Editorial: Whatever the motive, state mental health reform is essential

Editorial: Whatever the motive, state mental health reform is essential

As heartbreaking as it is that reforms to the mental health system only seem to be brought up with urgency by those in power in the aftermath of horrific tragedies, remedies for the system’s all too often overlooked problems are still needed and therefore welcome.

Regarding the Nov. 13 shooting at a University of Virginia bus that killed three football team players, or the Nov. 22 shooting at a Chesapeake Walmart in which a night manager killed six employees before committing suicide, the extent to which flaws in the mental health system will prove relevant remains unclear.

Governor Glenn Youngkin acknowledged this when he spoke to reporters Nov. 23. Nevertheless, he took the opportunity to highlight the proposals for mental health system reforms that he intends to send to the General Assembly in January.

“We have real progress to make,” he said, adding that he wanted to address the staffing shortages and lack of resources that make it incredibly difficult for someone in a mental health crisis to receive treatment in time. timely.

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To Youngkin’s credit, this question was on his mind before the Chesapeake shooting. “We have a massive behavioral health crisis,” he said during a Veterans Day speech at the Virginia War Memorial. On this date, the subject arose in the context of the prevention of suicides among veterans.

Health and Human Resources Secretary John Littel told the Richmond Times-Dispatch that Youngkin’s interest in addressing these issues was formed even before he took office.

The COVID-19 pandemic has thrown the Commonwealth’s overstretched and understaffed mental health system into deep crisis.

A well-meaning law from 2014, known as the “Beds of Last Resort Act”, stipulates that public psychiatric hospitals must find a bed for a patient subject to a remand order if, in the eight hours following the person’s placement in emergency custody, no bed can be found in a private psychiatric facility.

The idea was to put an end to the practice of “streeting”, i.e. releasing patients before they received treatment, because their temporary detention order had expired before they could be admitted to a hospital.

In practice, this has resulted in full capacity in public hospitals, exacerbated during the pandemic, as severe staffing shortages caused these hospitals to refuse to admit patients even though there were technically beds available. In the summer of 2021, the workforce crisis resulted in the temporary closure of five of eight Commonwealth psychiatric hospitals to new admissions, including Catawba Hospital in Roanoke County.

When a patient is not admitted to one of the public facilities, the obligation often binds the police officer or sheriff’s deputy who brought the detained person to the hospital pursuant to the state warrant. , leading to tense conflicts between law enforcement and mental health workers.

The problem has not diminished. According to the Richmond Times-Dispatch, from July 1, 2021 to June 30, at least 7,242 Virginians under temporary detention orders requiring immediate hospital admission waited an average of 43 hours – five hours before two days – to be placed in a bed.

Littel told the Richmond Times-Dispatch that the governor wants to increase access to mental health care across the Commonwealth. “The reality is that we played Whac-A-Mole. There is a crisis here, we operate, then it arises elsewhere,” he said. “We need to think about helping earlier, before people are in crisis.”

Speaking of a new crisis that requires special attention, the Virginia Mercury reports that Roanoke-based Family Preservation Services is set to stop providing mental health services to K-12 schools in the Far South. -West Virginia, following a change in how Medicaid funding is approved by the state combined with the increase in student mental health issues brought on by the pandemic.

As for the timing of Youngkin’s mental health remarks after the Chesapeake shootings, critics are right to point out that a focus on mental health treatment avoids the elephant in the room, access to fire arms. They are right to point out that what Youngkin has been talking about has nothing to do with solving the horror of mass shootings, or reducing them in any practical way.

Yet regardless of this issue, the mental health reforms he spoke of must take place and must be carried out with care and speed, just as mental health treatments must be carried out if the system is to work as it should. .

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