$40 Million Plan Parallels Ideas From Panel After Massacre

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Kaine Seeks to Bolster Mental Health Funding

Proposal Stops Short Of Broad Reforms

By L. and Tim Craig, Washington Post Staff Writers

Saturday, December 15, 2007; B04

Gov. M. Kaine (D) announced a plan yesterday to pump $42

million into Virginia's troubled mental heath system, a proposal that

advocates and state officials said is the beginning of an intense

discussion about how aggressively the state should adopt reform.

At a news conference in Richmond, Kaine stood alongside mental health

advocates and the parents of two students injured in the Virginia Tech

massacre, which prompted the reforms. He said he was seizing a

" historic opportunity and responsibility " to boost funding for mental

health programs, change the criteria required for someone to be

involuntarily committed and impose new regulations on community-based

clinics.

The system has come under intense scrutiny since 32 people were killed

at Virginia Tech by a gunman with a history of psychiatric problems.

Kaine's proposal follows closely the recommendations of the

independent panel that investigated the April 16 shootings by Seung

Hui Cho.

" We cannot ignore the mental health needs of students, neighbors,

seniors, those in the streets or those in jail, anywhere in Virginia, "

he said.

The reforms are part of the two-year proposed budget Kaine presents

Monday to the legislature's budget-writing committees. " The fixes are

not going to be easy or cheap, but they are fixes that need to be

made, " he said.

Kaine stopped short of proposing broader, more aggressive reforms that

some lawmakers have suggested they would like to see when the General

Assembly convenes next month. For instance, several legislators said

in interviews that they would like to see bills broadening the ability

of the state to coerce people into outpatient treatment. Such

proposals are expected to ignite debate on how far and how fast the

state should change its system.

The governor's plan, which must be approved by the legislature, calls

for additional money over the next two years to fund more caseworkers,

psychiatrists and other staff to help monitor the mentally ill in

their communities.

In addition, Kaine proposed spending $10.3 million over two years to

hire 80 additional clinicians to focus on youth or adult counseling at

outpatient facilities. A recent report by the state auditing agency

said Virginia is in dire need of more services for children.

" When someone steps forward and says, 'Hey I need help,' you have to

be able to take advantage of that window, " Kaine said.

A major part of the package directs about $14.6 million to emergency

mental health services. The money would provide greater access to

psychiatrists who specialize in treating mental patients in crisis,

increase staffing at intervention centers and create more local crisis

stabilization units, which are designed to stabilize those having a

mental health crisis in a small clinic instead of admitting them to a

hospital.

" It's years overdue, but we're off to a very good start, " said Mira

Signer, executive director of the National Alliance on Mental Illness

for Virginia.

Virginia will spend $154.8 million this year for community-based

services, which served more than 118,000 people in 2006.

One of the more controversial changes that Kaine announced yesterday

was in the criteria for emergency custody and temporary detention.

Judges and magistrates currently cannot order people into a treatment

facility unless they are " an imminent danger to [themselves] or others

as a result of mental illness " or so seriously mentally ill as to be

" substantially unable to care for [themselves]. "

Virginia is one of only five states to have such a high bar for

commitment, and supporters say the proposed change would improve

treatment for many mentally ill people.

Kaine's proposal would change that standard to a " substantial

likelihood that in the near future " a mentally ill person will cause

" serious physical harm to himself or another person. "

But some mental health advocates were skeptical of the proposed change.

" They're going down this path without any proof that anyone can

concretely predict whether someone will become dangerous or violent, "

said Diane Engster, president of the Northern Virginia Mental Health

Consumers Association, an advocacy group that opposes changing the

commitment standard. " Changing the standard won't help that. "

Still, politicians from both parties predicted that many of Kaine's

proposals would sail through the General Assembly.

Lori Haas, mother of injured Virginia Tech student Hass, said

she had mixed feelings about the governor's plan.

" There is certainly more to be done, but this is certainly a big and

grand first step, " she said.

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