Tuesday, September 29, 2009

Ken Cuccinelli unveils Mental Health plan

Today in a confrence call with reporters, Bob McDonnell and Ken Cuccinelli unveiled their plan to improve Virginia's mental health system. Here is the plan from Sen. Cuccinelli's website:

After more than a decade of working within the mental health system, I have a great appreciation for its many complexities and how it affects individuals, their families and the community. I have also come to believe that we in Virginia must help improve the current system for the benefit of the mentally ill and society at large.

My Record
  • Since 1997, I have worked within the Commonwealth's mental health system in a number of capacities, first by serving as a court appointed attorney for individuals in Virginia's involuntary mental commitment hearings.

  • I have been a frequent participant in the informal Temporary Detention Order (TDO) taskforce in Fairfax County where representatives from all aspects of the mental health and law enforcement systems work to continually improve the mental health system in Fairfax.

  • In 2008, I worked in a bipartisan manner, pushed through bills to ease the process for involuntary commitment, to restrict gun ownership rights for those found mentally ill and to help break down barriers for sharing information between doctors and our court system.

  • In 2009, I successfully worked with law enforcement to reduce their transportation burden by allowing family members transport mentally ill individuals in lieu of law enforcement when the mentally ill individual is not dangerous. This conserves law enforcement resources and results in more humane treatment for the mentally ill in Virginia, thereby giving them better long-term chances for success.

As Attorney General, I will propose a five point plan to help reform Virginia's mental health system:
  1. Transfer mentally ill prisoners to mental hospitals: It is estimated that up to 1/6 of all inmates in Fairfax jails are mentally ill. Jails are becoming mental health facilities of last resort. We need to move these people into the correct facility so they can receive proper treatment.

  2. Allow for "step-down" treatment: Right now, a person who is found to be mentally ill and is committed to a facility is placed in either in-patient or out-patient care, but that person cannot be transferred between the two without a new hearing. This makes little sense, given that as a patient progresses through their treatment, that person should be easily removable by the doctor from in-patient to out-patient care. This reform should be accompanied by long-term case worker oversight for at least six months, since all studies show that the oversight is necessary to have a real impact on the patient's life. This is an opportunity to save money and get Virginia's mentally ill better treatment.

  3. Require that Temporary Detention Order's be issued between 24 and 72 hours: There should be a minimum of 24 hours and a maximum of 72 hours from detention to TDO hearing. The 24 hour minimum is necessary because at least 24 hours is needed for all of the mental health professionals with responsibilities to be able to do their work and communicate their findings. The maximum is necessary for two reasons: 1) because evidence shows that there are very significant decreases in both commitments and in court "voluntaries" (those who volunteer for treatment instead of a contested hearing) over a longer time period, and 2) because smaller jurisdictions in Virginia only hold hearings on Monday, Wednesday and Friday.

  4. Allow for non-lawyer representation: In the foreseeable future, there will not be enough money in the system to provide all petitioners with legal help, but we do need to do everything we can to help find alternatives for families that are at the end of their rope and don't know where to turn for help. We should allow those law students who have a background in evidence and trial advocacy and who are interested in mental health issues to represent willing petitioners in court.

  5. Overhaul the Virginia Statutes regarding mental health: There are currently three different sections of the Virginia Code that deal with the mentally ill – §19.2-169.6; §19.2-176; and §19.2-177.1 – and these statutes are largely antiquated and inconsistent in language and scope. Therefore, we should both modernize these statutes and make them legally consistent with one another, and group them in one section under §19.2-169.6.

And from McDonnell's website their record of results:

Bob McDonnell’s Record of Results

Bob McDonnell has a background in healthcare as a Medical Service Corps Officer in the U.S. Army, and as a manager with the American Hospital Supply Corporation. Bob has an extensive record of leading on mental health reform issues, including major reforms to move to a more community based system (HB2596 2001; HB995 2002), and championing legislation to require a state and community consensus and planning team for any restructuring of the system of mental health services involving existing state mental health facilities. McDonnell was Co-Chair of the Virginia Supreme Court Mental Health Task Force from 2007-2008, helping to create major reforms in the system.

As Attorney General Bob issued a landmark opinion to end the terrible policy that forced some parents to surrender custody of their seriously mentally ill children to access state-funded services. He subsequently worked to improve the Comprehensive Services Act to better serve children in need of services.

Responding to the challenges facing Virginia’s mental health system over the past few years, particularly in the wake of the tragedy at Virginia Tech in April 2007, McDonnell worked with Governor Kaine to issue Executive Order Number 50 instructing all executive branch agencies to immediately begin including the names of individuals found dangerous and ordered to undergo involuntary mental health treatment in the database accessed before the sale of firearms by licensed gun dealers to ineligible individuals. During the 2008 General Assembly session, Attorney General McDonnell supported legislation to ensure access to mental health information and modify standards for involuntary commitment of the mentally ill.

Ken Cuccinelli’s Record of Results

A member of the State Senate since 2002, Ken Cuccinelli is the recognized expert on mental health issues in the General Assembly and is a leader in reforming the system. As a private attorney, Ken Cuccinelli has served as a court appointed representative for the mentally ill and worked with mental health professionals and patients and their families for over a decade. Ken has also worked for many years with Fairfax County’s TDO Taskforce to improve the delivery of services in Fairfax.

In the State Senate, Cuccinelli has been working to reform Virginia’s mental health system from the moment of his arrival in the Senate, with too many bills to mention since 2003 - long before others recognized the deficiencies in Virginia’s mental health system. Among his accomplishments are reducing the requirements for admission to Virginia’s mental health system, establishing the ability of school systems to share mental health information with our universities once their students go to college, and creating more humane transportation alternatives for patients while reducing the burden on law enforcement, among others.

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