Virginia’s mental health system has been stressed and struggling for years — facing a series of problems often discussed here in this space.
Now, add COVID to the mix.
“The house is on fire,” said Sen. Creigh Deeds, D-Bath, a long-time leader in efforts to improve Virginia’s behavioral health system. Sen. Deeds represents Charlottesville, Nelson County and part of Albemarle.
The newest problem gaining attention is the plight of elderly patients who are also mentally ill.
Older people in general are at higher risk of contracting COVID-19, especially if they have an underlying condition that weakens their physical health. (For clarity: Mental illness is not one of these cited conditions — which include obesity, serious heart problems, cancer, Type 2 diabetes, etc.)
Consequences have been seen in the many outbreaks of coronavirus at nursing homes and other senior facilities — where the factors of age, underlying health conditions and the risks of communal living combine, sometimes to deadly effect.
Now, consider the situation at facilities where the combining factors include age, underlying health conditions, communal living and mental illness.
Also consider that the pandemic itself is causing a breakdown in mental health, across age groups. Stress, isolation, economic instability and other emotional problems are taking a toll — while at the same time the pandemic is making it harder for people to get professional help when they need it.
When they have nowhere else to go, they may end up in a state mental hospital.
But an overburdened state system is having difficulty both keeping up with admissions and keeping patients safe.
A COVID outbreak has occurred at a geriatric state hospital in Nottoway County where five deaths occurred; the state behavioral health commissioner suspended admissions there more than two weeks ago, the Richmond Times-Dispatch reports. Last week, the commissioner halted admissions at a facility in Danville, site of another outbreak.
A third outbreak has occurred at a facility in Chesapeake.
In trying to care for the many people needing help, the Nottoway hospital had been operating over its capacity just prior to the outbreak, the newspaper reported.
Other hospitals at or over capacity, as of July 29, were: Western State Hospital in Staunton, at or slightly above 100%; Central State, at or slightly above 100%; Eastern State, 115%; Southwest Virginia Mental Health Institute, 110%; Catawba State, 105%.
Being over capacity means that a hospital’s residents are even less able to social-distance — difficult to do in such a setting at the best of times.
Now, let’s take this down to a personal level. Consider the plight of a patient who is mentally ill — who might even have been pushed into illness by the stresses of the ongoing pandemic. Emotionally disabled by the pandemic, he is sent to a hospital to recover — only to find himself at the very center of an outbreak. Consider that such a patient, already fragile, might be incapable of dealing with this additional stress.
The General Assembly has been trying, over several years and in a number of ways, to improve conditions in mental hospitals and for people being treated as outpatients. That has included additional funding to finance reforms.
But — irony of ironies — payout of that money in the current budget was suspended in April, when the state began to see just how deeply the COVID-induced recession was cutting into tax revenues.
The legislature returns to Richmond this month to look again at state budget figures, with an updated estimate of expenditures and revenues.
One of the planned initiatives is $15 million to reduce the daily census at state institutions. “That’s something I think should be a priority,” said Sen. Emmett Hanger, R-Augusta, who also works on mental health issues.
Significant support for local and regional mental health programs would be necessary if state patient loads are to be reduced.
State lawmakers will have to make hard choices about funding when next they meet. Just when the need for services grows, the ability to fund them withers. But mental health is a fundamental need that deserves their utmost consideration.