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Opinion/Editorial: New reform needed for mental health

Opinion/Editorial: New reform needed for mental health

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Virginia’s march toward mental health reform moves in fits and starts.

And although there is forward movement overall, sometimes moving forward causes the state to stumble over new problems.

That’s what’s happened with the issue of emergency custody orders for people needing psychiatric evaluation.

State Sen. Creigh Deeds lost his son due to the old rules regarding such custody orders. Gus Deeds had been taken to a regional services agency in the hopes of getting him the emergency psychiatric help that he needed.

But the family was caught in a bureaucratic trap: The agency was allowed to hold Gus for only six hours, and in that length of time no space was found at a hospital so that the young man could be committed for care. Instead, he was released; 13 hours later, he attacked his father with a knife and killed himself with a firearm.

Sen. Deeds became a tireless advocate for reforming the state’s mental health system and the laws and policies that govern it — including emergency custody orders.

Although he originally had asked that custody orders be extended to 24 hours, with patients in remaining in temporary care, the legislature approved only a two-hour extension.

Meanwhile, new reforms also ordered Virginia’s public mental hospitals to provide beds “as a last resort” if space at private hospitals could not be located. That ensures that mentally ill people are housed rather than “streeted” — released from custody even though they may be dangerous to themselves or others.

But the result has been to overload the state’s mental hospitals.

Mr. Deeds spoke recently at a meeting at Central State Hospital, where temporary-custody admissions have increased more than 1,000 percent. Similar burdens are crushing other state hospitals, where staff may work double and even triple shifts just to keep up.

As an accompanying letter to the editor points out, this is not the way to retain good staff; instead, it drives employees to look for other jobs. It’s also not the way to provide good care for patients.

Mr. Deeds said he might resume his push to lengthen temporary custody orders from the current eight hours all the way up to 24.

That would give state mental health agencies much more time to find private beds. Patients under temporary custody orders then could be transferred, instead of remaining in state care under crowded conditions.

People who are a danger to themselves or others do need to be held in custody, for their own safety and that of others. The holding period needs to be sufficiently lengthy to allow the system to work — that is, to allow time for state staff to find private hospital beds for patients — but without abusing patients’ Fourteenth Amendment rights to liberty and due process.

Twenty-four hours seems a reasonable compromise.

If anyone has a better idea, let’s hear it.

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I would like to thank The Daily Progress for front-page sharing of the Richmond Times-Dispatch story about state Sen. Creigh Deeds' efforts to lengthen the time of emergency custody orders for people needing psychiatric care (June 6). I am a physician who works at Western State Hospital. In the first three quarters of Fiscal Year 2014, we had 47 emergency admissions; in a similar period this year, we had 512 such admissions.

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