Reforming Virginia’s mental health system is about much more than reforming laws: it is about developing a less coercive, consumer-friendly system that encourages and supports people to get the help they need. The laws created since 2008 provide a legal framework for reform that involves not only Virginia’s civil commitment laws but also enhanced access to needed mental health services. On July 1, 2008, changes in the criteria and procedures for emergency custody orders, temporary detention orders, involuntary commitment proceedings and other important measures took effect. The changes in 2009 make technical changes needed following the implementation of the 2008 laws, and they also help make the commitment experience less traumatic.

This page is intended to be a resource to professionals involved in implementing the new laws and to advocates and consumers of behavioral health services who would like to learn more about this process. We hope this resource will lead to more consistent practices across the Commonwealth and will make the involuntary treatment process more fair and effective. 

• Guidance Memos
  • #1: Community Planning for Implementation of New Mental Health Laws
  • #2: Launch of Web Page
  • #3: Certification of Independent Examiners and CSB Evaluators
  • #4: DBHDS Approved Certification Program for Independent Examiners and CSB Evaluators for FY 2010
• Legislative Summary by Fiscal Year
• Practice Guidelines: Core Elements in Responding to Mental Health Crises (SAMHSA)
• Resources
  • Forms
  • Training Presentations from the 2010 Mental Health Law Update training
  • Other Resources
• Supreme Court Commission on Mental Health Law Reform
• Where to Go If You Have Questions About or an Issue with the Civil Commitment Process

     Questions or Comments?  Please click here to submit your questions to our office.
 

Trainings

May 2010—Presentations from the 2010 Mental Health Law Updates Training

The following PowerPoint presentations by the Office of the Attorney General provide training on Updates in Mental Health Law for 2010.

Mental Health Law 2010 Updates Training Presentations

• Alternative Transportation by Other Than Law Enforcement:
  • Alternative Transportation Orders Tables by Frequency and Provider Type (PDF)
  • Alternative Transportation Review (PDF)
• Appeals of Involuntary Admission Orders (PDF)
• Differences in Civil Commitment Practice in Virginia (PDF)
• Hospitalization of Jailed Inmates: Changes to the Jail Transfer Statutes (PDF)
• Mandatory Outpatient Treatment Following Involuntary Inpatient Admission (PDF)
• Psychiatric Treatment of Minors Act 2010 Revisions  (PDF)

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November 5, 2009—Advance Directives Training

A one day training event presented by DBHDS and the Office of the Attorney General in collaboration with the VACSB, VOCAL, NAMI and VOPA.

Advance Directive Training Presentations

• Understanding Psychiatric Advance Directives and How They Work 
  Jeffrey Swanson, PhD., Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine
• Use of Advance Directives in the Mental Health Context and Treatment Over Protest 
  Karen A. DeSousa, Office of the Attorney General
• Provider Utilization of Advance Directives in the Psychiatric Setting: PAD’s
  Yad M. Jabbarpour, MD, DFAPA, Chief of Staff Catawaba, Clinical Assistant Professor of Psychiatric Medicine, University of Virginia
• Clinical Assessment of Capacity to Consent
  Robert J. Gardella, MD, Assistant Professor of Clinical Psychiatric Medicine, University of Virginia
• Advance Directive Resources

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June, 2009—Overview of the Civil Commitment Law and Changes Made by the 2009 General Assembly

Five regional training events presented by DMHMRSAS and the Office of the Attorney General and co-sponsored by the VACSB, for DMHMRSAS and CSB/BHA staff, private providers, police, sheriffs, special justices, magistrates, hospital staff, consumers and family members.

Civil Commitment Law Training Presentations

• 2009 Legislative Update on Civil Commitment, Introduction
  James Martinez, Director, Office of Mental Health Services, DMHMRSAS
• Alternative Transportation Legal Requirements
  Jane D. Hickey, Senior Assistant Attorney General, Office of the Attorney General
• Privacy Issues—2009 Legislative Changes
  Allyson K. Tysinger, Senior Assistant Attorney General, Office of the Attorney General
• Overview of Other 2009 Mental Health Law Changes
  Karen A.D. Walters, DMHMRSAS Special Counsel, Office of the Attorney General
• Overview of Mandatory Outpatient Treatment for Adults and Juveniles
  Allyson K. Tysinger, Senior Assistant Attorney General, Office of the Attorney General

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2008—Overview of the Civil Commitment Law and Changes Made by the 2008 General Assembly

2008 Training Presentations

• Overview of Civil Commitment Law and Changes Made by the 2008 General Assembly
  DMHMRSAS Commissioner James Reinhard, M.D.
• Civil Commitment Criteria
  Jane Hickey, Office of the Attorney General
• Mental Health Law Reform 2008 Procedural Changes
  Allyson Tysinger, Office of the Attorney General
• Integrating Recovery Based Service Delivery With The Commitment Process
  Derrick A. Abney, CPS, Fairfax-Falls Church CSB
• The Role of Comprehensive Mental Health Law Reform in System Transformation
  Richard Bonnie, UVA School of Law
• Independent Examination
  Jill Milloy, Ph.D., Independent Examiner, Fairfax-Falls Church CSB
• Mandatory Outpatient Treatment
  Jane Hickey, Office of the Attorney General
• Privacy and the Civil Commitment Process
  Allyson Tysinger, Office of the Attorney General

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Forms

Effective July 1, 2009 the Office of the Executive Secretary of the Supreme Court assumed responsibility for preparing and distributing the petitions, orders and such other legal forms required for custody, detention, and involuntary admission. These forms are now available from the clerks of courts.

The Department continues to be responsible for preparing the preadmission screening report, examination and voluntary admission forms. Minor revisions to these forms incorporate 2009 legislation effective 7/1/09.

• Uniform Preadmission Screening and Report form
• Preadmission Screening CCS3 Values Sheet
• 1001 — Application for Voluntary Admission
• 1001-B — Application for Voluntary Admission Pursuant to Section 37.2-814
• 1002-IE — Independent Examination, Certification and Recommendations for Placement, Care and Treatment
• 1002-IE — Independent Examination, Certification and Recommendations for Placement, Care and Treatment—Print Only
• Advance Medical Directive Form – Sample advance medical directive form from the 2009 Health Care Decision Act

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Resource Documents

• Implementation Checklist #1 (2008 – This document provides guidance, not legal advice, for implementing the statutory amendments related to the involuntary civil admission process for adults with mental illness. It is intended to facilitate community planning and problem-solving, and to support a consistent understanding and application of the new laws.
• Advanced Directives Legislation (2009) – This link connects to the Health Care Decision Act which includes a suggested form for advanced directives.
• Advance Medical Directive Form – This is a sample advance medical directive form from the 2009 Health Care Decision Act.
• Enhanced Health Care Decision – Making Rights 2009 – This article highlights changes to the laws governing advance directives. Posted with the permission of Virginia Lawyers Media.
• FY 2010 CSB Evaluators and Preadmission Screeners Required DBHDS External Entities Certification Training Modules
• FY2010 Independent Examiners Required DBHDS External Entities Certification Training Modules
• Medical Screening and Assessment Guidance Material (2007)
• New York State Assisted Outpatient Treatment Program Evaluation (07/2009)
• Outpatient commitment: When it improves patient outcomes
  Current Psychiatry, April 2008, Vol. 7, No. 4
• Understanding and Applying Virginia’s New Statutory Civil Commitment Criteria
  Bruce J. Cohen, M.D., UVA Dept of Psychiatry and Neurobehavioral Sciences

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Court and Legal References

• 2008 Legislative Summary
• 2009 Legislative Summary
• Commission on Mental Health Law Reform
• Supreme Court of Virginia
• Understanding and Applying Virginia’s New Statutory Civil Commitment Criteria
  Bruce J. Cohen, M.D., UVA Dept of Psychiatry and Neurobehavioral Sciences, Richard J. Bonnie and John Monahan
• Virginia Attorney General’s Office
• Virginia General Assembly Legislative Information System

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Law Enforcement

• Commonwealth Consortium on Mental Health/Criminal Justice Transformation
• Virginia Department of Corrections
• Virginia Department of Criminal Justice Services

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Mental Health Advocacy

• MHAV – Mental Health America - Virginia
• NAMI – National Alliance of Mental Illness
• PSV  – Psychiatric Society of Virginia
• SAMHSA – U.S. Substance Abuse and Mental Health Services Administration
• VACSB – Virginia Association of Community Services Boards
• VOCAL – Virginia Organization of Consumers Asserting Leadership

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“True reform into a mental health services system that seeks to prevent before it must treat, and focuses on individuals and their path to recovery instead of on their illnesses, requires a thorough examination of the many facets of Virginia’s complicated system. These issues cannot be fixed in one legislative session, but will take focused attention by lawmakers, mental health professionals, the courts and the media for years to come.”
– James S. Reinhard, M.D. (former DBHDS Commissioner)

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