Rick Gibson | The other side of the story on privatizing psychiatric services

I’ve just read Leonard Gilroy’s Dec. 31, 2008 story concerning Virginia Gov. Kaine’s proposal to close The Commonwealth Center for Children and Adolescents. I feel that he has reported on only one side of this controversial story. There is much more to it. I, for one, believe that equal time should have been given to the opposing side of the story, supported by mental-health professionals from across the state, Virginia Tech families, parents of former and current patients, and even former CCCA patients themselves.

In the shadow of the Virginia Tech tragedy, when the state had vowed fix a system the had allowed a troubled young man – Cho Seung Hui – to “slip through the cracks” – the governor of Virginia is about to dynamite one of those cracks into a verible chasm, creating a lack of vitally-needed services for some of Virginia’s most troubled young people.

State officials have been perpetuating the myth that these children can be easily absorbed by private hospitals and community-based agencies. The fact is that the majority of the children and adolescents admitted to the CCCA have either been denied admission to or have been transferred out of these other facilities; due to either aggressive, violent behavior that these community-based agencies and private institutions have been unable to manage, or as a result of their having no private insurance (and yet not being eligible for Medicaid. It is a common practice for these private hospitals to transfer children out of their facility and to the CCCA as soon as their insurance benefits have been exhaused.

The Center treated 608 patients in its 48-bed facility in 2008, and was expected to serve 650 in 2009, before word of this closure was announced. In these troubled economic times, with so many families experiencing increased stress, the number of children needing such treatment is only expected to get larger in the new year. This facility serves children and adolescents from all over the state.

It must be understood that while the state of Virginia has many large psychiatric hospitals for the care of adult patients, the Commonwealth Center is the only such facility within the entire state that accepts children and adolescents. It has long served as the safety net for children without insurance; for unpredictably agressive and violent children; and for children facing legal charges, who have been court-ordered to have mental-health evaluations before continuing with the legal proceedings against them.

How often an adolescent child has been admitted to the Commonwealth Center after being arrested and charged with a crime, and then attempting or threatening suicide while locked in a juvenile detention center.

For a much more comrehensive analysis of the possible impact of the closing of the CCCA, please see: http://www.nami.org/Content/Microsites197/NAMI_Northern_Virginia/Home184/News2/CCCA_Proposal.doc , written by a mental-health professional and staff member at the Center. This report, entitled “Closure of CCCA: Possible Impact of Virginia’s Behavioral Health System of Care for Children and Families,” outlines with specific data the fears of psychiatrists, psychologist, social workers and other mental-health professionals all over the state of Virginia.

I, myself, am a former staff member of this hospital, who has been permanently disabled as the result of an attack by a violent adolescent at the CCCA – (previously, DeJarnette Center) – almost 11 years ago. I know firsthand the complexities and challenges of treating and caring for such difficult to manage children, which the Center routinely admits, when no other facility will have anything to do with them. A few of the more extremely violent and unpredictable adolescents have wound up having to be placed, upon discharge from the CCCA, in out-of-state hospitals and other facilities as far away as Florida, Colorado and other equally distant points; after being refused admission to any and every other facility within the state of Virginia.

One common misconception is that the Commonwealth Center warehouses children. In reality, the average length of stay for a child admitted to the Center is less than a month; and often only a few weeks. The Commonweath Center for Children and Adolescents might well be thought of in terms of the emergency room and the intensive care unit of a general hospital, all rolled into one. Such an analogy would be accurate. No one would begin to suggest that the ER and ICU of a general hospital be shut down, and their patients transferred to general wards of the facility. This is exactly what the governor of Virginia is proposing to do in closing the CCCA.

What makes this story even more controversial, however, are the questions that are now being raised as to the validity of the governor’s reasons behind closing the facility. Many people believe that the closing of the Center is not so much about addressing the state’s budget shortfall as it is about the commercail value of a little 28-acre tract of land, atop a small hill adjoining the intersections of Interstate 81, Exit 222 and U.S. 250, which happens to be the property that the CCCA was built upon, just 12 short years ago.

On the same December day that the governor announced that – along with his other state budget cuts – the CCCA would be closed by June 30, 2009, and that it would stop accepting admissions effective immediately, officials of the city of Staunton announced in a press conference that an deal had been struck between the city and state for the building of a new $130 million Western State Hospital (one of the state’s many psychiatric hospitals for adults).

The aging WSH – whose current 300-plus acre property adjoins that of the Commonwealth Center (but is mostly low-lying land that sits back in from these two major highways) – will be replaced, with the new facility being built in a new location, a few miles away. The state will put up the first $110 million, with constructon to begin right away in 2009, while the current hospital’s 300-plus acre property will be sold to the city of Staunton, in that the city has agreed to kick in the remaining $20 million on the project when it is nearing completion in 2010.

Staunton plans to put the property out for bids early in the new year to commercial developers, and anticipates the land becoming an enormous mixed-use commercial retail shopping area, with retail stores, restaurants and lodging facilities. City officials deny having had any knowlege of the closing of the CCCA, but during the December press conference, economic-development director Bill Hamilton stated: “The closing of the Commonwealth Center has been a surprise but, given the location of its campus, we would anticipate talking with the state about its possible inclusion in this project.” Whether this small town at all needs another such retail shopping complex raises serious questions. There is a Wal-Mart Supercenter and Lowes within a mile or so from the entrance to WSH/CCCA, and the Staunton Mall is within about three miles or so.

This author believes that the city is attempting to retrieve customers who’ve been drawn away from shopping in Staunton by a new Target strip mall that has recently been opened in Waynesboro, a smaller city nearby, and Staunton’s closest neighbor. Staunton only has a population of about 24,000. It was just recently announced on a national news piece on TV that the country currently has approximately twice the number of retail shopping malls that it can profitably sustain. This plan has been called by some, a White Elephant.

The point is that the CCCA – sitting atop its little hill, and looking more like a small, modern community-college satellite than a mental-health facility – is located right on the corner of the intersection of these two major arteries to Staunton, and is clearly visible from miles away on I-81, as well as U.S. 250. In addition, the intersection of Interstate highways I-81 and I-64 is also within sight of the center.

This key piece of land is probably the most valuable little tract of land anywhere in the area. Whereas the state is selling the 300-plus acre WSH land to the city of Staunton for $20 million, from the governor’s own 2009 budget proposal it states that the Center’s 28-acre piece of land is expected to fetch $12 million, which amounts to seven times per acre what the WSH land is being sold for.

Aside from being a key location for commercial development and for use as a signpost for the new shopping extravaganza; it seems fairly certain that the city of Staunton – which reportedly wants to retain complete control over just how all of this land will be developed – surely does not want to have a children’s mental-health facility in the middle of their new commercial shopping complex.

Additionally, at a time when the state is in such dire financial straits as to be forced to close its only child and adolescent mental-health facility, it at the same time has found approximately $15 million in grants for financial assistance to two worldwide computer memory chip manufacturers that have factories within the state – Micron Technology, Inc (NYSE: MU) and Qimonda, LLC (NYSE: QI) – which amounts to approximately one and a half times the annual operating budget of the CCCA.

 

– Rick Gibson resides in Vesuvius.


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