I work in mental health here in Va and the system is broken. DMAS and DBHDS pats themselves on the back but splitting Medicaid into 6 different MCO/HMOs, multiple waivers, and tons of hurdles to get help and service? Failure. The STEPVA attempt was supposed to help revamp things but it made them worse. Deeds sitting on his high horse as a victim and politician also didn’t really change anything. What was supposed to make services easier to access has made it harder in reality. There’s no plan or replacement for TDT and COVID exacerbated mental health issues in children exponentially. Depending on locality CSBs are often underfunded and it’s hard to hire and retain people, we’re burning out. Serious incidents and crises appear to be increasing, state hospitals (esp Commonwealth for kiddos) are a joke with staffing…private ones pick and choose who they want to admit in crisis often leaving children in an ED for days while trying to find a bed.

People will bitch about about it and providers will rally but the status quo will remain until another famous/popular person or their family has a mental health issue…then it will be in the news and politicians will be racing to politick and pander for talking points.

“Appropriators in both the House and Senate have also acknowledged that Virginia is in a mental health crisis and have stated their commitment to build a comprehensive mental health system. The proposed investments announced last weekend are not insignificant, with the House committee proposing $182.5 million and the Senate, $370 million.” …this is the same song and dance for years, just a different administration saying it.

People are daily falling through the cracks and Va is doing nothing, has been doing nothing, and the net sum will be more death, injury, and illness. Roadmaps like STEPVA and programs like the Marcus alert can’t do anything unless they’re put into action or funded and supported.

Local mental health providers (ie CSBs) are also at fault for not thinking creatively, not offering enough prevention based supports, and not pressing the state and local gov more. TDT was a cash cow…literally dripping wealth into the hands of CSBs as many made that and case management the foundation of their budget. They got greedy, Medicaid and the state interventions, and part of the repercussions reflect a lack of school based interventions. TDT is/was a valued service but with Medicaid billing the providers were incentivized to keep kids on the books for years, when it should have been far less. The state, localities, and community based providers can do better.