In some emergency mental health situations,  an individual in crisis may need a higher level of care than can be provided in the community but may be unwilling to receive care. In these challenging situations, Virginia State Law allows individuals to request an emergency custody order to ensure the individual receives a clinical evaluation to determine the most appropriate treatment. Similarly, licensed clinicians, following a thorough evaluation of the individual, may request a temporary detention order to ensure the individual receives treatment to ensure their safety and wellbeing.

(Please visit 24-Hour Emergency Services if you are looking for information for yourself or someone you care about who is in crisis and willing to talk with a clinician.)

If you are concerned about an individual and think they may be a risk to themselves, or unable to provide for their basic needs, or protect themselves, an individual with firsthand knowledge of the concerns may petition to obtain an emergency custody order from the Alexandria Magistrate’s Office, located at the Alexandria Adult Detention Center. An emergency custody order requires an individual to be evaluated to determine the most appropriate intervention.

To obtain an Emergency Custody Order:

1. Travel to the Alexandria Detention Center at 2001 Mill Rd, Alexandria, VA 22314. Be sure to bring photo identification.
2. Enter through security and advise them you are there to request an Emergency Custody Order from the Magistrate; they will direct you where to go.
3. Once at the Magistrate’s Office, inform them that you would like to request an ECO for the individual about whom you have concerns.
4. You will also be asked to swear an oath and provide the reason(s) why you are requesting an ECO. You will be asked to provide basic demographic information such as name, date of birth, physical description, and address for the individual.
5. a) If an ECO is granted, police officers will be dispatched to that individual’s location to place the individual into custody and transport them to the nearest emergency   room for clinical and medical evaluation.
   
   b) f an ECO is not granted, you may contact Emergency Services at 703.746.3401 for further assistance.

A temporary detention order is a legal order issued by a magistrate at the request of an Emergency Services clinician following a thorough evaluation of an individual in crisis. The order requires the individual to receive inpatient psychiatric treatment at a hospital to ensure their own safety and wellbeing. Such an order is pursued only when all less restrictive treatment options have been exhausted and only if a person’s mental health is creating a substantial likelihood that the person will, in the near future, cause serious harm to themselves or others, or will suffer serious harm due to lack of capacity to protect self or provide for their basic needs.

What Happens When a TDO is Issued?

1. DCHS Emergency Services will start working to identify a treatment facility, with priority given to facilities near Alexandria.
2. Upon identification of an accepting treatment facility, the individual will be transported to the identified facility.
3. The individual will receive treatment until a commitment hearing is held, within 72 hours of the TDO’s execution, not including weekends, holidays, and court closures.

Commitment Hearings 

Commitment hearings are presided over by a Special Justice. Individuals having a commitment hearing will be appointed an attorney by the court or may hire their own. The individual will also be assessed by an Emergency Services clinician and an independent examiner, who will offer their clinical opinions to the court during the hearing. Upon hearing all available evidence and testimony, the Special Justice makes a determination as to whether an individual is in need of further treatment in the hospital, and if so, whether he or she may receive that treatment on a voluntary basis. The Special Justice may also order the individual to Mandatory Outpatient Treatment.

DCHS Emergency Services will make efforts to notify family members of the hearing and facilitate participation. Family members or significant others are encouraged to attend to provide support and, as allowed, speak before the special justice.

“How to Cope When a Loved one Has a Serious Mental Illness”

Woolis, Rebecca (2003) When Someone You Love Has a Mental Illness, 2nd edition, Penguin Press, CA.

NAMI Family Support Group