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Half of Virginia Psychiatric Hospitals Forced to Close to New Patients Due to Overcrowding

August 3, 2021 by Alexa Hornbeck

The Virginia Department of Behavioral Health and Developmental Services has struggled for years with patient overcrowding in state mental health hospitals. Then, on July 9, five out of the eight state psychiatric hospitals were forced to temporarily close to new admissions. 

“Despite our aggressive recruiting and retention strategies, state hospitals continue to lose staff while admissions continue to rise. It is no longer feasible to operate all state beds in a safe and therapeutic environment,” said Alison Land, commissioner of the Department of Behavioral Health and Developmental Services in Virginia.

The five hospitals temporarily closed to admissions are Catawba Hospital, Central State Hospital, Eastern State Hospital, Piedmont Geriatric Hospital, and Western State Hospital. 

No existing patients within any of these five hospitals would be discharged in an unsafe manner, and that bed reduction would occur slowly through attrition, with new hospital admissions barred until staffing improves, according to Land.

Two hospitals for adults — Central State near Petersburg and Eastern State near Williamsburg — are completely full and three others are 99% full and three others also are operating at more than 90% of capacity, according to a June 15 story in the Richmond Times-Dispatch.

The Northern, Southern, and Southwestern Virginia Mental Health Institutes will remain fully operational, but Land said staffing levels will be monitored to ensure patients are not accepted which are over their staffing capacity. 

Hospital admissions have increased since the enactment of the Bed of Last Resort Laws in 2014, which requires Virginia psychiatric hospitals to admit patients after an eight-hour period if a bed can’t be found at another private hospital or behavioral health facility.

Since the law went into place, Land said the number of temporary detention order admissions to state hospitals rose from 3.7 patients a day in FY 2013, to at or over 18 a day as of July, or approximately a 392% increase. 

The staffing shortages and high patient volume turned into a crisis when the pandemic hit, as the department found that fewer patients were being discharged due to COVID-19 outbreaks, and there was a greater burden on providers who worked longer hours and felt less safe. 

There were also higher incidences of violence, as Land said that there had been 63 serious injuries of staff and patients reported since July 1st, and facilities were recording 4.5 incidents/injuries per day across state facilities.

Two weeks prior to the temporary closure announcement, Land said there were 108 resignations, with staff indicating during exit interviews that the resignations were directly correlated with work hours mandated and a lack of safety. 

Last March the department had more than 1,000 job vacancies, and as of last week the department reported that number has grown to 1,616 vacancies. 

Although the department is attempting to bolster its staffing levels with international nurses, and other staffing contracts, Land said the contracts are expensive, sometimes three times the regular staff salaries. 

Similar to state staff, Land said the contract staff are finding the unrelenting stress, required overtime, and the dangerous work environment to be exhausting and untenable, and that they are increasingly not renewing or leaving before their contract is over. 

To address some of the unsafe conditions employees have been experiencing, the department requested $24 million for security guards to improve safety at facilities, and another $300 million over the next several years to boost employment and provide adequate salary increases for staff from the $4.3 billion in funds the state recently received from the American Rescue Plan.

In the meantime, emergency facility funds will be provided from the American Rescue Plan to hire additional contract staff and give retention bonuses to staff who have held on throughout the COVID-19 pandemic.

Lauren Cunningham, spokesperson with the Virginia Department of Behavioral Health and Developmental Services, said as of last Monday, there are already 26 new contract staff brought on board to serve the five facilities over the next few weeks, and a total of 63 will be brought on over the course of several weeks through an emergency contract with a global staffing agency called GQR Healthcare. 

While there is no definitive date for the temporary admission closures to be overturned, Cunningham said once admissions do reopen, they will be taking one admission per one discharge and increase incrementally.

“We are incredibly grateful to everyone across the system, within the facilities and our central office, who are working tirelessly to care for the individuals we serve, discharge patients safely, and bring on new staff quickly,” said Cunningham. 

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