Psych services struggle to keep up in growing Loudoun County
“Of course the challenge for us is how do we meet all those needs,” said Wilson. “The key is getting them what they need at the time they're available and making sure they get the right kind of service.”
Loudoun's mental health service providers wage a constant battle to provide psychological care to an ever-increasing population.
“As [the county] grows the issues are going to grow with it. It's about positioning ourselves now to get out in front and stay in front of it,” said Angelo Wider, chairperson of the Community Service Board that oversees the county's mental health programs and services and informs priorities and decisions.
Not only does the population keep expanding, but the community is increasingly aware of the need for these services, creating a greater demand that providers have a hard time supplying.
Statewide, calls to mental health services and organizations that connect people and these services have increased. According to Wilson, the county's Department of Mental Health receives roughly 320 calls per month to the department's access line, which is separate from emergency services.
Eighty-five percent of callers are seeking community-based outpatient services. The other 15 percent are looking for more intensive services, according to Wilson.
A number of people end up on a waiting list while the department tries to match them with providers suited to their needs. The wait can be long, depending on what services are needed and how many are being served.
“We've got to be there [forming those public-private partnerships] because … there's no one way that county government can meet those needs alone,” said Scott Dieter, chief operating officer with the nonprofit Grafton Integrated Health Network's Leesburg branch. “How do we create the resource network to support a growing need. That is the primary focus of a lot of really engaged folks.”
Between 2009 and 2012, Virginia cut $37.7 million from its mental health care budget, according to the National Alliance on Mental Health.
In Loudoun County, funding for mental health services increased by more than $184,000 since fiscal 2009. In fiscal 2009 it was at $20.9 million. In the years following fiscal 2009, funding was reduced every year until fiscal 2012, with the lowest reduction coming in fiscal 2011 to $18.1 million.
Four cents of every taxpayer dollar goes toward health and welfare; however it's not yet know how well fiscal 2015 will provide for that category.
For Wider, you can't put a ceiling on how much is enough for mental health funding. But there's only so much money to go around, and when it comes to priorities, it's often who makes the most noise that gets the funds.
But funds are only part of the equation. Part of the county's job is to provide incentives for mental health providers to come to the county, something Wider thinks could be done better.
“I think [the county's] heart is in the right place, but they could do more [to bring people in], and I think they look to us [the Community Service Board] … to provide insight and information so they can make informed decisions,” said Wider.
The Department of Mental Health, Substance Abuse and Developmental Services was set up to bridge the gap between the community and the service providers in the area, alleviating the wait period as best they can.
The longer someone with a mental illness goes without help, the greater the chances that someone could harm themselves or others.
“It's a problem that effects a small portion of the community but the impact [on the wider community] can be vast if something goes wrong,” Wider said.
Things going wrong looks like suicides, attempted suicides and incidents where those with mental illness clash with the law.
Twenty percent of those held in Loudoun's Adult Detention Center are diagnosed with mental illness.
“... The true number of inmates suffering from mental illnesses is likely even greater,” said Sheriff Mike Chapman in a Loudoun County Sheriff's Office release from Jan. 16.
The Crisis Intervention Team is a task force made up of the sheriff's office, corrections division, Loudoun County Mental Health and other county, state-wide and national groups working to improve interactions between law enforcement and people suffering with mental illness and their families.
Beth Flaherty, Loudoun Mental Health's emergency mental health supervisor, acts as the liaison between the county and the sheriff's office in the training and awareness practices of 100 percent of deputies and first responders.
The county's Crisis Intervention Program began in 2012, spurred on by encouragement for counties in the state to develop the program and an perceived need in Loudoun for greater training when it comes to mental illness.
The training helps protect law enforcement and individuals going through a psychological crisis in the event of an incident.
While the training is thorough, mistakes still happen, as with the May 2014 police shooting of Christian Sierra, 17, of Purcellville. According to witnesses at the time, Sierra tried to stab himself while experiencing a depressive episode. A Purcellville officer who responded to the area demanded Sierra drop the knife he was holding. Sierra advanced, and the officer shot.
But for every rare instance of tragedy in interactions between law enforcement and people with a mental crisis, there are stories of success, in which Crisis Intervention training pays off and situations are diffused.
“People don't hear about the wonderful things that happen everyday [with these incidents], and I can tell you it's because of excellent mature policing,” Flaherty said
But the old adage holds true: prevention is the best cure.
Law enforcement training can help deputies spot people who could benefit from an evaluation before an incident occurs. And the more services are available, the greater chance people with mental illness will get the help they need before a crisis emerges.
“If someone goes off and hurts themselves or others, we've already lost the battle,” said Wider. “So it's all about protecting.”