Youngkin announces creation of task force on troubled temporary detention order system

As public hospitals continue to be strained by mental health patients in crisis, Governor Glenn Youngkin announcement On Monday, the creation of a task force to address shortcomings in the way Virginia treats people whose magistrates order involuntary detention for treatment.

Virginia’s current system “is bad for the patients, providers, families and law enforcement who are waiting with these patients for placement,” Health and Human Resources Secretary John Littel said in a statement. communicated. “This task force is a key step in improving the behavioral health system in Virginia.”

The announcement follows Youngkin’s comments in November after two mass shootings at the University of Virginia and a Walmart in Chesapeake that he intends to propose legislation in the next session to increase mental health resources.

According to the administration’s statement, the task force will focus on the state’s temporary detention order system. Below State LawTDOs may be issued by a magistrate for a person if a petition and assessment concludes that the person is suffering from a mental illness, that there is a “substantial likelihood” that they will cause serious physical harm to themselves or to others and is unwilling or unlikely to seek treatment on their own.

The task force’s goals will include “ending the TDO waiting list, finding quick placements for people on TDO, freeing up police officers from spending important hours patrolling the streets, keeping all parties safe and laying the groundwork for lasting systematic change in the way Virginia treats TDOs.

Youngkin Councilor Janet Kelly, who led a similar initiative this year aimed at ending the practice of foster children sleeping in government offices and other inappropriate places, will lead the new task force, which will include other officials involved in the mental health system. .

Since 2014, TDO admissions to public hospitals have increased, with a status report compared to last June, with an increase of 389% between fiscal years 2013 and 2019.

Virginia remand admissions, fiscal year 2013-22. (Virginia Department of Behavioral Health and Developmental Services)

This report concluded that these increases were “specifically linked” to the 2014 bed of last resort law proposed by Sen. Creigh Deeds, D-Bath, after his son Gus stabbed Deeds and then killed himself during a seizure. of mental health. State officials had been unable to find Gus Deeds a mental bed.

Under the Beds of Last Resort Act, public hospitals are required to admit patients undergoing DOT after eight hours if a bed cannot be found at another hospital.

In the wake of the legislation, limited bed capacity and staffing shortages have led to large backlogs at public facilities, with DOT patients waiting an average of 43.2 hours for a public bed over the past fiscal year. During this period, the share of ODT admissions from private hospitals also dropped, from 91% of all ODT admissions in fiscal year 2015 to 76% in 2019.

The issues culminated in July 2021, when Alison Land, former commissioner of the Virginia Department of Behavioral Health and Developmental Services, closed five state psychiatric hospitals to new admissionsciting labor shortages which have created an “unsafe environment where staff and patients are at increasing risk of physical injury”.

“The challenges facing public hospitals are now an immediate crisis for two reasons: first, the level of dangerousness is unprecedented and second, recent admissions are occurring in an environment that is no longer adequately staffed,” said writes Land in a letter dated July 9, 2021.

Staffing has been sustainable problem in state hospitals, with shortages only exacerbated by the pandemic. In May, Littel told the Joint Committee of the General Assembly on Health Care that hospitals were “losing a lot of people at Chick-fil-A” and other companies offering better pay and less stress than positions in public establishments.

The General Assembly decided this summer to increase salaries of direct care staff by an average of 37% using millions of US Federal Dollars Rescue Plan Act. The push was consistent with a proposal from the Republican-controlled House of Delegates, but less than that presented by the Democratic-controlled Senate.

“The current TDO process has failed by not providing care to patients when they need it most,” the Youngkin administration said in Monday’s statement. “The process also contributes significantly to increased burnout in the health care workforce and the long hours put in by our law enforcement.”

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