Youngkin wants to transform Virginia's struggling behavioral health system

Youngkin wants to transform Virginia’s struggling behavioral health system


Gov. Glenn Youngkin’s proposed $230 million expansion of the state’s behavioral health system was met Thursday with applause and questions from reform supporters who wonder how the state will attract hundreds of healthcare providers during a historic labor shortage.

Calling for a “revolution” in crisis services, Youngkin (R) on Wednesday proposed a sweeping plan to hire 30 mobile crisis teams, fund drop-in centers, expand mental health programs in schools and provide home services to 500 people awaiting Medicaid Waivers.

The proposal — intended to bolster a strained behavioral health system that serves as a public safety net for people in need of care — is one of many changes, including $1 billion in tax cuts, that Youngkin wants bring to the two-year budget lawmakers will consider when they meet in Richmond in mid-January.

“We are facing a level of mental health and addictions issues never seen before, all too often resulting in violence, suicides and murders,” Youngkin said in video of the announcement made at a suburban Richmond hospital. . “The behavioral health crisis is not unique to Virginia but let’s be clear, here in Virginia we are in crisis.”

Virginia’s public psychiatric hospitals have been stressed for years. Authorities last year closed several public hospitals to new admissions when the pandemic exacerbated overcrowding and staffing shortages. Youngkin’s plan aims to provide pre-crisis, crisis and recovery services to patients before they need inpatient psychiatric care.

On Monday, his office created a TDO Rapid Placement Task Force to quickly find services for those sentenced to crisis care who often languish in emergency departments for days, require constant monitoring by security forces. order and can be transported away from family and support systems when a bed is available.

Youngkin announced his behavioral health initiative, called Right Help, Right Now, at Parham Doctors Hospital, a campus of HCA-operated Henrico Doctors Hospital, which hospital officials say is the largest private mental health provider. state care.

Public and private hospitals disagree over who is responsible for patients who have nowhere to go; private hospitals admit the most crisis patients, but mental health advocates say they avoid the most difficult cases, leaving a public hospital to deal with violent and agitated patients.

Virginia religious leaders call for funding for crisis centers as an alternative to prisons

Youngkin said the scale of the problem is enormous: Prisons, emergency services and hospitals are seeing too many people in crisis, and law enforcement, teachers and health care providers are overwhelmed. He lamented Virginia’s ranking of 48th in the nation for youth mental health, which fell from 21st the previous year, according to data from Mental Health Virginia. The ranking is based on several factors, including the number of young people who had at least one major depressive episode in the past year, the number of those who did not receive mental health services and the number of insurance which did not cover mental or emotional disorders. problems.

Virginia’s reform efforts have long been driven by tragedies that thrust the state into the national spotlight: a high-profile 2007 shooting by an unstable undergrad that killed 32 people at Virginia Tech; the 2013 suicide of State Senator R. Creigh Deeds’ son Gus, who attacked his father after efforts to seek emergency mental health treatment failed. Last month, a man whose co-workers said he engaged in disturbing behavior killed six people at a Walmart in Chesapeake.

John Littel, Youngkin’s health and human resources secretary, said in an interview Thursday that the plan was informed by months of meetings, investigations and a comprehensive review of recommendations from the informally known Behavioral Health Commission. under the name of Deeds Commission. In the fall, the state hired McKinsey consultants to complete the work.

The plan is inspired by the Arizona model, which links crisis hotlines, mobile crisis units and drop-in centers like the type Youngkin proposes to expand to provide care in first 24 hours of a mental health emergency, Littel said.

Littel acknowledged that staffing would be a challenge, but said it was too early to say how many people needed to be hired; a detailed implementation plan is expected to be completed early next year, including an initiative tracking dashboard.

“We recognize that it’s going to take some really extreme effort to make sure we have a pipeline,” he said. “I don’t think we have a magic wand here.”

Anna Mendez, executive director of Haven, a day shelter and homeless service provider in Charlottesville, said she was hesitant to downplay the potential for transformative change, but noted that next steps would be critical. For example, although the plan includes $8 million for housing 100 people with severe mental illness, she said that without qualified exit planners to place customers “100 new slots won’t matter.”

“What remains to be determined is whether we are willing to invest to pay people enough money to want to do the work to make this happen,” she said.

Deeds (D-Bath) said he was impressed with the level of commitment from Youngkin, who called him on Saturday to fill him in on the plan but said two or three times the funding was needed to address the shortage of services, including the shortage of labour. Statewide, the agencies that form the backbone of Virginia’s public behavioral health system, community service commissions, have a vacancy rate of 28%, he said.

Last year, about $100 million for behavioral health, including $37 million in CSB salary increases, was cut from the final budget in compromises made to secure the governor’s tax cut, Deeds said.

He wondered if the scope of the plan had been sacrificed to pay for part of his proposed tax cut.

“He’s saying we’re going into a recession, so their idea of ​​maybe a big, bold plan has to be looked at in that context,” Deeds said. “They want to do something else so that this plan doesn’t seem as bold as they might like.”

Deeds said he hopes Youngkin’s plan is the floor of what the legislature will spend to strengthen public behavioral health services.

“I’m going to work like the devil for more,” he said.

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