SJ 47 Joint Subcommittee Update: A Vision for Public Mental Health Services in Virginia Takes Shape

Developments in Mental Health Law, October 2016 | Go to article overview

SJ 47 Joint Subcommittee Update: A Vision for Public Mental Health Services in Virginia Takes Shape


At the October 26, 2016 meeting of the SJ 47 Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century, the Subcommittee's Work Groups and members appeared to move closer to adopting a shared vision of a future statewide system of mental health services, while acknowledging the significant obstacles to realizing that vision. The Joint Subcommittee's Work Groups also recommended more immediate action on reforms within the current system to help to move it toward that future vision. The Division of Legislative Services (DLS) report on the October 26 meeting can be found here, and a more detailed description of each Work Group's activities and decisions from the summer of 2016 to the October 2016 meeting follows the summary below.

The Vision for the Public Mental Health Services System

Adoption of the STEP-VA (System Transformation, Excellence and Performance in Virginia) program model

Senator Hanger, the chair of the System Structure and Finance Work Group (Work Group #1), noted the Work Group's endorsement of the Department of Behavioral Health and Developmental Services' (DBHDS) STEP-VA plan for the Commonwealth's public mental health system. That plan is built upon the concept of providing access across the state to 10 "core" services that would ensure access to needed services for all individuals with mental illness. Those services are: (1) same day access to mental health screening and timely access to assessment, diagnostic, and treatment services; (2) outpatient primary care screening and monitoring services; (3) crisis services; (4) person-centered mental health service treatment planning services; (5) outpatient mental health and substance abuse services; (6) targeted mental health case management; (7) psychiatric rehabilitation services; (8) peer support and family support services; (9) mental health services for members of the armed forces and veterans; and (10) care coordination services.

Funding priority for "same day access" and outpatient primary care

Work Group #1 also endorsed the DBHDS proposal that full funding for these "core" services be implemented over a period of years, with such funding being sought first for the statewide implementation of two services: (1) same day access to mental health screening and timely access to assessment, diagnostic, and treatment services (estimated cost: $1.5 million in FY 2017, $12.3 million in FY 2018, and $17.3 million annually thereafter); and (2) outpatient primary care screening and monitoring services (estimated cost: $3.72 million in FY 2019 and $7.44 million annually thereafter).

Availability of Psychiatric Emergency Services (PES) units to persons in crisis

Delegate Garrett, chair of Work Group #3 (Mental Health Crisis Response and Emergency Services) described to the Joint Subcommittee the Work Group's endorsement of PES units, which, he explained, are an alternative to hospital emergency departments, and to psychiatric hospitalization, in providing treatment for individuals experiencing mental health crisis. Delegate Garrett noted that such units may reduce the costs associated with psychiatric boarding, but that the Work Group and its Advisory Panel are still attempting to determine the costs associated with psychiatric boarding in the Commonwealth and the potential cost benefits that may result from the establishment of psychiatric emergency services units.

Adoption of a model for criminal justice diversion

Delegate Bell, the chair of the Work Group #2 (Criminal Justice Diversion), reported that in 2017 the work group will focus on specific models for diverting persons with mental illness from the criminal justice system.

Permanent Supportive Housing

Senator Howell, chair of Work Group #4 (Housing), reported that an estimated 5,000 individuals in Virginia are in need of permanent supportive housing. Permanent supportive housing is a support for persons with serious mental illness that has been proven to be effective in both enabling people to stabilize their lives and reducing the costs of providing services to these individuals (who, without the housing and related services, experience more frequent hospitalizations, criminal justice system involvement, and crises requiring higher cost care). …

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