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First step in mental health reform

Richmond Times-Dispatch - 10/24/2016

During the first full week of October, Mental Illness Awareness Week, participants across the country work to raise awareness of mental illness, fight stigma, provide support and advocate for equal care. Here in the commonwealth, it is a time to reflect and recommit to reforming our system for delivering mental health care to improve the lives of the thousands of Virginians affected by mental illness. This important issue is a year-round focus for those families touched by mental illness and those of us in the General Assembly representing them.

In 2012, the Virginia inspector general's office warned that "streeting" - when a mental health patient is turned away because there are no psychiatric beds available - would become a crisis. Two years later, in the wake of public tragedy, the General Assembly took action and worked to address the gaps in our delivery system of mental health care. During the 2014 session, lawmakers passed mental health reform legislation including establishing a database of available psychiatric beds, extended the limits of the emergency detention order and passed a joint resolution ordering a three-year study due before the 2018 session intended to help lawmakers continue the reform effort.

We have seen the tragic consequences of what happens when there are too few psychiatric beds available for Virginians who need them. Time and time again a lack of access to psychiatric care is cited as the catalyst when a mental health crisis becomes a public tragedy in the news. We have taken bipartisan steps to address the challenges we face in mental health, and there is still much more that can be done. It has been my privilege to serve on the Joint Subcommittee to Study Mental Health Services in the Twenty-First Century, and I look forward to making additional recommendations on what can be done in our final report in late 2017.

Unfortunately, discussions about finding ways to ensure our most vulnerable citizens have access to critical mental health care frequently turn into debates over more funding for services. But there are steps that can be taken that will not cost taxpayers at all. The acute fact that our state's certificate of public need law (COPN) is blocking the addition of psychiatric beds is rarely mentioned. Like many of the things we have done so far on this issue, reforming COPN should be a bipartisan solution. In the month of July alone, multiple letters of intent to pursue a certificate of public need to add a total of 90 psychiatric beds to Virginia hospitals expired without the projects moving forward. Additionally, regulators denied at least four COPN applications to provide additional psychiatric beds in recent years.

The simple truth is that our state's certificate of public need law is only making it more difficult for us to address the shortage of beds. A good way to help ensure individuals have access to an inpatient or crisis stabilization bed when it is needed is to get government programs like COPN out of the way when they are making the problem worse. We should get rid of unnecessary regulatory barriers that delay much-needed psychiatric beds when minutes can make all the difference.

Health care is complex and there aren't any quick fixes, but we don't have to wait for the 2017 release of the pending mental health care study to fix this problem. The General Assembly should approve significant COPN reform legislation that eliminates this requirement for psychiatric beds. I'm committed to addressing Virginia's shared goal of improving our approach to mental health, and one of our next steps in mental health reform this legislative session should be comprehensive COPN reform.

Scott Garrett (R) represents District 23 (Bedford, Lynchburg and Amherst) in the Virginia House of Delegates. He is a member of the Health, Welfare and Institutions Committee and serves as a member of the Joint Subcommittee to Study Mental Health Services in the Twenty-First Century. He can be reached at DelSGarrett@house.virginia.gov.