Virginia Civil Commitment Procedure and Practice

Policy Analysis and Recommendations to Increase Voluntary Admission

What policy changes can the Virginia Commission on Mental Health Law Reform recommend and implement to reduce the number of involuntary commitments in favor of voluntary admission? The Commonwealth of Virginia Commission on Mental Health Law Reform (the Commission), is tasked with improving mental health laws, procedure, and policy to better serve people with mental illness. One of the Commission’s goals is to increase the fairness and effectiveness of the civil commitment process. All of the analysis presented in this report is the result of extensive inquiry. With the aid of quantitative data, I was able to identify and target areas of the state with large variation in involuntary commitment rates among either Community Service Boards (CSBs) or special justices. I interviewed CSB emergency services managers and special justices about their operating procedures and attitudes concerning civil commitment. I also spoke with mental health experts and hospital officials including doctors, intake coordinators, personnel managers, nurses, and social workers. While current civil commitment procedure in Virginia allows individuals suffering from mental health crises to admit themselves voluntarily, many people do not. There are several reasons beyond a lack of capacity that might influence a person’s decision not to agree to care voluntarily. Based on my research and analysis, I recommend five specific policies that the Commission could adopt or recommend to encourage the election of voluntary admission by people with mental illnesses in lieu of involuntary commitment.