Mental Health Facilities to Close in Virginia, while Boston’s Beth Israel Revamps its Psych Unit Plans
Virginia Gov. Jim Gilmore's (R) administration hopes to close at least two state mental hospitals during the next six years and cut the size of other facilities, shifting mental health care programs to private hospitals and community programs, the Richmond Times-Dispatch reports. Under the plan, the state would close the Southern Virginia Mental Health Institute in Danville within 18 months and shut down acute care units at state hospitals in Williamsburg, Staunton, Northern Virginia and the Roanoke area within six years. However, the hospitals, excluding Southern, would remain open for long term care and rehabilitation of the mentally ill. The state also plans to close Piedmont Geriatric Hospital in Burkeville by mid-2006, as well as beds serving mentally ill seniors at Southwest Virginia Mental Health Institute in Marion. In addition, the state would shut down remaining units for mentally ill seniors at Eastern State Hospital and Catawba Geriatric Hospital as part of a shift to private psychiatric care. Administration officials declined to discuss plans for specific institutions but confirmed that Gilmore will propose initiatives to "greatly diminish, if not eliminate," the state participation in acute or geriatric care for mentally ill patients. "Long term, the goal is to get out of the provision of care for the geriatric population in state hospitals," Arne Owens, deputy commissioner for public affairs and policy in the state Department of Mental Health, Mental Retardation and Substance Abuse Services, said. Owens added that the state plan, which Gilmore will likely announce in mid-December, would move short term care of the mentally ill to private hospitals and local programs run by community services boards. The plan also would revamp the Staunton-based DeJarnette Center -- the last major public institution for mentally ill children and teens -- from a state-funded care facility for those committed involuntarily to a center designed to serve emotionally disturbed youth referred by local programs "that would be partially responsible for paying the bill." Owens also confirmed a proposed state initiative to provide "some sort of residential programs for children and adolescents" under the Comprehensive Services Act, an eight-year-old law requiring the state and local governments to serve children in mental health, foster care, special education or juvenile justice programs. Owens added that the initiative would not affect the state's five training centers for the mentally retarded. "That's off the table," he said. The Gilmore administration has discussed the proposal with a number of organizations, which has generated a "mixed" reaction. Valerie Marsh, executive director of the National Alliance for the Mentally Ill-Virginia, called the proposed shift of care from state mental hospitals to community programs "really long overdue," noting, "It's what we really want to have happen." According to Marsh, however, her organization will not endorse the plan without more details to ensure that community programs and hospitals can serve mentally ill patients currently sent to institutions for acute care. Mental health advocates also argue that the state should use funds saved from state hospital closings to "improve and expand" community programs. "They would have to give us all kinds of assurances that the money would stay in the system," Marsh said (Martz, Richmond Times-Dispatch, 11/25).
Beth Israel Backs Down
Under "intense pressure" from public officials and staff members, Boston's Beth Israel Deaconess Medical Center has agreed to retain many psychiatric services slated for elimination, raising hopes that the facility will also reverse a decision to cut about four dozen inpatient psychiatric beds, the Boston Globe reports. In September, Beth Israel announced plans to close the psychiatry units, the largest among Boston's general hospitals, as part of a "cost-cutting" plan. However, during a Nov. 22 meeting between government and hospital officials, Boston Mayor Thomas Menino (D) and state Commissioner of Mental Health Marylou Sudders "made it clear" that they would move to keep the psychiatric beds open. Government officials have also "threatened" to invoke a new state law to review and delay the decision to close the beds, notifying the hospital in a "strongly worded" letter that it could face public hearing over the decision. Although hospital officials would not comment on their plans for the 43 inpatient beds targeted for elimination, spokesperson Geri Denterlein said Monday that "the medical center is involved in constructive dialogue with state and local agencies" and confirmed that Beth Israel will maintain its psychiatric residency program, academic department of psychiatry, outpatient mental health services and psychiatric consultations for inpatients. Sudders, who said she is "optimistic" about efforts to retain the inpatient beds, also suggested a possible compromise, noting that if Beth Israel agreed to maintain at least 25 psychiatric beds, "I'm pretty sure that, with time, we can create" at other hospitals "some extra beds to make up the difference." Massachusetts officials said that they "feel betrayed" by Beth Israel's planned closures, noting that the state had earmarked more than $1 million in public funds to help the hospital expand and add "lock-up capacity" to its psych unit. State and city officials expect a decision in January (Tye/Kowalczyk, Boston Globe, 11/28).