After Cho, Outpatient Orders For Mentally Dangerous Increase 

As lawmakers and mental-health advocates debate changes to the state's mental-health system in the wake of the Virginia Tech shootings, the state is under fire for the legal mechanism it uses to monitor patients deemed threats to themselves or others.

The state gives such patients "outpatient treatment orders" that don't require hospitalization, but instead mandate the person to manage their own plan. Cho Seung-Hui was placed under such an order 16 months before the April massacre when Cho took the lives of 33 people, including his own. The number of outpatient treatment orders has increased dramatically since. Just how to monitor someone under such an order has been an issue of hot debate in recent months.

At a recent meeting investigating new directions for mental-health law, a representative from Virginia Beach said they usually get only one or two a year, but have received notice of 10 outpatient treatment orders in the last few months. In the Richmond region there have been eight since April, a significant spike.

George Braunstein, who oversees state mental-health services in Chesterfield County, says one has recently come through his agency. Before that, he says, "I can't remember the last time Chesterfield had an outpatient commitment ordered. I've only been here seven years."

Some point to a broken system. How is it the component of the system that seems the most compromised in the Cho incident is now being relied on more heavily than ever?

"There is an irony there, I guess," says Mike O'Connor, who oversees state mental-health services in Henrico County. "I think because of the increased scrutiny more conservative decisions are being made and obviously the discussion has brought more attention to this as an option."

In the meantime, local state health care providers are bracing for Virginia Tech students and families to return to their communities across the state. Research from the investigation into the Columbine High shooting in 1999 suggests that the 18- to 24-month period after a traumatic event is most critical for people who survive.

Richmond has one of the highest concentrations of Tech students in the state, and local boards are preparing for low-level, outpatient services such as counseling to be in slightly higher demand. The Virginia Department of Mental Health has asked the federal government for additional funds to be able to better service survivors of the tragedy, but no there is no word as to how much extra money, if any, will be available. S

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