Mental health changes aftermath of Va Tech shootings

[Guest guest]

Mental health changes unveiled in Tech shootings aftermath

The governor's proposal addresses many of the issues revealed by the

Virginia Tech shootings. By Sluss, Roanoke Times

RICHMOND -- Nearly eight months after the Virginia Tech shootings

exposed weaknesses in the state's overburdened mental health system,

Gov. Tim Kaine proposed a package of spending increases and policy

changes Friday to help fix the problems.

Kaine called for new spending to address needs for emergency and

outpatient care and policy changes that will improve the state's

ability to treat and monitor individuals who are at risk of harming

themselves or others.

The governor's proposals set the stage for legislative action on one

of the major issues lawmakers will face in the 2008 General Assembly

session. The April shooting deaths of 32 people by a mentally ill Tech

student heightened awareness of problems in Virginia's mental health

system, and lawmakers from both parties joined Kaine on Friday in

promising to push for changes.

" We have to acknowledge, and Virginia Tech showed us in such a

startling and stark way, that the system we have has demands that are

much more significant than our current capacity to deliver services, "

Kaine said in a news conference attended by mental health advocates,

legislators and a Tech shooting survivor.

" This year we really do have an historic opportunity, and really more

of a responsibility, to address those significant gaps in services

that we provide to Virginians, " Kaine said.

Tech junior Haas, who was wounded in Norris Hall, stood behind

Kaine along with her mother Lori, and Goddard, the father of

shooting survivor Colin Goddard.

The governor based many of his proposals on recommendations made by a

state panel that investigated the Tech shootings. Seung-Hui Cho, whose

shooting rampage ended when he killed himself, had a history of

behavioral problems that began long before he enrolled as a student at

the Blacksburg campus. But the panel identified problems with how Cho

was handled following a December 2005 incident that led to his

temporary detention in a behavioral health facility.

Cho never received court-ordered outpatient treatment following a

commitment hearing. Kaine's appointed panel found fault with the

commitment process, the oversight provided by the local mental health

board and a statewide system that lacked adequate outpatient and

emergency services.

Kaine's proposals would extend the amount of time a patient can remain

in emergency custody, require representatives of community services

boards to attend commitment hearings, and clarify the roles and

responsibilities of authorities involved in the commitment process.

Kaine also called for changing the criteria for involuntary

commitments, making it easier to detain individuals who present a

danger to themselves. At least 18 states have taken similar steps

since 1999.

Kaine's proposal would change the current standard from " imminent

danger " to " substantial likelihood " of causing harm to themselves or

others. Attorney General Bob McDonnell joined Kaine in supporting the

revised standard.

The governor also called for $42 million in new spending over the next

two years for specific improvements such as hiring new case managers,

therapists and clinicians, and improving monitoring and accountability

of community services boards. The new spending represents a 13.6

percent increase in community mental health funding from the state and

will be part of the budget proposal Kaine formally submits to

lawmakers Monday. Kaine said he also will ask lawmakers to authorize

bonds to finance " significant capital work " at state mental health

facilities.

Policy changes, such as requiring a board representative to

participate in commitment hearings, will require coordination, said

Ann Bergeron, the executive director of the Virginia Association

of Community Services Boards. But Bergeron complimented Kaine and

lawmakers for acknowledging that the new funding is a first step in a

long effort to improve community mental health services.

" It was very clear ... that this was a downpayment, " Bergeron said.

Cochran of Blacksburg, chairwoman of the state mental health

board, praised Kaine's proposals but said: " There's a lot of work to

be done to make it all happen. "

In addition to problems identified in the statewide system, Cochran

said, New River Valley services remain strained because of needs

stemming from the Tech shootings.

" We've seen an increase in the number of calls for crisis care

directly resulting from the trauma that the community endured, "

Cochran said.

Lawmakers from both parties, including House Majority Leader

Griffith, R-Salem, attended Kaine's news conference to demonstrate

support for mental health reforms.

" This is one of those positive times where there looks like there is

consensus on an issue that needs to be addressed, " said Del. Phil

Hamilton, R-Newport News, the chairman of the House Health, Welfare

and Institutions Committee.

Sen. Janet Howell, D-Fairfax County, said all three branches of state

government have concluded that " our mental health system is broken. "

Fixing the problems will take time, Howell cautioned. But in the

aftermath of the Tech shootings, she said, " it's a moral imperative

that we act. "

Prescriptions for change

Gov. Tim Kaine proposed a series of policy changes and spending

increases Friday to address problems in the state's mental health system.

POLICY CHANGES

Allow emergency custody orders to be extended to eight hours.

Require independent evaluator and treating physician of a temporary

detention order patient to be available at a commitment hearing.

Require community services board staff to participate in commitment

hearings.

Change the criteria for emergency custody and temporary detention from

" imminent danger " terminology to: " substantial likelihood that in the

near future he will (a) cause serious physical harm to himself or

another person, as evidenced by recent behavior causing, attempting,

or threatening such harm, or ( suffer serious harm due to

substantial deterioration of his capacity to protect himself from such

harm or provide for his basic human needs. "

Clarify the roles and responsibilities of community services boards

and the independent examiner throughout the detention process,

commitment hearing and case disposition.

Explicitly authorize disclosure of information between providers in

order to provide, coordinate and monitor treatment; and between

providers and the courts to monitor compliance with treatment orders.

SPENDING INCREASES (OVER TWO YEARS)

$14.6 million to improve emergency mental health services, including

around-the-clock psychiatric consultation, emergency clinicians and

crisis stabilization.

$8.8 million to add 106 case managers for mental health services

provided through community services boards.

$5.8 million to hire 40 clinicians specializing in children's mental

health.

$4.5 million to increase availability of outpatient clinicians and

therapists at community services boards.

$875,000 to create four positions to expand monitoring and

accountability of community services boards and to develop core

standards and service improvement plans.

$6 million to expand a pilot program for jail diversion services.

$600,000 to establish a law enforcement training program for crisis

intervention.

http://www.roanoke.com/politics/wb/143524