Monday, March 31, 2008
Editorial: Mental health system still needs attention
In the aftermath of the Virginia Tech massacre, reform has begun. Much work remains, even if public attention begins to wander.
From the RoundTable blog
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The public's intense interest in Virginia's mental health care system is likely to be fleeting.
The public duty to reform the system is not, and the state still has far to go.
Policymakers did make advances, as expected, at this year's General Assembly, the first after a mentally ill student shot and killed 32 others, then himself, at Virginia Tech.
How could they not? Lawmakers were faced with the worst-case consequence of too many years of neglect. They went to Richmond determined to work with Gov. Tim Kaine in a bipartisan way to expand resources and tighten accountability.
Even gloomy revenue projections that got only darker over the two-month session could not erode their determination to put more money into the mental health system -- and to ask more of it.
But last week's story by staff writers Laurence Hammack and Mike Gangloff point up just how wide the gap remains between needs and funding. Lawmakers appropriated $41.7 million in new money, largely to help local mental health community services boards hire more staff.
At the same time, CSB workers will be required to attend all commitment hearings and to spend more time monitoring people under mandatory outpatient treatment orders. Tech gunman Seung-Hui Cho had ignored such an order.
Lawmakers also lowered the criteria for involuntary treatment of people with mental illness who might be a danger to themselves or others. Whether the new standard will have a significant effect on the number of people getting treatment is unknown. If it does, that will have a significant impact on CSBs, too. States must provide treatment in the least restrictive environment possible, and for many people with even severe mental illnesses that is in their homes.
Even if the new involuntary treatment standard has little effect -- as treatment advocates fear -- the new money will go only so far in a system the state underfunded before it added new expectations. Put the new money against the new requirements, divvy it up among all the state's CSBs, and $41.7 million is not a huge amount.
As the executive director of the Virginia Association of Community Services Boards noted in last week's stories, the state's CSBs had been going to the General Assembly each year asking for between $30 million and $50 million to meet high-priority needs even before Cho riveted lawmakers' attention on mental health.
So this will be a year of seeing how well the changes wrought in Richmond -- in funding, in mandates, in the commitment law -- will work. Next session, lawmakers should be prepared to do more.
They now should know, a good mental health system cannot be a fleeting interest for them.
