Is there a political fix for Virginia’s troubled mental health system?

Bob McDonnell. File photo. Bob McDonnell. File photo.

As the tragic case of Gus Deeds—who attacked his father, State Senator Creigh Deeds, one day after undergoing a mental health evaluation and being released due to a reported lack of hospital space—shows all too clearly, the way a state chooses to allocate its budget resources can make a huge difference for people in need.

While there are still many unanswered questions about what actually happened to Gus Deeds between the expiration of his psychiatric emergency custody order and the terrible events that ended with his suicide, one fact is undisputed: Virginia’s mental health system is wholly inadequate when it comes to housing and treating people in crisis. As Mira Signer, director of the Virginia chapter of the National Alliance on Mental Illness, put it in an interview with The Washington Post: “If a family with resources and know-how has difficulty accessing and navigating the mental health system, it speaks volumes about what happens to people who don’t have resources.”

To Governor Bob McDonnell’s credit, he immediately ordered his secretary of health and human resources to review the “overall capacity of our mental health system, not just at the state level but also at the local level to see what more we can do.” He also vowed to use his final budget proposal to address any “glaring problems” this review might find.

The problems with this approach, however, are twofold. First, even if McDonnell increases mental health spending, there’s no guarantee it will be approved by the Republican-dominated General Assembly. And even if it is, there’s a high likelihood that services will be cut again once the spotlight has faded. (Following the mass shootings at Virginia Tech in 2007, the GA allocated an extra $42 million for various mental health-related services, but ended up cutting $37 million of that during the recession years of 2009 and 2010.)

The second issue is the question of priorities. While more money would certainly help, Virginia’s current emphasis on “community-based solutions” (as opposed to state-funded institutional care) has created a patchwork system in which private hospitals and psychiatric facilities are paid to take in patients with emergency mental health needs, space permitting. This all too frequently results in time running out (as it did with Gus Deeds, according to the director of the local community services organization that initially took him in) before a suitable institution can be found.

And then there’s the elephant in the room: Obamacare. The massive expansion of federal Medicaid funding that accompanied the passage of the Affordable Care Act would greatly increase the number of low-income and indigent people who could receive quality medical and mental health care. But Bob McDonnell has repeatedly rejected this much-needed infusion of cash, and the Assembly’s elephants have vowed to resist implementing the program, even though Medicaid expansion is a top priority of newly elected Governor Terry McAuliffe.

We can only hope that the horrible tragedy that has befallen one of their own will finally cause the legislature’s recalcitrant Republicans to reconsider their ill-advised position.

Odd Dominion is an unabashedly liberal, bi-monthly op-ed column covering Virginia politics.