Earlier this month, two rural hospitals -- one in Wheeling, one just across the river in Ohio -- announced they were closing. Since then, stakeholders have been meeting to discuss strategies for maintaining at least some of the services the hospitals provided -- especially mental health care. Because in rural states like West Virginia, losing a facility doesn’t just impact the community but can have ripple effects across the state.
Let’s look at the impact on the local sheriff’s department. Local policing is often associated with safety -- writing traffic tickets, providing security at public events, responding to 911 calls. But a big part of the job also involves providing support services when someone is having a mental health crisis.
“The sheriffs in West Virginia [are] tasked with all of the transports to and from hospitals,” explained Major Nelson Croft with the Ohio County Sheriff’s Department.
A mental hygiene order takes place when an adult applies for the involuntary hospitalization of another person whom they believe is addicted to a controlled substance and/or is mentally ill and likely to harm oneself or others. When that application is approved, it’s the responsibility of the local sheriff’s department to pick that person up and take them to the hospital.
“We have to take them to the emergency room first,” said Sheriff Tom Howard of Ohio County. “From that emergency room they get checked out and processed and through that process they will end up in the Hillcrest unit.”
Hillcrest is the comprehensive behavioral health system located inside Ohio Valley Medical Center. The early August announcement that OVMC would be closing also meant the behavioral health unit would be going away. The next closest healthcare facility, Wheeling Hospital, does not have inpatient psychiatric beds. Wheeling Hospital CEO Douglass Harrison has said the facility is exploring the idea of adding inpatient beds as a short-term fix, but to date, no official plans have been announced.
This means the sheriff’s department isn’t just transporting people with mental health problems to a local hospital, it is now in charge of that person until a bed can be found.
“My staff would have to stay with them the entire time and once that process begins it could take 10 hours [or] it could take 20 hours. But my deputies have to stay with them the whole time,” said Howard.And once the orders are finally issued, they will have to be transported to a hospital that has inpatient psychiatric beds.
And WHERE does not mean the institution that’s closest, but which one has available beds. Sometimes these patients will have to be taken to Fairmont or Morgantown -- a trip of about an hour and a half each way. But sometimes it might be Beckley or Charleston -- more than twice as far.
Patients who have been involuntarily committed are entitled to a court hearing in their own county. So after that patient has been transported to some distant hospital, the deputies have to go and get them for their hearing. If they are released after the hearing, the deputies are done. But if treatment is ordered, the deputies may have to make the trip back to Beckley or Huntington with the patient.
In short: Fewer officers on the street. And those who are working, are going to be working a whole lot more.
“We have to have deputies every day of the week, which I don’t have,” said Howard. “So we are looking at the possibility of having to hire more deputies.”
“For the past several months we have been taking trips on Tuesdays and Thursdays only,” said Major Croft. “Just starting this week, tomorrow I believe we will be on our third trip of the week. We’ve had trips to Charleston and Fairmont so far...As for tomorrow, we’re not exactly sure where we’re going yet.”
For instance,“we were guaranteed a bed in Fairmont on Monday,” said Croft. “That was only if we left on Monday. If we waited until our traditional Tuesday, they couldn’t guarantee us a bed anymore. So instead of going to Fairmont, which is two hours, I may have had to send two deputies to Bluefield, which is five hours, or Huntington, which is five hours.
And it’s not just the Ohio County Sheriff’s Department that will be affected. There is already a shortage of psychiatric in-patient beds in West Virginia, which is why Fairmont couldn’t guarantee a bed even a day later. With behavioral health beds closing in Wheeling, that means more people vying for fewer beds across the entire state.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.