Fairfax's Ailing Poor Waiting

By Bill Turque
Washington Post Staff Writer
Friday, March 17, 2006

If you are poor and mentally ill in Fairfax County, it can take you as long as six months to see a therapist. If you need a place in a group home, you could be waiting for years.

Those bleak assessments come from the Fairfax-Falls Church Community Services Board, an agency that operates mental health, mental retardation and substance abuse programs for the county on a $149 million budget.

Driving the prolonged waits for service are staff shortages and caseloads that are growing in volume and in the complexity of the problems patients present, according to agency officials, who delivered their annual report to the Board of Supervisors this week.

"We're in bad shape," John DeFee, director of mental health services, told supervisors.

Long waits for social services are a chronic problem for local governments. While Fairfax enjoys a reputation for efficient delivery of services, aid to those with the most acute needs, such as the homeless and the mentally disabled, has lagged. The sheer size of the county's population -- slightly more than 1 million -- and rapid growth have compounded those challenges.

As of March 1, according to agency records, 173 people were awaiting initial screening by therapists, and they might not see therapists for as long as six months. Once they have received diagnoses, patients can wait again, anywhere from two weeks to two months for placement in adult outpatient programs.

More than 660 people are seeking temporary or permanent spaces in group homes, where a wait for one of the 575 beds can run from eight to 10 months to "literally years," depending on the length of the stay, DeFee said.

"Quite frankly, it depends on whether someone moves out or passes away," he added.

The mentally ill aren't the only county residents struggling for access. Agency waiting lists show 344 adults seeking alcohol or drug treatment. The average wait is described as "variable."

Supervisors expressed dismay about the waiting periods and gave the Community Services Board 90 days to devise a plan to address the issue.

"I shudder to think that someone might have to wait six months for a diagnosis," said Supervisor Penelope A. Gross (D-Mason). Fairfax County provides about 55 percent of the agency's budget; Medicaid pays 22 percent. Advocates have long criticized the state's level of funding, which was 12 percent last year.

Dotti McKee, a Fairfax resident and advocate for the mentally ill whose 36-year-old son is severely mentally disabled, called the county's system "a nightmare." When her son was released from a state mental hospital this year, she was told it would be two years before the county could place him in a group home, she said. In the interim, she has found him rooms in private homes that she said are ill-suited to his needs. Once a month, he sees a county therapist for 30 minutes.

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