Annual Statistical Report Operation of the Civil Commitment Process in FY 2013 – FY 2014

A.A. Allen, J.K. Bonnie
June 2015

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

Developments in Mental Health Law

Volume 33, Issue 3-4, December 2014

This double-issue of DMHL features a thoroughgoing overview of systematic reassessments of mental health law and practice in Virginia following a tragic assault and death at the home of a prominent Virginia legislator in late 2013. Actions of the Virginia General Assembly, Governor, and Department of Behavioral Health and Developmental Services are included in the overview.

VA CSB Evaluations Reports

A Comparison of Face-To-Face Emergency Evaluations of Veterans and Non-Veterans and Non-Veterans Conducted by Community Services Boards in April 2013
 

October 2014

Funded by the Virginia Department of Behavioral Health and Developmental Services, and in collaboration with the Virginia Association of Community Services Boards

VA CSB Evaluations Reports

A Study of Face-To-Face Emergency Evaluations of Veterans Conducted by Community Services Boards in April 2013

October 2014

Funded by the Virginia Department of Behavioral Health and Developmental Services, and in collaboration with the Virginia Association of Community Services Boards

VA CSB Evaluations Reports

A Comparison of Face-to-Face Emergency Evaluations Conducted by Community Services Boards in June 2017 and April 2013

September 2014

Funded by the Virginia Department of Behavioral Health and Developmental Services, and in collaboration with the Virginia Association of Community Services Boards

Developments in Mental Health Law

Volume 33, Issue 2, May 2014

This Issue of DMHL features an informative summary - Virginia General Assembly Enacts Mental Health Reform Legislation in Response to Tragedy - and also highlights a variety of decisions pertaining to forensic mental health delivered from several state and federal courts regarding dangerousness, sexual offenders' patient privilege, immunity with juveniles' polygraph examination and other matters. Also, be sure to visit the interactive blog of DMHL at www.dmhl.typepad.com

Developments in Mental Health Law

Volume 33, Issue 1, February 2014

This issue highlights several topics - Risk-Based Firearms Policy, Mental Health Firearms Prohibition and Reporting Requirements, "Clear and Present Danger" Mental Health Reporting Requirements - as well as Recently Decided and Pending Cases.

Virginia Mental Health Law Reform

A Study of Face-to-Face Emergency Evaluations of Adults in April 2013: Variations Across Regions and CSBs

December 2013

Funded by the Virginia Department of Behavioral Health and Developmental Services, and in collaboration with the Virginia Association of Community Services Boards

Advance Directives in Mental Health Care

Advance Directives Presentation to Consumers: Advance Directives with Instructions for Mental Health Care

Heather Zelle
VOCAL Statewide Mental Health Consumer Conference 2013

Developments in Mental Health Law

Volume 32, Issue 4, November 2013

Recently decided and pending cases are discussed in this Issue of DMHL. A variety of concerns are considered including issues involving capital cases, insanity defense, public access to a competency evaluation, and medically necessary treatment.

Advance Directives in Mental Health Care

Promoting Use of Advance Directives by People with Serious Mental Illness under Virginia’s Health Care Decisions Act: A Study of Implementation

An overview of the research and implementation projects underway in Virginia.

Developments in Mental Health Law

Volume 32, Issue 3, July 2013

The lead article in Volume 32, Issue 3 is authored by the DMHL Editor, who explores the domain of public policy regarding gun prohibitions for people with mental illness. This timely piece includes exposition of historical and legal issues under the topic. "Recently Decided Cases" informs of recent decisions in federal courts.

Virginia Mental Health Law Reform

A Study of Face-to-Face Emergency Evaluations Conducted by Community Services Boards in April 2013

December 2013

By University of Virginia Institute of Law, Psychiatry and Public Policy, VA Department of Behavioral Health and Developmental Services, and VA Association of Community Services Boards, Inc.

Advance Directives in Mental Health Care

Advance Directives Research Presentation
Advance Directives with Instructions for Mental Health: The Research

A presentation summarizing relevant research, given as part of a workshop at the May 2013 VACSB conference.

Developments in Mental Health Law

Volume 32, Issue 2, April 2013

This issue features a helpful overview of "Mental Health Related Provisions of the Patient Protection and Affordable Care Act and the Potential Impact of Medicaid Expansion in Virginia." Other items of special interest are an "Update" from the 2013 Virginia General Assembly, and "Recently Decided Cases" in several state and federal courts.

Decisions to Initiate Involuntary Commitment: The Role of Intensive Community Services and Other Factors

Elizabeth Lloyd McGarvey, Ed.D., MaGuadalupe Leon-Verdin, M.S., Tanya Nicole Wanchek, Ph.D., J.D., and  Richard J. Bonnie, LL.B.

Objective: This study examined the predictors of actions to initiate involuntary commitment of individuals experiencing a mental health crisis. Methods: Emergency services clinicians throughout Virginia completed a questionnaire following each face-to-face evaluation of individuals experiencing a mental health crisis. Over a one-month period in 2007, a total of 2,624 adults were evaluated. Logistic hierarchical multiple regression was used to analyze the relationship between demographic, clinical, and service-related variables and outcomes of the emergency evaluations. Results: Several factors predicted 84% of the actions taken to initiate involuntary commitment. These included unavailability of alternatives to hospitalization, such as temporary housing or residential crisis stabilization; evaluation of the client in a hospital emergency room or police station or while in police custody; current enrollment in treatment; and clinical factors related to the commitment criteria, including risk of self-harm or harm to others, acuity and severity of the crisis, and current drug abuse or dependence. Conclusions: A lack of intensive communitybased treatment and support in lieu of hospitalization accounted for a significant portion of variance in actions to initiate involuntary commitment. Comprehensive community services and supports for individuals experiencing mental health crises may reduce the rate of involuntary hospitalization. There is a need to enrich intensive community mental health services and supports and to evaluate the impact of these enhancements on the frequency of involuntary mental health interventions. (Psychiatric Services 64:120–126, 2013; doi: 10.1176/ appi.ps.000692012)

Virginia Mental Health Law Reform

Civil Commitment Hearings in FY 2012: District Court Variations

December 2012

Developments in Mental Health Law

Volume 32, Issue 1, January 2013

Highlights in this issue include: Confidentiality: A Conundrum in Veterans Behavioral Health Care; and Faculty Handbook Provides Guidance in Assisting Students in Distress; and discussion of cases decided in the US Supreme Court, the Virginia Supreme Court, and other courts.

Developments in Mental Health Law

Volume 31, Issue 6, October 2012

The Issue explores the topic of Advance Directives with three pieces: (1) Promoting Use of Advance Directives by People with Serious Mental Illness under Virginia’s Health Care Decisions Act: Implementation Study Update; (2) Survey of Stakeholder Knowledge, Experience and Opinions about Mental Health Advance Directives in Virginia Published; and (3) Advance Directives: A Tool for Reducing Coercion

Use of Longer Periods of Temporary Detention to Reduce Mental Health Civil Commitments

Tanya Nicole Wanchek, Ph.D., J.D. and Richard J. Bonnie, LL.B.

Objective: This study examined whether lengthening the holding period for an individual experiencing a mental health crisis under a temporary detention order (TDO) can reduce the number and length of postTDO involuntary hospital commitments. Methods: Data from the Virginia Court System were matched to the Commonwealth of Virginia Medicaid claims database for July 1, 2008, through March 30, 2009. The final data set included 500 Medicaid recipients who had a mental health diagnosis and at least one TDO during the study period. Covariates included sex, race, age, primary diagnosis, and Community Service Board serving the individual. Logistic and multivariate regression models were used. Results: Longer TDO periods were correlated with an increased probability of a dismissal of the commitment petition rather than hospitalization after a TDO. Among individuals who were hospitalized, longer TDO periods were correlated with an increased likelihood of voluntary hospitalization, rather than involuntary commitment, and shorter hospitalizations, although the net care time (TDO period plus post-TDO hospitalization) increased for individuals whose TDO length was greater than 24 hours. Conclusions: Longer TDO periods were correlated with shorter hospital stays and fewer involuntary commitments. These findings support previous work showing that short TDO periods provide insufficient time to stabilize and evaluate individuals. More research is needed to establish a causal link between TDO length and health outcomes. (Psychiatric Services 63:643–648, 2012; doi: 10.1176/appi.ps.201100359)