Five years after his son's suicide, Creigh Deeds is impatient with the pace of mental health reform

This story, part of an ongoing examination of mental health care in Virginia, was supported by the Dennis A. Hunt Fund for Health Journalism at USC Annenberg Center for Health Journalism.

BATH COUNTY — In the weeks before Sen. Creigh Deeds returned to the state legislature armed with the moral authority only a tragedy can bring, he paced for hours in the cold, alone, reciting the serenity prayer.

Weeks earlier, his son had attacked Deeds and killed himself with a rifle in the Millboro house that no longer felt like home. His staff was shielding him from work at the office.

So he walked and willed away the memories leading up to Austin C. “Gus” Deeds’ final minutes.

He trained his mind on images of a happy Gus: dancing at a bluegrass festival, surrounded by his three sisters, smiling on Christmas morning — anything but the 24-year-old with a knife who attacked his father even as Deeds repeated, “I love you.”

Maybe it was love that stopped Gus. Maybe.

Tears fell, but Deeds didn’t — he couldn’t. There was work ahead. He survived the physical and psychological scars by embracing the serenity prayer’s command to accept the things he couldn’t change and to change the things he could.

It’s not a bright line, some days. What is in the power of one man to do?

Deeds drops a shoulder anyway and runs through his pain into the fray.

Five years after Gus died, Deeds is impatient with the work of a commission he launched, which has secured mental health reforms but has not yet led to the wholesale change he envisioned while lying in his bed at the University of Virginia Medical Center.

He had so many questions then about what had gone wrong — not just on the day before Gus stabbed him 13 times, but over years spent feeling helpless while his bright, beautiful, bipolar son would re-emerge and unwind.

Among them: How could someone in so much pain that he had become a danger to himself or others be turned away from help?

Lawmakers have since changed the rules to require that state hospitals take anyone in Gus’ situation. But after becoming the place of last resort for emergency cases, the state’s understaffed facilities have seen a spike in admissions, a situation that worries Deeds and state officials.

“In many respects, we’ve made huge strides,” Deeds said, “but the frustrating part is that no matter how much you do, there’s still so much to do.”

His commission is slated to issue final recommendations next year. But Deeds has asked House Speaker Kirk Cox, R-Colonial Heights, for a permanent space to continue the work.

Five years later, he needs more time.

‘I am alive so must live’

In the aftermath of Gus’ death, Deeds didn’t seek counseling. He sought impact.

So he returned to Richmond and to public life, working to close the loopholes laid bare by Gus’ case.

“I wasn’t surprised that he came back so soon,” said Bill Howell, then the House speaker and a Republican delegate from Stafford. “I think it was probably healthy for him as part of his emotional recovery to be surrounded by people who cared so deeply.”

Grieving privately was never an option for a man who’d run two statewide campaigns and held elected office for more than 20 years.

He hadn’t changed his phone number since 1996. He still won’t. He tells his story so it will be easier for other people to tell theirs.

“I am alive so must live. Some wounds won’t heal. Your prayers and your friendship are important to me,” Deeds posted to Twitter the day he left the hospital.

The replies were instant and number 419, beginning with “Everyone is pulling for you and your family.”

Friends sent sympathy cards, and strangers unburdened themselves in handwritten notes, phone calls and emails seeking help from a man who hadn’t yet helped himself.

“People want me to have all the answers,” Deeds said, “and I don’t.”

Lawmakers that year established the commission, doubled to 12 hours the maximum time that someone conducting a court-ordered mental health evaluation has to secure further psychiatric assessment for someone, and required that state hospitals accept anyone found to be in need of additional evaluation, among other reforms.

State hospital admissions have soared since then, straining a system with an average 25 percent staff vacancy rate across its facilities, according to the Department of Behavioral Health and Developmental Services.

“People were being released because there wasn’t space for them. We had to solve that problem, so we did,” Deeds said. “Now we have to solve another problem.”

The problems are complex. The state behavioral health department forecasts a need for more hospital beds even as state lawmakers and public health officials hope to lessen a reliance on institutions and spend more on services that are available closer to home.

The absence of options is felt most acutely in rural areas of the state where local spending on mental health is paltry, and the community services boards tasked with helping people spread across vast swaths of the state are stretched thin.

What is available at the community-based agencies — 40 in total — that form the backbone of the state’s public system of mental health services has varied widely, a fact the STEP-VA plan aims to address by raising the floor of what each must offer by 2021.

“I think we’ve planted some seeds out of which can grow the transformation of mental health care,” Deeds said. “Have we completed the job? No. Are we close to completing the job? No.”

Dr. Hughes Melton, the commissioner of the Department of Behavioral Health and Developmental Services, says the plan will be deployed on schedule. The agency also is revisiting how it evaluates and pays for services provided at a local level.

“As we continue to transform and improve the system, our efforts will concentrate on balancing the clear commitment to build STEP-VA services and support the substantial growth in censuses among the state hospitals,” Melton wrote in a statement provided by the department. “For the first time, we will also be able to demonstrate specific outcomes for specific investments in services and answer the critical question, ‘Are people getting better?’”

Deeds says he is able to work well with the state despite feeling that the system failed his son. Last month, he settled the surviving prong of a $6 million wrongful death suit he had filed against the state behavioral health agency, the Rockbridge Area Community Services Board and the man who evaluated his son. The total settlement was for $950,000.

He talked to Gus’ mother and sisters before making the decision.

“I still think that, you know, we could have accomplished more had we probably tried the case,” he said. “But the other side of it is the emotional part of reliving so much of it was going to be awfully stressful.”

‘I wasn’t going to leave him’

On the anniversary of his son’s death, Deeds will be working. He will go to court, and later a school board meeting. He doesn’t set aside days for mourning.

He has spent other November 19ths in the same way. Birthdays and holidays are hard. But he lost his father before Gus, and a brother since.

“The older you get, the more bad anniversaries you have,” he said.

He’s still a lawyer, still a lawmaker, still a husband and a father with responsibilities to his family and community that he plans to uphold.

But he pauses over every 19th day of any month on the calendar.

He may have settled the lawsuit, but he is not ready to talk about forgiveness.

The mental health worker who evaluated Gus knew within five minutes that he needed more help, the complaint states. But Gus walked out of Bath Community Hospital anyway. He was dead 13 hours later.

“My faith tradition teaches that we can’t expect forgiveness unless we’re willing to forgive. I’m not perfect, and I’ve really not thought that one through,” Deeds said. “I struggle with that all the time.”

An absence of protocols, communications breakdowns resulting in costly delays, barriers to finding care and missteps by the evaluator all combined to produce a tragic outcome, according to a state inspector general’s report on his case.

Deeds wonders now whether he should have said something when he realized the man examining Gus had no clue who he was.

“I always told my kids not to think of me being in politics as a reason for them to be treated in any way special,” he said. “I worry that maybe that’s the one time I should have pulled rank, as if a state senator has any rank to pull.”

They stopped at a gas station first. Deeds bought Gus a Reese’s or a Snickers, then realized they had no food at home. They pulled over for sandwiches. He’d just returned from Ireland, where he’d gone to help his second wife scatter her mother’s ashes.

Gus was better when Deeds had agreed to the trip. Months earlier, he’d been a counselor at Nature Camp in Vesuvius, a formative place for him that now has a pavilion bearing his name.

That spring, Gus had been on the Dean’s List at the College of William & Mary. He loved to learn and loved to perform. He made up songs for the people he cared about and considered pursuing a career in music.

“He could have been anything he wanted, he really was that smart,” Deeds said. “He could do everything I couldn’t.”

The camp received Gus’ stringed instruments. Others went to the high school band. A sister kept his piano.

Deeds asked that Gus’ room be cleared before he returned from the hospital. He kept some things; among them, a three-ring binder in which Gus wrote of executing his father.

It sits in a box on the floor of Deeds’ office. Gus shaded rainbow hues down the spine and traced two red handprints on the inside cover.

He scribbled into it furiously on his last night on earth, as Deeds slept behind a bedroom door that he had locked for the first time.

Gus’ mother texted Deeds to tell him to get out of the house that night, but he wouldn’t — he couldn’t — even after he heard Gus try the knob.

“He was my son, and I wasn’t going to leave him.”

Deeds was not worried about the gun as they ate their last meal together in silence. There had been no ammunition for it in the house. The Virginia State Police investigated. He still doesn’t know where the bullets came from.

Deeds asked his lawyers to destroy the rifle, which he had given Gus for Christmas as a boy.

“I probably could have done it myself,” Deeds says, “But I just didn’t want to have it in my hands.”

The other side of love

A week shy of five years since the last time Deeds tried to get Gus help, tourists in thick coats wandered in the shadow of the Homestead resort, blocks from the two-room law office where Deeds is mulling his remarks on the centennial of the Great War’s end.

As a rural Democrat, Deeds is an endangered species in a swath of the state that is becoming steadily more conservative. The New Deal generation that once was his base is dying off, young people more inclined to be liberal are voting with their feet, and many of the people who remain feel left behind as jobs crop up elsewhere, he said.

Deeds hesitates. What could he, a country lawyer who’d never enlisted, share with these men and women on Veterans Day that would ring true?

But there he was on the front page of the local paper, scheduled to speak.

“It’s like that Pete Townshend song — ‘I’ve Known No War,’” he says, as the playlist lilting from his laptop — always — drifts to Neil Young’s “Harvest Moon.”

The scars on his face have faded, but Deeds hasn’t regained all the feeling he lost in the attack.

Gus was strumming his left-handed banjo when Deeds came home the day before to sit with him and wait for the deputies Gus didn’t know were coming.

He was almost himself when he was playing.

Deeds had been through the process of obtaining a court order for Gus’ psychiatric treatment twice before, and his heart sank that day when the man he’d called for advice told him it might be time for long-term care.

He tries not to think about what might have been.

“There’s no looking back,” he says. “If we’d had a hospital bed, Gus would’ve had a chance, and we would’ve had a chance for more time with him. But we didn’t get that chance.”

The world has changed since: a new president; the rise of the Black Lives Matter movement; Ferguson, Mo; Charlottesville; an economic recovery that left much of rural Virginia behind.

Gus would be 29 now and on fire for some of the environmental issues of the day, Deeds lets himself think, before pushing the notion away.

He still calls out for him, sometimes, when he’s alone in the house. The silence that follows hurts.

Deeds leans forward in his chair and shakes his head. He won’t go there.

“Grief is just the other side of love,” he says moments later, paraphrasing a letter the musician Nick Cave wrote about losing a child. “That’s the whole thing.”

He flashes a tight smile. He has three daughters and two grandsons. And there is work to be done.

Always another tragedy

Past the resort and the shops selling fuel, firewood and ammunition, beyond the reminders to drive safely in memory of other people’s children, the veterans are waiting.

Deeds doesn’t carry notes, following the example of a pastor he admires who helped him learn how to be an introvert with something to say.

After the high school band plays, Deeds stands in the Bath County Courthouse empty-handed, looks his audience in the eyes and speaks his truth: It’s hard when someone who doesn’t understand says they do.

It has happened to him in the grocery store and at the bank and on the street and in his law office where — a few weeks after doctors closed the wounds that could be shut — he told a woman who called to say she knew, that she didn’t.

He would handle it differently now.

“That was really an unkind thing to say,” he says. “I have a responsibility to help them with their issues, and people are doing the best they can.”

That responsibility will lead him this legislative session to, among other things, pursue better care for inmates with mental health needs, eye changes to the way money for public behavioral health services is allotted, and fight for what’s needed to fully implement the STEP-VA program.

State officials have not determined what that will cost. Estimates range from $150 million to $200 million a year.

“After Virginia Tech, we did more for mental health than we’d ever done before — like $40 million — then it all disappeared,” Deeds says, shaking his head.

Lawmakers shifted priorities after initially rallying when a troubled student at the school murdered 32 people and killed himself in 2007.

In the year Gus died, state lawmakers had set aside about $240.6 million for community mental health and substance abuse services. This year, it was $332 million, according to the behavioral health department.

It will take more than money, said Melton, the commissioner, who has called for the sustained focus of those charged with affecting change.

“I believe Virginia has the will and expertise to make this happen, and we will develop the high-quality and consistent services that Virginians with behavioral health disorders and their families truly deserve,” he said.

Thoughts, prayers, promises, action, always another tragedy. Deeds has work to do. So he presses on, with wounds that won’t heal, unscripted, hoping for change and testing the limits of serenity.

[This story was originally published by Richmond Times-Dispatch.]