The governor has called for an internal review and the state inspector general’s office has launched an investigation into the release of state Sen. R. Creigh Deeds' son from emergency custody 13 hours before he stabbed his father and killed himself, officials said Wednesday.
Officials from three area hospitals, including the University of Virginia Medical Center, said that space was available for psychiatric care Monday, when the emergency order expired, but no inquiries came from Rockbridge Area Community Services. That agency’s top official said time ran out on the emergency order before a hospital could be found for Austin Creigh “Gus” Deeds, 24, to undergo further evaluation of his mental health.
He left Bath Community Hospital at 6:30 p.m. Monday following his release. At 7:25 a.m., police received a 911 call regarding an altercation between him and his father. He stabbed the senator repeatedly outside their Bath County home, then went inside the house and shot himself with a rifle, police said. The elder Deeds’ condition was upgraded Wednesday from fair to good, UVa officials said.
After The Daily Progress reported Wednesday that two area hospitals — Rockingham Memorial Hospital in Harrisonburg and UVa — said they had available space Monday evening, G. Douglas Bevelaqua , of the inspector general program for behavioral health in Virginia , announced that his office was investigating.
Such reviews, he said Wednesday night, are mandated in cases “involving allegations of abuse, neglect or inadequate care by state service providers.”
“The media reports suggest that the outcome of [Deeds’] case is something that we need to look at,” Bevelaqua said.
Gov. Bob McDonnell ordered Bill Hazel, secretary of health and human resources, to review the case.
"The governor has directed [Hazel] to conduct a full internal review of the tragic events leading up to Tuesday's tragic situation,” McDonnell spokeswoman Taylor Keeney said Wednesday night. “The secre tary has already begun his assessment, working in cooperation with all relevant state and local authorities."
A Rockingham official told The Daily Progress on Tuesday that while psychiatric beds were available Monday, no one from the Rockbridge agency called. A UVa official said the same Wednesday, as did John Beghtol , director of community services for Western State Hospital in Staunton .
“We did get some calls Monday night but no one from Rockbridge spoke with a member of our psychiatric emergency team and there were no messages left,” said Rockingham spokeswoman Deb Thompson.
A fourth hospital, Augusta Health in Fishersville, lacked available beds, an official there said.
The circumstances that led Gus Deeds to be held under the emergency order remained murky Wednesday. State police said the Bath County Sheriff’s Office responded to a non-emergency call Monday at the Millboro Springs home on Vineyard Drive , where he lived with his father. Deputies had not responded to the home before, state police said.
Under Virginia law, magistrates can issue emergency custody orders allowing mental health officials to hold people for four to six hours. After that time expires, if officials determine further evaluation is warranted, a temporary detention order can be issued allowing the individual to be held for up to an additional 72 hours — but only if an available psychiatric bed can be found. Otherwise, the individual must be released.
“Calling a hospital is not just a simple matter of calling a hospital up and saying, ‘Hey, we’ve got somebody here, can we bring them in?’ And they say, ‘Yes,’” Dennis A. Cropper, executive director of Rockbridge Area Community Services, said from his office Wednesday. “We have to fax them information from the evaluation we just completed, fax them medical information, and they then take it and talk among their admission staff … and make a determination as to whether they can … or are willing to accept this individual.”
Emergency orders can be extended for two hours, which happened in Gus Deeds’ case, Cropper said Tuesday afternoon. But the time to find a hospital ready and willing to take on a patient can be prohibitive, especially in rural areas, where available beds could be a two-hour drive or more away, mental health experts said.
“Sometimes, it can take up to 30 minutes, maybe even an hour, before we get a response back from the hospital,” Cropper said. “If they were to say no, we then have to go to another hospital and do the whole process again. This is where the extension for the time limit comes into play.”
Rockbridge’s community services board is one of 40 across Virginia tasked by the state with forming the first line of defense in mental health, making key decisions in the trenches about whether further evaluations are needed, even if that means obtaining a temporary detention order to hold people involuntarily.
The job is widely regarded as a difficult one. Mental health experts agree that Virginia faces a shortage of available beds, particularly available staffed beds — meaning that enough mental health professionals are available to provide care. A state inspector general’s office report released last year identified a drop in public and private hospital beds that coincides with a decrease in staffing for available beds.
The gap rendered 235 of 1,540 psychiatric beds in private facilities unusable in 2010, according to data from the Virginia Hospital and Healthcare Association, which represents 38 member hospitals and health systems.
Still, an April study by the University of Virginia found that community mental health clinicians were able to find an open bed after calling one or two hospitals in 80 percent of cases in a study group of 1,260 incidents. In 87 percent of those cases, clinicians found a bed in less than four hours.
About 20,000 temporary detention orders were issued last fiscal year, according to data collected by the University of Virginia Institute of Law, Psychiatry and Public Policy.
“I don’t think we, as a state, have even close to enough resources to address the need,” said Katharine Webb, a senior vice president at the Hospital and Healthcare Association and a former faculty member at the UVa Medical Center ’s pediatrics department.
Webb said it’s less complicated for hospitals to treat a patient suffering a heart attack than one enduring a psychotic break.
“It’s not as simple as just having a bed available,” she said. “You don’t stitch up a person with a mental health issue and send them home. It’s a process.”
While scrutiny tightened on the mental health system and Sen. Deeds, 55, continued his recovery, some details emerged from state police regarding Tuesday’s attack.
Police said an autopsy on Gus Deeds had been completed in Roanoke, determining that he’d been killed by the self-inflicted rifle shot. Investigators recovered what they believed was the weapon Deeds used in the stabbing of his father. Police said they wouldn’t elaborate on the type of weapon until forensic tests confirmed it was the same one used in the attack.
Otherwise, Tuesday’s drama had faded by Wednesday. The entrance to Deeds’ driveway was blocked by crime scene tape, but neither state police nor sheriff’s deputies appeared to be at the home.
Gus Deeds’ body was transported from his home Tuesday in a hearse from Nicely Funeral Home in Clifton Forge. A representative there said Wednesday that no funeral arrangements had yet been set.
Bob Stuart of the (Waynesboro) News Virginian contributed to this story.