By Sandhya Somashekhar
Washington Post Staff Writer
Tuesday, January 29, 2008

RICHMOND, Jan. 28 -- The Virginia General Assembly continued to move forward Monday to overhaul how the state cares for people with mental illness, promising to fix a system whose flaws were exposed last year after the shootings at Virginia Tech.

Committees of the Senate and House of Delegates endorsed a variety of revisions, including tightening restrictions on gun ownership by the mentally ill and lowering the standard by which a person can be committed to a mental institution against his or her will.

A bill passed by the House Courts of Justice Committee would ensure that those who have been ordered to seek treatment are monitored by mental health workers. Seung Hui Cho, the gunman who shot and killed 32 students and teachers at Virginia Tech in April before killing himself, was ordered into treatment in 2005, but the local mental health agency never followed up.

One revision would put Virginia's mental health system in line with those elsewhere, such as in New York, that give states greater authority in deciding who needs outpatient treatment, lawmakers said.

"What we did today was the most significant change in mental health law in Virginia in over 25 years," Sen. Ken Cuccinelli II (R-Fairfax) said. "Of course, the reason the political momentum is there is because of the tragedy at Virginia Tech. I just wish it didn't take someone going so far for us to get legislation like this."

But some advocates say many of the bills do not go far enough in repairing gaps in the state's system and preventing another large-scale tragedy.

"On a scale of one to 10, Virginia right now is a one when it comes to mental health," said Jonathan Stanley of the Arlington County-based Treatment Advocacy Center. "With this, they're jumping to a two or a three. As far as I'm concerned, this is a very modest change."

A major hurdle for some of the changes will be funding. Gov. Timothy M. Kaine (D) has set aside $42 million in his proposed budget to pay for mental health changes, but several lawmakers said Monday they were concerned that some efforts could require substantially more money at the same time that the state faces one of the worst budget pictures in years.

In particular, a bill advanced by the Senate Courts of Justice Committee on Monday would create a statute similar to New York's Kendra's Law, which gives social workers, doctors and relatives more power to bring mentally ill people before a judge and force them to get outpatient treatment.

"Most of us support the concept on this, but it has a huge, huge fiscal impact," said Sen. Janet D. Howell (D-Fairfax), the chief sponsor of the Senate bill that includes most of the other changes. "We just don't have the caseworkers to do that right now, and we just don't have the funding."

Among other changes, Howell's bill would lower the bar for who could be involuntarily committed.

Currently, people must be deemed an "imminent danger" to be hospitalized against their will. Under Howell's bill and a similar one advanced by a House committee last week, there must be a "substantial likelihood" that a person would cause "serious physical harm to himself" in the near future or could "suffer serious harm due to substantial deterioration."

Stanley and others advocate an even lower standard that would give relatives and doctors more options to seek help for those who refuse it. Howell, however, said that the overhaul will probably be a multiyear effort that is phased in because of its costly and complicated nature.

Many of the changes, which have bipartisan support in the House and Senate and have been endorsed by Kaine, were proposed in the wake of the Virginia Tech killings. Cho was able to buy guns and avoid treatment despite a long history of mental illness.