In the last two weeks or so, there has been a lot of laudatory legislative activity in the Virginia state legislature. An initial article cataloging the pending impressive legislation: “Commentary: Progress in Mental Health,” by Adam Ebbin of February 22, 2017, a Virginia state senator from District 30, In this article he lists and explains briefly the various bills that have been pending there to begin to move on what has been a very credible and massive effort for the last nearly 3 years in that body to begin to implement real reform in mental health services delivery at a state’s level. I would commend this article to the interested reader, as much for its reference to the tragic history of the suicide-death of Gus Deeds, a young adult with psychotic mental illness and the son of State Senator Creige Deeds of Bath, Virginia, and a clinical psychologist. But also, this article is worth reading on its own as it talks about the massive effort that went into these pending bills, and how the Virginia legislature approached this massive problem. For those of us tired of gridlock in the national Congress and in one’s own state perhaps, reading how the Virginia legislators have taken on this task and actually made immense legislative headway, is encouraging.
As some readers will recall, State Senator Creige Deeds is a practicing clinical psychologist himself. His late son Gus killed himself in 2014 after he stabbed his father while psychotic, spent four days in a hospital ER and an inpatient psychiatric bed could not be found for him. He was released from the hospital’s ER, and then shortly thereafter killed himself. His father State Senator Deeds took it upon himself to spearhead and prod his fellow state legislators to face the mental health crisis and the resulting legislation has emerged from his and many others’ efforts.
Some of the pending initiatives include:
- establishing a statewide mandatory registry of available psychiatric beds in all psychiatric inpatient facilities, public and private, that is constantly updated and available to providers anywhere in the state seeking inpatient treatment for a patient;
- a bill to establish local Community Service Boards to provide additional mental health services;
- work toward very specific measures to be followed upon the discharge of a mentally ill state prisoner from the corrections system, and referrals for service at the time of parole;
- future provision of funding for “permanent supportive housing,” for the chronically mentally ill;
- expansion of local CSB;s services to include: same day emergency access to MH evaluation services, SA (substance abuse) services, peer counseling, family services, and mental health case management (connecting a client with appropriate services);
- the inclusion in both the House and Senate budgets of more money to provide rent subsidies and other support to help get people out of state hospitals or off the street and into housing;
- prescreening projects and funding for local county and state jails by clinical personnel of mentally ill or symptomatic new inmates, and grants for pilot MH treatment projects in various jail settings;
- increasing exchange of information at all levels of need between local MH agencies and all relevant sites of the local criminal justice entities in the state;
- redefining the professional credentials of persons serving on the statewide Board of Corrections to permit inclusion of MH clinicians and patient advocates.
This is an impressive raft of proposals. It emerged from the “Deeds Commission,” a legislative committee, the Joint Subcommittee Studying Mental Health Services, who have worked tirelessly for more than two years. Their mission was to study the current menu of state MH services, consult with many persons all over the state in various capacities or levels of concern, propose solutions that were feasible and then craft a number of bills which contain the various changes referred to above. This is in my opinion, a model that all states in this country who are not so far along in their efforts of mental health reform, can study and take ideas from. It is a good example of legislative action that has been fruitful, studied and has overcome bipartisanship that has been in short supply for a number of years everywhere in this country.
But now the not so good news. As detailed yesterday in the article in The Virginian-Pilot, available on its online site, PilotOnline.com in an editorial: “Coming up short again on mental health,” only a few proposals were voted upon and passed, including a bill to set aside $5M to start pilot MH programs. But the other bills that would have put into place the elements listed above, were not acted upon before Virginia’s Governor’s House of Delegates adjourned in December. The editorials seemed to be highlighting the need to maintain momentum when the legislative House of Delegates reconvenes and one can only hope this is indeed the case, and I expect, for one, that it will be so. In any case, compared to many other states struggling with many similar issues, Texas, Florida, Washington, etc., that I and many more authoritative figures than this humble writer are following, Virginia is well placed to set a national, positive example in comprehensive mental health reform.
I am a older child, adult, geriatric teaching psychiatrist with over 30 years' practice experience in North Carolina, first at Duke as clnical teaching faculty, then in Western NC as a primary child psychiatry specialist. I have taught and supervised child psychiatrists and psychiatrists in training and many other mental health professionals and taught at two medical schools. I have served in many public and private practice settings. My primary interest is in observing and documenting the ongoing mental health reform efforts in the State of North Carolina and documenting its sucessess and failures at all levels. My favorite pastime among many others is spoofing my friends and kids with my deadpan sense of humor. View all posts by Frank