The Daily Progress
Published: January 22, 2009
Mentally ill Virginians languishing in jails because there was no room for them in health facilities was a story that shocked many of us, not long ago.
Now a budget-cutting proposal from Gov. Timothy M. Kaine risks a similar fate for young people.
Mr. Kaine proposes closing the Commonwealth’s Center for Children and Adolescents in Staunton and the adolescent unit at the Southwestern Virginia Mental Health Institute.
These are the only public facilities in the state that offer inpatient beds for adolescents. Closing both would leave no reliable option for adolescents who need residential care.
The plan is to transition patients into locally based community care. This would be provided by:
— Publicly funded outpatient programs.
— Private residential hospitals.
To successfully absorb these new patients, local public programs would need more state funding — at a time when the state is trying to cut spending.
But even in good financial times, the state has often failed to meet its promises for funding community mental health programs. We can’t help but fear that this history will repeat itself.
And some young mental patients simply should not be transferred to outpatient programs at all; their problems are too severe.
The state’s answer to that is to rely on private hospitals. The budget proposal even offers about $2 million in state reimbursement to hospitals for taking on these patients. (The state becomes involved when families cannot pay private health-care costs and must rely, at least in part, on public programs.)
But private hospitals are not required to take in state patients. It is often not so much an issue of lack of state reimbursement, say opponents of the plan, as it is an issue of liability. Private hospitals do not want to deal with the most serious cases.
These are children who have made threats of violence at school, or who have been charged with other crimes, or who display other high-risk behaviors.
The Staunton facility has cared for about 200 such young people over the last year. When these beds are lost, where will the children go?
Not all into outpatient programs — that would be too dangerous for them and the community.
Not all into private hospitals that are unprepared for them — that would be too dangerous for the staff and other patients, not to mention the hospitals’ reputations.
No, these children would go to juvenile detention centers.
Not only would they fail to receive the mental-health help they need, in fact they could learn behaviors that would make their illnesses even worse.
Not two years ago, a young man who fell through the cracks of the mental-health system murdered 32 people at Virginia Tech.
The two cases are not exactly the same, but they are parallel in this regard: Under this proposal, Virginia is creating new cracks in the system.
Will we someday be lamenting the fact that in 2009, in a rush of budget-cutting, Virginia set the stage for additional tragedy?
This is a huge step backward for Virginia — a step we ought not tolerate.
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