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Deaths rose in Virginia’s mental hospitals last year, but COVID-19 wasn’t the prime culprit

Eastern State Hospital in James City County
Eastern State Hospital in James City County(Virginia Department of Behavioral Health and Developmental Services)
Published: Jun. 10, 2021 at 6:59 AM EDT
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Like many congregate facilities, Virginia’s state-run mental hospitals reported an increase in deaths during the coronavirus pandemic. But the “vast majority” of those deaths weren’t the result of COVID-19, according to a state watchdog group tasked with advocating for Virginians with disabilities.

The findings are raising concerns that patients are being inappropriately admitted to mental hospitals with complex medical conditions, said Colleen Miller, executive director of the Disability Law Center of Virginia. The private nonprofit has been designated as the state’s protection and advocacy system for patients with disabilities since 2013. But for the last three years, it’s also collected data from critical incident reports submitted to the Virginia Department of Behavioral Health and Developmental Services, which oversees 11 mental health facilities across the state.

Those reports show that deaths have been steadily increasing in state-run mental hospitals since 2014 when Virginia passed what’s commonly known as its “bed of last resort” law. Under state code, Virginia’s psychiatric hospitals are required to admit patients after an eight-hour period if a bed can’t be found at another facility (including private hospitals with behavioral health units).

There’s broad consensus that the law unintentionally caused admissions to surge at already crowded state-run facilities. Virginia code also allows patients living with dementia to be involuntarily committed if they’re going through a mental health crisis. Over the years, Miller said that’s likely resulted in a growing number of what DLCV calls “inappropriate” admissions — patients who would be better served in settings equipped to provide medical care.

“None of the psychiatric facilities run by the state are medical hospitals,” she said. “They’re just not in the position to deal with those kinds of acute conditions.”

For DLCV and other advocates, the problem is earning new scrutiny amid another reported increase in deaths. In the fiscal year that ended in June 2019, deaths at state-run hospitals declined for the first time in five years, dropping to 56 after a high of 76 the year before. In fiscal 2020, though, the total count rose again to 62.

Despite the pandemic, most of those deaths weren’t due to COVID-19, the organization reported. Piedmont Geriatric Hospital in Burkeville, for example, recorded a total of 25 deaths — more than a quarter of the state total. Only seven of those 25 were “due to or concurrent with” a coronavirus infection, according to the hospital’s own reporting.

“And COVID is a problem that’s hopefully unique to 2020,” Miller said. “But it doesn’t explain the fact that what we think are inappropriate medical admissions have been going on for years.”

Currently, there’s scarce information on the number of people admitted to state-run mental hospitals with complex or long-term medical needs. Lauren Cunningham, a spokeswoman for the Department of Behavioral Health and Developmental Services, said the agency doesn’t have a standard definition or category for those kinds of patients, making the number difficult to quantify.

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The Virginia Mercury is a new, nonpartisan, nonprofit news organization covering Virginia government and policy.

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