ST. THOMAS – The 35th Legislature of the Virgin Islands’ Committee on Health, Hospitals, and Human Services, led by Senator Ray Fonseca, met at the Earle B. Ottley Legislative Hall. Lawmakers met to consider a measure to increase access to behavioral health services. Additionally, the Committee received testimony on the status of behavioral health and substance abuse in the territory.
Lawmakers first met to consider Bill No. 35-0224, an act amending Title 19, Part V, Chapter 45, Subchapter VI to increase access to behavioral health services, with a focus on a Psychiatric Emergency Response Team to provide mobile crisis intervention services, and the 9-8-8 telecommunication system. The measure was proposed by Senator Diane T. Capehart. The proposed measure was voted upon favorably and will be sent to the Committee on Rules and Judiciary for further consideration.
Additionally, the Committee received an update from various stakeholders on the status of behavioral health and substance abuse in the territory. Nicole Craigwell-Syms, Assistant Commissioner of the Department of Health delivered comments. The Behavioral Health Division provides psychiatric services, care, management, therapeutic interventions, substance use treatment, opioid treatment programs, forensic, and outreach services. The Division’s outpatient team includes two part time psychiatrists, eight counselors, three case managers, two newly onboarded case managers, three clinical staff members, an opioid project director, and additional support staff. Craigwell-Syms stated that the Department is actively pursuing grant funding to expand services. Between April 2023 and April 2024, there have been 22,033 behavioral health outreach encounters, and 2,045 patients visited DOH Clinics during this period. The Division oversees all off island residents, provides case management services and participates in treatment team meetings and remains responsive 24/7.
Averil George, Commissioner of the Virgin Islands Department of Health, spoke of the importance of mental health. George stated that many do not usually think about mental wellness until situations arise in our personal lives, at work, in the news, on social media, or in the community. The mandate and focus of the Department of Health is to provide social services that facilitate independence and self-sufficiency in the lives of those vulnerable. When the Department is faced with those experiencing behavioral health challenges, programs are referred for assessments, evaluations, and services. Upon evaluation of the client, referrals are then made to Drug Dependency Service, (VIDOH) or private agencies and providers via individual provider agreements and via the Medical Assistant Program (MAP or Medicare). In severe situations, families are advised to take their loved ones to the hospital.
Victor Somme III, Assistant Commissioner of the Virgin Islands Department of Education stated the department supported promoting mental health education and awareness, as it is beneficial to students’ social-economic learning. In testimony delivered by Somme, he stated that mental illness is misunderstood, but we are all faces of mental stress. He stated that while we may not be the homeless person walking the streets of Frederiksted, Savan, or Cruz Bay, we are the ones who live with depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, and anxiety every day. The Department interacts daily with public and private therapeutic institutions in providing a wraparound standard of care for students with issues related to mental health.
Dr. Laurie McCormick, a Board-Certified Physiatrist and Family Physician, stated that there was a mental health crisis in the territory and that it has gotten worse. She stated this is so because there has not been enough funding for a full-time community psychiatrist within the Department of Health on St. Thomas who could facilitate involuntary commitment to inpatient, outpatient, and long-term facilities since 2016, when previous psychologists left the island. The entire annual budget allocated to the Division of Mental Health through the Department of Health, (of almost $7 Million) is diverted to off island facilities to house 44 Virgin Islanders. There is one psychiatrist on the island of St. Croix under the Department of Health. However, there are no psychiatrists for outpatient services on St. Croix and there is a lack of adequate coverage on St. Thomas.
Anya Stuart, Executive Director of the Family Resources Center stated that victims of crime are more prone to further and increased violent crime because of imposed vulnerability. Victims of crime experience setbacks that they have difficulties rebounding from, which may lead to further victimization. The Virgin Islands, being a region that is separated geographically with limited resources, can create more layers of hardship for those who are already suffering challenges. Victims of crime may need access to medical care, without the ability to pay, may need medications, and counseling services that might not be immediately available. These victims are also at risk of losing wages due to the inability to work from damages from the crime, as well as victims feeling shame or responsibility for what happened to them. Mental health has been a focus of attention in the territory, since the passage of the hurricanes Irma and Maria, which devastated the territory in September 2017.
Tina Commissiong, Esq., Chief Executive Officer of Schneider Regional Medical Center stated that as an acute care hospital pursuant to the Virgin Islands Code, SRMC is required to provide emergency stabilization and inpatient care to persons requiring treatment for acute presentations of behavioral health. As a public hospital, it is required to provide care, regardless of a person’s ability to pay. Behavioral health can accommodate up to eight patients and usually has a census of six patients. Patients who are in this unit usually have diagnoses of psychosis, manic/bipolar disorders, and substance abuse problems. During FY 2023, SRMC had 107 admissions to the BHU and for FY2024 through May 7, 2024, there have been eighty-three. The average length of stay at the BHU is incredibly long, averaging 83 days. It cost SRMC $1,177,522 to operate the unit in FY2023. For FY2024, through May 7, more than $764,071 has been spent. SRMC treated 541 patients in the Emergency Department for behavioral health concerns during FY 2023. SRMC has had to pay the cost of transferring BHU patients to other facilities, Between FY2023 and 2024, air transportation has cost SRM $53,388.40. Commissiong stated that behavioral health needs in the territory were great, and that families in the territory are impacted by the lack of such services. Additionally, SMRC is owed $877K from the BOC for services provided by the hospital from 2020 to the present.
Paulette Venzen-Potter, Operations Manager and Clinical Worker for the Behavioral Health Program at St. Thomas East End Medical Center, stated that the STEEMCC behavioral health team is mindful of the needs of our community and the necessity to improve access to behavioral healthcare and wellness throughout the territory. In the 2023 Calendar year, behavioral health providers saw 2,306 patients, Unfortunately, these services were discontinued after three months after the departure of the psychiatrist. Venzen-Potter spoke of the need to accommodate more space for new hires and student interns, as well the need for more staffing. Doug Koch, Chief Executive Officer of the Juan F. Luis Hospital delivered testimony. Koch continued to emphasize that the Virgin Islands has a critical issue of mental health and an urgent need for a collaborative approach to addressing it. JFL is a temporary hardened structure with fifty-two inpatient beds. The behavioral health area has four individualized patients’ rooms, one bathroom, and a nursing station. A person can access behavioral treatment services voluntarily or through emergency commitment as outlined in the VI Behavioral Health and Developmental Disability Act. From April 2023 to April 2024, there have been 164 behavioral health evaluations and sixty emergency visits for anxiety complaints. This data was not broken down by voluntary or involuntary commitments.
“Addressing behavioral health must involve all of the community. We must also accept that mental health and behavioral health is a serious issue. It must be treated on parity like you have cancer or diabetes.” said Senator Fonseca.
Senators present at today’s Committee hearing included Ray Fonseca, Kenneth L. Gittens, Diane T. Capehart, Novelle E. Francis, Jr., Marise C. James, Carla J. Joseph, and Milton E. Potter.
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