Joint Action to Address System Capacity Challenges

August 18, 2021

As many of you are aware, Commissioner Land (DBHDS) has halted admissions to the majority of the state psychiatric facilities and, has closed some wards to allow for more efficient deployment of staff.  This action is not unlike the closure of community program locations which we have seen increasing in recent weeks. 

The significant difference in the impact between the two actions, however, is that the actions taken by DBHDS have left individuals who are in severe crisis with no alternative than a hospital Emergency Room stay (potentially of many days), the sheriffs who are responsible for the security and transport required to be taken away from more pressing duties for extended periods, and the CSB Emergency staff spending just as long repetitively searching for a bed that just simply does not exist!

Seven associations have come together to try to engage the Commissioner and DBHDS staff proactively in coordinating a more effective response.  The community partners are:

  • National Alliance on Mental Illness of Virginia
  • Virginia Association of Chiefs of Police
  • Virginia Association of Community Services Boards
  • Virginia College of Emergency Physicians
  • Virginia Hospital & Healthcare Association
  • Virginia Sheriffs’ Association, and
  • Virginia Network of Private Providers

The letter we sent can be found here and her response in most part is as follows:

“Thank you very much for your detailed letter stating your concerns. It is clearly an unprecedented and extraordinarily challenging time for so many stakeholders within and around Virginia’s behavioral health system.

I first wanted to mention your reference to Va. Code § 37.2-316, which triggers the creation of very prescribed community consensus and planning teams. While DBHDS has acted on Va. Code § 37.2-316 when it has made proposals to close a hospital in the past, the current census and staffing admission closures are meant to be temporary in nature. In fact, we do not want this time of crisis to last a day longer than it must before conditions are safe enough to reopen on a limited basis. Once that level of safety is reached, we will continue safe discharges and staffing recruitments that allow us to incrementally work toward normal operations.

That said, I am fully aware that the tremendous challenges being faced by the state hospitals are also sending ripple effects beyond our system that spill over into other sectors. I have called on stakeholders many times in recent months to work together for solutions, and have personally reached out to many of you during this crisis. We are all stopped at this intersection together, and I agree we should meet together to work on these incredibly difficult problems. This meeting will be time to discuss the many issues and concerns at hand and work toward solutions.  I am happy to discuss several ideas DBHDS is pursuing to ameliorate the crisis.”