t offer anything real,” Clair said.
Clair said legislators need to fix the problem.
“Law enforcement has been sounding this alarm for the last year. A year where the General Assembly spent their time worried about how many marijuana plants somebody can have, or how many tail lights can be out before the police can stop you,” he said. “I want the General Assembly to focus on this issue, with tangible solutions.”
Mental Health America of Virginia Executive Director Bruce Cruser said, “Adults and children in crisis are waiting indefinitely in emergency rooms for treatment facilities. Local jails hold many whose incarceration could have been prevented with access to appropriate services.”
Virginia Association of Community Services Boards (CSB) Executive Director Jennifer Faison mentioned her organization’s ARPA allocation ask of $160 million in grants over two years.
“For every dollar the Governor and the General Assembly decides to invest in the state hospitals, an equal investment needs to be made in community-based care,” she said.
“We completely understand the pressures created by a lack of staff at state hospitals, and we understand the risks associated with operating in that environment. Many CSBs operate 24-7 residential programs serving individuals with significant behavioral health challenges just like our state hospitals do. However, closing state hospitals to admissions simply shifts those risks from the hospitals to the communities, and it does not solve the underlying problems.”
Department of Behavioral Health and Developmental Services Commissioner Alison Land has asked for $216 million in ARPA funds to alleviate problems hiring and retaining staff in the state’s mental hospitals. She’s also asked private hospital networks to participate in meeting capacity needs.
The Virginia Hospital and Healthcare Association has said that some private networks could open more beds if they received ARPA funding to staff the beds. On Monday, the VHHA issued a letter debunking suggestions that private providers aren’t doing enough.
“Private hospitals in Virginia continue to handle the vast majority of both voluntary and involuntary (including TDOs) psychiatric patient admissions in the Commonwealth,” VHHA Vice President of Communications Julian Walker said in a press release.
“It is our belief that some of the data cited by DBHDS significantly underestimates the increased behavioral health care treatment burden that private hospitals have shouldered during the pandemic because many individuals presenting for psychiatric care at an emergency department were stabilized, and appropriately discharged, or referred to a less restrictive alternative care setting,” VHHA President Sean Connaughton said in the letter.
Connaughton said Virginia’s request for assistance from private hospitals was for help handling medically complex, aggressive, intellectually disabled, or dementia patients.
“An acute care setting is not the appropriate venue for providing optimal and safe care to meet the needs of these patients,” Connaughton said.
Still, he renewed the offer of emergency short-term psychiatric bed capacity, requesting about $33 million to provide necessary changes including renovation and staffing.
Next week, the General Assembly will meet to allocate Virginia’s $4.3 billion in ARPA funds. Land has said long-term budget increases also need to be considered.
DeBoard and the other speakers at the Tuesday press conference expressed similar long-term needs. DeBoard said in the 2022 General Assembly session legislators will need to work to get resources down to local community partners to get help to people before they have a crisis.
“There is money that should be put quickly and directly toward making beds available and space available to get people into treatment that need it now, and the next step of that would be in January to work closely with our partners up here,” she said.
DeBoard said, “We urge our General Assembly to work with us closely, and this has to be an ongoing process moving forward.”
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