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About Mental Health

It is hard to believe that it has been 10 years since the horrific day at Virginia Tech when 32 students and faculty were killed and many others were injured by a young student with untreated mental illness. Ten years since countless lives and families were altered forever, including my own. And yet, in many ways it hurts like it was yesterday.

Flowers lay on a bench on Virginia Tech’s campus in Blacksburg, Va, on Tuesday, April 16, 2013, the sixth anniversary of the shooting at the school that claimed 32 lives. (Rebecca Barnett/Associated Press)

My daughter Emily was among the victims. She was 18, a freshman, an animal and poultry sciences major, and member of the equestrian team. She, like the others, had so much to offer and so much more to do.While I searched for answers and attempted to understand how such a horrible event could occur, it became clear that a flawed and inadequate mental-health system was a major factor. That finding gave my surviving daughter and me the determination to move forward and be part of a movement to spur significant changes in Virginia’s mental-health system. Many individuals, organizations and agencies rallied to improve mental-health care in Virginia.

At the time, Virginia’s community mental-health system was stretched extraordinarily thin and was severely underfunded. Long waiting lists and inadequate services and staffing meant you could wait for days, weeks or even months to get an appointment. The involuntary commitment process was hurried and poorly coordinated. Many areas in the state lacked access to basic crisis-stabilization services and comprehensive outpatient services. Limited state and private hospital beds and an inadequate network of community-based services pushed many people with mental illness into jails. Accountability was lacking.After the tragedy, lawmakers responded swiftly and decisively. Since 2008, numerous reforms have been passed to try to clarify and strengthen laws governing mental health treatment practices. For example, criteria in Virginia’s involuntary commitment statute were modified to eliminate the requirement of “imminent” dangerousness in a person — bringing the state in line with nearly all other states. Procedures for court-ordered outpatient treatment were tightened. Time periods for emergency custody and temporary detention processes were lengthened, allowing for an appropriate time to evaluate and begin treatment for people experiencing mental-health crises. More recently, Virginia’s code was amended to ensure that people in crisis who require evaluation and meet the criteria for a temporary detention order are placed in a psychiatric hospital until their hearing.

And there have been funding improvements. Weak laws and historic underfunding meant that most mental-health care in Virginia was delivered© in crisis mode, often by police officers or in emergency rooms. Efforts are being made to put more funding into community-based services to better balance the overwhelming burden on institutional facilities. This makes for a healthier, proactive mental-health system rather than a reactive system.

Immediately following the tragedy, then-Gov. Tim Kaine (D) allocated a $42 million “down payment” to fund high-priority initiatives. Although much of that initial funding was lost in budget cuts in the recession, the funding has slowly been reinstated as the economy has improved, and each governor since Kaine has proposed additional funding. Since 2008, the General Assembly has approved more than $70 million in new state funding for mental-health care, including:• Emergency services and crisis stabilization: $18 million

• Supportive housing: $10 million

• Criminal justice system diversion: $9.4 million

• Assertive community treatment programs: $8.8 million

• Children’s mental-health-care services: $8.4 million

• Transition-age youth mental-health-care services: $7.5 million

• Same-day intake and assessment: $6.3 million

• Mental Health First Aid and suicide prevention: $1.4 million

Although progress has been good, Virginia sits in the bottom half of states in overall ranking for mental health care per person. Virginia still needs funding to establish consistent and comprehensive services in all communities; to expand intervention, treatment and transition programs for young adults, especially for those experiencing the first signs of mental illness; to attract and retain mental-health providers in the face of a critical workforce shortage; and to establish strict quality and performance outcomes to meet the needs of families and communities in our commonwealth.

The 10th anniversary of the Virginia Tech massacre must serve as a reminder of where we came from and where we need to go. Although I am heartened by the progress, I know that those who work hard to advocate, legislate and provide need to keep the focus on continuing improvement.

Mental-health conditions affect 1 in 4 families. We have seen, too many times, the consequences of untreated mental illness and the pain it causes individuals, families and communities. We must continue our efforts in remembrance of the lives lost 10 years ago, for the lives of those who are with us today and for the lives of those tomorrow.

April 14