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Solutions sought for mental health access, treatment

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Officials learn care lacking in region

By Sally Voth -- svoth@nvdaily.com

EDINBURG -- Regional advocates for the mentally ill and intellectually disabled shared horror stories and sought solutions during a mental health forum Wednesday morning.

It marked the first Regional Consortium on Improving Access to Mental Health. Doctors, community services board members, nurses, hospital administrators, EMS workers, lawyers and law-enforcement officers gathered for the breakfast meeting at Creekside Plain & Fancy.

A community health needs assessment revealed care of patients with mental health issues was lacking.

In an interview Wednesday, Dr. Don Jansen, Shenandoah Memorial Hospital vice president of medical affairs, said it was noticed that the hospital and various agencies were having similar difficulties getting immediate help to people suffering mental health crises.

"Putting that all together, we said, 'Why don't we bring some people together from different agencies and really just have an open forum where we can work through these processes?'" he said.

Sen. Mark Obenshain, R-Harrisonburg, and two lawyers specializing in health care law shared information with the group.

Attorney Mary Malone explained the laws surrounding emergency custody orders and temporary detention orders. A major problem faced by all hospitals in Virginia is a lack of bed space for psychiatric patients, she said. Malone said she sympathized with her hospital clients who face being accused of false imprisonment for holding some patients they fear are suicidal.

That concern was echoed by Lisa Stokes, vice president of patient care services at SMH.
"I've had the [emergency department] physicians say, 'If they walk out and something happens to them, I'm never going to forgive myself,'" she said.

Attorney Michelle Calloway discussed advanced directives that people with mental illnesses can sign while lucid that directs their treatment during times when their illness incapacitates them.

Jansen said another session would be held to discuss problems facing everyone -- hospitals, professionals and institutions, and a third one to focus on problem-solving. He said the focus is on their patients, and how to treat them with respect and dignity.

"I think we need to continue to push for these services to continue to be provided, and at minimum not be cut," Jansen said.

Northwestern Community Services Chief Executive Officer Buddy Hall said during a break in the forum that getting the right treatment for persons with psychiatric issues is a "community problem."

"The number one need that came out [of the needs assessment survey] is mental health and substance abuse [services]," he said. "It's really going to take an orchestrated effort of all of us who are involved with the mentally ill to work together and see if we can be innovative in the approaches we take. Somehow, I think, we're going to have to establish a central point where law enforcement, our agency of course, and others in the community can take people where they can be assessed and then a determination made as to the best course of treatment and where that treatment should be provided.

Hopefully, we can come up with some type of common patient flow where people receive the treatment that they need."

Obenshain said the downturn in the economy -- funding for mental health services in Virginia has been cut 9 percent over the past several years, he said -- provides an opportunity to look at how to best use money.

"We need to take advantage of this opportunity to challenge traditional notions, and look at whether what we have been doing in the past is the way that we want to be providing mental health issues going forward," he said.

A conservative, Obenshain said that doesn't mean he needed to "make foolhardy decisions."

"There are areas where we have serious ongoing priority obligations, and I look at them, for me, the priorities in legislating and the priorities in governing include law enforcement, transportation and taking care of those who cannot take care of themselves," he said.

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