Dec 13, 2023 - News

State auditor says conditions in Virginia's youth psychiatric hospital "abhorrent"

Photo: Courtesy of DBHDS

Things have gotten so bad at Virginia's only state-run psychiatric hospital for children that it should be shut down, state auditors concluded in a report released this week.

  • The facility stands out as the worst among Virginia's nine state-run psychiatric hospitals, per the review by the legislature's Joint Legislative Audit and Review Commission.

Why it matters: The document called the hospital an "immediate threat to the health and safety of the patients."

  • The patients, who generally range in age from 12 to 17, are among the most vulnerable in the state's mental health system.
  • Most children admitted to the facility are diagnosed with disorders related to trauma, impulse control and depression.

By the numbers: The Commonwealth Center for Children and Adolescents, in Staunton, had the:

  • Highest rates of violence.
  • Highest rates of patient self-harm.
  • Highest rate (and raw number) of substantiated human rights complaints.
  • Highest use of physical restraints against patients.

What they're saying: Sen. Jeremy McPike, D-Manassas, called the numbers "abhorrent" during a meeting reviewing the findings Monday.

  • "It turns my stomach," he said.

The other side: Nelson Smith, Gov. Youngkin's commissioner of behavioral health, cast the poor performance as a holdover from the Gov. Northam's administration.

  • He said improvements are already in the works, citing a change in leadership after Youngkin took office and a reduction in the use of restraints this year and staffing improvements.

Of note: Youngkin's administration has no plans to act on the audit's recommendation that the facility be shut down, said John Littel, Youngkin's secretary of health and human resources, per the Times-Dispatch.

Context: Virginia's state-run psychiatric hospitals have been struggling for years.

  • In 2021, half of the system closed to new admissions, with administrators citing a "dangerous environment where staff and patients are at increasing risk for physical harm."

The big picture: The latest review found those issues have persisted, with state hospitals still operating at or above maximum capacity and struggling to attract and retain staff.

  • Auditors blamed an array of factors, including a 2014 law that barred state hospitals from refusing patients who are subject to involuntary commitment.

What we're watching: The review suggested a variety of ways the state could divert more patients to private facilities, which are not facing the same overcrowding pressure.

  • It also suggested increasing salaries for key positions, like social workers and psychologists, to reduce turnover.
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