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Opinion/Editorial: Shortage in staffing hurts state mental health care

Opinion/Editorial: Shortage in staffing hurts state mental health care

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Three years ago, we warned in this space about the consequences of overcrowding at Virginia’s psychiatric hospitals.

Since then, not only has the problem not been resolved, it has grown worse under the stresses of COVID.

Burdened by increased workloads, coupled with low pay, staff are leaving — only intensifying the load on remaining employees.

The Department of Behavioral Health and Developmental Services operates its facilities on the assumption that they will be 90% occupied, reports the Virginia Mercury. But during fiscal 2021, the statewide census at one point reached 112% of capacity.

In 2018, officials were concerned when occupancy surged to 97% of capacity. That was enough to flag the need for added bed space and the added staff to match.

The problem actually traces to 2014. That’s when the General Assembly passed a much needed package of mental health reforms that included requiring state hospitals to admit patients if no other bed could be found for them.

That part of the legislation stemmed from the experience of state Sen. Creigh Deeds, whose son, experiencing a mental health crisis, had been taken to a mental health agency for evaluation. But because no bed could be found for him within a state-mandated deadline, he was released from temporary detention. Within hours, he had attacked Deeds and then killed himself.

The law attempted to ensure that no one in future who needed hospitalization would be turned away.

The Mercury reports that since 2017, there’s been an overall statewide decline in temporary detention orders, which mandate mental health evaluations and emergency hospitalization. But state hospitals’ share of care has increased — likely because there are fewer private facilities to take these emergency patients.

Fast-forward to 2020. You can imagine how COVID walloped Virginians with more stressors — lost jobs, lost incomes, disrupted schools, lack of child care, shutdowns of social service programs, and imposition of social distancing and isolation protocols that deprived some people of needed human contact while compelling others to consolidate households and live more closely with others than might have been good for them.

DBHDS Commissioner Alison Land recently told lawmakers that state are hospitals are operating at roughly 65% to 70% of staffing.

But are they running at 65% to 70% occupancy? Of course not. Even as staffing declines, beds are filling up. Most facilities are at or beyond capacity, she said.

Caring for those who are mentally ill is one of the most important jobs in our society. It also is one of the most difficult. Assaults from agitated patients and injuries to staff are not uncommon, Land said.

Wages for direct-care workers start at a mere $11 per hour. Walmart and Target, Sheetz and Wawa pay better than that, she said.

If living wage advocates want a new focus for their activism, here would be a good place to start.

But not only are direct-care staff giving up and leaving for other jobs; so are higher placed staff such as psychiatrists and other physicians. The vacancy rate for that category of employment is an astounding 52%.

Mental health care is foundational to so many other areas of life — the ability to hold a job and engage in healthy relationships, among them. It minimizes suffering, often excruciating suffering. And it helps protect individuals and society at large, since suffering people who lose their grip on normal living often loose their demons on others through violence.

It’s also a complex issue, difficult to regulate. We don’t know how to solve all those complexities, but we do know this: First-line employees who serve in the crucial roles of caring for these patients deserve more than $11 an hour.

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