Virginia governor Terry McAuliffe’s plan to close Catawba Hospital, a 110-bed psychiatric facility located near Roanoke, is the latest blow to the state’s underfunded and uncoordinated mental health system.
Over the past four decades, Virginia has already lost nearly 80 percent of its psychiatric hospital beds, leaving fewer than 1,500 statewide. Compounding the problem is the lack of community-based services, such as counseling, housing and treatment, needed for people struggling with mental illness to get the care they need outside an inpatient facility.
Due to the state’s failure to invest in those services, hundreds of discharge-ready patients are crowded into a limited number of beds, stuck at a hospital level of care because there is no plan for them to step down. This leaves little room for those who are most at risk.
As a result, people suffering from mental illness and substance disorders are left in a place that is ill-equipped to care for them: the criminal justice system. Nearly 7,000 Virginians with mental illness are currently incarcerated, more than four times the number in psychiatric hospitals.
Lack of Services Leads to Tragedy
Without the dedicated care they need, inmates with mental illnesses are at increased risk of abuse, neglect and suicide. In one recent tragedy, Jamycheal Mitchell, a mentally ill 24-year-old man, was arrested after shoplifting $5 worth of snacks from a convenience store. He wasted away and died after four months of neglect in jail.
A judge repeatedly ordered that Mitchell be transferred to a psychiatric hospital, but no beds were available. Meanwhile, at Eastern State Hospital, the nearest state psychiatric facility, some two dozen patients had been designated ready for discharge but remained in their beds due to a lack of community-based services.
Even when beds are available, failures to effectively coordinate care can be deadly. In November 2013, Austin “Gus” Deeds, a 24-year-old college student with bipolar disorder, stabbed and slashed his father, R. Creigh Deeds, 13 times before dying by suicide.
That night, the Deeds family had gotten a court order that gave the state six hours to place Gus in an inpatient treatment facility. Mental health evaluator Michael Gentry claimed he called 10 facilities that could care for Gus, but phone records show that he only called seven. Tragically, two of the three facilities that were not called had space available.
The elder Deeds, a Virginia state senator, survived the attack and has been a vocal advocate for mental health reform since. He is also pursuing a $6 million wrongful death suit against the state.
A Nationwide Trend
Virginia’s issues with mental health are far from unique. Rather, the lack of psychiatric beds is a result of a nationwide initiative in the 1970s to downsize psychiatric hospitals in favor of community-based care. While well-intentioned, this initiative ultimately led to cuts across the mental health system, as funding did not follow the patients into the community.
As such, people suffering from mental illness and their loved ones are left to deal with confusing bureaucracy, long wait times for services, overcrowded facilities and overworked care providers. In such environments, patients are commonly neglected and even abused, leaving them at elevated risk for inpatient suicide.