DATE: Tuesday, October 14, 1997             TAG: 9710140013

SECTION: LOCAL                   PAGE: B10  EDITION: FINAL 

TYPE: Editorial 
                                            LENGTH:   69 lines

MENTAL HEALTH STATE MUST STOP LAGGING COMING REPORTS WILL MAKE THE CASE FOR CHANGE

Slowly, the wheels of government are bringing Virginia to a decision point regarding the future of mental health services. Not a moment too soon.

An assortment of groups - state and federal, public and private - will soon be issuing reports that, almost certainly, will point to redirection and greater commitment to community-based care for the state's mentally ill.

As Val Marsh, executive director of the Virginia Alliance for the Mentally Ill, points out: ``Virginia ranks second in the nation in per capita spending for public psychiatric hospitals. Yet such spending appears to have no bearing on the overall quality of care provided.

``Failure of the system can be seen in the numbers of homeless mentally ill persons, the burgeoning numbers of people with mental illness in our jails and prisons, and, most horrifically, in human rights abuses that have received so much publicity lately.''

Over the past five years, suspicious deaths and reports of abuse have prompted U.S. Justice Department reviews of four Virginia facilities for the mentally ill and retarded. The latest, a probe last spring and summer of Central State Hospital south of Petersburg, resulted in a scathing assessment.

The state has made a public commitment to improving conditions at Central State. But, unfortunately, reports filtering out from patients' families suggest that it is easier to talk the talk than to walk the walk of change.

Patients are still not being treated uniformly with the dignity and attention they deserve, those reports indicate.

Last week's announcement that Dr. Antoni Sulikowski will take over the directorship of Central State is a positive sign. Sulikowski was brought in to straighten out the Northern Virginia Mental Health Institute in Fairfax when it was in trouble a few years ago.

But high-powered troubleshooters cannot forever rotate from hospital to hospital in Virginia, plugging dikes. More comprehensive reform is needed. There will be no lack of proposed guides to the shape that reform should take:

A legislative study group is taking a comprehensive look at mental health services in Virginia. They should have a partial agenda in time for the 1998 legislature.

A special panel looking at the human rights system for mental health patients is due to report to the study group next month. That group has heard testimony that both the Department for Rights of Virginians with Disabilities (DRVD), which gets federal money to advocate for mental patients, and the mental health department's internal advocacy program are inadequate.

The federal office that monitors DRVD has been conducting a review. Its report should be out soon.

The national accrediting agency for health facilities, known as The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), recently conducted a re-evaluation of Central State Hospital.

JCAHO renewed the facility's accreditation earlier this year, without noting any of the massive problems reported by the Justice Department. Outraged critics, including some from within JCAHO, demanded a reassessment.

Their conclusions also should be public soon.

For most of the 1990s, mental health has been on the back burner of public-policy concerns in Virginia. As personnel and budgets have been squeezed to meet the demands of government cutbacks, services have suffered.

In a state where care never was delivered on a lavish scale, the deterioration has been unacceptable. More money needs to be invested in mental health. Psychiatric hopsitals and other facilities should be de-emphasized; community-based services should be invigorated.

In the past quarter-century, there has been a revolution in the understanding and treatment of mentally illness. As with heart disease or diabetes, medicines and lifestyles can make an enormous difference in the ability of patients to function.

Virginia has not kept pace with those changes. The time for reform is now.

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