Shortage of Psychiatric Beds Preceded State Senator’s Stabbing

The son of Virginia State Senator Creigh Deeds received an emergency mental evaluation the day before the apparent attempted murder-suicide, but no hospitals could admit him. The problem isn't new

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Early on Tuesday morning at his Bath County home, Virginia state senator Creigh Deeds suffered multiple stab wounds, and his 24-year-old son Gus died from an apparent self-inflicted gunshot in what police are considering an attempted murder-suicide.

The events that led up to the shocking incident are still under investigation, but according to a report from the Richmond Times-Dispatch, the younger Deeds underwent an emergency mental-health evaluation on Monday. He was reportedly released hours later because there were no psychiatric beds available for him in western Virginia.

Known as “streeting,” the practice of releasing at-risk psychiatric patients for whom no bed is available is uncommon at the facility where Deeds was evaluated, says Rockbridge County Community Services Board executive director Dennis Cropper. “I would say in terms of finding a bed, it’s usually 97% of the time. It is unusual that we’d never find a bed for somebody,” Cropper tells TIME.

Rare or not, it’s an issue Virginia has struggled with before. In 2011, Virginia inspector general G. Douglas Bevelacqua released a report chastising the state for turning away in a month an estimated 200 patients determined to be a threat to themselves or others who met the criteria for a temporary detention, only because state facilities lacked the room to hold them. Twenty-three of Virginia’s 40 community-services boards acknowledged that “streeting” occurred at their facilities.

“I wouldn’t say this happens every day, but it’s more common than we’d like for it to be,” Mary Ann Bergeron, the executive director of the Virginia Association of Community Services Board, told the Washington Post.

Under Virginia’s emergency-custody-order process, the family of a patient petitions a magistrate to order an evaluation, and medical staff have a four-hour window to decide whether someone should be committed, according to Cropper, who declined to speak about the specifics of the Deeds case out of respect for the family’s privacy. The clock starts when a sheriff picks up the patient and brings him or her in for clinical evaluation. Once the evaluation is complete, physicians make a recommendation to the magistrate. If the magistrate approves, medical staff then search for an available hospital bed.

It all has to happen during the four-hour time frame. “We can sometimes get an extension of two hours on that, but beyond the six hours we cannot. So if we don’t find a bed within six hours, then an individual would have to be released. We can’t keep them,” says Cropper.

The availability of inpatient psychiatric care has decreased nationally in recent years. Research from the Treatment Advocacy Center, a national nonprofit focused on eliminating barriers to treatment of severe mental illness, found that the number of state psychiatric beds decreased nationwide by 14% between 2005 and 2010. In 2005 there were 50,509 state psychiatric beds nationwide, and in 2010 there were 43,318. It’s estimated that a person with severe mental illness is three times more likely to be in a state prison than a psychiatric hospital.

The trend is long running. In 1975, the federal government specifically excluded Medicaid payments for patients in state psychiatric hospitals as part of an effort to get Americans out of institutions, and to shift payment back to the state. But that also led to fewer available beds for emergency patients, a shortage that continues to exist today.

Tightening state budgets have widened the gap in available beds. In the wake of the 2007 Virginia Tech shooting that claimed 32 lives, Virginia’s legislature took measures to revamp the emergency-evaluation processes, updated the criteria for involuntary psychiatric commitment and raised state funding for community mental-health services. But according to a report from the National Alliance on Mental Illness, Virginia’s overall state mental-health budget decreased $37.7 million dollars from $424.3 million to $386.6 million between fiscal years 2009 and 2012.

“The consequences of not providing treatment should demonstrate the importance of the need for it,” says Kristina Ragosta, director of advocacy at the Treatment Advocacy Center. “Most people with mental illness are no more violent than the general population, but when we talk about people with untreated mental illness, they are at greater risk of committing violent acts.”

— With reporting by Charlotte Alter / New York City

79 comments
TERESANEXTDOOR
TERESANEXTDOOR

Time to change the mental health laws to reflect the violence of our times.  This young man should have been held in protective custody until a bed was available.  It no longer matters if a person is over 18, they are AT RISK now more than ever before.  Our times are more violent, and there is more mental illness.  Laws have to reflect this.  How many more times do I have to hear stories of patricide, matricide by mentally ill children because laws no longer protect our society.  LISTEN TO THE PARENTS, LISTEN TO THEM. SAVE THEIR MENTALLY ILL CHILDREN, you might be saving the parent's lives as well.

DeanJackson
DeanJackson

Well, I was right after all...this was a staged event, and all of you fell for it (see my earlier comments to this thread)!


"Austin Deeds, who was 24, had undergone a psychiatric evaluation Monday, and officials initially said the reason he was not admitted to a hospital was that no bed was available. But multiple nearby hospitals later confirmed that they had available space but were never contacted."


http://www.washingtonpost.com/local/virginia-politics/state-mental-hospital-in-staunton-had-room-for-deedss-son-on-monday/2013/11/20/5faeccaa-51fd-11e3-9fe0-fd2ca728e67c_story.html

sadmominwa
sadmominwa

We definitely need to draw attention to this problem.  My 22 year old son has been gone less than a month now, he committed suicide.  We took him to the hospital with suicidal ideation and they didnt have a bed and couldnt find him a bed.  4 days later he walked to the hospital himself...got inside and got a hospital bracelet on but was not watched...walked out of the emergency room and jumped off an overpass.  He suffered from schizoaffective disorder.  He did NOT want to die, he wanted help.  He truly believed the delusions in his head.  I hope to fight for other people who might run into this same dilemma so that this might not rip apart more families.

jtahoe
jtahoe

Dave, another thought. Denmark's success at having the smartest kids in the world, according to the book, "The Smartest Kids in the World," is due to the high status that teachers have in their society, and the fact that they only accept students into teaching programs that are in the top third of their class. A high societal view of the profession, coupled with high standards to pursue the career, appear more important than the almighty dollar. But a good income, I would certainly agree, is important to a good life. Less billionaires, and more people living well, with the mentally ill being treated, would seem to be a good direction to head!

jtahoe
jtahoe

 @DavidMoultrup Dave nice thoughts. As a political economist, I would suggest that a complete rethinking of our economic system is in order. The Scandinavian countries, notably Norway and Denmark, appear to be the only countries on this very messed up planet that have been successful at creating societies that share the wealth and income of the country in a way that is both supportive of personal growth and development, incentivizes entrepreneurship and hard work, while providing access to free education all the way through graduate school, free healthcare, comfortable retirement incomes, and which produce very low unemployment rates and low rates of poverty. Norway has the highest rankings for years for human development, democracy, economic growth and development, educational attainment, the fairest distribution of wealth, based on the gini coefficient (see wikipedia for Norway, Denmark, and Gini Coefficient); while Denmark is rated the highest for child education in the book "The Smartest Kids in the World." We idolize the billionaires, most of which have inherited their monies, and many on Wall Street and the business world that have ill gotten billions. While we have seen the wealth and income of the bottom 99% go down since the Reagan era began (see Emmanuel Saez, UC Berkeley). Literally almost all of the gains of the industrial / technological era have gone to the top .1% of the families in the United States, roughly 3,000 - 4,000 families. While the mentally ill, the bottom 99% and the rest have seen their lives deteriorate over this forty year period of "trickle down" "plutocratic" economics. When will we as a country wake up and realize that our total economy is broke, there are other models that provide great incentives to advance for the masses, provide incentives for the hard working entrepreneurs, while giving the less fortunate a reasonable hope for help. The end of modern civilization the second half of this century, due to the end of fossil fuels; the host of problems due to over population (global warming, fresh water shortages, farmable land shortages, etc., etc); and, the enormous fiscal gaps ($220 Trillion in the US, larger than the value of all financial assets globally) may be horrific for billions of people that are likely to suffer due to the insane greed that has ruined our Plutocratic Empire. To even suggest that you like the Scandinavian model as a politician - would be to label yoursself as a "socialist!" God forbid, dammed to hell forever! People in our country do not have a clue what the "market socialist" models of scandinavian countries mean. Let alone how much better they are than our system. They are taught that they are the work of the devil, and are anti-Christian. We have a lot of work to do! Maybe in another couple hundred years, after the massive collapse that many of us anticipate the second half of the century, people may wake up to the fact that the benefits of the whole society do not trickle down to the masses from the top .1%, and use the democratic process to make the system work for the other 99.9%. Also, I would suggest that low wages do not attract women either! To a better world some time, some where, over the rainbow!

IliveahWaters1
IliveahWaters1

Many hospitals had room(s).    IF gus truly was danger to self/others he would not have been let out of custody.   

 Normal medical/legal protocol is S/H folk are  even held on suicide watch in local jail if needed, until hospital room opened up.  

All factual details combined implicate father, Creigh, is most likely the abuser/criminal using his power to blame & shut up his son, the victim.    Gus had decades of history showing he had no issues - Creigh did.     


Narcissists/abusers using "psych" "evals" (labeling their enemies as "crazy) might sound looney to some -  it happens all the time and it has happened for centuries.     This entire event stinks of abuse/corruption.

DeanJackson
DeanJackson

For those of you who believe anything the media reports, you're credulous.

A state senator denied anything? Can't you see that this is a staged event? Purpose, you ask? To implement the "mental screening" of all citizens, and determine who's sane and who isn't.

Those considered insane (or mentally ill) will be those like me, who can see clearly what's going on, while people like you, who lap up anything the media tells them no matter how ludicrous, will be diagnosed sane (or mentally vibrant!).

The last fifteen months has witnessed ludicrously staged false flag operation in Aurora, Colorado, Oak Creek, Wisconsin (Sikh Temple); Sandy Hook, Connecticut, Washington, DC Naval Yard, the Capitol Hill killing of an unarmed women just this October, and the LAX shooting two weeks ago. Guess what all had in common? Yeah, persons who obviously looked deranged or were said deranged, in need of "mental health assistance". 

Well, here's the proof that in the case of the Sandy Hook Elementary incident, it wasn't Adam Lanza inside the school:


YouTube: Sandy Hook False Flag - "School Nurse Sally Cox"

pa2llo
pa2llo

If shootings start huge conversations about gun control, then why doesn't an incident like this foster the same type of dialogue about the deplorable state of mental health care in this country? Not as flashy a subject, I suppose.

lanbr3
lanbr3

Not enough beds for the son.  I knew it - taxpayers fault again.

longcat
longcat

My condolences to this family for what they are going through right now. Mental illness does not often erupt into violence, however, when individuals who have paranoid ideations, delusions are not treated, these problems can cause violence to take place. We are in a silent mental health crisis. Mental illness is not visible, it is not cute, it is hidden, and often myth-bound. We depend upon chemicals way too much without the additional supports that make interventions possible (such as intermittent hospitalizations). The health system needs to take a long look at how we treat people who have mental illness and to be 1) more willing to provide help, just as we would for cancer patient; 2) increase the number of hospital beds to help treat crises; 3) educate the public about mental illness and debunk some of the myths. 

Chiroderma
Chiroderma

That's in a public hospital, but what about a private institution? they obviously have the means to afford it ...Just can't believe a politician of his rank can't put his son in a psychiatric facility because beds aren't available

formerlyjames
formerlyjames

In patient mental health care was vastly reduced in the 80s as part of a progressive deinstitutionalization plan often by court order.  Criminally inclined mental cases were absorbed by the vastly increasing prison system, while noncriminal patients were absorbed by family or the streets.   

sunny1soblu
sunny1soblu

Back in the mid 1980s there was a mass closing of mental "hospitals".  This was a result of civil rights violations of the people that lived in these institutions.  Many were mentally ill, mentally deficient, or a combination of symptoms that did not allow them to safely exist in society unsupervised.  There were also a portion of of that population that were a danger to themselves or others if not treated with the proper meds and therapies.

Today we have places where people can be admitted for treatment and safety.  Some are very expensive.  Some are trendy, like the places people go to clean up their addiction problems.  Most of the units for crisis intervention are small and well used.  Mental health is a poor step child in health care because it is difficult to supervise and measure progress.  That along with some programs that kept people until their days were all used up before they were discharged, have given mental health inpatient care a bad name.  It's amazing how a person can be severely ill on Friday and when they run out of days or money, they are suddenly cured on Monday.

So now we have group homes which help to care for some of the vulnerable people than otherwise might have been institutionalized.  We have street people.  We have huge social service departments that follow people if the person trusts the system enough to check in and get the help they offer.  It is still a mess and people fall through the cracks all the time.  The latest that come to mind are the kid in Colorado that shot up the movie theater, the kid that tried to kill Gabby Giffords, and Sandy Hook.

Plainly stated, we are doing a horrible job with mental health problems.  The seriously ill people are getting away with murder because we are not finding them, treating them when it could make a difference.  I'm not sure how to improve on the problem.  I just know that even when we find them we often don't have the resources to treat them.......  

Piacevole
Piacevole

It would be interesting to know just how Creigh Deeds has voted on the subject of psychiatric facilities, their funding, and beds available.

jamesgordon777
jamesgordon777

You  would never  believe the  cutting  of  funds and  closing  of  hospitals  Republican  Governor bobby Jindal has  done  here in Louisiana , that is  unless you  live  here , Republicans are obsessed with  cutting  spending  for  anything  other  than military .They seem  to  believe  the only role  for  government is  starting  wars and  killing  people ,Then  rebuilding the  other  country and  providing  that  country  with health care .

mantisdragon91
mantisdragon91

You mean the GOP's  obsession with cutting social services and safety nets has real life consequences?!? Cue the shocked face.

OzarkGranny
OzarkGranny

Thank you for a factually accurate and thorough discussion of the problem.  Politicians trip over each other to get headlines after every tragedy, then they cut the budget for mental health and allow insurance companies to do the same.

DavidMoultrup
DavidMoultrup

@DeanJackson There are a couple of different levels to this issue.  Your insistence that it was a staged event, based on my experience with the mental health system, is innaccurate.  The fact that there was massive confusion is entirely possible.  But there's a difference between a conspiracy or a staged event and a massive - and tragic - lack of execution.  The fact that it was so difficult to do the necessary thing at the appropriate time is yet another manifestation of the fundamental deterioration of the mental health infrastructure.  It is not an indication of some massive hoax that is being perpretated on the reader.

kelly.dnn
kelly.dnn

I am so sorry for your loss and that the mental health system failed your son.

cynicann
cynicann

@IliveahWaters1 What happened with Gus Deeds is under scrutiny from many fronts at this moment, and the sources I've read appear to agree that, in the 6 HOURS allotted time, AFTER the family followed the legal process in reaching out for help for their son, there were no spaces available.

If you have information that proves this scenario wrong, or untruthful, let's see that factual information NOW, in detail, instead of the generalized innuendo you offer.

SharonCooper
SharonCooper

@IliveahWaters1From the Post article quoted by BillFair:

"t remained unclear Wednesday which hospitals were called and why Austin Deeds was not taken to one of the available facilities."

The hospitals who say they had beds available might not have been called.  It is MORE than possible.  They were close, but still about two hours away.

  "Normal medical/legal protocol is S/H folk are  even held on suicide watch in local jail if needed, until hospital room opened up."  You're kidding, right?  People are released all the time because there are no beds!    

"All factual details combined implicate father, Creigh, is most likely the abuser/criminal using his power to blame & shut up his son, the victim.    Gus had decades of history showing he had no issues - Creigh did"  WTF have you been smoking?  What issues?  What do you know that the rest of the world does not?  As for Gus having 'decades'- he was really here for TWO. .   

"Narcissists/abusers using "psych" "evals" (labeling their enemies as "crazy) might sound looney to some -  it happens all the time and it has happened for centuries.     This entire event stinks of abuse/corruption."  To whom?  The paranoid right?  No one else would come up with the crap you're shoveling.



DeanJackson
DeanJackson

@BillFair, as I commented on this thread (an hour before you posted your comment): 


"For those of you who believe anything the media reports, you're credulous.

A state senator denied anything? Can't you see that this is a staged event? Purpose, you ask? To implement the "mental screening" of all citizens, and determine who's sane and who isn't...."


Great catch!

momof4inVa
momof4inVa

@BillFair Of course it won't seem right. The articles regarding the hospitals that had beds available weren't posted prior to this article being posted. Check your times.

SharonCooper
SharonCooper

@BillFair And they say they weren't called.  Does it shock you that a doctor's office of ANY type is not efficient?  It shouldn't.

wood
wood

@DeanJackson As a family member of Gus's, I can tell you that he was a fantastic boy

cynicann
cynicann

@DeanJackson If I were a member of your family, I might take a careful look into "emergency evaluations" of relatives.................

BillFair
BillFair

@DeanJackson So, you are saying none of those events happened?!  Tell that to the parents, brothers, sisters, extended family of the dead ones..

rpearlston
rpearlston

@pa2llo That's the NRA's standard answer, and it's just as immoral, jsut as inconsiderate, just as lacking in compassion when it comes from an individual.

Piacevole
Piacevole

@lanbr3 Maybe.  Who handles the distribution of taxpayers' money, if not a Virginia State senator?

momof4inVa
momof4inVa

@longcat Not to mention, that people with mental illness aren't stupid by any means. My son is now 19. He started acting out just after he turned 15 and was diagnosed with ADHD, ODD and "manic tendencies." However, he was never evaluated for any treatment beyond medication. We found out he was cheeking his meds, so what good did they really do? And when he would go in to see his counselor and psychiatrist, he knew exactly what to say to them to keep himself out of a hospital. But when he was home, it was a totally different story. He was verbally abusive to my husband and I, punched numerous holes in our walls, started a fist fight with my husband and threatened to kill me. But when we tried to get something done, he would talk his way out of it, to the point that WE seemed like the crazy, paranoid ones. Now, he has a pretty long record, over a short time span. He has been arrested for credit card theft and forgery, assault on a police officer and resisting arrest (age 16), 19 counts of destruction of property (age 17), 7 counts of entering vehicle with intent and 7 counts of petit larceny (age 19). He has been on probation since he was 16. 2 years was juvenile probation, which is a joke, but neither here nor there. It was transferred to the adult division because it kept getting extended where he couldn't keep his nose clean. The 14 charges he was found guilty of at age 19 were the most recent. He was sentenced Oct. 17 to 1 year supervised probation. Having been on probation just barely a month, he was arrested TWICE this past Saturday for underage possession of alcohol. He was release ROR the 1st time because he hadn't consumed the alcohol he was caught with, and the 2nd time, he was too drunk to talk himself out of it. Seems fair, right? I am hoping, in the midst of this tragedy, that Sen. Deeds (MY state senator) can take this bad situation and get some good to come from it. I hate that he is at the center of it, and I hate that ANYONE has to go through it, but if someone can do something to stop anyone else from having to deal with this same situation, then at least it wasn't for nothing. I wouldn't wish what I have went through for the past 4 years on my own worst enemy. 

momof4inVa
momof4inVa

@Chiroderma They only have a small window of time to locate a bed before they have to release a person. Max is 6 hours. And who knows...maybe his son talked his way out of a bed. My own son did it. He would say all the right things to his counselor and the psychiatrist, and at home he was a different person, to the point that WE seemed crazy and paranoid when we called the crisis hotline. Just because someone suffers from a mental illness doesn't make them stupid. 

Keilz
Keilz

@Chiroderma Being a state senator is a part time job; the salary is only <$20,000.  Additionally, he was given the custody on monday, and this happened early Tuesday morning, even if they were researching private institutions they didn't really have enough time.

hoosiernewman
hoosiernewman

@sunny1soblu as my memory serves me correct. They were using the term 'mentally ill' too broadly. Institutionalizing blacks in the South was one way to get rid of them.  If they were developmentally or even socially 'retarded' as the term was in the 80's they would put them in and sometimes they disappear get lost or simply ignored by the system. This was quite frequent.  But in a broad statement to mandate releasing and correcting the problem the states and federal put them on the streets and effectively reduced the amount of money available, and beds.  Many of the traumatized Vietnam veterans were left without treatment or options, whether the family requested treatment, or walk-in self commitment.

So, many times results are forced upon hospitals without guidelines or projections of consequences. But "imagine the money saved" was always the highest priority, not the individual or protecting families and citizens. 

Even after this episode, AZ Rep. Gifford, and all the Afghan veterans coming home, no logical or real solution will be proposed.  Remember the congress is made of average people, and rarely do excellent results can come from them.  It takes committees of the brightest minds in the field, not average minds. Let the average minds ask the questions, not make solutions.

rpearlston
rpearlston

@Piacevole Given his son's history, chances are very, very good that he understood the need for such facilities and the funding of such facilities, and has therefore voted yes whenever the subject came up.  Being a victim of someone with a mental health problem no matter how it is/was that you came to be a victim, has a way of changing your mind pretty quickly, if you were ever against it.

jcq707
jcq707

@jamesgordon777 Wow!!  I couldn't say it better !!!!!!

DeanJackson
DeanJackson

@DavidMoultrup, the only confusion with this incident is the sociopaths failure to get their stories straight! The beds were available at multiple hospitals. If you can't see an obvious staged event, then God bless you.

sadmominwa
sadmominwa

@kelly.dnn  thank you.  It is so frustrating.  Hopefully bringing attention will start making change.

DeanJackson
DeanJackson

@momof4inVa, when a bed is available, that means their availability has already been posted, otherwise the bed can't be said to be available. How is that not apparent to you? Check your logic.



DeanJackson
DeanJackson

@momof4inVaare you saying that the USA Today reporter for WTOP television (Washington, DC) lied when she reported that Sandy Hook Elementary school nurse, Sally Cox, saw the shooter and identified the shooter as the son of an "experienced" kindergarten teacher at the school? Now, why would you accuse the media of such a thing? The media always reports the truth, doesn't it?


Too bad you're a snob, refusing to watch mainstream news broadcasts because they're on YouTube! 




DeanJackson
DeanJackson

@cynicann, you need to take a "careful look" at all the evidence when incidents such as I've documented take place, not just accept what the media/authorities spoon feeds you. Remember, you have a brain between your ears for a purpose. Also remember, politicians create staged events in order to implement favorite policies. Politicians don't take chances that their policies will be implemented by chance, especially if the policy is controversial. 

DeanJackson
DeanJackson

@BillFair says"Tell that to the parents, brothers, sisters, extended family of the dead ones.. "


What parents? What sisters? What brothers? What grandparents? Since I've just proved that the Sandy Hook Elementary incident was a staged event, what does that tell you about the "relatives" of any of the other staged events? 

Have you bothered to watch the interviews with the relatives of Sandy Hook Elementary "victims"? How about the interviews with teachers? Notice anything odd in those interviews?

YouTube: BEST SANDY HOAX VIDEO COMPILATION EVER.

pa2llo
pa2llo

Wow, to be associated with the NRA and called immoral in one sentence. Ouch! My point is that no one ever wants to talk about the terrible way we approach mental health care in this country. I think that's immoral, and i think people don't want to talk about it if it doesn't affect them directly. What was inconsiderate about what I said? I really want to know, because it wasn't meant as a shot.

DeanJackson
DeanJackson

@DeweySayenoff, are you saying that the USA Today reporter for WTOP television (Washington, DC) lied when she reported that Sandy Hook Elementary school nurse, Sally Cox, saw the shooter and identified the shooter as the son of an "experienced" kindergarten teacher at the school? Now, why would you accuse the media of such a thing? The media always reports the truth, doesn't it?


Too bad you're a snob, refusing to watch mainstream news broadcasts because they're on YouTube! 



DeweySayenoff
DeweySayenoff

It would appear, Dean, that your more than intimate knowledge of the psychological detention system came from direct experience as opposed to research and was obviously NOT as a worker or practitioner in one.

Because ANYONE who believes ANYTHING they see on YouTube and buys into it as "truth" - ESPECIALLY something of THAT nature - is paranoid, delusional and has certainly been involuntarily committed more than once.

If you're not taking your meds, they can still find you when you post stuff like that, you know.