When Joan Houk comes home from work, she braces herself for how she might find her 16-year-old mentally ill son, who must stay home alone.
"He may be sitting there doing nothing, not even watching television. Or if he has had a bad day, there are new holes in the walls," or he may be scared and huddled in a corner, Houk told state mental health officials at a hearing yesterday in Fairfax County.
"We have been told our son is too ill to be at home but not ill enough to be in a state hospital," said Houk, a Loudoun County mother of six who was speaking on behalf of the Alliance for the Mentally Ill.
He should be in a group home with a professional trained in dealing with the mentally disabled, she said, but these are rare.
Nor is there a day program he can attend, nor respite care available so the family can get a rest from the strain of caring for him.
Houk was one of more than 100 witnesses who signed up to testify at the hearing, one of 11 being held yesterday and today around the state on a proposed comprehensive six-year plan for providing services to the mentally disabled and substance abusers.
Most of the witnesses, primarily local officials and mental health advocates, spoke of a large unmet need for services in Northern Virginia and throughout the state and urged state officials to increase funding substantially for programs.
Mentally ill persons seeking admission to state psychiatric facilities are put on long waiting lists, and 43 percent of mentally ill persons who have been discharged are not housed appropriately, according to the Coalition for the Mentally Disabled Citizens of Virginia.
According to the six-year plan by the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services, 3,619 Virginians are on waiting lists for local residential programs for the mentally disabled and substance abusers.
Another 3,677 are on waiting lists for day programs, and 7,081 are waiting for outpatient and case management services.
Currently, there are 6,800 inpatient beds at state facilities for the mentally ill, mentally retarded and substance abusers, of which only 13 are for substance abuse, according to the plan.
There are a total of 7,060 slots statewide in day programs.
Residential programs in all three categories have a total of 2,167 beds.
Of these, 673 are for the mentally ill, including 159 beds statewide in group homes.
The department's proposal calls for a $106.9 million increase in funding in the next fiscal year, about 25 percent above the $414.4 million budgeted for the current fiscal year, department officials said.
The bulk of the increase, $70 million, would go into community services programs to fund more residential programs and slots at day centers.
An additional $3.56 million would be used for specialized programs, most of them for adolescents, including those diagnosed as being both mentally retarded and mentally ill and for those with aggressive behavior.
The department will submit a final plan to Gov. Gerald L. Baliles in conjunction with its budget request later this year.
Local officials said that even with the proposed increases, the current demand for services would not be met in Northern Virginia.
Fairfax County, for example, has about 950 people on its waiting list to receive residential and support services through the Community Services Board, and the county would have to more than double the number of beds to meet that need, said Fairfax County Supervisor Nancy K. Falck (R-Dranesville).