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New behavioral and mental health services seek to reduce law enforcement and emergency rooms' involvement in crises

Virginia rolled out six new mental and behavioral health services for Medicaid members Wednesday, alongside a program that seeks to avoid involving law enforcement in mental health crises.

The new services focus on crisis response and stabilization. The goal is to keep patients out of emergency rooms and to avoid involving law enforcement in crises.

Five regions of Virginia are setting up Marcus Alert pilot programs, named for Marcus-David Peters. In 2018, a Richmond Police officer killed Peters while he was having a mental health crisis. The program seeks to divert 911 calls to mental health professionals instead of law enforcement.

Marcus Alerts will cover all of Virginia’s localities by 2026.

Princess Blanding, Peters’ sister, said the law implementing Marcus Alert is subject to too much local control. 

“If we do not put more direct parameters as to how police are to be engaged or not to be engaged we're going to keep getting what getting right now,” Blanding said. “The bill passed in my brother's name, but to me it's very symbolic because what's in the bill is not sufficient. It is not going to prevent a person that's having a mental health crisis from receiving death as their final verdict or brutalization or incarceration.”

The six new programs cover Virignia’s 1.9 million Medicaid members. A third of those have behavioral health needs, according to a spokesperson from the Department of Medical Assistance Services.

The new programs include rapid response and stabilization in the period after an acute psychiatric crisis. Enrollees experiencing an acute behavioral health emergency can receive up to 23 hours of crisis stabilization in a community-based setting, and short term 24-hour residential evaluation for psychiatric and substance use cruises, rather than being admitted to an inpatient facility.

The Director of DMAS, Karen Kimsey, said that 96% of patients who get a direct referral to these types of services don’t need to go to an emergency room.

State hospitals face a critical shortage of staff, partly because too many people are inappropriately referred to the hospital.

“The services launched today are another step towards our goal of helping individuals in need of behavioral health care receive it in their own community, as opposed to state hospitals, when possible. In addition to being a best practice for the individual, this helps to alleviate the high bed census at state hospitals,” said Lauren Cunningham, a spokesperson for the Department of Behavioral Health and Developmental Services, in an email.

This summer, five of Virginia’s state hospitals, which serve Virginians with mental illness, paused admissions due to staffing shortages. Staff at state hospitals had been quitting in droves due to low wages and long hours in a risky job.

Federal money allocated to state hospitals from American Rescue Plan extra funding hasn’t solved staffing shortages at one of Virginia’s state hospitals, the Commonwealth Center For Children in Staunton.

The new services also offer two therapy programs directed towards children. 43% of Medicaid members are children.

One, multisystemic therapy, is for youth with disruptive behaviors and substance use disorders, and another, functional family therapy is for short-term treatment after a referral from schools or juvenile justice systems.

This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.

Jahd Khalil is a reporter and producer in Richmond.
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