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Agency Wasn’t Aware That Cho Needed Care

May 23, 2007

By Bill McKelway

The local agency responsible for mental-health care in the Blacksburg area now acknowledges that it should have set up a treatment plan for Virginia Tech gunman Seung-Hui Cho in December 2005.

Dr. Les Saltzberg said his agency, the New River Valley Community Services Board, is required by law to set up a plan of care for mentally ill patients who are being released into the community for outpatient care, as Cho was ordered by a special justice.

But Saltzberg said his agency was never aware that Cho was in outpatient care and that no board representative attends commitment hearings, formerly a standard practice in the area.

In previous statements since the Virginia Tech shootings, the board has contended that it formulates and monitors outpatient care only for patients who have been hospitalized rather than temporarily detained.

Devising outpatient care for all patients had been a part of CSB operations in the past for many years, said Joseph G. Painter Jr., a special justice, who said he conducted thousands of commitment hearings prior to 2000 and for each one made sure a representative of the services board was present.

"It was done for each one of the 15,000 hearings I conducted," said Painter, a Blacksburg lawyer, who described the handling of Cho's case as "an egregious breakdown of a system that had been in place for years."

Saltzberg, who became executive director of the New River Valley CSB in July 2006, said that a CSB representative used to be present for commitment hearings to set up a treatment plan "but that was many years and many dollars ago."

In Cho's case, however, Saltzberg said his agency was never notified that Cho was a candidate for outpatient treatment and was never ordered to devise a treatment plan as required by state law.

The special justice who conducted Cho's commitment hearing never notified the CSB that the hearing was taking place or that Cho was going to be released for outpatient care, Saltzberg said. And the court order merely said that Cho was to undergo unspecified outpatient treatment.

"Who knew about the plan or who told Cho what to do, nobody knows," Saltzberg said.

Community services boards administer mental health care in 40 regions across the state.

Records of a search warrant obtained by Virginia State Police in the days immediately after the April 16 shootings indicate that Cho received counseling from Virginia Tech's counseling center, but it is not clear from the records when that counseling took place or its outcome.

The apparent breakdown in care illustrated by Cho's case is a major focus of the Virginia Tech Review Panel. But it has yet to question Saltzberg, the special justice in Cho's case, or Cho's lawyer, Terry Teel. Nor is there any certainty that any care Cho may have received would have affected the events April 16.

Teachers and students detected serious problems with Cho's conduct in December 2005, some 16 months before the shootings, and it was that conduct that resulted in Cho's overnight stay at Carilion St. Albans Behavioral Center near Radford on a temporary detention order.

At a commitment hearing Dec. 15, 2005, Special Justice Paul Barnett ordered Cho released for outpatient treatment despite concluding that he was mentally ill and a danger to himself.

Records of the proceeding obtained by The Times-Dispatch show that no one was present except Cho, his lawyer, and Barnett.

"Only the judge could have been the one to tell him," Saltzberg said. "Maybe verbally, he said, 'Go to the CSB, go to the college counseling.' Nobody knows."

Barnett, who in initial interviews with The Times-Dispatch complained that laws allowing monitoring of outpatient treatment "don't have teeth," has refused to comment further on Cho's case. He could not be reached yesterday.

But state laws require monitoring of outpatient treatment by the CSB or treatment provider and permit a special justice to call a person back for review for noncompliance.

In Cho's case, however, there is no indication on any of Barnett's orders that an agency was required to monitor Cho's care.

In new forms provided to special justices and court clerks in the wake of the Cho case, special justices are now required to specifically name the treatment provider and the agency monitoring care.

But the forms do not specifically require the special justice to notify the treatment provider and monitoring agency. That task is left to court clerks, as part of their obligation to also notify state police about mental orders that can affect background checks.

Clerks contacted in the past two weeks, however, said that the court proceedings resulting in commitment orders often don't reach them for several days, many times in batches of orders conducted over days or weeks. That means that several days can pass before state police or a treatment provider actually learn of the court order.

In an interview Monday, Saltzberg said he will meet this week with Barnett and others to iron out details of how to get notification about the hearings, create a treatment plan, and to make sure that monitoring is occurring.

"Basically, we need to develop a better mechanism of communication. We need to know who is going to be responsible for what," Saltzberg said.

Contact staff writer Bill McKelway at bmckelway@timesdispatch.com or (804) 649-6601.