RICHMOND, Va. - With reforms underway in Virginia for children's mental health services, lawmakers and advocates want to hear from people dealing with the issues every day. Voices For Virginia's Children is hosting a community conversation Thursday in Charlottesville.

Executive director Margaret Nimmo Crowe says there will be a brief panel discussion that will include lawmakers looking to rewrite state policy. But she says most of the time will be for frank and open talk, including folks who know about the issue first-hand.

"Providers of mental health services, families who have children who experience mental health disorders tell us what is working and what is not working," says Nimmo Crowe. "What services are you able to get easily and what types of treatment are still needed?"

Nimmo Crowe says for the last five years they've been working on a long-term effort to improve access and funding for crisis services. She says lawmakers could make major changes to the system over the next few legislative sessions.

"We want to make sure those changes are informed," she says. "That policy makers are really hearing from the people on the ground, who either need the services or are trying to provide them."

She says much of the focus has been on adult mental health but it's important not to ignore children's needs, even if the issue is hard to talk about.

"We know that half of all mental illness begins before the age of 14, so if we're leaving the children's system out of the solution, we're really missing a big part of it," Nimmo Crowe says.

State Sen. Creigh Deeds will be on the panel. A year ago Deeds was violently attacked by his son, who was suffering from a mental illness. Since then Deeds has led much of the effort to reform Virginia's mental health services for children. Nimmo Crowe says it was crucial he be there.

"For us it was very critical to have him be part of this, not only to share, but also to hear what people are saying, because he is heading up the four-year legislative study commission."

Thursday's event is free and open to the public. It'll be held at the Jefferson School City Center in Charlottesville. Some snacks will be served, starting at 6 p.m.


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A new book by a University of Washington professor on the death penalty finds support for executions may be motivated by people's own fear of death.

Philip Hansten, professor emeritus of pharmacology at the University of Washington and author of "Death Penalty Bulls---," argues against the practice.

Hansten draws on work by Ernest Becker, an anthropologist who said reminding people of their own mortality made them cling tighter to their cultural views and even increases people's punitive urges in order to defend their culture.

Hansten suggested hearing about a murder could cause somebody to think more about death, especially if it happens in their community.

"The murderers are an out group in general; I mean most of us aren't murderers," Hansten pointed out. "So the murderer is automatically an out group, somebody who we would tend to protect our culture from anyway."

Hansten argued it could make people more likely to support the death penalty. He also noted the fear of death can inspire xenophobia and racism in people who feel they need to protect their culture.

Becker's Pulitzer Prize-winning book The Denial of Death led to the creation of a study known as Terror Management Theory.

Hansten contended Becker's theory puts death row in a new light.

"If the terror of death has such a huge influence on all of us, putting people on death row for decades, it would be hard for me to imagine something more cruel than that," Hansten stated.

Hansten added Terror Management Theory also makes it clear people do not necessarily create their views on issues like the death penalty with their rational minds.

"You give them all this data and all the rational arguments and show how it's totally arbitrary, etc., etc., and it just falls on deaf ears because this death terror is preventing them from hearing it," Hansten emphasized.

Seventy percent of the royalties for Hansten's book go to the group Death Penalty Focus.

Most South Dakotans live in federally designated mental-health professional shortage areas, and a new report recommended steps Congress and other decision-makers can take to help states close gaps within the behavioral health workforce, amid a growing demand for mental-health services and a shortage of licensed providers.

Kendall Strong, senior policy analyst for the health project at the Bipartisan Policy Center, said one solution is to enhance the role of those with mental-health training who do not have the full credentials. She argued behavioral-health support specialists are certainly up to the task.

"These people are underutilized," Strong contended. "They have a lot to offer because part of the folks that we're talking about are folks like peer-support specialists, who have lived experiences and can really connect with folks who are struggling."

Others in the group are community health workers and paraprofessionals. The report recommends reducing barriers for them to take on bigger roles in behavioral health, including adopting a certification framework to promote flexibility but still protect patients.

Strong acknowledged a divided Congress might provide obstacles but added there is optimism with both parties recognizing the provider shortage.

The report advised pulling in more help can free up licensed providers who are dealing with patient backlogs. Strong added behavioral health support specialists are embedded in the community and can meet in a nonclinical setting. She suggested it can be especially helpful in rural areas where mental-health stigma still might exist.

"In areas where there is just less infrastructure visibility as compared to urban areas, it's really clear if you're going into a health care facility," Strong noted.

The report also called on federal officials to explore expanding Medicaid and Medicare coverage of services provided by behavioral-health support specialists.

The Kaiser Family Foundation said South Dakota has nearly 60 areas with provider shortage designations, which affects nearly 800,000 residents.

A recently proposed plan has been devised to better fund Virginia's mental-health programs.

The new Right Help, Right Now plan calls for $230 million in funding for upgrades to the state's mental-health system.

Some elements of the plan include expanding mental-health programs in schools, growing tele-behavioral health operations in high schools and college campuses, and creating more than 30 mobile crisis centers.

However, some feel the plan is a good start with more to be done.

Bruce Cruser - executive director of Mental Health America in Virginia - said in the past, more money has been put toward hospital care than community care. Although this plan changes that dynamic, he outlined what else needs to be addressed in the state's mental-health landscape.

"What we don't see there is funding for the Community Services Board's employees," said Cruser, "and they're really the front line of care in the community to help prevent people from having to go into the hospital. And so, what we'd really like to see is some additional funding to make up the ground for the Community Services Board, the direct care staff."

The plan finds 106 of Virginia's 133 counties are classified as having a mental-health professional shortage.

Cruser said the COVID-19 pandemic only exacerbated existing flaws in Virginia's mental-health system. This resulted in less people being able to get the help they needed.

While he said it's fortunate to see the attention this plan is creating, he noted that it's a shame it took years of crisis to reach this turning point.

Although the plan has great support, Cruser also noted that there will be challenges to implementing this plan. Specifically, he noted that the pay rate from insurance or Medicaid needs to be increased.

But, Cruser said he feels there are two elements of this plan which ensure people won't always end up in hospitals for behavioral-health issues.

"The mobile crisis and the crisis receiving centers would help build up that continuum of care in the community so that people don't have to end up going to the hospital," said Cruser, "They can get the care they need, they can get the crisis resolved, they can find the services that they need in the community with much better outcomes."

He added that this would boost the state's mental-health system a lot.

Over the Virginia General Assembly's next legislative session, Cruser said he is eager to see this proposed plan become a package of legislation that'll advance the state's mental-health system.