Describing Virginia’s current behavioral health system as in “crisis,” Gov. Glenn Youngkin on Wednesday laid out a sweeping $230 million plan to address gaps in how the state cares for adults and children facing mental health, substance abuse and other behavioral issues.
“The commonwealth’s behavioral health safety net is not equipped to address the demands that are being placed upon it,” said Youngkin.
At an occasionally emotional announcement at Henrico Doctors Hospital, the Republican governor previewed parts of a budget proposal he plans to unveil Thursday while outlining a six-point plan that his administration says will bolster Virginia’s struggling systems for providing aid to people undergoing crisis.
“Almost 1.5 million Virginians have some form of mental health challenge,” he said. “About 340,000 of those have serious mental illness. And yet six out of 10 adults with any form of mental illness did not receive any form of treatment.”
Under the “Right Help, Right Now” plan, Youngkin is proposing large investments in crisis response solutions that don’t rely on emergency rooms such as mobile units and crisis receiving centers, as well as the expansion of community-based care, initiatives to strengthen the state’s chronically understaffed behavioral health workforce and funding for substance abuse treatment efforts.
“The current behavioral health system is being overwhelmed and failing to meet the needs of Virginians in crisis with an outdated model of care that relies too heavily on hospitals,” the Youngkin administration said in a release.
‘Comprehensive continuum of care transformation’
Sen. Siobhan Dunnavant, R-Henrico, a practicing OB-GYN, called the proposal a “comprehensive continuum of care transformation” that offers an improvement on the General Assembly’s past “whack-a-mole” approach to behavioral health.
“We are in crisis and we all know it,” she said.
Both Democrats and Republicans will have to agree to Youngkin’s budget requests, which include $20 million for 34 new mobile crisis units, $58 million to increase the number of crisis receiving centers and crisis stabilization units statewide, $9 million to expand tele-behavioral health services in public schools and on college campuses and $9 million for transportation and in-hospital monitoring by law enforcement and other personnel.
Dunnavant said she believes the overall budget proposal will have bipartisan support but may face disagreements about the specific breakdown of dollars.
“I think the only variable will be how the money is spent,” she said.
Several Senate Democrats on Wednesday reacted positively to the announcement, with Sen. Barbara Favola, D-Arlington, saying, “We are delighted that the governor is willing to work with us on an issue that Democrats have taken the lead on for years.”
“We certainly are willing to work in a bipartisan way,” said Favola, who also serves on the Virginia Behavioral Health Commission.
The challenge, she said, would be in implementing Youngkin’s proposals, particularly with worker shortages in the field.
One solution she proposed was reform of Virginia’s laws governing barrier crimes, which prohibit many health and social services providers from hiring people with certain criminal convictions. While barrier crime laws are not unusual, Virginia’s version of the restriction is widely seen as unusually far-reaching, with 176 different convictions disqualifying applicants from working in behavioral health. Prior legislative efforts to reform the state system have failed, but Favola said she hopes the proposal could garner more support this year.
Virginia’s behavioral health system has faced high-profile challenges in recent years, with a dwindling workforce that in July 2021 led to the temporary closure of five of its mental hospitals to new admissions.
The state has also struggled to meet the requirements of a 2014 “bed of last resort” law that requires state hospitals to admit patients under a temporary detention order within eight hours if a bed cannot be found at another hospital, including private facilities.
Temporary detention orders are issued by a magistrate for people undergoing a mental health crisis who officials determine have a “substantial likelihood” of causing serious physical harm to themselves or others.
The bed of last resort law was put forward by Sen. Creigh Deeds, D-Bath, after his son Gus stabbed Deeds and then killed himself during a mental health crisis. State officials had been unable to find Gus Deeds a psychiatric bed.
The incident was one of several Youngkin and his wife, first lady Suzanne Youngkin, referenced Wednesday in support of the plan to overhaul the state’s behavioral health system. Both also mentioned the 2012 death of Lt. Gov. Winsome Earle-Sears’ daughter and two grandchildren in a car crash during a mental health episode Earle-Sears’ daughter was undergoing.
“There’s not a person in the room who hasn’t been touched directly with a mental or behavioral health challenge, and our family’s no different,” Youngkin told reporters after the announcement. “Lt. Gov. Earle-Sears is a very dear friend, and you all heard her story. And we have so many friends who have similar stories.”
The governor also pointed to two high-profile mass shootings at the University of Virginia and a Walmart in Chesapeake last month as examples of the need for expanded mental health resources. Following the Walmart shooting, Youngkin told reporters he intends to propose legislation during the upcoming session on the issue.