Sheriff Complains About Lack Of State Hospital Beds In Virginia: Part Of National Bed Crisis

Sheriffs angry about lack of hospital beds. (WDBJ)

(4-2-21) An influential Virginia Sheriff lashed out at the state’s behavioral health department and the General Assembly during a press conference this week stating that both needed to “stop passing the buck and step up to develop and implement solutions to address the constant bed shortages and other deficiencies in the state response to mental health crises.”

Flanked by other sheriffs and police chiefs, Montgomery County Sheriff Hank Partin warned: “Folks that are in crisis, that need help – they aren’t receiving help.”

It is not uncommon, the sheriff said, for his officers to spend hours driving across the state searching for an available state hospital bed only to arrive and be told that none is available.

The officers’ complaints about a lack of state hospital beds for Virginians, who are being held under Temporary Detention Orders (TDOs), is hardly new.

A decade ago, then Inspector General G. Douglas Bevelacqua warned that there were not enough crisis care beds available at state psychiatric hospitals or at local hospitals. During a 90-day period, he discovered emergency rooms had turned away 200 individuals who had met involuntary commitment criteria and were judged dangerous. He called it “streeting” – simply kicking ill individuals to the streets.

In November 2013, state Sen. Creigh Deeds took his son, Gus, to a mental health facility but was told no local hospital bed could be found within the necessary time period for a TDO. Deeds and his son were sent home where Gus attacked his father with a knife, slashing his face, before ending his own life.

In 2015, Jamycheal Mitchell, age 24, died from “wasting away” syndrome in a Hampton Roads Regional jail after waiting 101 days for a state hospital bed. He suffered a heart attack after literally starving to death.

Virginia is not the only state that doesn’t have enough crisis care beds. Back in a 2005 study, the Treatment Advocacy Center warned:

“The consequences of the severe shortage of public psychiatric beds include increased homelessness; the incarceration of mentally ill individuals in jails and prisons; emergency rooms being overrun with patients waiting for a psychiatric bed; and an increase in violent behavior, including homicides, in communities across the nation.”

Fifteen experts cited in that report recommended states have “50 (range 40 to 60) public psychiatric beds per 100,000 population for hospitalization for individuals with serious psychiatric disorders.” At that time, Virginia had less than half that recommended number – 22.5 beds.

Calls for repeal of the IMD Exclusion are growing because of a national bed shortage. But some advocates worry ending its 16 bed restrictions will take money away from community based services and encourage a return to the dreaded days of warehousing in state hospitals.

In recent years, more and more sheriffs and police chiefs have been pushing for jail diversion and better community and state hospital mental health services. On average, 16 % of their prisoners have a serious mental illness, such as schizophrenia or bipolar disorder, and need treatment not necessarily incarceration.

Let’s hope this new round of complaints by Sheriff Partin and his colleagues will prompt Virginia’s elected officials into action.

What’s the bed situation in your state? What are your elected leaders and advocates doing to insure those who are in crisis get help? Please let me know by putting a comment on my Facebook page. 

You can watch a short clip of Sheriff Partin’s comments here.

Montgomery Co. sheriff, others blast ‘systemic failure’ in state mental health admissions

By Mike Gangloff, The Roanoke Times newspaper

CHRISTIANSBURG — Montgomery County Sheriff Hank Partin was joined by five other sheriffs and the police chiefs of Christiansburg and Blacksburg Wednesday as he laid into the Virginia Department of Behavioral Health and Developmental Services for what he termed a “systemic failure” in admissions to state mental health hospitals.

“The folks that are in crisis, that need help – they aren’t receiving help,” Partin said at a news conference called at the county Public Safety Building.

Specifically, Partin and his fellow law-enforcement leaders took the state to task for delays in admitting people held on Temporary Detention Orders, which are issued when someone is found to be a danger to themselves or other.

The magistrate-issued order tells officers to transport the person to state mental facilities like the Southwestern Virginia Mental Health Institute in Marion. Too often, Partin said, officers may have to drive across the commonwealth to find a bed. Frequently, they find the state facility is at capacity and will not admit the person. Then the person having the mental health crisis waits in an emergency room, under an officer’s guard, until the mental health facility has a bed available, Partin said.

This can sometimes take more than a day, and wait times have only grown longer during the year of the pandemic, especially with the state facilities declining to admit anyone who tests positive for COVID-19, Partin said.

“For the department … to take the position that people simply can’t have a mental health crisis during COVID is disturbing, but not surprising,” Partin said.

Partin was joined Wednesday by Montgomery County’s two police chiefs, as well as the sheriffs of Roanoke County and the counties of Floyd, Bedford, Amherst and Campbell.

Partin called on the state behavioral health department and the General Assembly to “stop passing the buck and step up to develop and implement solutions to address the constant bed shortages and other deficiencies in the state response to mental health crises.”

Partin, a Republican, said he had reached out to the legislature by describing the problem two years ago to “the delegate,” but “didn’t hear jack” in reply. Parts of Montgomery County are represented in the House of Delegates by both Chris Hurst, a Democrat, and Nick Rush, a Republican who this month said he is leaving the General Assembly at the end of the year.

Hurst responded to Partin’s comments Wednesday with a lengthy emailed statement saying he had sought solutions to problems of mental health admissions and capacity since before being elected in 2017.

“I wish this was a case where we could wave a magic wand and everything is solved,” Hurst wrote. “But when you restrict someone’s civil liberties through a commitment order, someone must be responsible while that person is in state custody. We have made significant attempts to reduce the demand for crisis care but our efforts to meaningfully address mental healthcare have only recently begun in earnest with the new majority. Bed space, finding a bed and transporting the patient to that facility remains a problem but to categorically blame the General Assembly or one specific legislator is imprecise and divides us at a time when collaboration is key. “

Among the measures that Hurst pointed to are the state’s seeking proposals to upgrade its bed registry, so that law enforcement and other agencies will have a more real-time list of available spots in mental health facilities.

Meghan McGuire, chief public relations officer for the Virginia Department of Behavioral Health and Developmental Services, also emailed a statement responding to Partin. She said that the department realizes the situation is “incredibly difficult” for law enforcement and appreciates officers’ work. McGuire wrote that state facilities are often operating at 100 percent capacity, that the pandemic has added many complications, and that the state is working on ways to prevent mental health crises and to streamline safe discharges in ways that would open more state hospital beds.

“The critical reality is the state hospitals will remain in this cycle until Virginia implements more comprehensive payment strategies and rules for admissions to private hospitals and strengthens community services that facilitate discharges,” McGuire wrote.

Hurst and McGuire pointed to the alternative transport program that Virginia launched in recent years, with the New River Valley being one of the first localities to gain the service. The alternative part of the system is that a private company, rather than law enforcement officers, takes some subjects of Temporary Detention Orders to state facilities. Hurst said that the new system could handle up to half of mental health transports.

But with many requirements including that the person not have a history of violence or medical issues, the alternative transport program has not helped Montgomery County much, Capt. Kris Weaver of the sheriff’s office said after the news conference. Weaver said he did not have exact numbers but thought very few alternative transports had been done in the county.

Christiansburg police Chief Mark Sisson and Blacksburg Chief Anthony Wilson estimated that about five times per week, they or Partin, or their senior officers, had to get personally involved in bringing state hospital doctors, private hospital emergency room physicians, and others together to work out a mental health admission – to “arbitrate a truce of some kind,” Wilson said.

As for officers’ lengthening waits with would-be mental health patients, Sisson, Wilson and Partin said it was the wrong task to assign to their agencies.

“We can’t sit with them,” Sisson said. “We’re not clinical psychologists.”

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.