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Study Reveals Gaps in Access to Mental Health Crisis Care in Virginia

December 19, 2013

The data from a recent survey is giving a glimpse into Virginia's mental health crisis care.

The report is called "A Study of Face-to-Face Emergency Evaluations Conducted by Community Services Boards in April 2013."

University of Virginia professor of law and medicine Richard Bonnie served as chair of the study, which looked at data collected from emergency evaluations performed statewide.

The data is being released on the heels of a statewide discussion about mental health crisis care, following the November stabbing of Sen. Creigh Deeds and the death of his son.

While the study has no connection to the incident, Deeds' son reportedly attacked his father then took his own life after he was released following a mental health evaluation because there were no open psychiatric beds.

One focus of the study was whether there are enough psychiatric beds available across the commonwealth.

"The number of beds continues to decrease, but overall there are enough beds," said Bonnie.

Bonnie says some people have to travel out of their region to be treated, which is not ideal.

Clinicians currently have a maximum of six hours to find individuals a hospital bed before they are released. It took more than that allotted time to find individuals a bed in 3.2 percent of adult cases. For juveniles, only one case took longer than six hours.

"In addition to studying this issue about beds and availability of beds and how long it takes to do evaluations, we also asked the evaluators whether, if other services had been available, hospitalization could have been avoided," said Bonnie.

The study found 25.8 percent of involuntary and 47.9 percent of voluntary hospitalizations could have been avoided among adults. For juveniles, 35.1 percent of involuntary and 48.9 percent of voluntary hospitalizations could have been avoided had there been certain services or resources available.

"That is still one of the major opportunities to reduce the scale of this problem -- is to continue the effort to create alternatives to hospitalization, which will then take the pressure off the acute care beds," said Bonnie.

Alternatives might include residential care, access to immediate psychiatric evaluations and using tele-psychiatry in remote areas where psychiatrics may be sparse.

The study extends a previous study conducted in 2007 to give ongoing oversight of the emergency mental health services system and the judicial procedures that follow.

Bonnie says over the years, some efforts to address gaps were interrupted by the recession, but he says it is gaining momentum again.

"I think that what the governor has already announced and the governor elect I think has endorsed, is what I'm basically considering a pushing the restart button on reform in Virginia to kind of basically accelerate and intensify the efforts that are being made," he said.

The study was funded by the Virginia Department of Behavioral Health and Developmental Services in collaboration with the Virginia Association of Community Services Boards.

To view the full study, click HERE.

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