A Virginian facing a psychiatric crisis can also be faced with limited options, or no option at all.
A story in The Virginia Mercury recently reported on the case of a Gloucester County teen with a substance-abuse disorder who self-reported to a local hospital. During withdrawal, he became increasingly uncontrollable. For 90 hours, the hospital’s only option was to confine him to the emergency room, guarded by deputies.
Why? Because there were no inpatient treatment beds at any of the state’s 10 mental hospitals. This is an ongoing crisis that seems to be getting worse.
The new Central State Hospital in Petersburg will have 25 fewer psychiatric beds than the one that’s in use now. The legislature has denied a request for 56 new beds at Catawba State Hospital outside Roanoke. At Eastern State Hospital in Williamsburg, total admissions have doubled in the past four years. Only one facility, Western State in Staunton, has added to its capacity, but those beds won’t be available until hospital workers can be found and hired.
It’s not as if the issue hasn’t been well-publicized. In November of 2013, state Sen. Creigh Deeds’ son killed himself and seriously wounded Deeds during a mental health meltdown that could have been prevented if a psychiatric bed had been forthcoming in a timely manner. That tragedy led to the creation of the Deeds Commission, which was supposed to make things better. Legislation in 2014 led to the “bed of last resort” law.
Yet we still have a situation in which a teen with serious psychiatric issues has to be kept under guard in an emergency room for nearly four days because there are no beds available in a mental facility.
The problem lies with how the state feels it should deal with mental health issues. Virginia spends about 75% of its mental health funding on inpatient beds. A better way, some experts believe, is to focus on funding community services to keep patients out of mental hospitals altogether.
That’s a laudable idea, but it requires money. The state is providing funding to expand bed capacity outside the state system, but the private hospitals where those beds reside aren’t equipped to provide the same kind of long-term care as state facilities, and some private hospitals are reluctant to admit patients with major mental issues.
Giving Virginia’s 40 community service boards the kind of funding that would intercept a lot of psychiatric issues before they became critical requires money, and that commitment has not been sufficient so far.
Thus, we have a plan that calls for more intervention from community services to keep people out of mental hospitals and makes beds in those mental hospitals harder and harder to come by, but the state hasn’t funded outpatient services and other community services solutions sufficiently. So the number of people left stranded in emergency rooms and elsewhere in private hospitals grows.
Virginia needs to either bite the bullet and give more than lip service to the community services solution, or we need to have enough beds in mental hospitals so that a kid having a breakdown doesn’t spend 90 hours under guard in an ER while he waits for a bed.
Either do a better job on outpatient care or open more psychiatric beds. There is no other humane, sensible solution.
From The Free Lance-Star, Fredericksburg. Editorials published from other sources are offered in an effort to share additional opinion and information.