Va. Reviews Mental Health Reforms

Agencies Look at System Overhaul After Va. Tech Shootings

Slow-moving efforts to improve Virginia's mental health system, including changing the way mentally ill people are monitored and when they can be committed, have accelerated in the two months since Seung Hui Cho killed 32 people at Virginia Tech and could be in place as soon as next year.

Three separate bodies spanning all branches of state government are considering some of the most sweeping changes to the system in more than a generation.

Tomorrow, the Republican-led House of Delegates will hold the first of several hearings to address shortcomings in the system the shootings exposed. In addition, the Virginia Supreme Court launched a commission in the fall to recommend broad changes, and Gov. Timothy M. Kaine (D) appointed a task force after the April shootings to investigate all aspects of the massacre.

"Clearly, the tragedy makes the problems we were looking at concrete," said Richard Bonnie, director of the University of Virginia Institute on Law, Psychiatry and Public Policy and chairman of the Supreme Court's Commission on Mental Health Law Reform. The timetable for presenting recommendations from the commission has been moved up by at least several months because of the tragedy, Bonnie said.

"We just can't sit around and say we're going to study it," said Del. David B. Albo (R-Fairfax), chairman of the House Courts of Justice Committee, which will probably consider legislative proposals during next year's General Assembly session. "I think we also want to take a hard look at the laws and see what needs to be improved."

In addition to a call for more funding, the most immediate changes probably will address laws that oversee how those with mental illnesses are monitored after they receive community-based services. Such people often do not need to be in a hospital but need to stick to treatment, which could include medication, therapy or both. Many mental health experts and lawmakers have said the state's oversight of people in this category is lax and the law is not specific enough to address those who do not comply with court orders.

Early discussion has centered on designing step-by-step guidelines for special justices, lawyers and mental health officials to follow plans they develop for people receiving community-based treatment. The proposals also suggest more specific guidance on when and how those who do not comply with court orders may be picked up by authorities and whether they should be reevaluated and committed to psychiatric facilities.

Cho's case underscores some of those flaws, officials have said. He was referred to the New River Valley Community Services Board in 2005 after Virginia Tech police said he had harassed two female students. The board, the government mental health agency that serves Blacksburg, found that Cho was "mentally ill and in need of hospitalization," according to court papers.

On Dec. 14, 2005, Paul M. Barnett, a special judge hearing the case, decided that Cho was an imminent danger to himself as a result of mental illness and ordered him into involuntary outpatient treatment. But three law enforcement sources familiar with Cho's medical records have said that Cho never received treatment. There was no follow-up from the community services board or the courts.

State law says community services boards are responsible for setting up treatment plans for mentally ill people receiving outpatient care. Even so, some say that's not enough.

"Procedures are just so misunderstood by community services boards in terms of what you're supposed to do when someone is not compliant," said Mary Zdanowicz, executive director of the Treatment Advocacy Center in Arlington. "It's important that there is a specific process . . . and I think we're making some good progress."

Some of the suggested changes will be discussed when the Supreme Court Commission meets in Fredericksburg this week.

But some lawmakers and advocates for the mentally ill expressed reservations about rushing to make changes based on a single high-profile incident. They said new laws aren't necessary -- just better enforcement of current ones and better training of mental health officials. They also said changes to the law could infringe on the civil rights of the mentally ill.

Some also said that changes in service options, such as providing more supervised housing opportunities, outreach and direct intervention on streets, would be as effective as overhauling laws.