During a similar episode in 2010, we brought her to Children’s National Medical Center in the District and were told there were no beds. We chose to bring her home rather than transport her by ambulance to another hospital, which we thought would be too traumatic for a young child.
For us, the decision to return home then was the right one. For the Deeds family, it ended in tragedy. And it makes me worry about what’s ahead.
Under Virginia’s Comprehensive Services Act, my family qualifies through Fairfax County for services including home-based therapy, parent training and respite care — weekends when my daughter stays in a therapeutic foster care home to give us time to rest and recuperate from caring for her every day. These services help keep my daughter stable, most of the time.
When she isn’t stable, we have an emergency plan that includes calling the Fairfax Mobile Crisis Unit (which is rarely available, since there is only one), our therapists and, as a last resort, the police. And when needed, we can take her to a hospital and sign her in.
Our ability to direct her care will change three years from now. Once she turns 14, we will be at the mercy of Virginia’s temporary detention order system. Like Austin Deeds’s caregivers, we will have to seek an emergency order from a magistrate when we think hospitalization is in her best interest.
If there are no beds — what then? Will we be able to take care of her on our own?
I run a support group for parents of children with mental illness in Northern Virginia. Many of the parents with older children feel helpless because the law doesn’t allow them to make decisions about their treatment. Some of the parents have children in their 20s living at home who aren’t stable enough to work. Yet those parents aren’t in a position to force their children to seek help, and sometimes their grown children end up relying on alcohol and drugs to self-medicate.
This has gone on long enough. Families are hurting. Young people are suffering. People are dying. We need to fix Virginia’s mental health system. We need to make it easier for Virginians with mental illness to get the care they need and easier for their families to navigate the system.
We need to increase the availability of stabilization services for mentally ill children and adults. In fiscal year 2013, the General Assembly funded three pilot programs to increase children’s access to crisis intervention and psychiatrists. They helped reduce admissions to the state children’s psychiatric hospital by more than 10 percent and cut overall use of the state hospital by 21 percent compared with 2012. Two additional pilot programs will be added soon. But most areas of Virginia do not have access to these critical services. Those that do are understaffed.
Meanwhile, we need to bridge the gap between children’s and adult services to help vulnerable youth transitioning from home to college or independent living. We should add clinical staffers to each of the state’s 40 community services boards to work intensely with at-risk youth, as recommended by Gov. Robert F. McDonnell’s school safety task force.
Finally, Virginia should expand its jail diversion programs — crisis-intervention teams and 24-hour drop-off assessment centers — to keep mentally ill young people out of the corrections system. The state’s reduction of hospital beds, which are down about 25 percent from 2000, and its inadequate network of community services put more mentally ill people in Virginia’s jails. More than 6,000 prisoners in the state — 24 percent of the incarcerated population — have a mental illness. Nearly half of those have a serious condition such as schizophrenia or bipolar disorder. Meanwhile, 65 percent of youth committed to Virginia’s justice system have a mental illness prior to admittance, and 60 percent of boys and 80 percent of girls in Virginia detention homes are in need of mental health treatment.
This tells us that Virginia has been too slow to build up its community services. A comprehensive array of services — case management, outpatient, emergency — is needed. Of course, treatment needs funding — funding that was cut in 2009 as memories of the Virginia Tech massacre faded. But we can’t just throw money at a system that isn’t working. Our legislature and Gov.-elect Terry McAuliffe should find new solutions.
The Deeds tragedy has given them an opportunity. They should use it.
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