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Mental health demands outstrip supply

The death of a state senator’s son last week has many in Virginia talking about the state of the commonwealth’s mental health system.

Sen. Creigh Deeds’ son, Gus Deeds, stabbed his father and then killed himself. According to media reports, Gus Deeds had been seen at a Bath County hospital and held for possible involuntary psychiatric commitment, but had to be released when the hospital couldn’t find him an inpatient bed.

Northern Virginia also experiences a shortage of inpatient psychiatric beds, said George Braunstein, director of the Fairfax-Falls Church Community Services Board. The CSBs are the state-mandated agencies that provide public mental health services throughout the state.

However, Braustein said, the local CSBs have the benefit of local funding, in addition to state support, which gives them more options.

“To say it could never happen would be to misinform,” Braustein said. “There is always a chance that there is no bed available anywhere in the state.”

The Fairfax-Falls Church CSB and other Northern Virginia CSBs will go to great lengths, even transporting patients to other parts of the state, to find an available inpatient bed in an emergency.

“If they need hospitalization, we will do everything we can to find them a hospital bed,” Braunstein said.

In a worst-case scenario, he said, the CSB’s emergency mental health team would put together a community safety plan to keep the individual safe in the community until another option became available.

The CSBs have contracts with private providers like Inova Health System, Dominion Hospital and the Northern Virginia Mental Health Institute to provide beds for people who need inpatient care.

However, in the last fiscal year, July 2012 to June 2013, Northern Virginia CSBs sent 224 patients to other parts of the state because there were no available inpatient beds here. In some cases, Braunstein said, some hospitals are not willing or able to take certain types of patients, including involuntary commitments or people with serious behavior issues.

“Not all the private psychiatric beds in the Northern Virginia region are willing to take any of our referrals,” he said.

The Fairfax-Falls Church CSB also has less intensive supports available for people who are experiencing a mental health crisis but don’t present an immediate danger, such as outpatient treatment where patients spend the day at the hospital but return home at night.

The agency has a mobile crisis team and has trained about 40 percent of county police officers in crisis intervention.

“Without local funds, we wouldn’t be able to do all of these things,” Braunstein said.

Although emergency services tend to get the most attention, Braunstein said that the bulk of the CSB’s mental health services are intended to provide standard mental health care and prevent crises from occurring in the first place.

Anne Edgerton, executive director of the advocacy organization Mental Health America of Virginia, said Virginians should focus on programs and services aimed at getting people mental health care early.

“We as citizens of VA need to make mental health issues a priority,” she said. “We have not told our elected officials that this is something that is incredibly important and we want funding behind it.”

Mental Health America of Virginia supports programs like suicide prevention programs for middle school students.

“We really want to be here earlier with positive coping skills,” Edgerton said. “It needs to be really serious and not just as an aside during gym class.”

The organization also advocates for mental health first aid training for first responders and other government employees. The Fairfax-Falls Church CSB offers this training to the general public, much like the Red Cross provides CPR training.

“Our goal is to be as effective as possible at getting people into service before there is a crisis,” Braunstein said. “We don’t want our crisis system to be a primary point of access.”


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