Among the few states to enact major mental health legislation in the 2009
legislative session is West Virginia, which in April approved a statewide
increase in expenditures for mental health care. The funding boost is part of
a bid to stave off further court interventions on behalf of residents with
The Mental Health Stabilization Act of 2009 (SB 672) aims to rebuild West
Virginia's community-based mental health system by increasing reimbursement
rates for a range of publicly funded mental health services provided at
community mental health centers.
"The state has been the subject of various court orders as result of
the manner in which it dealt with people with mental health needs, and the
legislature desires to be proactive and resolve issues surrounding mental
illness without the intervention of the courts," according to the
legislation, which was sponsored by state Sen. Jeffrey Kessler (D).
A report by a court-appointed "ombudsman for behavioral health"
found that among the public mental health system's problems were serious
overcrowding and understaffing at one of the state's two public psychiatric
hospitals, Bateman Hospital. The report of the ombudsman, David Sudbeck, led
to a West Virginia Supreme Court ruling in January that the ombudsman should
conduct evidentiary hearings into conditions at Bateman Hospital and assess
whether the state is providing sufficient care for traumatic brain injury and
case-management services throughout the public system.
Another recent marker of the decline of the state's mental health system
came from the National Alliance on Mental Illness, which downgraded West
Virginia's public mental health system from a "D" in 2006 to an"
F" in its recent "Grading the States 2009" report
(Psychiatric News, May 1). That report concluded that needed
reforms in the state included a redesigned Medicaid plan, increased use of
evidence-based practices, and implementation of crisis-intervention,
jail-diversion, and former-inmate reentry programs.
The new law is designed to reverse some of these underperformance findings
through funding expansions of the state's existing community mental health
centers. Increased funding for prevention and treatment should cut current
rates of involuntary mental health commitments and incarceration in jails and
prisons of people with psychiatric illness, practices that use significant
state resources, according to supporters of the measure.
Sidney Lerfald, M.D., president of the West Virginia Psychiatric
Association, told Psychiatric News that he hoped the new law would
help reduce an overuse of involuntary commitment.
"The [public] system poorly funds early interventions to prevent
patients from getting to the point where they require hospitalization, which
requires a crisis before someone can get treatment," Lerfald said.
The scope of the problem in West Virginia is significant. More than 37,000
people who need treatment for mental illness are placed in regional jails each
year, advocates of the new law pointed out. They said that the funding burst
should begin to return West Virginia to a position of national leadership in
mental health as it was when it led national deinstitutionalization efforts in
Another statewide effort recently approved by a state legislature was a
measure (HB 897) requiring a legislative study of the entire public mental
health system in Mississippi. The legislation, advocated by the Mississippi
Psychiatric Association (MPA) and signed into law in April, stemmed from
growing concerns about poor access to mental health services throughout the
The study will assess the availability of treatment for people with mental
illness in various parts of the state, identify gaps in the ability to follow
a patient from one facility to another, and examine what some describe as the
trend of hiring nonpsychiatrists to oversee more functions at Mississippi's
mental health facilities. Advocates of the study expect that its
recommendations will provide impetus and direction for future legislatures in
the state to reform mental health care.
The law mandating this study stemmed from an MPA-sponsored forum for state
legislators in December 2008 that sought to educate elected officials on
mental health issues and the roles of clinicians, patients, and the state
government in the provision of mental health care.
The report and draft legislation to implement its recommendations are both
due to the legislature by December 1.
The Mental Health Stabilization Act of 2009 can be accessed at<www.legis.state.wv.us>
by searching on the bill number, SB 672. The Mississippi mental health study
measure can be accessed at<http://billstatus.ls.state.ms.us>
by searching on the bill number, HB 897. ▪