When Virginia State Sen. Creigh Deeds was injured by his 24-year-old son Gus on Nov. 19, the attack was preceded hours before by a mental-health evaluation of the younger Deeds, who was recommended for emergency custody, an order that could have forced the young man to be held from 4 to 72 hours.

But there were no psychiatric beds available. So he was released, stabbed his father multiple times, and committed suicide.

The tragedy is not unheard of at a time of increasing need and decreasing support.In Peoria, a draft of a Community Mental Health Needs Assessment was released on Nov. 15, and officials hope it will provoke a new discussion that could touch on policy implications and even funding questions.

“This was in response to a state mandate from 2011 pushed by the Association of Community Mental Health Authorities of Illinois, the 708 boards,” said Greg Chance, Administrator at the Peoria City/County Health Department.

A 708 Board, or Community Mental Health Board, was established by the Illinois Community Mental Health Act of 1963 to empower a community, municipality or township to plan and fund mental health, developmental disability and substance abuse services.

“At the County, we have never much looked at health beyond the traditional approach,” Chance continued. “When we speak about health, it is not as simple as looking at it from a physical standpoint. We must include oral health and mental health of an individual.

“Our intention is use data-driven analysis of the issues to start the dialogue,” he added, “to provide a platform, an opportunity for some enlightened discussion.”

The analysis, completed for the Peoria County Mental Health Advisory Committee by researchers from the University of Illinois College of Medicine at Rockford, used interviews with dozens of stakeholders such as State’s Attorney Jerry Brady, Sheriff Mike McCoy, Heartland Clinic CEO Farrell Davies and Unity Point Health-Methodist Hospital’s Director of Behavioral Health Services Dean Steiner, plus six focus groups convened at places such as the Human Service Center and the South Side Office of Concern, and input from State Rep. David Leitch’s Central Illinois Coalition for Mental Health Recovery.

The Peoria County Community Needs Assessment on Mental Health, Substance Abuse and Developmental Disabilities Services’ key findings for needs and action included:

Mental health needs – psychiatric services, dual diagnoses (mental health and substance abuse) services and comprehensive mental health system; actions – supporting existing programs, help people pay for medication, and increase providers, especially by recruiting and retaining psychiatrists.
Substance abuse needs – more individual counseling, a comprehensive system including case management for transition from inpatient to outpatient services, and more substance abuse services; actions – increase availability of treatment services and medication, recruit and retain staff, and provide dual diagnoses treatment.
Developmental disabilities needs – support for families with kids and adult children, more trained staff, and improving the PUNS (Prioritization of Urgency of Need for Services) waiting list; actions – Support residential programs, recruit and retain staff, and improve the efficiency of the PUNS list.

Of course, mental illness is a broad description, covering anxiety, substance abuse and Attention Deficit Hyperactivity Disorder (ADHD); dementia, depression and bipolar conditions; and neurosis, schizophrenia or psychosis. Regardless of the problem, there are profound gaps in rates of treatment and access to care, according to the U.S.

Department of Health and Human Services report “National Survey of Drug Use and Health: Mental Health Findings.”

“More than 60 percent [of mentally ill Americans] had not received mental health services in the past year,” it shows.

The state is also deeply troubled. Illinois has a grade of “D” by the National Alliance on Mental Illness (NAMI), the nation’s largest nonprofit, grassroots mental-health advocacy group. That appraisal is actually up from an “F” in 2006, “which is not much to be proud about,” NAMI said.

“States such as Illinois, which made devastating cuts to mental health services previously, made further cuts for fiscal year (FY) 2012, putting tens of thousands of citizens at great risk,” says NAMI’s 2011 report “State Mental Health Cuts: The Continuing Crisis.”

It reported that Illinois’ mental health budget dropped from $590.7 million in 2009 to $403.7 million by last year. Illinois cut $187 million from mental health services – 31.7 percent – over that time.

“Illinois leads the nation in numbers of people with serious mental illnesses warehoused in nursing homes,” it says.

Illinois in 2010 settled a lawsuit by agreeing to transfer 5,000 mentally ill nursing home residents into community programs, but by 2012, just 45 had been moved.

The availability of inpatient psychiatric care has plummeted, according to the national nonprofit Treatment Advocacy Center, whose report, “The Shortage of Hospital Beds for Mentally Ill Persons,” found that in 1955 there were 340 public psychiatric beds available per 100,000 U.S. citizens. By 2005, the number fell to a mere 17 beds per 100,000 persons – the lowest availability since the mid-19th century.

When facilities existed – such as Peoria’s Zeller Mental Health Center (shut down in 2002) or even the Illinois Asylum for the Incurable Insane in Bartonville (shuttered in 1973) – the mentally ill received treatment, In the 1950s, for example, about 500,000 patients were being treated in psychiatric hospitals; by the 1970s, that number had fallen to 160,000.

However, in the 1960s, the American Psychiatric Association and the American Medical Association urged deinstitutionalization, integrating some mentally ill people into society through outpatient services administered through community mental health centers. Some providers and politicians alike saw that as a way to cut spending, and the responsibility and funding started to be shifted to states. But hospitals closed faster than community mental health centers could keep up, then the Reagan administration gutted the community mental health center system, reducing federal funding 30 percent until by 1985 federal support was just 11 percent of mental-health agency budgets.

“The federal government essentially abdicated their role years ago,” Chance said.A lack of psychiatric facilities and community mental health centers has resulted in unintended consequences ranging from homelessness to crowded jails. There’s been a 50 percent increase in mentally ill people incarcerated in county jails, according to Dr. Joe W. Hatcher, a psychology professor, and Shauna Pichette, writing for Corrections Connection. They say that prisoners with mental illness cost the nation $9 billion a year and add that investing $2,000-$3,000 annually in mental health treatment would save $50,000 in jail costs.

In the spring of 2011, Cook County Sheriff Tom Dart threatened to sue the state of Illinois, “accusing it of allowing the jail to essentially become a dumping ground for people with serious mental health problems,” NAMI reported in 2011.

Now, from the rising frequency of post-traumatic stress disorders (PTSD) to high-profile violence such as attacks on U.S. Rep. Gabby Gifford, and at Virginia Tech, Aurora, Colo, and Sandy Hook Elementary School, it’s more obvious that besides the mentally ill not being served, public health in general can be jeopardized by the lack of attention to mental health.

In fact, 10 percent of homicides are committed by the mentally ill, according to Dr. E. Fuller Torrey, psychiatrist and author of “American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System.”

“That’s a conservative estimate,” he said. Dee Roth, with the National Advisory Council of the federal Substance Abuse and Mental Health Services Administration (SAMHSA), part of the federal HHS, echoed Chance’s perspective.

“We have to think about mental-health care in a public health framework,” Roth said. “Public health measures solved rickets, cholera, people dying when they’re 30.”

Besides beds and therapy, there’s funding, of course. Screening at schools, early treatment programs, rehabilitation programs, and more intensive case management all are desperately needed. But at a time when the economy continues to struggle and some politicians are enamored with austerity, that’s a challenge.

“People with mental illness are not valued in this society,” Roth said. “It’s not a place where people want to give money. We’re in a country right now that is so mean-spirited, people really aren’t in any mood to spend any money on anybody.”

Chance, stressing that the Peoria County assessment is just a starting point, said “We’d like to be moving toward some sort of local, sustainable system.”