This chaos has degraded care. When no hospital beds are available, those in psychiatric distress wait as long as three days for treatment. Patients deemed a risk to themselves or others are handcuffed and placed in police custody. This week, police officers pleaded for increased mental health funding. “We’re not therapists,” said Marion Police Chief John Clair. “We’re going to do the best we can, but we’re not going to offer you anything real.”
“Patient dumping” is partially to blame. Private hospitals increasingly exploit a well-intentioned “bed of last resort” law mandating that state hospitals treat anyone requiring involuntary psychiatric care. Private hospitals can hand off costly or labor-intensive patients, and the number they are directing to state facilities has exploded, leading to dangerous overcrowding.
State lawmakers will meet in August to begin divvying up $4 billion in covid-19 relief funds. Mr. Northam has said a “significant amount” will go to mental health, and on Wednesday he announced $485 million in new funding for mental health services, including $200 million for staffing at state behavioral health facilities and intellectual disability training centers.
Much of that will go for raising pay for mental health care workers, which is appropriate. Virginia’s pay for those workers ranks in the bottom 10th percentile among states, driving workers to seek safer, better-paying jobs.
The state needs more psychiatric facilities to lighten the crushing caseloads that forced facilities to close. Prince William County activists have urged Mr. Northam to fund a 24-hour “crisis receiving center,” which would add beds to the state psychiatric system and allow Northern Virginians to await treatment without police involvement. This good idea might work in other areas of the state, too.
Mr. Northam should lean on private hospitals that dump patients into public facilities, particularly patients with major medical problems such as cancer, whom state mental health facilities are unequipped to treat. Community health services designed to help people before their conditions become crises require long-term funding that goes beyond the one-time cash injection Mr. Northam proposed. The state should fully fund the System Transformation Excellence and Performance (STEP-VA) initiative to bulk up Virginia’s behavioral health infrastructure, as well as find places to discharge the reported 220 patients who remain in state care only because they have nowhere else to go.
Leaders across the country rarely give mental health the attention it deserves, placing extreme burdens on police officers, social workers and stressed mental health officials. Mr. Northam should seek not only to solve the current crisis but also to build a resilient system up to addressing the state’s needs.