Jails, mental health linked, panel hears

GENERAL ASSEMBLY

BLACKSBURG - Virginia's jails and mental health hospitals are inextricably linked, members of the Senate Finance Committee heard Thursday.

The large number of mentally ill inmates in Virginia jails is caused, in part, by the lack of open beds at the state's nine psychiatric hospitals - two of which state lawmakers considered closing earlier this year.

Members of the Senate Finance Committee met at the Inn at Virginia Tech to hear strategies to improve mental health options across the state so as to reduce incarceration of people with severe mental health problems like post-traumatic stress disorder, schizophrenia, depression and bipolar disorder.

But the sessions were preceded by a look at Gov. Terry McAuliffe's updated budget that includes a $1.5 billion revenue shortfall.

During budget talks, legislators were encouraged to think about measures to cut state spending. At the latter presentations, financial analysts warned none of the mental health solutions mentioned are possible without additional spending and thus, unlikely to occur in the short term.

In June, there were about 3,300 mentally ill offenders - or about 8.4 percent of all incarcerated offenders - in local and regional jails across the state. Roanoke's jail is one of the 12 jails that account for nearly two-thirds of all seriously mentally ill inmates in Virginia.

The State Board of Corrections gives each jail the ability to set its own mental health practices; the board only requires each jail have a written policy of how it handles inmates in need of treatment. The board does not mandate any mental health training for jail employees.

Deputy Staff Director Dick Hickman called the high number of seriously mentally ill inmates a symptom of a bigger problem - the inadequate capacity of the state mental health system.

"The mentally ill cannot be diverted from jail unless there is sufficient capacity somewhere else," he said.

A mental health population forecast, that would estimate future mental health needs across the state could help policymakers decide where additional resources should be directed in the future.

The state relies heavily on the affordability of incarcerating mentally ill people, which costs about $12 per day, said Sen. David Marsden, D-Fairfax.

But localities should try to get prisoners out of their jails and into state prisons as quickly as possible so inmates can receive mental health treatments that the larger, regional prisons often offer, he said. Then, local jails could be used for re-entry programs to prepare inmates for society.

"We've got our system kind of backwards," he said.

The nine state psychiatric hospitals all have seen the number of admitted patients rise in the past four years. Now, the hospitals that have anywhere from 72 to 302 beds are generally more than 85 percent full at any given time. Oftentimes, they're full. On average, each hospital pays about $237,000 annually per bed to treat patients.

A report from the Virginia Department of Behavioral Health and Developmental Services last year recommended closing Catawba Hospital in Roanoke County and Piedmont Geriatric Hospital in Southside - the two oldest state mental health hospitals.

This summer, the behavioral health department searched for a consultant to conduct a thorough study of Catawba to determine if the state should close the hospital in favor of enhanced community services. The department couldn't find anyone able to complete the study by year's end.

In Blacksburg Thursday, financial analysts recommended maintaining all state hospital beds in the short term, developing more community care options and in the long-term, and explore creating a stand-alone mental health agency.

After the committee meeting, Sen. John Edwards, D-Roanoke, said Catawba, which currently houses 110 patients, has room for 270 people if additional funding is made available. He estimates an additional $2.4 million could open 30 more beds at the facility, but the tight budget made tighter by the shortfall makes this unlikely in the next fiscal year.

But to Edwards, the mental health solution is more than a matter of money.