Increase in Deaths, Staff Resignations After Virginia Law Requiring Mental Health Facilites Not Turn Away Patients

A landmark law passed in 2014 to improve Virginia’s mental health system has contributed to an increasing number of patient deaths and falls -- as well as staff resignations -- inside the Commonwealth’s mental health hospitals, Virginia officials have found.

The law was passed after the son of state Sen. Creigh Deeds stabbed his father, then committed suicide, after reportedly failing to find an available bed at a state mental health hospital.

The law prohibits state hospitals from turning away any patient in need of a placement at a state mental health facility. And state health officials said it has succeeded in finding bed spaces.

But officials said the law has also had "unintended consequences" for patients and staff inside Virginia’s nine mental health hospitals.

Admissions have increased 43 percent at the state hospitals since 2014, mental health advocates and Virginia state officials said in interviews.

But staffing levels have not increased to fully handle the added load of patients, according to Virginia Department of Behavioral Health Services assistant commissioner Daniel Herr.

"We have an increase in patients who are very acutely ill," Herr said. "It’s a significant increase in overall workload."

A report by the state inspector general found staff turnover has spiked 29 percent between 2014 and 2015.

"The turnover of direct care staff creates numerous risks to inpatient facilities, among them the cost of terminating staff, covering open shifts with overtime, use of mandatory overtime, costs of recruiting, hiring, and orienting new employees," the report read.

The number of patient deaths has increased in state hospitals in the time since the new safety net law was approved, the report found. And it found the number of falls and fractures suffered by patients has increased by more than 30 percent during the same time period.

State health officials said the law has succeeded in preventing patients from being turned away from hospitals, due to bed shortages.

"It fixed the problem it was intended to," Herr said. "It was intended to ensure everyone who needed a psychiatric bed was able to find one."

Tammy Peacock, director of the Northern Virginia Mental Health Institute in Falls Church, said the safety net law has contributed to a larger percentage of patients with severe medical conditions or violent tendencies inside state facilities -- because they have to stay.

"If they're becoming more aggressive, there's nowhere else to send them. We can't say no."

But, she said, administrators are responding and assisting staffers amid the growing workload. 

"We really have to make sure that our staff know we value them, we support them, we know what they're facing," Peacock said.

Deeds did not respond to requests for comment.

This story was reported and written by Scott MacFarlane. It was shot and edited by Jeff Piper.

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