By Chris L. Jenkins and Tim Craig
Washington Post Staff Writers
Saturday, December 15, 2007
Gov. Timothy M. Kaine (D) announced a plan yesterday to pump $42 million into Virginia's troubled mental heath system, a proposal that advocates and state officials said is the beginning of an intense discussion about how aggressively the state should adopt reform.
At a news conference in Richmond, Kaine stood alongside mental health advocates and the parents of two students injured in the Virginia Tech massacre, which prompted the reforms. He said he was seizing a "historic opportunity and responsibility" to boost funding for mental health programs, change the criteria required for someone to be involuntarily committed and impose new regulations on community-based clinics.
The system has come under intense scrutiny since 32 people were killed at Virginia Tech by a gunman with a history of psychiatric problems. Kaine's proposal follows closely the recommendations of the independent panel that investigated the April 16 shootings by Seung Hui Cho.
"We cannot ignore the mental health needs of students, neighbors, seniors, those in the streets or those in jail, anywhere in Virginia," he said.
The reforms are part of the two-year proposed budget Kaine presents Monday to the legislature's budget-writing committees. "The fixes are not going to be easy or cheap, but they are fixes that need to be made," he said.
Kaine stopped short of proposing broader, more aggressive reforms that some lawmakers have suggested they would like to see when the General Assembly convenes next month. For instance, several legislators said in interviews that they would like to see bills broadening the ability of the state to coerce people into outpatient treatment. Such proposals are expected to ignite debate on how far and how fast the state should change its system.
The governor's plan, which must be approved by the legislature, calls for additional money over the next two years to fund more caseworkers, psychiatrists and other staff to help monitor the mentally ill in their communities.
In addition, Kaine proposed spending $10.3 million over two years to hire 80 additional clinicians to focus on youth or adult counseling at outpatient facilities. A recent report by the state auditing agency said Virginia is in dire need of more services for children.
"When someone steps forward and says, 'Hey I need help,' you have to be able to take advantage of that window," Kaine said.
A major part of the package directs about $14.6 million to emergency mental health services. The money would provide greater access to psychiatrists who specialize in treating mental patients in crisis, increase staffing at intervention centers and create more local crisis stabilization units, which are designed to stabilize those having a mental health crisis in a small clinic instead of admitting them to a hospital.
"It's years overdue, but we're off to a very good start," said Mira Signer, executive director of the National Alliance on Mental Illness for Virginia.
Virginia will spend $154.8 million this year for community-based services, which served more than 118,000 people in 2006.
One of the more controversial changes that Kaine announced yesterday was in the criteria for emergency custody and temporary detention. Judges and magistrates currently cannot order people into a treatment facility unless they are "an imminent danger to [themselves] or others as a result of mental illness" or so seriously mentally ill as to be "substantially unable to care for [themselves]."
Virginia is one of only five states to have such a high bar for commitment, and supporters say the proposed change would improve treatment for many mentally ill people.
Kaine's proposal would change that standard to a "substantial likelihood that in the near future" a mentally ill person will cause "serious physical harm to himself or another person."
But some mental health advocates were skeptical of the proposed change.
"They're going down this path without any proof that anyone can concretely predict whether someone will become dangerous or violent," said Diane Engster, president of the Northern Virginia Mental Health Consumers Association, an advocacy group that opposes changing the commitment standard. "Changing the standard won't help that."
Still, politicians from both parties predicted that many of Kaine's proposals would sail through the General Assembly.
Lori Haas, mother of injured Virginia Tech student Emily Hass, said she had mixed feelings about the governor's plan.
"There is certainly more to be done, but this is certainly a big and grand first step," she said.