Following the Virginia Tech tragedy, Virginia drew upon work done by the Virginia Tech Review Panel and the Commission on Mental Health Law Reform. These efforts investigated or studied the tragedy to make recommendations to strengthen the civil commitment process so that individuals with serious mental illness might receive help when they need it.
The 2008 budget included an infusion of funds to build core community services such as emergency services, case management and outpatient treatment. Unfortunately, many of these gains were lost as a result of the economic downturn.
Other efforts have since made helpful recommendations, and the General Assembly has added funds to bolster Virginia’s underfunded mental health system. In truth, it is not possible to produce the array of community services needed while Virginia lags so far below the rest of the nation for spending on community behavioral health services.
Governors and the General Assembly have added funding to the system, but there has been a lack of consistent funding and legislative action to produce a consistent, accessible array of services for people to have their needs met before crises arise. As a result, Virginia’s behavioral health system remains a system of pieces that is not sustainable and that cannot consistently and adequately serve individuals with behavioral health disorders and their families.
The Department of Behavioral Health and Developmental Services is now working closely with the administration, the General Assembly (in particular the Joint Subcommittee to Study Mental Health Services in the 21st Century) and system stakeholders to reform this system that has been patched together by responses to crises into one that truly moves Virginia forward in a cohesive, strategic manner.
As a result, DBHDS built System Transformation Excellence and Performance (STEP-VA), an innovative initiative to address the unique needs and preferences of Virginia. Over time, STEP-VA incorporates services that are strongly recommended by Virginia stakeholders and federal best practices.
STEP-VA features a uniform set of services with consistent availability across Virginia, high quality measures, and improved oversight in all Virginia communities. Last session, the General Assembly funded a portion of the first step of STEP-VA by providing funds for an initial group of CSBs to implement Same Day Access, a program that allows a person who calls or appears at a community services board to be assessed that same day instead of potentially waiting weeks for an appointment.
DBHDS has also applied for a $9.7 million federal grant that focused on reducing the deaths of individuals from opioid overdoses and which also provides funds for Medicated Assisted Treatment, a STEP-VA service to help combat Virginia’s opioid epidemic.
Once all of Virginia’s CSBs implement Same Day Access, the next phase of STEP-VA over the next few years will be to improve health outcomes by providing linkages with primary care, strengthening outpatient services and improving key mental health services for children. Other steps will follow, but Virginia is now on the precipice of making deeply needed changes to its system to finally focus intently on timely access to quality, consistent behavioral health services, and on ensuring consistency and accountability across the system. Virginia possesses the foundation, the will and the expertise to move forward now.
Jack Barber is interim director the Department of Behavioral Health and Developmental Services.