The Virginian Pilot recently ran on article on depressing state of declining psychiatric beds and lack of care for the mentally ill in Hampton Roads. According to the research: “the number of private psych beds has decreased during the past two decades, in part because of a preference for more community-based, outpatient care. Also, the state has been downsizing Eastern State Hospital, a facility in Williamsburg that provides mental health care. The number of beds available there has dropped 40 percent since 2003.”
A state inspector started a survey of emergency workers after learning about a practice called “streeting,” a phenomenon that occurs when a mentally ill patient meets the criteria for a temporary detention order but is released back onto the street because no facility could be located for them. After surveying emergency workers from Community Services Boards, which are public agencies that provide mental health services to people in crisis and to those who can’t afford mental health care or don’t have insurance, the inspector found 200 instances of the practice across the state of Virginia from April 2010 through March 2011.
The report show that “streeting” was most prevalent in Hampton Roads, where eight of nine Community Services Boards reported such situations during that period. Calling the “questionable and dangerous” practice a failure of the public safety net, these findings have forced communities across the state and Hampton Roads to acknowledge a lack of necessary mental health care. There are a few reasons for these trends:
- Decreasing number of private psych beds
- Downsizing at Eastern State Hospital
- Lack of public funding for mental health services
- Private facilities are reluctant to admit high risk patients
“Hospital emergency rooms need to be able to stabilize, evaluate and treat emergency medical and psychiatric conditions,” says Katherine Williams, the Administrative Director of Behavioral Health Services at Bon Secours Maryview Medical Center. Maryview Behavioral Medicine currently has an inpatient capacity for 42 adults and 12 children/adolescents and also offers an outpatient chemical dependency program. But as psych beds become more scarce, Williams shares the state inspector’s concern at the findings. “We are very fortunate to have very experienced clinicians who evaluate patients in crisis,” she says, “and work closely with Community Services Boards and private outpatient providers in Portsmouth, Hampton, Norfolk, and Chesapeake to find appropriate level of care for patients, but this is a serious issue that will undoubtedly continue to put pressure on behavioral health services in Hampton Roads, in Virginia, and across the country.”