By Colin Kennedy

Capital News Service

A proposed joint subcommittee stands at the center of a clearly defined focus on mental health services in Virginia less than two months after tragedy shook the state capital.

Sen. R. Creigh Deeds, D-25, whose son was treated for bipolar tendencies before ultimately stabbing his father and killing himself, is the chief patron of Senate Joint Resolution 47, which seeks to establish a nine-person subcommittee to study the mental health services in the commonwealth.

The joint resolution is one of at least 60 mental health related bills proposed thus far during the 2014 session, according to the National Alliance for the Mentally Ill Virginia state chapter. And though the latest flurry of mental health initiatives promises to bring change to the lives of thousands of Virginia citizens, skepticism doesn’t come unwarranted.

Delegate Kenneth R. Plum, D-Reston, the co-patron of SJ 47, has represented his district since 1982 and acknowledges that Virginia’s mental health services fail to measure up to other state systems nationally.

After former Gov. Bob McDonnell pledged $38 million expand mental health programs in December, Plum says he thinks the governor’s reactionary budget move might expose an alarming trend in the commonwealth’s commitment to mental health services.

“It needed to have been done anyway,” Plum said. “We wait for tragedy sometimes to bring us to the point of doing something.”

This isn’t the first time Virginia has seen sudden spikes in legislative consideration for mental health services. Similar attention was directed toward the subject six years ago, when the General Assembly authorized $42 million for health care reform in the wake of the 2007 Virginia Tech shooting.

However, legislators reportedly retracted $37.7 million of that funding within a two-year period, according to NAMI Virginia, and subsequent budget issues have helped hinder any large-scale reform efforts since.

One of the chief concerns among mental health service advocates is that Virginia’s historical approach to repairing the mental health system has left the public sector incapable of providing sufficient services for those in need.

The deficiency of the commonwealth’s public providers largely stems from skewed spending. Virginia ranks ninth in the country for spending on hospital-based care, according to the National Association of State Mental Health Providers, but ranks 39th in spending on community-based care for services that assist in stability and recovery.

This heavy focus on institutional funding takes away from the more critical preventative services, and Family Insight President and CEO Sam Gray says it ultimately costs the state more money long-term because neglected patients often end up institutionalized.

Instead of pouring money into hospitals and jails, Gray says the legislature should be working to equip Community Service Boards, which are the state’s public mental healthcare providers, with more efficient preventive services in an effort to mitigate the problem before it occurs.

“There are so many people who suffer from mental illness who do not get the case management that they need,” Gray said. “The CSBs maybe give them one hour or two hours a month, because they don’t have the time or the qualified people.”

An estimated 308,000 Virginia adults have had a serious mental illness during the past year, NAMI Virginia reports. But with only 40 CSBs statewide, the public sector faces a nearly impossible task in trying to adequately provide mental health services for all those in need.

Molly Cheek, the clinical director at Dominion Youth Services, says she believes the commonwealth should strongly consider partnering with private providers to deliver preventative services for Virginia’s mentally ill.

“There’s sort of a rift between the public sector, which traditionally handles the lower socio-economic population, and private providers who got into it because the local CSBs can’t handle it all,” Cheek said. “I would like to see more cooperation.”

Another way to tackle the same problem would require Medicaid expansion, Cheek said. Because most private companies only can help individuals covered by Medicaid, a large portion of patients are forced to sit on waiting lists for CSBs where preventative services are either lacking or absent.

The commonwealth ranks 48th nationally in per capita Medicaid expenditures, according to Healthcare for All Virginians, a healthcare advocacy group. Cheek says she thinks an expansion of the program would alleviate pressure on the CSBs by allowing more patients to utilize private providers.

Cheek says it’s time cooperation overtake competition as the public and private sectors work toward one common goal.

“We should very well be able to forge a partnership,” Cheek said. “At the end of the day, we should make sure that everyone has access to a provider that can help them.”