Sen. R. Creigh Deeds, D-Bath leads a legislative commission studying the state’s mental health system.
When Carroll County deputies stop to refuel in Waynesboro on the last leg of a 20-hour day spent bringing someone in mental health crisis to involuntary care, they sometimes pass officers coming from the jurisdictions they just left.
It’s not a happy sight for bone-tired workers criss-crossing the state to bring patients to hospitals that often are hundreds of miles from home. They often come in on days off or work overtime to fulfill mandates lawmakers assigned but haven’t funded, county Sheriff J.B. Gardner said.
“My citizens are complaining that we have no coverage for calls for service in the county and they are absolutely correct,” Gardner said. “It’s a struggle to find deputies for transport without taking them off the road.”
A state study released this month calls for the agency overseeing public mental health services in Virginia to establish a statewide alternative system of transportation, which could serve adult patients who are mobile and not considered by a magistrate to be a flight risk or pose a danger to themselves or others.
About 40 percent of people mandated to receive care under the terms of a temporary detention order met those conditions during a pilot program conducted in five Southwest Virginia counties between Jan. 1, 2016, and March 13, 2017.
G4S Secure Solutions provides the services in North Carolina and estimated it would cost about $4.8 million annually to do the same in Virginia, according to the study. There was no estimate provided of potential savings for local law enforcement agencies.
The solutions are imperfect but represent a chance at progress, said state Sen. R. Creigh Deeds, D-Bath, the leader of a legislative commission studying Virginia’s mental health system.
“It’s not going to work in every situation,” he said. “But although it won’t fix all the problems, it could help in some places.”
No one is happy with the way things are: Not mental health advocates who want to see a more humane process; not state legislators grappling for solutions; and not law enforcement leaders tired of seeing their overtime budgets blown and their employees overworked.
“The experience of being involuntarily committed for mental health issues already is traumatic,” said Rhonda Thissen, executive director of the National Alliance on Mental Illness of Virginia. “Being put in the back of a police car doesn’t help.”
Short-staffed law enforcement agencies long have been strained by the demands of transporting people to court-ordered care, but a package of bills the General Assembly passed in 2014 to shore up gaps in the state’s public system of mental health exacerbated the demands, Gardner said.
“(Lawmakers) want to speak about the mental health crisis and how they will fix it, but so far their fix has left my county with much reduced coverage for hours at a time, transportation costs that are not covered and overtime (pay) that is nonexistent,” Gardner said.
Several law enforcement chiefs report that their agencies are fielding more mental health-related calls, staying longer for evaluations and traveling farther to transport patients since the laws were passed.
The legislative fixes addressed issues laid bare by the death of Deeds’ 24-year-old son, who attacked his father before killing himself in November 2013 after efforts to secure him court-ordered inpatient treatment fell through. A clinician had six hours to find Austin C. “Gus” Deeds a bed, but she ran out of time and he went home.
Legislators in response extended the time clinicians have to evaluate someone from a maximum of six hours to eight hours, bumped the possible hold for someone found to need inpatient treatment under a temporary detention order from 48 hours to 72 hours and also required state facilities to admit patients who qualify for court-ordered inpatient treatment if a suitable private bed cannot be found before time runs out.
“I don’t want to sound hard — these people need and deserve the help, obviously — but we figure on at least 10-12 hours tied up each time we get a call,” said Rick Clark, chief of the Galax Police Department, who had just finished signing time sheets for his agency of 24 sworn officers.
The latest trip on a mental health call cost taxpayers $632, plus $34 in per diem expenses for a pair of officers dispatched to Eastern State Hospital near Williamsburg. They left at 6 p.m. and returned around 5:30 a.m.
Deeds said he’s eager to improve the situation but willing to live with the perceived consequences of passing the laws.
“Was it worth it? Yes, absolutely, it was worth it,” Deeds said. “My son’s situation, it got a lot of attention, but (what happened to him) happened to a lot of others before him.”
Clark’s agency participated in the alternative transportation pilot program, which operated through the Mount Rogers Community Services Board and serviced Galax and Bland, Smyth, Wise, Carroll and Grayson counties.
Qualifying patients were transported by Steadfast Security LLC by plainclothed, unarmed drivers in unmarked vehicles without restraints. The drivers had completed specialized training designed to de-escalate crises and interact respectfully with people in a crisis.
“We already have such a stigma surrounding mental illness, and transporting people in squad cars kind of deepens the stigma,” said Thissen, who welcomed the report’s recommendations.
One potential wrinkle Deeds foresaw is that most people would not qualify for alternative transport. By definition, people who qualify for temporary detention must represent a danger to themselves or someone else, he said, which in theory would render them unlikely to meet a magistrate’s criteria for the program.
Law enforcement agencies transported people in about 99 percent of the 25,000 cases for which temporary detention orders were issued in the 2016 fiscal year, although existing law allows for a friend, family member or other agency authorized by a magistrate to bring a person to court-ordered treatment, the report states.
Law enforcement agencies transported people in about 60 percent of the 1,159 total cases that occurred during the pilot program, but the percentage of cases in which alternative transportation was used increased over time as those involved became more familiar with the process, according to the study.
Smyth County Sheriff Chip Shuler participated in the program but isn’t convinced an alternative is the solution.
“I think they’re talking about putting a lot of money into the alternative transportation project, but it’d be more effective if they’d just put it into the sheriff and jail budgets so we can manage what we’re seeing,” he said.
The report does not address the possibility of using alternative transportation for children. Shuler recently had to find a car seat so his deputies could transport a 5-year-old to court-ordered treatment in Staunton.
“It broke our hearts to see that,” he said. “My heart breaks for anybody who needs this help.”
He has been pulling detectives and school resource officers off their duties to juggle spikes in calls for service that include seven transports to mental hospitals in one day in August. With a sworn force of 37, Shuler said the volume can be unmanageable.
“We do not have the staff to manage this and safeguard the county,” he said. “ My worry is we’re doing these transports and I’m not going to be able to respond to things happening back here. It’s a daily problem.”
