Modern life, it seems, may bring to us at times, more than our share of tragedies. A person who has suffered and endured what I consider the most painful such loss in recent memory, is Dr. Craige Deeds Ph.D., a clinical psychologist in Virginia. He is also a Virginia state legislator who has dedicated himself more than ever, to the cause of reforming and improving mental health care delivery in Virginia. He lost his son in 2013 when his then schizophrenic son, committed suicide after trying to stab his father Dr. Deeds. Dr. Deeds had endeavored to hospitalize his son after that incident but somehow in the whole state, there were no beds for his sons, a circumstance I cast a very skeptical eye upon, with my own suspicions as to why none could be found at all. His son was treated for four days with medications in an ER and then had to be released when he had calmed and was no longer deemed dangerous. Four days later, he suicided.
Dr. Deeds faced this tragedy and turned his tragedy and sorrow into something positive which is about the only thing one can do. He redoubled his previous efforts in mental health legislation and singlehandedly almost has nudged the state of Virginia into enacting and putting into place several well thought out reforms, changes and additions to the state’s public mental health system. The first reform was a long needed statewide registry database of open psychiatric beds. This enabled mental health professionals and law enforcement officials and courts to place quickly acutely ill persons needing urgent inpatient psychiatric care, into hospital beds. One radical aspect of this law and change was that private psychiatric beds were mandated to be included. This prevented private psychiatric units from refusing involuntarily committed patients or unruly persons from being rejected out of hand for admission.
Dr. (State Senator for his second title) Deeds has labored mightily to take one broad, large, unwieldy state-wide system issue in Virginia’s broken system of public mental health services delivery after another. It can be easily said that he has done what no one else has done, and accomplished as a result of these efforts, more than any other single person in this country. I regard him personally with utmost respect as our present modern day personification of the great reformer, Dorothea Dix. One of the things that Dr. Deeds has done, has been to cross the political aisles in his state. He has brought the two feuding political parties together in a common effort and fashioned a new alliance that has passed a set of legislative advances for over 3 years since his efforts began to take off in 2014.
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.
In a recent editorial, the Virginia News & Advance newspaper published on May 29, 2016, entitled “Trying to Remake State’s Mental Health System,” Virginia’s commendable mental health reform efforts were enumerated in a concise fashion. Virginia’s efforts are somewhat unique in the country’s landscape concerning this issue which now dominating many American state legislatures.
Virginia’s efforts, similar to a few others states’ efforts, have been singularly prompted by a highly publicized tragedy, that of the death of a young adult, Gus Deeds. What is very different is that his father is a mental health professional, and a Virginia state legislator.
This young man while psychotic tried to stab the father, Craige Deeds. He was held in a local hospital emergency room for several days while awaiting a referral and placement in either a private or public state psychiatric hospital. There was no bed to be had and he was released a few days later. Shortly thereafter, he suicided. His father, state senator Deeds Ph.D. has made this a personal and public service legislative cause and mission to author and see enacted to address the deficits in Virginia’s mental health system to prevent another tragedy.
State Senator Deeds’ efforts have been very well placed and appropriate. However, even he has had difficulty in seeing this well crafted and reasonable legislation passed as the above-cited editorial, unfortunately points out. This is emblematic of many state’s efforts. The limiting factors are budgetary and many state legislatures, governors, and legislators are finding it very hard to find and devote the long needed monies to mental health reform. Some states have made creditable progress such as my home and practice state of North Carolina. But it remains quite hard to address the funding issues in many states that have permitted the development of state mental health system crises that we see presently almost everywhere. One can only hope that these difficulties can be overcome as efforts continue.