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Post-Cho Debate: More Therapy or Lock 'Em Up?

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In the wake of the Virginia Tech tragedy, local Republican lawmakers want to change what happens when a mental-health patient reaches the end of his or her rope. But mental-health care providers say intervening earlier is better.

State Sens. Walter Stosch, R-Henrico, and Stephen Martin, R-Chesterfield, are among the group of GOP lawmakers who last week floated the first set of legal rewrites aimed at shoring up the state's mental-health system since the Tech shootings.

The state's mental-health system has been widely criticized since the tragedy, in which Seung-Hui Cho killed 32 people on the Tech campus April 16, and then killed himself. Last week, Gov. Tim Kaine's Virginia Tech Review Panel concluded the state's health system is underfunded and has systematic gaps.

The Republican lawmakers' three-part plan focuses on how to improve the system that allowed Cho to slip through the cracks. It addresses what legal threshold people must cross before they can be held in a mental hospital against their will, or "involuntarily committed." It also proposes building "crisis stabilization centers" for people in emergency situations and recommends that someone from the local mental-health board be required to attend any hearing that might result in an involuntary commitment.

Those three steps address some of the shortcomings the governor's panel highlighted: that the definition of who can be committed is vague, that there was no adequate facility to monitor Cho, and that the local community services board didn't know about the troubled student.

Lawmakers announced the plan in a press release immediately after a House of Delegates committee hearing in which mental-health professionals called for changes in a different direction.

Health workers say that rather than focus solely on emergency services, the state's health system should focus on intervening before involuntary commitment becomes necessary.

Charles Hall, head of Hampton's mental-health program, told lawmakers they should rewrite state laws to require that local mental-health departments provide preventive services such as therapy to show that the "community-based" options have been exhausted before involuntarily committing someone.

Richard Bonnie, who chairs the state chief justice's commission on Virginia mental-health law, told the panel, "We'll be much better off if we draw people to services rather than push them away through fear of stigmatization or coercion."

During the hearing, Delegate Phil Hamilton, R-Newport News, chairman of the House Health Welfare and Institutions committee, joined Stosch and Martin in sponsoring the proposed legislation. Hamilton says it's been 37 years since Virginia first established community services boards with the philosophy of keeping people out of state mental-health hospitals. He says the funding has never been sufficient.

It's practically become a mantra among mental-health providers that money has never materialized for services that might prevent a patient from reaching the point where they could harm themselves or others. "Thirty-seven years and we're not there yet," Hamilton says. S

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