A few days after Gov. Albert Bryan declared a mental healthcare emergency in the U.S. Virgin Islands, a real emergency showed up at the Roy L. Schneider Hospital. But according to a former official familiar with the situation, the person in crisis was simply sent away.
Now, one week later, there is no clear answer as to what happened or what was done to relieve one family’s apparent sense of desperation.
The scenario surfaced during a public discussion on government services. Former Veterans Affairs Director Harry Daniel expressed concern over the availability of mental health care.
On the morning of March 13, Daniel said he got a call from the relative of a veteran. The relative told Daniel about a health problem that worsened to the point where they showed up at the RLSH emergency room demanding that their vet be admitted.
“The hospital released her and said they couldn’t keep her because she didn’t want to stay,” Daniel said. “The next question was, they don’t have a psychiatrist to see her. The next question was the court give a court order and the doctor refused to sign it, and put the veteran out on the street.”
The former director said his next action would be to call on the current director of Veterans Affairs, Patrick Farrell.
Attempts to reach top officials at Schneider Hospital for an explanation failed.
Among those searching for an answer was Delegate to Congress Stacey Plaskett, who sent an aide to make an inquiry. Plaskett is in town conducting outreach with constituents and the local media.
“I don’t have the specifics so I’m asking Cleitus Clendinen to get with Mr. Farrell and find out what happened,” Plaskett said Tuesday. “There is a requirement that they have to at least admit them for 24 hours.”
Farrell said he, too, heard the story and was still trying to pin down the facts. One thing the Veterans Affairs director was fairly sure of: if the patient was turned away, it was likely not because she was a vet.
“That case, that just sounds like in the V.I. who just needed care, but couldn’t get it,” Farrell said. Yet veterans get care at the hospital regularly, he said.
But often vets relying on their Veterans Affairs benefits have to wait for testing, specialty services or for a bed to open up at the nearest VA hospital, which is in Puerto Rico. Recent actions taken in Washington could make that increasingly passe.
In June 2018 President Donald Trump signed the VA Mission Act, giving vets the right to seek medical care outside of the VA if there’s too long a wait before they can be seen by a healthcare professional.
But here, in the Virgin Islands, getting the Mission Act up and running is a mission in itself.
“The president just passed the Mission Act, now I’m working on the logistics of it,” Farrell said.
When the governor issued his executive order on Feb. 19, the focus appeared to be on finding resources. There did not appear to be much consideration for the resources already in place or helping patients navigate the system that was already out there.
Except for the governor say, in effect, “Thank you for your service.”
“Declaring this emergency will give our Department of Health access to federal resources and allow the department to expand its search for mental health providers. I thank the providers who have worked tirelessly to fill this void, but we have to provide the help they need. I am calling on the agencies where these services will be provided to work together creatively to provide this important service to our community,” Bryan said in a March 19 statement.
Several days after declaring a mental healthcare emergency in the Virgin Islands, one family in crisis could not benefit from a coordinated effort among intervening agencies. SRMC Chief Executive Bernard Wheatley was not available for comment. Neither was Chief Operating Officer Tina Commissiong or Medical Director Luis Amaro.
The task of providing a response was sent to Dr. Lori Thompson, an on-call psychologist on contract to Schneider Hospital. Thompson is among the clinicians who evaluate persons to determine whether they must be admitted to the RLSH Behavioral Health Unit.
Citing federal patient privacy rules, she offered limited comments. “I can’t give any information because it’s a HIPPA violation,” Thompson said. HIPPA is the Health Insurance Portability and Accountability Act of 1996 that, among other things, guarantees security of patient records.
“I am not aware of anyone who was brought in with a court order,” she said.
Thompson qualified the statement by saying there are other documents directing that action be taken on behalf of patients in need. Those documents can lead to obtaining an order from the court after an evaluation. And the rules for obtaining court intervention are strict and complicated, she said.