Spike in Emergency Patients Threatens to Stretch Virginia Mental Health Hospitals

By Scott MacFarlane
|  Friday, May 9, 2014  |  Updated 2:00 PM EDT
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Virginia state mental health hospitals are grappling with a spike in admissions of emergency patients. The News4 I-Team's Scott MacFarlane reports.

Scott MacFarlane

Virginia state mental health hospitals are grappling with a spike in admissions of emergency patients. The News4 I-Team's Scott MacFarlane reports.

Virginia state mental health hospitals are grappling with a spike in admissions of emergency patients, according to state records and databases obtained and reviewed by the News4 I-Team.

The number of “temporary detention orders,” in which judges order patients hospitalized, has swelled 23 percent statewide this year.

The increase is happening amid large scale changes in Virginia’s mental health system and is creating new pressure for local mental health hospitals, which are experiencing increasing backlogs and bed shortages.

Earlier this year, Virginia’s state legislature reformed the commonwealth’s system for holding and hospitalizing the mentally ill, in the wake of the high-profile stabbing attack against state Sen. Creigh Deeds by his son Austin, who’d suffered from mental illness and committed suicide. The state recently passed a law expanding the length of time the state can hold mentally ill patients in custody while awaiting orders to hospitalize them. Virginia also approved and established a new online “bed registry” to help authorities find available hospital “beds” in which to place those patients, amid a state mental health hospital system that often operates near capacity.

In the first three months of 2014, according to the records reviewed by the I-Team, the state issued 357 temporary detention orders to hospitalize patients, an increase from 294 such orders in the first three months of 2013. In many cases under temporary detention orders, the patients are hospitalized against their will for their own safety. James Newton, director of the Northern Virginia Mental Health Institute, the state mental health hospital in Fairfax, said, “There's obviously a newfound sense ... a heightened sense of making sure Virginians are safe."

The spike in temporary detention orders is threatening to stretch Virginia’s mental health safety net, according to interviews conducted by the News4 I-Team. Five of the state’s nine mental health hospitals reached full-capacity, with zero available beds for new patients, at some point in 2014, including the state hospital in Fairfax. Rural mental health hospitals have been particularly jammed. The Southwest Virginia Mental Health Institute in Smyth County has already reached full capacity 54 days in 2014, according to the database reviewed by the News4 I-Team.

Under the newly passed mental health reforms, Virginia state hospitals are prohibited from turning away a patient, even if beds are unavailable. In January, the state established an online bed registry and phone system to help officials search for vacancies at other state hospitals in other regions of Virginia.

“If I cannot find a bed (at my hospital), it’s up to me to call one of my colleagues,” Newton said.

In the meantime, as emergency orders increase, the Northern Virginia Mental Health Institute is suffering a growing backlog of patients awaiting discharge. The News4 I-Team’s review found at least 30 patients currently awaiting their release from the hospital, but unable to leave. Hospital officials said there aren’t enough available spaces in group homes, nursing homes or other health facilities into which those patients can be placed. Officials said family members are also unwilling, in some cases, to accept some of those mental health patients back into their homes.

The backlog limits the available space needed for mental health hospitals to accept and admit new patients, even emergency patients.

Bradley Ambrose, a Virginia man diagnosed with paranoid schizophrenia, said the care he received at the state mental health hospital in Staunton was the best overall care he’s received at any hospital. Ambrose, who was admitted against his will under a temporary detention order in 2012, said his parents petitioned a judge to order the hospitalization after he’d attempted suicide.

Ambrose said the increase of temporary detention orders unearthed by the News4 I-Team is likely the result of newfound cautiousness by state health officials triggered by the attack on Creigh Deeds.

“They're erring on the side of caution,” Ambrose said. “They're afraid if (they) let people out on the street and they stab someone, then it's on (their) heads."

Private mental health facilities accept a large number of Virginia’s mental health patients. Newton said state mental health hospitals are largely responsible for handling the patients who have limited or no health insurance coverage.

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