Virginia’s mental health agency plans to add 56 beds to Catawba Hospital to keep up with demand placed on the public psychiatric hospitals by a law requiring that they turn away no one in need.
The state Department of Behavioral Health and Developmental Services plans to have six beds ready for patients by November and to have 28 total available by June. The beds will be reserved for older adults. The initial expansion of the Roanoke County facility will require hiring 94 employees.
The next 28 beds are planned for the following year.
The state’s psychiatric hospitals have seen a three-fold increase in admissions over the past five years following enactment of a law that requires them to admit anyone who’s under a temporary detention order if a bed at a private hospital cannot be found.
“We are calling them temporary beds,” said Mira Signer, acting commissioner of the department. “With the pressures on the state hospitals and very, very high census numbers that are holding steady statewide at all our state hospitals, it is not necessarily a sustainable trajectory for the long term. Nevertheless, we must meet our statutory obligation and meet the critical need going on right now with regards to the bed-of-last-resort legislation and the responsibly that we have to ensure that inpatient level of care is there when needed.”
Lawmakers in recent years have begun adding more money to the public mental health system and have endorsed the department’s STEP Virginia plan, which, over time, is expected to develop more community services to help people avoid crises and hospitalizations.
Signer said she is encouraged by early signs from same-day access programs across the state and by the creation of outpatient services, but it is too soon to affect hospital admissions.
Daniel Herr, deputy commissioner for facility services, said the department has needed 28 to 30 more beds every year.
“I think there are efforts underway to take a look at the bed-of-last-resort legislation and the practices around that, but because of the growth in the number of beds that we need to provide to meet our statutory obligation, we were at that point that we needed to plan for sufficient beds,” he said.
Western State Hospital in Staunton is undergoing expansion.
The bed-of-last-resort legislation was passed in 2014 following the tragic death of Sen. Creigh Deed’s son, Gus, who killed himself after attacking his father. Deeds had tried to have his son committed for psychiatric care but the detention order expired before a placement was found.
The law requires state hospitals to always have room for people who are being committed because they are thought to be a danger to themselves or others.
Herr said that TDOs have remained constant, at about 25,500 a year, but that there is increased pressure on public hospitals, which are caring for a larger portion of people who are committed without their consent. Private hospitals have said that they have been taking on more patients who voluntarily seek admission and that they are adding beds.
Patient counts at the state hospitals have grown so much that in April, the department reported to a legislative committee headed by Deeds that all were operating beyond 85% capacity, the level considered safe for patients and staff. Seven of the nine hospitals were greater than 90% capacity, including Catawba at 95%.
The Catawba beds are being classified as temporary. The hospital has 110 beds, with 60 reserved for older adults. Herr said the initial 28 temporary beds will also be for older patients, as that is the greatest need. They will be funded out of the department’s budget.
The department will ask for the next 28 beds to be included in the state budget. A cost estimate was not immediately available from the department.
Before the department understood the impact of the bed-of-last-resort legislation, it had recommended closing Catawba, citing the facility’s age and projections that fewer beds would be needed.
Catawba has two floors that were not being used that can be put into service without much renovation, Herr said.
“Another important piece at Catawba is they have what we would call adequate programming and day activity space for additional patients, which is as important as having a good quality place for someone to sleep,” he said.