The Letter to the Director

In mid-September this letter was hand delivered by the Human Rights Advocate to the new director along with almost 100 signatures in petitions.... that's a 1/3 of the patient population.

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Dear Director,

I am writing as a current patient at Western State Hospital (WSH) to formally appeal the policy banning incoming packages. This ban hinders therapeutic progress, leads to longer recovery times and increases costs for supplying hygiene and clothing. I request its immediate reconsideration to allow packages with appropriate safety measures. This letter aligns with a petition among patients and advocates opposing the ban.

This ban not only hinders therapeutic progress but also leads to longer recovery times and increased costs for supplying hygiene and clothing. Psychiatric hospitals face high operational costs, with average housekeeping expenses (including hygiene supplies) around $699,000 annually. Providing patient-specific hygiene and clothing adds to this, potentially increasing per-patient costs by hundreds of dollars daily when factoring in extended stays due to poorer recovery outcomes.

Low-quality products are problematic and frequently out of stock. For example, state deodorant blocks pores and creates sweat, the blue body wash/shampoo makes textured hair fall out, conditioner is frequently out of stock, and patients are given used underwear and ill-fitting sweat clothing with stains. In addition, WSH lacks a commissary with which to supply patients.

Evidence-based studies highlight how access to personal items and mail supports mental health recovery in psychiatric hospitals. For instance, research on illness management and recovery programs shows that personal resources enhance self-management and reduce relapse risks. Positive patient experiences, including access to personal belongings, promote recovery by reducing isolation and building hope. Conversely, restricting personal possessions leads to longer recovery times, increased distress, anxiety, and depression, as seen in studies on restrictive practices and isolation. Evidence-based studies show receiving packages enhance patient recovery.

This policy also violates patient rights under Virginia Code § 37.2-400 and DBHDS Human Rights Regulations (12VAC35-115). Virginia law guarantees patients the right to "sufficient and suitable clothing" and to "keep and use their own possessions and personal resources." The package ban directly limits these rights by preventing receipt of essential items such as religious and spiritual contents (e.g., Bibles, prayer beads, inspirational books), handmade gifts and activities (e.g., drawings from children, craft supplies for therapy), nutritious snacks and special dietary needs not addressed sufficiently by the hospital (e.g., gluten-free or culturally specific foods), and toiletries not provided or patient-specific (e.g., hypoallergenic products, items for textured hair). These items are vital for morale-boosting, family bonding, community support, and overall well-being, fostering a sense of connection and normalcy during treatment.

Banning packages will cost WSH more money than investing in mail screening equipment. Packages from families can benefit from mail screening with narcotics detection machines, but there is no need to screen packages from Amazon or stores, which minimizes machines needed and prevents the process from being overwhelmed. Also, in our community, we are experiencing a change in patient population with significantly fewer forensic patients to manage. This approach balances security with recovery-focused care, especially as our patient population shifts to fewer forensic cases, reducing overall risks.

Mail screening equipment, such as X-ray or T-ray scanners from vendors like RaySecur or Smiths Detection, are available via affordable subscriptions (starting from monthly fees) or government pilots at no initial cost. We have contacts to a resource and application that can provide government-used scanning equipment for added security on incoming packages, such as those referenced in the BOP SCAN Mail Act or similar correctional programs. Also, alternatives like random drug dog sweeps in wards, as used in other hospitals, could further enhance safety without a ban.

I urge WSH to lift the package ban or implement supervised delivery protocols to comply with state law and prioritize patient well-being. Please provide a written response within 14 days, detailing any appeal process through DBHDS or internal channels. I am open to discussing solutions in a patient advocacy meeting.

Thank you for addressing this matter and supporting patient-centered care.

Sincerely, Concerned Patients and Families of Patients at WSH