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Shootings refocus attention on mental health gaps

January 27, 2013 | Virginia News

President Barack Obama has put mental health services high on his list, and Virginia Gov. Bob McDonnell has appointed a task force to look at the state’s mental health system, along with public safety and education.

Virginia Secretary of Health and Human Services Bill Hazel said the mental health work group has met twice to consider what he calls the “low-hanging fruit” to propose for this session of the General Assembly by the end of the month. The group will also look at longer-term fixes, such as more consistent funding across the state for crisis stabilization, emergency services and housing, for future sessions.

... (A) state commission on mental health law reform that began meeting in October 2006 ... was appointed by a Virginia chief justice because of concerns that mentally ill people were landing in courtrooms and jails rather than receiving services they needed.

Ironically, one of the questions that surfaced early was how to educate the public and get people to see themselves as stakeholders in the issue, even if they didn’t have a family member with mental illness.

“In a way, the Virginia Tech shootings solved that problem,” Bonnie said of the massacre on campus in April 2007. “These are tragedies, and you hope they never happen, but sometimes it’s the only way you bring attention to the problem.”

The shootings accelerated the commission’s timetable, as legislators, propelled by a worried public, wanted to take immediate action.

Among the key changes:

- Language in the involuntary commitment criteria was changed from “imminent” to “substantial” danger to make it slightly easier to have someone committed to a mental health facility without his or her agreement. The change brought Virginia in line with most other states.

- The commitment process was streamlined and strengthened to make it more respectful to those with mental health problems, such as mandates for response times; transportation options besides police cars; and better coordination among magistrates, law officers, mental health workers and psychiatric centers.

- Procedures and monitoring were tightened for mandatory outpatient treatment, along with data monitoring of commitments. The Virginia Tech shooter had been ordered to outpatient treatment but never sought it, and nobody in the system followed up to make sure he did.

- Advance directives were developed to help people with mental illness designate treatment preferences while of sound mind for times when they have a mental episode.

- Money was allocated – $42 million in the 2008-10 state budget – to bolster emergency services, crisis-stabilization units, jail diversion programs, and training of law enforcers and other people who deal with those in mental distress. Community services boards, the most common avenue of treatment for people who can’t afford care, received much of that funding.

While model programs were instituted in some areas, a consistent reform of the system fell short, largely because of the recession and the state budget cuts that followed.



Legislative bills before the General Assembly involving mental health services:

$1 million budget amendment for crisis services, case management and in-home services for children in mental health situations.

$450,000 in funding to create mental health crisis units for children in Northern Virginia and Hampton Roads.

$750,000 to help discharge people from state hospitals who are ready to transition home. (National Alliance on Mental Illness Virginia is lobbying to increase this amount, which the organization says will help only 15 of the approximately 160 people ready to make the transition.)

HB2287 Mental health first-aid training in which school boards, in conjunction with local community services boards, will develop a program to train teachers to see the warning signs and symptoms of depression, anxiety disorders, trauma, substance abuse and psychotic disorders. To be developed by July 1, 2014.

HB1680 Increases the maximum duration a person may be detained in a temporary detention order to 72 hours, from 48.

HB2221 Prohibits selling firearms to people who are found legally incompetent or mentally incapacitated, people involuntarily admitted to a mental health facility or sent for involuntary outpatient mental health treatment, and those who had a temporary detention order and agreed to voluntarily admit themselves to a mental health facility.

HB2322 Requires community colleges to develop a mental health referral policy that designates at least one person at each college to serve as a point of contact with a community services board person, or other qualified mental health service provider, for screening and referral of students who may have urgent mental health needs.

SB920 Requires magistrates to arrange alternative transportation, if available, to people in emergency custody or under an involuntary temporary detention order if the person has a mental illness and poses no substantial danger to self or others.

Read the full story in The Virginian-Pilot...