Bath County, Virginia does not seem like a typical place for a murder-suicide story to grab national attention, but then again, what place would? Bath County is a sleepy rural expanse on the border of West Virginia, home to not even 5,000 residents whose major industries are a local hydroelectric plant and a variety of hot mineral springs. It is represented in the Virginia state Senate by 55-year-old Creigh Deeds, a Democrat whose long political career has earned him the friendship and respect of his colleagues on either side of the aisle.
Deeds joined the House of Delegates in 1992 and in 2001, he joined the Senate. There, he ran for attorney general in 2005, and for governor in 2009. Both times, he was beaten by the current governor, Bob McDonnell. Deeds’ gubernatorial loss was compounded when in 2010, his marriage collapsed, the result of more than 20 years of the pressures that come with a political career. Deeds’ friends noted that he has going through a rough time. But that would be nothing compared to the early morning hours of Tuesday, November 19, when his son 24-year-old son Austin stabbed him multiple times in the head and upper body, and then killed himself with a single gunshot.
As yet, details on what exactly transpired in the moments leading to the attempted murder-suicide remain sparse.
After his stabbing, Deeds, escaped his home and walked some 75 yards to a nearby road where a cousin picked him up and brought him to a nearby farm. From there, Deeds was flown to the University of Virginia Medical Center in Charlottesville. He was immediately listed in critical condition but soon upgraded to stable. Conscious and lucid upon admission, Deeds was able to relate details of what transpired during the attack, but those details have not yet been made public. They may never be. There, he quickly upgraded from critical to fair condition, and three days later, he went home. Hours after his release from the hospital, he tweeted, “I am alive so must live. Some wounds won’t heal. Your prayers and your friendship are important to me.”
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Austin “Gus” Deeds was one of four children, and had been attending the College of William and Mary since 2007, though not continuously. Earlier this semester, he withdrew from school and was not enrolled at the time of his death. He was regarded as a good student with a strong academic record.
Austin was charged with underage possession of alcohol in 2009, though those charges were later dropped. According to the Richmond Times-Dispatch, by Monday, November 18, Austin was evaluated at Bath Community Hospital, under an emergency custody order that allowed Deeds to be held for as long as four hours to determine whether he should be kept longer, up to 48 hours, under a temporary detention order. However, a lack of psychiatric beds meant that none could be found for Gus anywhere in western Virginia, and he was released. Hours later, he stabbed his father and killed himself.
The event shocked Virginia and became a national story, especially because of Gus’s mental health evaluation, and the failure to hold him not because he was deemed well, but because there were insufficient public resources with which to treat him. Governor McDonnell issued a full investigation as to how Gus Deeds could have been allowed to leave Bath Community Hospital, but the Governor’s order has all of the hallmarks of a too-little, too-late order that will only confirm what people already know.
Virginia, like many other states since the start of the Great Recession, has drastically cut public mental health care funding. According to figures released by the National Alliance on Mental Illness, Virginia cut its mental health budget by 8.9% ($37.7 million) from 2009 to 2012, from $424.3 million to $386.6 million. The state’s austerity on this front is the 11th highest in the country. Other states, such as South Carolina, Illinois and California to name a few, have cut their mental health care budgets far deeper than that. All told, 28 states and the District of Columbia have cut their mental health care services since 2009, mostly cutting inpatient hospitalization services. Of those states that have not cut spending, all but six have increased their spending by single digits only. (One of those states, Vermont, closed its only state mental hospital in the wake of Hurricane Irene.)
All of this points to the stark reality that even during times of fatter state and federal budgets, looking to the state for adequate health services was an option fraught with uneven service and public stigma. A private solution through health insurance has been touted by many within the health insurance industry especially, as the way to go. But is it, really? And especially for mental health care?
National Underwriter has been examining this issue for nearly a year, here, here and here, ever since the Sandy Hook school shooting touched off a national dialogue about gun control and mental health care. The gun control issue has a life of its own, and continues every time a subsequent issue of mass violence erupts, which has happened over the course of this article series before the publication of each additional installment. Violence inflicted by the mentally ill upon the public appears to be something that happens with grim regularity, just enough to remain in the public consciousness, not often enough to spur any real action to address it.
In the third part of this series, we examined what the private health insurance markets have to offer policyholders who are seeking to get health insurance mainly for the mental health care benefits they provide. The results were not good, which comes as little surprise,given that the health insurance industry needed to be forced by legislation to provide parity for mental health services in their health care plans in the first place.
As we gathered the data to get a sense of just what the private health insurance market has to offer those seeking to protect themselves from mental illness, a few trends emerged worth noting. We already pointed out that there seem to be three kinds of mental health plans for anyone looking to buy health insurance – plans that offer full coverage but are so expensive as to obviate the need for coverage, plans that offer partial coverage which open the policyholder to crushing costs halfway through treatment, and plans that simply do not cover mental health services at all. With such an array of insufficient options, one does not wonder why there are so many Adam Lanzas and Gus Deeds in the United States. One wonders why there are not more.
Another point worth noting is that, in many states, there is simply not a competitive marketplace worthy of the name. Numerous states are dominated by a single health insurance provider. Those that are not are dominated by two or three in most cases, all offering policies that bear complicated, ill-describing names designed for actuarial reference rather than to interest the consumer. These virtual monopolies were to be addressed by the Patient Protection and Affordable Care Act, in part, with a federal program meant to lend money to start health insurance co-ops in states and provide a not-for-profit alternative to established health insurance providers. The idea was to apply competitive pressure to insurers who were experiencing none, and thereby spur them to produce more compelling products for the marketplace. The funding crisis that resulted from the so-called “fiscal cliff” at the end of 2012 meant that this program was scrapped, and only 24 co-ops received federal start-up loans. The last of these companies, Land of Lincoln, began enrollment in Illinois on Oct. 1. There would have been many more new insurers like Land of Lincoln had the loan funding not dried up.
The generally poor nature of private mental health insurance becomes even more evident when run through a report card grading system. National Underwriter took the sample data it pulled from Healthcare.gov (the much-maligned Obamacare website, which provided a broad sampling of the mental health care plans available in any given state) and ran it through a scoring system to tally the presence of co-payments, co-insurance after deductibles, and failure to cover mental health needs at all.