University of Virginia law professor Richard Bonnie released a preliminary report Monday urging Virginia’s state legislators to prioritize community mental health services in 2018.
The recommendations were part of a two-day presentation to a General Assembly joint subcommittee tasked with comprehensive mental health reform in the state. The effort follows the 2007 Virginia Tech shootings and, more recently, the 2013 suicide of state Sen. Creigh Deeds’ son, Gus.
Bonnie is coordinating a set of expert advisory panels for the General Assembly’s mental health study and chairs the panel providing input on health system structure and financing. With a decades-long track record as an expert health policy adviser, he directs UVA’s Institute for Law, Psychiatry and Public Policy and holds joint appointments in the Frank Batten School of Leadership and Public Policy and the School of Medicine.
If adopted, the panel’s funding recommendation would be more than just a short-term fix. It would signal a commitment to revising the state’s current budgeting approach, which Bonnie’s group says relies too heavily on crisis care in state hospital settings and doesn’t align incentives for investing in community services.
“Establishing accessible community services statewide will enable the Commonwealth to substantially reduce its investment in maintaining and operating state hospitals for crisis mental health admissions,” the report says.
The preliminary report notes an “unprecedented surge in admissions” to state hospitals and an increasing number of patients waiting to be released back to “suitable community placements.” If hospital utilization is not brought down, the report says, the state faces the prospect of inefficient investment in older state facilities that ought to be closed or downsized.
The report stresses that legislators should act immediately to address the current pressures while they continue to implement a long-term plan for enhancing community services that the General Assembly embraced in the 2017 session.
For the next budget cycle, “[a]n urgently needed short-term infusion of resources is necessary to stabilize the current situation and to put in place the conditions required to permanently reverse the unsafe and unsustainable trajectory of state hospital admissions.”
The report goes on to outline where the subcommittee believes initial resources should be allocated.
The subcommittee was charged in 2014 with investigating systemic reform. Deeds asked Bonnie to convene and oversee the advisory panels, which include Bonnie’s structure and financing group and three others. The expert advisers include several UVA School of Law alumni with expertise in health and public safety. The panels report to the subcommittee’s work groups.
UVA law students are supporting the research and coordination efforts. UVA’s Batten School and School of Medicine are also assisting the efforts, with funding from the General Assembly and the Department of Behavioral Health and Developmental Services.
A final report of recommendations was originally scheduled for completion in December, but the General Assembly granted a two-year extension last year to allow the joint subcommittee to develop a detailed and comprehensive plan.