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New Group Aims To Lessen Burden On State Psychiatric Hospitals

All of Virginia’s state psychiatric hospitals are currently above what’s considered a safe capacity level of 85%.
Members of a new work group looking into solutions to address the growing census in Virginia's psychiatric hospitals met Monday. Megan Pauly/WCVE

All of Virginia’s state psychiatric hospitals are currently above what’s considered a safe capacity level of 85 percent. The number of patients being admitted to the hospitals has been on the rise ever since a 2014 “bed of last resort” law required state-run psych facilities to accept patients if no other bed could be found in a private hospital.

Earlier this year, lawmakers asked the state Department of Behavioral Health to put together a work group to come up with solutions about how to take some of that pressure off of the state facilities. They held their first meeting Monday. At the table were representatives from private hospitals, public hospitals, law enforcement, and advocacy groups.

“We are here because he have to tackle this very difficult issue,” said Marvin Figueroa, Deputy Secretary of Health and Human Resources. “Our hope is to conclude this workgroup with consensus or at the very least some level of agreement on how to long to extend the emergency custody order period for, and for what population, how to address the custody concerns of law enforcement officials and how to divert unnecessary admission from state mental health hospitals.”

There was limited discussion Monday about whether or not to extend the amount of time patients stay in police custody often in an emergency room before being transported to a state psychiatric hospital if no other bed is found in a private facility. It’s called an ECO period, which stands for an emergency custody order period. Right now, the window of time Community Services Board staff have to do the bed search is eight hours.

Executive Director of the Virginia Association of Community Services Boards Jennifer Faison says many community mental health centers have hired additional staff just to help with the bed search.

The emergency custody order period was extended from six hours to eight hours in 2014, following the death of Gus Deeds, the son of Virginia Senator Creigh Deeds. He was discharged after his ECO expired. He took his own life shortly afterwards.

“If it [extending the ECO period] helps to save peoples’ lives and keep people safe then I think it’s something we need to talk about,” said Rhonda Thissen, Executive Director for the National Alliance on Mental Illness of Virginia. “But I don’t see it as a panacea to addressing this whole issue.”

Meanwhile, law enforcement officials like Ashland Chief of Police Doug Goodman say they don’t want to see the ECO time period extended. “Because that’s not fair to the individual who is in crisis,” Goodman said. “Ideally we want to make sure that individual in crisis can get to a treatment facility as fast as we possibly can get them.”

Goodman says extending the time period would mean more time local police officers away from the communities they serve, and more time for patients in police cars and emergency rooms. “This is a big, big problem. And it’s going to require some creative solutions, and some of these solutions are going to take time,” Goodman said. “It takes a while to turn a big ship around, and we need to get the ship sort of started turning in a different direction. Everyone in the room I’ve seen so far has the interest at heart of folk in crisis and [are] the individual cogs and wheels of this machine.”

The group will meet again in a month. They’ll hear about what some other states are doing when it comes using a bed registry and delivery of crisis services.


Megan Pauly covers education and healthcare issues in the greater Richmond region. She was a 2020-21 reporting fellow with ProPublica's Local Reporting Network and a 2019-20 reporting fellow with the Education Writers Association.