Nov 23, 2013

senator-r-creigh-deeds-austin-son-stabbing-mental-health-psychiatric-evaluation-hold-early-release-violence-truth-frequency-radio-chris-geo-sheree-geo-alternative-media-news-informationThe inspector general in Virginia started an investigation last Wednesday into why the son of state Sen. R. Creigh Deeds was released from psychiatric care the day before he stabbed his father before allegedly shooting himself with a rifle. 

And the Governor, Robert F. McDonnell, said he’s directed his top health official to conduct a review of state and local mental health services in the wake of the incident.

24-year-old Austin Deeds had undergone a psych evaluation on Monday, and officials at first said that the reason he wasn’t admitted was because no beds were available. However, multiple nearby hospitals later confirmed that they did have beds available, and that they had never been contacted. Sound like an inside job yet? Just wait, it will.

R. Creigh Deeds was the 2009 Democratic nominee for Virginia governor. There was apparently an altercation outside his home in rural Bath County. He was stabbed repeatedly in the face and chest, and his son was found dying of a self-inflicted gunshot wound, according to the authorities.

“We’re going to investigate the circumstances that led up to Austin Deeds’s release at the expiration of the emergency custody order,” said G. Douglas Bevelacqua of the Office of the Inspector General.

This all comes 6 years after the Virginia Tech Shooting, when a gunman killed 33 people (himself included). The massacre caused the entire state of Virginia to willingly throw their friends, family, and neighbors in a psych ward without the same restrictions as before, and millions of dollars in funding were used for a “wholesale evaluation and revamping” of the mental health care system. 

Virginia’s DHHS secretary Bill Hazel promised to push for “changes” if further “deficiencies” are discovered, but this probably means that nothing about the system or the amount of power it holds over the public will change, just that they will learn how to scare the public into submission and acceptance of it better.

“I’ve still got two more weeks before I’ve got to submit the budget, and if there are glaring problems I can address those,” McDonnell said in an interview at the Republican Governors Association conference in Scottsdale, Ariz. “What we need to do now is to see why there was a breakdown” in communication.

Police say that the sheriff’s office had been called to Sen. Deeds’ home on Monday for a “non-emergency call for assistance”, but wouldn’t tell the media if the purpose was to transport Austin to a facility for a psych eval. There hadn’t been any other 911 or non-emergency calls made before that.

Also, an autopsy by the Office of the Medical Examiner in Roanoke “confirmed” that the gunshot wound was self-inflicted and “fired from a rifle”. However, the toxicology results have not come back yet and won’t for possibly weeks.

Mira Signer from Virginia’s NAMI chapter said Wednesday that it was “crucial that officials figure out where things fell apart in a system that is often difficult for families to navigate”:

 

“Generally our feeling is that if a family with resources and know-how has difficulty accessing and navigating the mental-health system, it speaks volumes about what happens to people who don’t have resources,” she said.

senator-r-creigh-deeds-austin-son-stabbing-mental-health-psychiatric-evaluation-hold-early-release-violence-truth-frequency-radio-chris-geo-sheree-geo-alternative-media-news-informationOn Monday, an emergency custody order was issued by a magistrate for Austin Deeds after he’d been evaluated by officials at the Rockbridge Area Community Services Board.

According to the law:

In Virginia, mental-health authorities can hold people for four to six hours after such an order is issued. After that, the magistrate must issue a temporary detention order to allow a person to be held for 48 to 72 hours for further evaluation and treatment. But the order cannot be issued without an available bed.

Since he was 24, Austin Deeds would have been able to walk out the door after the 4-6 hour window closed if the officials hadn’t found him a bed. Even if his family wanted to continue looking for a bed for him, they would’ve been powerless if he didn’t want to go.In that state, it was up to the community services board to find that bed. The head of the Rockbridge Area Community Services Board is Dennis Cropper, who initially told the Richmond-Times Dispatch that his agency had called many hospitals throughout western Virginia on Monday trying to find Austin a bed. Mary Ann Bergeron, leader of the Virginia Association of Community Services Boards, said the same thing.Neither one has returned several messages from the media.Who are these people, and why did they lie about calling many hospitals to find him a bed, when there were 3 nearby with beds available? Why are they refusing to comment?senator-r-creigh-deeds-austin-son-stabbing-mental-health-psychiatric-evaluation-hold-early-release-violence-truth-frequency-radio-chris-geo-sheree-geo-alternative-media-news-informationDennis Cropper’s LinkedIn Account has some pretty creepy connections:

Executive Director

Rockbridge Area Community Services

July 2003Present (10 years 5 months) Lexington VA

Provide services to prevent and treat mental illness, developmental disabilities, and substance abuse, to individuals who experience these conditions in the Cities of Buena Vista and Lexington and the Counties of Rockbridge and Bath, Virginia

Director of Adult Services

New River Valley Community Services

February 1982June 2003 (21 years 5 months) Blacksburg VA

Managed programming for adult Mental Health, Substance Abuse, and Intellectual Disability Services for the New River Valley area

Clinical Psychologist

East Arkansas Regional Mental Health Center

January 1980January 1982 (2 years 1 month) Wynne, AR

Provided Mental Health Therapy to all ages and problems

Clinical Psychologist

North Central Arkansas Mental Health Center

November 1978December 1979 (1 year 2 months) Newport, AR

Provided mental health therapy to all ages and issues

Dennis Cropper’s Education

Texas A&M University

Doctor of Philosophy (Ph.D.), Clinical Psychology

19731976

Texas A&M University

Master of Science (M.S.), Oceanography

19691973

Officer, U.S. Navy (July, 1970 – December,1971)

University of Cincinnati

Bachelor of Science (B.S.), Zoology/Animal Biology

19651969

senator-r-creigh-deeds-austin-son-stabbing-mental-health-psychiatric-evaluation-hold-early-release-violence-truth-frequency-radio-chris-geo-sheree-geo-alternative-media-news-informationShe even wrote a paper  and an article on the Virginia Tech shooting’s effect on the mental health care industry in Virginia, which was substantial:

The Virginia Tech Review Panel’s August 2007 report made broad recommendations that included:

  • campus and law enforcement security procedures at state universities;
  • mental health practices and procedures relating to emergency services, temporary detention, and civil commitment processes;
  • needed legislative changes;
  • changes in information exchange; and
  • improved coordination among involved agencies and the courts.

Seung-Hui Cho’s family made his health and school records available to the panel (not to the public), which allowed for deeper insight and led to recommendations around information sharing and coordination of efforts between and within school systems. Amazingly, Cho did well with special accommodations in school and intensive and consistent counseling outside school hours during his school years in Fairfax County, well enough to be accepted by Virginia Tech….

Within weeks of the tragedy, each of Virginia’s 40 community services boards (CSBs) had examined in minute detail its own process of emergency services response in coordinating efforts with magistrates, private and state hospitals, law enforcement, and the local court systems of special justices (attorneys appointed by the respective circuit courts to preside over involuntary commitment hearings). CSBs, the local authorities designated by the Code of Virginia, are mandated to ensure, within every Virginia locality, provision of emergency services for psychiatric issues. Among their broad spectrum of services, CSBs can recommend individuals for involuntary temporary examination, detention, diversion, and outpatient treatment. Internal scrutiny by CSBs produced revisions in local practices and additional evidence for necessary changes in the law.

True to his word, Kaine announced last fall that his biennial budget for 2008-10 would include allocations for a $42 million “down payment” to begin upgrading mental health services. It is significant that funds were designated to CSBs to improve the following community services: emergency, outpatient, case management, and crisis stabilization capability for youths and adults suffering from psychiatric disorders. Kaine specified the need for identifying problems, intervening, and treating them as early as possible, so that individuals with mental illness can engage in services quickly and begin a path to recovery that could avoid psychiatric crisis and the trauma of involuntary detention or commitment….

The omnibus bills clarified the ability to share vital information while preserving confidentiality and remaining in alignment with federal laws, including HIPAA and FERPA. Major roles and responsibilities for CSBs, the courts, facilities where individuals are detained involuntarily, and for independent examiners who recommend treatments to the courts were clarified in the bills. Additionally, a section of the bills outlined a new and quite specific mandatory outpatient commitment process (see sidebar).

Finally, the omnibus bills proposed a major change in the criteria for involuntary detention and inpatient/outpatient commitment. Virginia Code prior to July 1, 2008, had required that the person “presents an imminent danger to himself or others as a result of mental illness or is so seriously mentally ill as to be substantially unable to care for himself.” As of July 1, 2008, the language of the Code is as follows:

[T]here exists a substantial likelihood that, as a result of mental illness, the person will, in the near future, (a) cause serious physical harm to himself or others as evidenced by recent behavior causing, attempting, or threatening harm and other relevant information, if any, or (b) suffer serious harm due to his lack of capacity to protect himself from harm or to provide for his basic human needs, (ii) is in need of hospitalization or treatment, and (iii) is unwilling to volunteer or incapable of volunteering for hospitalization or treatment.

As the omnibus bills and approximately 50 other related bills proceeded through Virginia’s legislative process, changes were debated, revisions made, and compromises achieved with the culmination of House and Senate bills that could be supported by, or at least accepted by, the governor, General Assembly, advocates, providers, and most of the stakeholders in Virginia. Even as state revenues continued to plummet, Kaine and the General Assembly retained almost the entire proposed down payment for reform. Kaine signed the legislation into law on April 23, 2008.

Some voices dissented regarding the involuntary commitment criteria and the increased involvement of law enforcement and the courts. Others did not believe the law went far enough and would have preferred an outpatient commitment law more like New York State’s Kendra’s Law. Advocates on both sides of the debate did agree that in state after state, the more available appropriate community services are, the less often compulsory treatment is needed.

Individuals with mental illness proved to be exceptional advocates and successfully convinced the General Assembly that language supporting recovery should be included in the final bills, as well as language that promoted consumer preferences for treatment. These advocates were not in favor of the broadened criteria for involuntary detention and commitment. Even though the new criteria were adopted, these individuals educated legislators and others about the potentially serious and permanent side effects of psychotropic medications and what it takes to engage people in the mental health system in a positive, voluntary way.

Some may argue that the new law and the new funding reflect a propensity to detain and commit more individuals to psychiatric facilities. The governor; commissioner for the Department of Mental Health, Mental Retardation, and Substance Abuse Services, Jim Reinhard, MD; and VACSB and its member CSBs hope to offer and achieve a different approach. Our shared goal is to intervene, engage, and stabilize individuals early; provide vehicles for adequate follow-up treatment; promote recovery-oriented services; and avoid individuals’ cycling in and out of emergency rooms and psychiatric facilities.

Accomplishing our goal will be a challenge of huge proportions, even if the stigma and discrimination attached to mental illness were not ever-present:

  • The down payment will have to be followed with continuing biennial “mortgage payments.” Such funding will have to remain a priority even if state revenues continue to decline.
  • Such “mortgage payments” will be complex as federal actions gnaw at the delicate balance in state and federal partnerships of funding sources such as Medicaid.
  • Local agencies and stakeholders will have to stretch, tug, and overcome discrete agency agendas in their efforts to coordinate and implement the new law.
  • Individuals with mental illness will be asked to take some responsibility for their own disease management and recovery.
  • Communities at large will be called upon to recognize that mental healthcare is a responsibility of the entire community.

Mental illness, in its complex and unique impact on each individual, does not fit neatly into a law, however thoughtful and reasoned. Almost every psychiatric crisis produces an exception that demands flexibility to meet and accommodate specific individual needs.

Um, yeah, like letting patients go home and stab their state senator father before shooting themselves with a rifle (which is tough to do, by the way)?Screenshot_1According to this document found from a company called Magellan Health Care – a company that coordinates payments to the military/civilian mental health system in Virginia and D.C. – their new methods were to be tested “in early November”. Maybe the new “methods” include sending patients home (even if they’re homicidal/suicidal) so that the insurance companies don’t have to foot the bill for a 72-hour-or-longer-hold.

Even though the initial response from the media was rebukes about mental health funding in Virginia, the fact that the beds were available for Deeds’ son and that Rockbridge totally dropped the ball on this one puts the focus now on them. They get some funding from local governments but are licensed and overseen by the state Department of Behavioral Health and Developmental Services.

State officials – speaking on the condition of anonymity – told the Washington Post their understanding is that the Rockbridge agency made multiple calls in search of a hospital bed but ran out of time before finding one.

However, the University of Virginia is working on a study right now involving emergency mental health evaluations in the state and has found that in the vast majority of cases, beds are quickly found.

The study this year examined all 1,260 cases in which involuntary admission was recommended in a single month, April. In 80 percent of those instances, a bed was found after officials contacted one or two facilities. In 87 percent of cases, a bed was found within four hours. Officials were unable to locate a bed within six hours in 4 percent of cases.

Officials from Western State Hospital in Staunton, Rockingham Memorial Hospital in Harrisonburg and the University of Virginia Medical Center in Charlottesville — all within two hours of Deeds’ home — confirmed Wednesday that their facilities had all been in a position to accept Deeds’s son but were never asked to do so.Deeds ran for governor of Virginia in 2008 and ran for attorney general in 2005, losing to McDonnell by only 360 votes. His son, a banjo-player, was a campaign volunteer for his dad and dropped out of the College of William and Mary just last month. He was one of four children from Deeds’ first marriage, and his only son.Anonymous sources “close to the family” say that Austin Deeds had struggled with mental illness in recent years, and in 2009, police charged him with possession of alcohol as a minor, according to court records. The case was dismissed, however, after he performed community service. Other than that, he has no criminal record. Sounds like a normal kid to me.State investigators said Tuesday that after his son attacked him, Deeds walked to the edge of his driveway, where his cousin spotted him while driving by. He called police at 7:25AM and then drove Deeds to a nearby farm. A helicopter then flew him to U of V Medical Center, where the doctors performed surgery.

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