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Mental health advocates: Shortage of beds could mean more violence

CNN
Wednesday, November 20, 2013 - 8:00pm

Even as authorities sort out the tragic events that ended with a Virginia state senator stabbed and his son dead from a self-inflicted gunshot wound, mental health advocates Wednesday warned that a national shortage of beds for psychiatric patients could portend similar violent incidents.

Sen. Creigh Deeds was stabbed Tuesday after an altercation with his 24-year-old son, Austin "Gus" Deeds, state police said. The younger man then shot himself, authorities said.

The Richmond Times-Dispatch reported Tuesday that Gus Deeds had received a mental health evaluation under an emergency custody order one day earlier, but he was released because no psychiatric bed could be found in the area -- an alarming national trend that advocates say is responsible for a long list of violent acts.

"This is such a crystal clear example of the problem," said Doris A. Fuller, executive director of the Virginia-based Treatment Advocacy Center.

"If Sen. Deeds weren't a public figure, we wouldn't be talking about this. The fact of the matter is that individuals and families and communities suffer every single day everywhere in this country because there are not sufficient acute facilities for people."

Research from the nonprofit found that the number of state psychiatric beds decreased nationwide by 14% between 2005 and 2010. In 2005 there were 50,509 state psychiatric beds, compared to 43,318 in 2010. Fuller said a person with severe mental illness is more likely to end up in jail or a state prison than a psychiatric hospital.

"This is a population with no voice," Fuller told CNN. "The people who are sick enough to be committed to a hospital for care are not people who are voting, and they are not people who are a political constituency. They're not a political priority."

Gus Deeds withdrew from The College of William and Mary last month after being enrolled off-and-on since 2007, according to a statement from the school.

He had been given a mental health evaluation under an emergency custody order Monday but was released because no psychiatric bed could be located across a wide area of western Virginia, Dennis Cropper, executive director of the Rockbridge Area Community Services Board, told the Richmond Times-Dispatch on Tuesday. Cropper declined to comment on the specifics of the case but said not finding a bed was unusual for his agency.

In fact, the state of Virginia averages 17.6 state psychiatric beds per 100,000 people, according to the Treatment Advocacy Center. "That's actually above average," Fuller said.

The recommendation is 50 beds per 100,000 people to provide the minimally adequate intensive care for people in crisis, Fuller said.

Arizona, for instance, has 4.1 state psychiatric beds per 100,000 people. England has 62 beds per 100,000 people.

Cory Jessee, a high school and college classmate of Gus Deeds, described him as brainy and a talented bluegrass musicians. He said those close to Deeds knew the family had sought professional help for him.

"I can't imagine him being conscious of what he was doing," he said of the assault. "I knew his family was trying to get him help. Everyone did.

"I knew they had the means and the ability to search for stuff like that and put time into it. I wasn't aware of how much time."

Cropper told CNN that under Virginia's emergency custody order process, medical staff have four hours to decide whether someone should be committed after the family petitions a court to order an evaluation. Medical staff have a four-hour window to decide whether someone should be committed. The clock starts when authorities deliver the patient for clinical evaluation. Physicians make a recommendation to the court after the evaluation. If a magistrate approves, medical staff search for an available hospital bed.

"In certain conditions a two-hour extension is granted by a magistrate, but under no circumstances can a person be held beyond six hours involuntarily," Cropper said in a statement.

Fuller said the shortage of psychiatric beds dates back half a century to President Kennedy's signing of the Community Mental Health Centers Act in 1963. The goal was to shut down public psychiatric hospitals, replacing them with small community based centers.

"It was a perfectly reasonable idea, except the community facilities were never built," she said. "The hospitals were closed and the people who once got hospital treatment for the most part no longer do, and the beds aren't there, period."

In 1960, there were 535,000 public psychiatric beds. By 2010, that number dwindled to 43,000.

"We have an estimated 450,000 people with mental illness in jails and prisons today," Fuller said. "You sort of add up that we have 43,000 in beds and 450,000 in jails and prisons, and you're almost back to the hospital bed number we had in 1960 -- except we've just re-institutionalized. And, of course, If Gus Deeds had not killed himself, he would be today in jail. There wasn't a hospital bed for him, but we would have found a cell for him."
 

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Governor McDonnell, we do not need to spend more money on yet another Glossy Report to Nowhere on the mental health system. We know it is broken as it has been for years. We, who have kids who have brain diseases already know how to fix it. We need more beds. We need discharge plans and community services and therapists and outpatient help. My son's 842 days in hospitals, jails and shelters cost more than $365,000. A group home with treatment is only about $28,000 per yr.

Governor McDonnell wants to fund another Glossy Report to Nowhere. We who have kids with brain diseases already know how to fix it. We need more beds. We need discharge plans and community services and therapists and outpatient help. My son's 842 days in hospitals, jails and shelters cost over $365,000 when the cost of a supportive group home is less than $28,000 a yr. $500,000 was spent on the Beaman Commission. The Va Tech study cost hundreds of thousands. Spend it on Treatment.

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