Mental Health Care Emergency Looms, N.Va. Officials Warn

The closure of the psychiatric unit at Potomac Hospital, above, and at three other hospitals puts more pressure on the sole state-run hospital. (Margaret Thomas -- The Washington Post)

"They told him there were no beds available,'' said McKee, who did not want her son's last name used. Mike, a college graduate, soon found himself in a homeless shelter, where he got into a fight with another resident. Then, his condition worsening, he attacked two teenagers on a bus.

"He thought they were talking about killing me,'' McKee said.

That incident landed him in Fairfax County Adult Detention Center, where he stayed in near isolation for 37 days, McKee said. McKee said she met with county authorities and begged them to send Mike to a mental hospital, but they said he was not in "imminent danger.''

Mike then stopped eating and lost 30 pounds in jail.

"He figured if he did something drastic he could get a bed,'' said McKee, who now serves on her local board of the National Association of the Mentally Ill.

He was soon sent to Western State Hospital and now is at the state-run Northern Virginia Mental Health Institute in Fairfax, where McKee said he is finally getting the help he needs.

"If they would have put him in a bed the first time, he would have balanced his meds and he would not have wound up in jail or in the hospital for so long,'' she said.

James Kelly, a psychologist and manager of emergency services at the outpatient Woodburn Center, said he could not comment on the specifics of Mike's case.

But, he said: "I can't think of a time when someone who was seriously needing hospitalization was turned away. It might take a while, but we would figure it out.''

One thing is clear: There are not enough beds at state-run hospitals for all of those in need in Northern Virginia.

Lynn DeLacy, director of the Northern Virginia Mental Health Institute, said her 127 beds are almost always full. The state has to "buy'' dozens of additional slots at private hospitals daily to take care of those most in need. Most of them are indigent or have been ordered detained by the courts.

On a recent tour of the hospital, which is discreetly behind Inova Fairfax Hospital, some patients were preparing for a plant sale. Others were reading newspapers, and still others were getting their daily exercise, walking an internal route around the sprawling, single-story hospital. But a few sat forlornly and alone, including one who had a jacket covering his head.

DeLacy said just counting beds is not the answer.

"The simple answer is more beds. But we need more community resources to get people out of the hospitals and back into the community,'' said DeLacy, who co-authored a study of the bed shortage last summer.

Her co-author, James A. Thur, executive director of the Fairfax-Falls Church Community Services Board, said the answer is more, broader services to meet the growing need. Their report recommends better reimbursement rates for inpatient hospitalization and additional funding for other, less intensive care.

"Across the commonwealth, residential care, day treatment, medications, all of these things are universally underfunded,'' Thur said. "And that increases the likelihood that someone will need inpatient care.''