Virginia will reopen one of five state-run mental hospitals to new admissions

Catawba Hospital, a state-run psychiatric facility near Roanoke, will begin accepting a limited number of new patients on Thursday, according to a release from the Virginia Department of Behavioral Health and Developmental Services. 

The announcement comes nearly 20 days after Commissioner Alison Land halted admissions to five of the state’s nine mental hospitals, including Catawba — an unprecedented step she acknowledged was taken without consulting department attorneys or the office of Gov. Ralph Northam. At the time, Land said her decision was forced by deteriorating conditions at the facilities, which have struggled for years with understaffing combined with “dangerously” high census levels.

As of Monday, there were still 1,616 staff vacancies across the state hospital system, according to Lauren Cunningham, a spokeswoman for the department. But Catawba “has reduced its census and consolidated staff to cover 85 beds,” according to the release, allowing the facility to safely accept a limited number of admissions.

“There are currently 84 patients at Catawba with more discharges underway,” the department announced. “Initially, the hospital will be held to a census of 85 out of its 110 beds to ensure the situation remains safe and manageable.”

Reopening the facility is a small victory for the beleaguered agency, which has struggled to manage a growing share of involuntary psychiatric admissions compared to private hospitals. Admissions were closed to give the hospitals more time to discharge more patients and narrow the ratio between residents and providers. 

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Those widespread staffing shortages created “dangerous” conditions for both patients and employees, Land said. Within the first week of July, there were 63 serious injuries among staff and patients, with an average of 4.5 serious incidents across the hospital system every day. Mandatory overtime and high census levels also led to a slew of resignations — including 108 in the two weeks preceding Land’s decision.

Since then, the agency has reduced the census by 17.5 percent across the five closed facilities and 12.4 percent statewide, Cunningham said. There is still no estimated date for when the remaining four hospitals will reopen to new admissions.

The closures have had a ripple effect across Virginia’s mental health system. State hospitals are often the only residential treatment option for people experiencing a mental health crisis. Even before the halt in admissions, acute bed shortages often left patients stranded in local emergency rooms — sometimes for days — as community responders searched for treatment options.

Catawba’s reopening will only make a small dent in the underlying problem. “State hospitals that are still open shouldered the burden of diversions from their sister hospitals and are now at 100 percent capacity with staffing concerns of their own,” DBHDS stated. “This crisis continues to be fluid and intense across the commonwealth.” 

State lawmakers have also struggled to address the challenges facing state hospitals, which have been exacerbated by decades of underfunding for mental health services. The agency has submitted a request for $335.5 million in federal rescue funding just to address staffing at the facilities. 

Land has devoted roughly $25 million in pre-allotted funding to offer bonuses to hospital workers. Temporary employees will also arrive over the next three weeks to “reinforce and augment current staffing levels” at Catawba and other facilities, according to the release.