Virginia has been moving ahead in serving its mentally ill residents.
But every step forward seems to reveal yet another gap where a stepping stone needs to be placed.
The tragedy of Sen. Creigh Deeds’ son, who attacked his father and killed himself after a community services staff member failed to find space for him to be hospitalized, exposed a problem in the state’s system for providing mental hospital space and making sure that vacancy information was readily available.
Fixing that problem created a surge in the number of people being involuntarily committed to hospitals — including commitments to hospitals distant from their homes where bed space was available.
This, in turn, obligated local law enforcement departments to provide emergency transportation to hospitals more frequently. That necessity caused added trauma for those patients who felt they were equated with criminals and for officers who were pulled away for long shifts and were not at home to protect their communities.
Responding to that problem, Virginia now has contracted with a private transportation firm to lift some of the burden from local law enforcement officers. The first roll-out of the program is planned for this week in Southwest Virginia.
But all this begs the question: How are patients supposed to get home?
Under the system intended to find space as quickly as possible, a patient can be transported hundreds of miles across the state if that’s where a bed can be located.
But when patients are ready to return leave the hospital, only a patchwork system exists to get them home.
In some cases, patients are on their own to find friends or family members who can make the trek to the hospital to pick them up and take them home. In some cases, community services boards arrange transportation. In some cases, the hospitals take responsibility for ensuring that patients make it home — even if that requires hiring taxis for them.
If a patient is sent to a psychiatric hospital on an emergency order, that means he or she is in extremis. When the patient is released, he or she has been judged to be no longer a danger to self or others and is ready for a different level of care.
But the patient still could be in a fragile state in which coping with transportation issues might cause a setback.
“You can be placed anywhere all over the state, only to be stuck there,” said Heidi Campbell, who has experienced hospitalizations as a patient and also serves on the board of directors for the Central Shenandoah Valley chapter of the National Alliance on Mental Illness of Virginia.
The state doesn’t collect data on how patients are able to make it home, or how difficult it is for them to find help.
It certainly doesn’t pay for the return trip as part of its new program to provide transportation through a private contractor.
Not every problem can be, or should be, solved by government. But even if the state never offers a full-fledged ride home program, it might be able to assist patients by coordinating transportation as a consistent, reliable part of the discharge process.
In any case, the first step is obtaining more information about the nature and extent of the problem. Until policymakers have a better grasp of the need, they cannot determine potential remedies.