Va. Tech Report May Signal Tough Choices on Reforms

By Chris L. Jenkins
Washington Post Staff Writer
Sunday, September 2, 2007

Buried deep in the review panel's report on the massacre at Virginia Tech is a finding that many mental health professionals already knew quite clearly: The state's system for treating the mentally ill "has major gaps in its entirety."

It is a reality that Virginia has struggled with and ignored for years, they say.

But now, the panel appointed by Gov. Timothy M. Kaine (D) to investigate Seung Hui Cho's slaying of 32 people April 16 -- after Cho slipped through those gaps -- has homed in on the issue, raising advocates' hopes for change.

The report, released Thursday, makes 13 recommendations concerning the mental health system, but it does not contain any mention of a question that has thwarted change for decades: How would the state pay for improvements that could cost tens of millions of dollars a year?

Answering that question falls on Kaine and the General Assembly, which has commissioned a panel to examine the state's long-troubled mental health system. Leading lawmakers in both parties have said that addressing the issues will be a priority during the legislative session that begins in January. It won't be easy; the state is mired in a budget shortfall that is expected to top $600 million by June.

"No state has ever made substantial change to its mental health system without real leadership and commitment from a governor who made it a priority and a legislature that followed suit," said Ron Honberg, director of policy and legal affairs for the National Alliance on Mental Illness. "Governor Kaine and Virginia legislators have a chance to do that."

The Virginia Tech panel was highly critical of the mental health system, saying that there is a severe lack of funding and that it is plagued by vague laws that don't give clear instructions to local mental health officials on how to implement rules and regulations. Clearer laws and more beds, caseworkers and managers are needed to adequately meet the demands of the nearly 120,000 people who used the community mental health system last year, the report says.

In Cho's case, the report says, there was a lack of oversight after he was deemed to be a threat to himself and ordered by a judge to receive outpatient treatment. Cho never got the treatment. Kaine and others have indicated that the lapse is not isolated and that it is a flaw that must be addressed.

Kaine said Friday that he and his advisers will study the panel's report and make recommendations to state and federal lawmakers. He will also see what solutions he can implement.

"I think this is a huge issue," he said. "I know it's not just a problem in Virginia. It's a problem elsewhere. This is an issue that has recently gotten greater attention. . . . We need to fix this issue of follow-up. We need accountability."

The panel recommends changing the standard by which people can be admitted involuntarily to a mental health facility. That would allow "a broader range of cases" to come before mental health professionals, the report says.

The panel also calls for more options for people who are experiencing an emergency but don't need hospitalization. Experts said that such a change would give local providers more tools to assess and treat patients like Cho who need monitoring.

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