Virginia College Mental Health Study

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Report on the Virginia College Mental Health Survey

The Joint Commission on Health Care of the Virginia General Assembly, in coordination with The Commission on Mental Health Law Reform, conducted a survey to gather comprehensive empirical information from colleges in Virginia regarding the adequacy of students' access to mental health services and the ways in which colleges respond to students' mental health crises.

Commission on Mental Health Law Reform

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Civil Commitment Hearings: District Court Variations, July 2009 -  June 2010

In this report, the Commission summarizes the disposition of commitment hearings for FY 2010. The data presented below pertain only to hearings involving adult respondents not under a commitment order or in penal confinement at the time of the hearing. (In other words, the data exclude recommitment hearings as well as cases involving juveniles and persons in jail.) We refer to these hearings as “initial commitment hearings.”

Virginia Civil Commitment Procedure and Practice

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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.

Mental Health System Transformation After The Virginia Tech Tragedy

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Richard J. Bonnie, James S. Reinhard, Phillip Hamilton and Elizabeth L. McGarvey

Health Affairs 28, no.3 (2009):793-804
doi: 10.1377/hlthaff.28.3.793

ABSTRACT: On 16 April 2007, a deeply disturbed Virginia Tech student murdered thirty-two fellow students and faculty and then shot himself. Less than one year later, the Virginia legislature improved the emergency evaluation process, modified the criteria for involuntary commitment, tightened procedures for mandatory outpatient treatment, and increased state funding for community mental health services. The unanswered question, however, is whether the necessary political momentum can be sustained for the long-term investment in community services and the fundamental legal changes needed to transform a system focused on managing access to scarce hospital beds to a community-based system of accessible voluntary services. [Health Affairs 28, no. 3 (2009): 793–804; 10.1377/ hlthaff.28.3.793]

A Study of Civil Commitment Hearings Held in the Commonwealth of Virginia During May 2007

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The following is a summary of the key findings of the Commission on Mental Health Law Reform’s Study of Civil Commitment Hearings Held in the Commonwealth of Virginia During May 2007 (the “Commission’s Hearing Study”). The Commission’s Hearing Study was designed to examine the prehearing, hearing, and disposition phases of civil commitment proceedings in Virginia for both adults and children. Civil commitment proceedings, which can result in the involuntary inpatient hospitalization of individuals with severe mental illness, operate under a detailed statutory framework and engage law enforcement, health professionals and courts. The study was designed to provide a window into how the civil commitment process functions in Virginia. A complete description of the findings is contained in the full report.

Study of Emergency Evaluations

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Conducted by Emergency Services Personnel in Community Services Boards, June 2007

A Report to the Commission on Mental Health Law Reform

The following is a summary of the key findings of the Commission on Mental Health Law Reform’s Study of Emergency Evaluations Conducted by Emergency Services Personnel in Community Services Boards, June 2007 (the “Commission’s CSB Study”). The Commission’s CSB Study was designed to examine characteristics of emergency evaluations at Community Services Boards (CSBs) across Virginia. Community Services Boards are the public entry into mental health, substance abuse and mental retardation services in Virginia. When a person experiences a mental health or substance abuse crisis, he or she may be referred to a CSB for an evaluation from a CSB clinician for an “emergency evaluation” or “assessment”. This report examines characteristics of those emergency evaluations such as CSB clinician and client characteristics, client pathways to the CSB emergency response system, clinical evaluation results, CSB recommendations for treatment, and gaps in service capacity. A complete description of the findings is contained in the full report.

Civil Commitment Practices in Virginia

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Perceptions, Attitudes, and Recommendations

A Report for the Commission on Mental Health Law Reform Commonwealth of Virginia

The Commission on Mental Health Law Reform was established by the Supreme Court of Virginia to examine the Commonwealth’s existing mental health statutes and to make recommendations for any changes required to establish an accessible service delivery system and a fair and effective process of civil commitment when needed by people experiencing mental health crises. As part of the Commission’s work, an evaluation team of faculty and staff at the University of Virginia completed a large scale qualitative study to inform the need and direction of reform. Information about the current system of civil commitment was obtained from all representative stakeholder groups. Two hundred and ten (210) individuals participated in the study.