Plea for Virginia's Mental Health System

The state of Virginia took an important step when it created the position of inspector general to serve as watchdog for the state mental health facilities (Psychiatric News, May 2). As a staff psychiatrist at Eastern State Hospital in Williamsburg, Va., I know that this position, held by Anita Everett, M.D., has had a positive impact on the quality of care that is afforded to psychiatric patients served at this and other state facilities. Even with limited resources, she has done an exemplary job in ensuring that state and national guidelines are followed.

It is, however, disturbing to note that Dr. Everett's position may be eliminated this summer. At the same time, there is a crisis brewing in the provision of public mental health care in Virginia. The Governor's Restructuring Initiative calls for shifting of funds from state psychiatric hospitals to the local Community Services Board (CSB) without actually creating new money. This initiative will require closure of acute care beds in state hospitals with provision of inpatient care in the private sector. The result will be shorter stays and patients being discharged before they are truly ready to reintegrate back into the community. In addition, there is already a bed shortage in private hospitals.

I am a strong proponent of care in the least-restrictive setting. However, this plan will result in more patients being inadequately treated and increased risk of death, readmissions, and incarceration. At such a time, I implore Gov. Mark Warner not to eliminate this important position and to increase the budget for mental health so that both the state hospitals and the CSBs can benefit from increased funding and continue to provide the best possible care to their patients.

There continues to be a need for safeguards, and Dr. Everett and her staff play an important role in the provision of safe and effective delivery of public psychiatry.