THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Sunday, February 11, 1996 TAG: 9602090207
SECTION: VIRGINIA BEACH BEACON PAGE: 14 EDITION: FINAL
TYPE: Cover Story
SERIES: SPECIAL REPORT: Mental Illness
SOURCE: BY JO-ANN CLEGG, STAFF WRITER
LENGTH: Long : 171 lines
IF YOU ARE LIKE most Virginia Beach citizens, you probably are not aware that your residency makes you eligible for a form of community disability insurance.
Like private policies, this public protection is something you hope you'll never have to use. But it's nice to know it's there.
Your agent, in this case, is an 11-member panel called the Virginia Beach Community Services Board. Your federal, state and local tax dollars helped fund their efforts to the tune of $14 million last year alone.
The funds are used to meet the needs of those who require mental health, mental retardation or substance abuse services in the city.
``We're the safety net for the community, at least as far as those needs are concerned,'' said Dennis Wool, who has been the board's executive director since 1983.
The board provides direct services to more than 7,500 individual consumers in at least 30 different programs at 13 sites around the city. Indirectly, they impact the lives of thousands more, ranging from parents, spouses, children and siblings to neighbors, co-workers, employers, classmates and teachers.
Despite the Virginia Beach CSB's 25-year history, few people, other than those directly impacted by the board, know what it is or does.
Wool says that's probably because the problems that the board deals with are those that people think always happen to someone else.
``People never think they're going to need our services,'' he explained. ``They never think that someone in their family is going to have a Down syndrome baby, be hit by a drunk driver or have a parent who develops Alzheimer's or goes into a psychotic depression.''
Another reason the CSB lacks recognition may be the name itself. Community services take many forms, but the ones this board offers would probably not be the first that come to mind.
Adding to the confusion, the Community Services Board appears in most listings of city departments as the ``Department of Mental Health, Mental Retardation and Substance Abuse Services.''
Part of the confusion also stems from the way the three services have evolved over the years, not just in Virginia Beach but across the state and nation.
It parallels, and has been greatly affected by, changes in behavioral science, medicine and society. It also parallels changes in how the mentally ill, mentally retarded (or developmentally disabled) and substance abusers traditionally have been treated.
In the first half of the century, the pendulum swung from family and community care to custodial care in large state institutions. In the 1950s, the pendulum began moving back - especially in mental health, where medications were developed to control symptoms.
Today, most seriously mentally ill individuals can live comparatively normal lives in the community, if the needed support systems are in place.
These support systems are what allows clients such as Jacob Smith, the youngster featured in the accompanying story, to be at home with his family. The systems are complex and expensive, although far more affordable than maintaining a patient in a public or private institution.
Maintaining a mentally ill or mentally retarded person at home requires a great deal of coordination, but with the school or employer, physician, family and mental health care system working together, it can be done.
The Virginia Beach CSB is a direct descendant of an advisory board organized in November 1959 to develop a mental health clinic for Virginia Beach, Princess Anne County and Eastern Shore residents.
Named the Atlantic Mental Hygiene Center, it opened in September 1960 on 17th Street. Within two years, it had outgrown its space and moved to larger offices over a restaurant in the 2000 block of Atlantic Ave.
By the early 1970s, with patients being returned to communities from the state hospitals in record numbers, the clinic moved into a building on land the city had purchased on Wildwood Drive, just west of First Colonial Road.
Local women's clubs, which had adopted the center as a favored project, spearheaded the drive for funding. Major construction funding came from the federal government, which, recognizing the need for community care, had passed a Community Mental Health Act in the 1960s.
At the same time, the state, recognizing the increased need for community-based care, passed major legislation to improve the quality of mental health and mental retardation services in Virginia. Among the requirements were boards of local citizens to administer programs. City Council chartered the first Community Services Board (then called a Chapter 10 Board) in August 1970, almost 10 years to the day after the first small clinic had opened.
The original advisory board of the Atlantic Mental Hygiene Center focused on care for the mentally ill. By the time the CSB was established, mental retardation services had been added to the board's purview. Substance abuse programs soon followed as the need for drug and alcohol prevention and treatment programs grew in the 1970s.
Members of the CSB, who have the power to make and administer policy rather than just advise staff as the original board did, are appointed by the City Council. The board in turn hires its own executive director who answers to the board and, in his position as a department head, also reports to the city manager.
CSB services are funded through a patchwork of city, state and federal monies, insurance payments and fees received from individuals for services.
``There are two major myths about our services,'' Wool said recently. ``One is that they're free. They're not. A fee is charged for most services. It's adjusted, based on ability to pay, but there is a fee.
``The other is that because we're a public agency, we're second rate. I'd put our staff up against anybody (providing the same services) anywhere.''
In the early days, the Atlantic Mental Hygiene Center concentrated on services for the seriously mentally ill. Over the years, Comprehensive Mental Health Services, the mental health component of the CSB, has expanded its offerings to include crisis intervention, counseling for children, adults and older adults not suffering from major mental illnesses, and a variety of support groups and educational programs for clients and their families.
However, with tighter human services budgets, the emphasis recently has returned to serving the seriously mentally ill, said CMHS director Terry Jenkins, who has been with the Community Services Board since 1977. Comprehensive Mental Health Services worked with 3,600 individuals during the 1994-95 fiscal year, which ended June 30.
Only 40 percent of those are considered to suffer from serious mental illnesses, but seven of the nine services offered by CMHS - case management, psychosocial rehabilitation, residential, intensive and respite in-home care, supported employment and day treatment - are dedicated primarily to the needs of that population.
The future of CSB programs is uncertain as welfare and medical care have become political issues at every level of government.
The rate of changes in funding has been alarming, leaving the CSB and its staff members scrambling to keep existing programs and add those that they know are sorely needed.
The most recent change came Feb. 1 when Medicaid added behavioral medicine to the services covered under its new HMO system.
Depending on which HMO the client has chosen, the changes in how he receives mental health care may be many, few or none.
In the meantime, the board and staff are filling out the reams of forms and watching the figures along with everyone else.
``Right now,'' program director Jenkins said, ``we're just trying to keep an eye on everything.'' MEMO: ABOUT THE AUTHORS
Staff writer Jo-Ann Clegg and correspondent Nancy Lewis bring
different perspectives to their combined look at the Community Services
Board. Clegg worked for Comprehensive Mental Health Services for 15
years, retiring in 1991. She has worked as a free-lancer for the Beacon
even longer and became a staff writer last year. Lewis moved here from
Connecticut in 1994 and has covered various social issues for the
newspaper as a free-lance writer.
[Also see a related story, see page 14.]
ILLUSTRATION: GRAPHIC
COMMUNITY SERVICES BOARD EXPENDITURES
MENTAL HEALTH SERVICES CONSUMERS
COMMUNITY SERVICES BOARD
The Virginan-Pilot
SOURCE: Community Service Board
[For a copy of the graphic, see microfilm for this date.]
KEYWORDS: MENTAL ILLNESS MENTAL RETARDATION by CNB