That could be said for every state

There are a ton of obligations for modern governments and not enough revenue to fund everything. And no one wants tax hikes.

The behavioral health lobby sure is dropping a lot of money lately. It's mentioned two or three times every morning in the axios newsletter, and now on Richmond.com too.

I don't have any opinion on behavioral health, I'm just annoyed by anything so blatantly advertised at me.

Could it? Did you read the article? Virginia ranks middling to lower end when it comes to access for mental health care, particularly in regards to youth mental health. These kinds of issues have knock on effects, ever wonder why kids keep showing up to schools with loaded handguns?

Ya'll say we should do more, and speak more about the problems facing us, but when someone does more and says more the general response is apathy?

Having worked with the author of the article, and having gotten to know her, she is a very passionate advocate when it comes to mental health access and treatment, particularly for vulnerable populations in the state. She isn't trying to sell you something as much as she is trying to highlight the disparities between access in Virginia vs other states.

“The behavioral health lobby,” aka advocates trying to get people health care to keep them safe and healthy after decades and decades of underfunding and divestment that has led to a crisis point where people are dying from a lack of care

It's almost like slashing away the top marginal tax bracket every few years since 1970 has resulted in budget issues for the government. Who knew.

That is what lobby means

I don't think they were being apathetic as much as they were acknowledging that no state funds behavioral healthcare adequately.

Do you think all lobbying is bad? Public healthcare? Environmental protections? I could go on, but unless you think there is zero difference between good and bad things, then you are just resentful of the fact that someone asked you to care.

I don't think lobbying is bad, but you are reacting like you think lobbying is bad

https://investigate-rva.com/

Wow, hello bad faith argument. Maybe reread your own original comment then.

Edit for letter

I think the point is that the bar is already woefully low, and we're not even clearing that.

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.

The disparity isn't because of the government. The CSBs are grossly mismanaged. Therapeutic Day Treatment was the biggest money maker for them, but the local school boards didn't want them for a variety of reasons. My wife did TDT for nine years, and her school board kicked them out because her boss pissed off the superintendent (and a private entity two counties over did some shady stuff to win the contract). Thankfully, she got a job in private practice three days before it was announced they lost the contract.

If you really want to make a difference in the access to mental health services for the youth of Virginia, you'd tell the author of the article that the cheapest option would be to force the school boards to use the CSBs for TDT. That would alleviate the need for further funding from the state.

I’m a bit apprehensive of the limited post history

It’s not so clear cut but you do make good points. Mental health and local politics go hand in hand and I’ve seen how local leadership in CSBs reflect in contracts, MOUs, and more. The government has not given a clear roadmap with realistic and achievable goals and continues to give local mental health agencies mixed signals. CSBs used tdt as a cash cow and abused the system, using it as a foundation to pad their budget. Often keeping kids in service for longer than needed. At this point tdt is gone with no replacement offered. CSBs and agencies that used to provide the service don’t have staff for it and claim they won’t hire because of Medicaid auths and difficulty coupled with no guidance from the state. State is apparently asking the csbs why they don’t provide TDT. Finger pointing in both directions.

I speak from personal and professional ties to the field and am working closely to try to address some disparities in my community so my soapbox isn’t just grandstanding 😇

All of that points back to what I said: they are mismanaged.

Very well stated.