Characteristics of Adult Residential Crisis Stabilization Units in Virginia

S.A. Larocco
October, 2018

PRODUCED BY THE
Institute of Law, Psychiatry, and Public Policy at the University of Virginia

In recent years there have been dramatic increases in admissions to both public and private hospitals. Residential crisis stabilization units (CSUs) have been suggested as a possible solution to this problem, allowing an alternative environment where people in crisis can go instead of the hospital. This report explores the characteristics of Virginia’s adult CSUs, including the populations they work with and the features and resources that allow them to do their work. CSUs work with patients with depression, anxiety, bipolar disorder, post-traumatic stress disorder or substance use disorder, but they are not equipped to care for patients with medical complexities.

Children’s Residential Crisis Stabilization Units

S.A. Larocco
August, 2018

PRODUCED BY THE
Institute of Law, Psychiatry, and Public Policy at the University of Virginia

As psychiatric hospitalizations increase in Virginia and the census at the Commonwealth Center for Children and Adolescents is at an all-time high, advocates and policymakers look for alternatives to hospitalization to ameliorate the problem. One such alternative is the crisis stabilization unit, a therapeutic environment for people in a sub-acute state of crisis. Current approaches used in these programs are geared toward patients with depression, anxiety, post-traumatic stress disorder, substance use disorders and executive functioning deficits.

Developments in Mental Health Law

Volume 37, Issue 1, Spring 2018

 

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This issue of DMHL presents two updates on Virginia mental health law and mental health initiatives including an overview article SJ 47 Joint Subcommittee: Mental Health Initiatives at the 2018 General Assembly Session; (b) a Data Corner discussing Incidence and Characteristics of TDOs in Psychiatric Admissions to UVA Hospital in 2015; and (c ) outlines of significant recent cases in various federal and state courts.

In This Issue:

I. Article: SJ 47 Joint Subcommittee: Mental Health Initiatives at the 2018 General Assembly Session [p. 1]

II. Update: Mental Health Related Bills Introduced in the 2018 General Assembly Session [p.12]
Bills Related to Mental Health That Have Survived [p.13]
Bills Carried Over to the 2019 Session [p.23]
Bills Related to Mental Health That Did Not Survive [p.24]

IV. Case Law Developments
United States Supreme Court [p.34]
Federal Circuit Court Decisions [p.35]
State Court Decisions [p.40]

V. Institute Programs [p.47]

Increased Utilization of State Hospitals from Fiscal Year 2017 to 2018

S.A. Larocco, R.J. Bonnie
April, 2018

PRODUCED BY THE
Institute of Law, Psychiatry, and Public Policy at the University of Virginia

Over the past three years, temporary detention order (TDO) admissions to state psychiatric hospitals have been on the rise in Virginia. The current report focuses on increases in TDO admissions to state hospitals from the first half of fiscal year 2017 to the first half of fiscal year 2018. Fiscal year 2018 saw the greatest increase in TDOs to state hospitals in recent history, largely the result of reduced TDO admissions to private hospitals.

Trends in Utilization of Adult Psychiatric Beds in Virginia

R.J. Bonnie, S.A. Larocco
February 2018

PRODUCED BY THE
Institute of Law, Psychiatry, and Public Policy at the University of Virginia.

Over the past five years, admissions to state psychiatric hospitals have increased by 55%. This report looks at the changing nature of those admissions, as admissions under temporary detention orders are taking up an increasing share of hospital capacity. The greatest increase in state hospital admissions occurred in the 2016 fiscal year, and this increase was driven by temporary detention orders. Forensic admissions have been increasing steadily, but more slowly, and other civil admissions have been in sharp decline.

Development in Mental Health Law

Volume 36, Issue 3, Fall 2017

 

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This issue of DMHL presents a feature article - An Opportunity for Further Reflection on Police Encounters with People in Mental Health Crisis – by Stephen L. Braga, Professor of Law, University of Virginia School of Law. Outlines of significant recent cases in various federal and state courts are also in this DMHL including cases involving due process with violent sex offenders, Eighth Amendment rights of jail inmates, forcible administration of antipsychotic medication, and other cases.

In This Issue:

I. Article: Holloman v. Markowski: An Opportunity for Further Reflection
on Police Encounters with People in Mental Health Crisis [p. 1]

II. Editor’s Comment: Excessive Force Jurisprudence and Police Encounters
with People in Mental Health Crisis [p. 16]

III. Case Law Developments
Federal Circuit Court Decisions [p. 22]
State Court Decisions [p. 30]

IV. Institute Programs [p. 40]

Characteristics of Communities Associated with Increased Utilization of State Hospitals

S.A. Larocco, R.J. Bonnie
December 2017

PRODUCED BY THE
Institute of Law, Psychiatry, and Public Policy at the University of Virginia.

Over the past three years, temporary detention order (TDO) admissions to state psychiatric hospitals have been on the rise in Virginia. This removes patients from their communities and creates unsafe conditions as state hospital utilization rises well above 90%. A previous report has identified some of the important events associated with the increase in the number of TDOs across the Commonwealth since 20141. The current report focuses on increases in TDO admissions to state hospitals. Much of the increase in TDOs to state hospitals is driven by increases in TDOs in general, especially in the Northern Virginia Mental Health Institute (MHI), Western State and Catawba catchment areas. There was, nonetheless, a substantial part of the increase attributable to changes in private hospital acceptance of patients under a TDO, especially in the Central State and Southwestern MHI catchment Areas.

Mental Illness in Jails Supplement, FY 2016

University of Virginia Institute of Law, Psychiatry and Public Policy
S.A. Larocco
April, 2017

Virginia’s Compensation Board provided data on jail inmates with mental illness. A previous report has been written that describes that data. This analysis expands on that report, providing additional detail on diverse components of the dataset such as inmate aggression and mental health screening.

Mental Illness In Jails Supplement, FY 2015

University of Virginia Institute of Law, Psychiatry and Public Policy
S.A. Larocco
April 2017

Virginia’s Compensation Board provided data on jail inmates with mental illness. A previous report has been written that describes that data. This analysis expands on that report, providing additional detail on diverse components of the dataset such as inmate aggression and mental health screening.

Rise in Temporary Detention Orders in Virginia, 2013-2017: Possible Contributing Factors

University of Virginia Institute of Law, Psychiatry and Public Policy
S A Larocco, R J Bonnie, H Zelle
January, 2017

From 2013 through 2017, there has been a substantial increase in temporary detention orders (TDO) in Virginia. State hospitals are absorbing an increasing number of these patients. This report explores various theories put forth to explain the increase in temporary detention orders in general. Factors that appear to have contributed to the increase in temporary detention orders in general include attention to the death of Austin Deeds, the implementation of the Governor’s Access Plan, and the opening of increasing numbers of crisis intervention team assessment centers, although other factors may have had subtle effects as well.

Developments in Mental Health Law


Volume 36, Issue 2, Summer 2017

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This issue of DMHL presents two premier articles on gun violence: a.The Gun Violence Restraining Order: An Opportunity for Common Ground in the Gun Violence Debate and b. Doctors, Patients, and Guns: The First Amendment Rights of Doctors to Counsel Patients about Gun Safety and the Statutory Privacy Rights of Firearm Owners. Case Law Developments in federal and states courts are highlighted.

In This Issue:

I. Article: The Gun Violence Restraining Order: An Opportunity for Common Ground in the Gun Violence Debate [p. 1]

II. Summary Tables of Preemptive Firearm Removal Statutes [p. 23]

III. Article: Doctors, Patients, and Guns: The First Amendment Rights of Doctors to Counsel Patients about Gun Safety and the Statutory Privacy Rights of Firearm Owners [p. 29]

IV. Case Law Developments
United States Supreme Court Decision [p. 35]
Federal Circuit Court Decisions [p. 36]
State Court Decisions [p. 42]

V. Institute Programs [p. 51]
 

Telemental Health in Emergency Settings

AA Allen and KM Faris
June 2017

PRODUCED BY THE
Institute of Law, Psychiatry, and Public Policy at the University of Virginia.
PREPARED FOR
The Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century
WITH SUPPORT FROM THE
Department of Behavioral Health and Developmental Services

“Smart Practices” for Community Services Boards Learned from the Field

The following report was created to support “SJ-47” – the Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century, specifically, the work of the Emergency Services Expert Advisory Panel. Telemental health has been frequently discussed by the panel as a way to enhance emergency services. In order to inform the panel and Community Services Boards (CSBs) statewide on how telemental health can be used specifically to enhance emergency services, researchers from the Institute of Law, Psychiatry, and Public Policy (ILPPP) have been looking closely at existing emergency telemental health practices and their current and potential use in emergency departments and other emergency settings. Researchers interviewed five CSBs who were identified as using emergency telemental health services through ILPPP surveys of CSBs in 2016. Two hospitals that have partnered with Fairfax-Falls Church CSB were also identified during the interview process and contacted for interviews on their experiences and perspectives on their internal use of telemental health and their telemental health partnerships with Fairfax-Falls Church CSB.

This report, using the experiences and examples provided by these existing programs, provides “smart practice” recommendations for CSBs when implementing and structuring an emergency telemental health program. The recommendations were formed after speaking with the five CSBs that either currently have an operating emergency telemental health program or are in the process of implementing a program. The recommendations themselves come from researchers’ synthesis of information gained from the interviews and from recommendations offered by CSBs and CSB partners.

We would like to thank the CSBs, hospitals, and VACSB who contributed their time and expertise to this report. Your contributions are greatly appreciated.

Annual Statistical Report Adult Civil Commitment Proceedings in Virginia FY 2016

University of Virginia Institute of Law, Psychiatry and Public Policy
AA Allen and TM Ko
January 2017

Annual Statistical Report: Adult Civil Commitment Proceedings in Virginia, FY 2016. The report is published by Institute of Law, Psychiatry and Public Policy, and has been funded by the Virginia Department of Behavioral Health and Developmental Services in cooperation with the Office of the Executive Secretary of the Supreme Court of Virginia. For citation the report's authors are AA Allen and TM Ko (January 2017).

Developments in Mental Health Law


Volume 35, Issue 4, Winter 2016

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This issue features timely updates on actions and recommendations to the 2017 Virginia General Assembly by the SJ47 Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century and its Work Groups. An insightful article discusses and a Data Corner describes issues of permanent supportive housing for persons with serious mental illness. Case Law Developments in federal and states courts are highlighted. Programs in ILPPP's current calendar are announced.

In This Issue:

I. Updates:
      A. SJ 47 Joint Subcommittee Actions and Recommendations to the 2017 General   Assembly Session [p. 1]
           Work Group #1: System Structure and Financing [p. 1]
           Work Group #2: Criminal Justice Diversion [p. 5]
           Work Group #3: Mental Health Crisis and Emergency Services [p. 6]
           Work Group #4: Housing [p. 7]
      B. Other Mental Health Related Bills in the 2017 General Assembly [p. 9]

II. Article: The Case for Permanent Supportive Housing for Persons with Serious Mental Illness: Improved Lives, Reduced Costs, and Compliance with Federal Law [p.17]

III. ILPPP Data Corner: Permanent Supportive Housing: Virginia Investment and Estimated State Cost Avoidance [p.23] 

IV. Case Law Developments [p.27]
      Federal Circuit Court Decisions [p.27]
      Virginia Court Decisions [p.33]
      State Court Decisions [p.33]

V. Institute Programs [p.37]


 

Developments of Mental Health Law

Volume 35, Issue 3, October 2016

This issue features an update article SJ 47 Joint Subcommittee Update: A Vision for Public Mental Health Services in Virginia Takes Shape. The article continues and builds from articles in past editions of DMHL. A fascinating Data Corner describes Virginia summary data from the National Mental Health Services Survey. Case Law Developments in federal and states courts are highlighted. Programs in ILPPP's current calendar are announced.

Developments in Mental Health Law

Volume 35, Issue 2, July 2016

This issue features an update article: SJ 47 Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century. DMHL's section on Case Law Developments features discussions of cases in the Fourth Circuit (on Treatment over Objection, etc.) in other Federal Circuit Courts (on the ADA Integration Mandate, etc.) and in Virginia and other State Courts. Programs in ILPPP's current calendar are announced.

Developments in Mental Health Law

Volume 35, Issue 1, March 2016

This issue features an article regarding the Fourth Circuit's establishment of constitutional 'excessive force' standards for taser use, placing new limits on officers' use of force when responding to individuals in mental health crisis. The ILPPP Data Corner presents data regarding use of court-ordered alternatives to law enforcement for transporting people during mental health emergencies. Also find an extensive compilation of case law developments.