Handcuffed and in crisis: With a shortage of nearby beds, police drive mental patients across the state for treatment

In late July, two police officers in Abingdon helped two children into the back of a cruiser.

The kids, 11 and 14 years old, hadn’t committed any crimes, and they weren’t on their way to the police station or to a juvenile detention center. They were going to mental health treatment facilities in Petersburg and Newport News, and the only people who could drive them across the state from Abingdon were police officers.

The children were under temporary detention orders that required they receive immediate mental health treatment. But the closest available beds were across the state, over 300 miles away. So the officers put them in the back of the car, gave one a cell phone to play games on, and drove.

“Why are we taking people of any age out of a service district where their home support network is, where mom and dad and friends can get to them, and driving them all the way across the state?” said Abingdon Chief of Police Tony Sullivan. “More importantly, why are we sending an 11-year-old in the back of a police car?”

For years, police officers in Virginia have been the de facto transportation unit for people with temporary detention orders, meaning the person has been ordered by a magistrate into mental health treatment. That has become a serious problem over the last several years as fewer and fewer beds are available.

It is a harrowing experience for the patient, who is often in a mental-health crisis and must then be placed into the back of a police car, usually handcuffed, and transferred to a treatment center.

“When you have someone with a mental illness and you put them in a police car, and you handcuff them, you’re really criminalizing their illness,” said Sandy Bryant, executive director of the Mount Rogers Community Services Board. “You’re also traumatizing them. Most of them have had a long history of trauma anyway, so it’s re-traumatization.”

And the practice presents major challenges to law-enforcement agencies, especially in rural areas that must spare one or two officers to make the trek across the state and back. At times it leaves small towns without officers to do their regular duties as well.

“We’re concerned about it — it’s a drain on our resources and it’s unfunded,” said John Jones, executive director of the Virginia Sheriffs’ Association. “These people are not criminals and they’re being treated like criminals and that’s the problem. It’s dehumanizing to the person that’s receiving the service.”

It’s a costly job, too. Last year, Abingdon police officers — there are 25 of them — traveled more than 650 hours to transport people under temporary detention orders, an expense of more than $20,000, according to a report the department submitted to Town Council in July.

The state is due to address the problem in the next two years. The General Assembly included $7 million in the 2019 and 2020 fiscal year budgets to implement an alternative transportation model throughout the whole state for adults and children.

“There may be a little bit of light at the end of the tunnel,” Jones said.

A request for proposals should be released this year, and the Department of Behavioral Health and Development Services confirmed it will be sending the request out soon.

From 2015 to 2017, Mount Rogers Community Services Board conducted a pilot project using an alternative transportation model to take patients to treatment facilities. The patients were transported by an unarmed, trained person without restraints and in an unmarked vehicle.

There were restrictions to the pilot. Minors were still required to be transported by police officers, as were those deemed a high safety risk to harm themselves or others. Ultimately, 59 percent of those with temporary detention orders were still transported by law enforcement by the time the pilot ended in early 2017.

But it was still considered a success, and a report submitted to the General Assembly noted that every person who used the alternative transportation model reached his or her destination safely.

“Rather than putting them through something that historically is associated with criminal activity, we’re normalizing the experience, because the truth is that mental illness in our society is extremely common, much more common than most people realize,” said Mindy Lindamood, program director of clinical services with the Mount Rogers Community Services Board.

The transportation problem, however, has been exacerbated by a lack of mental health treatment beds. And that isn’t going to be fixed by an alternative transportation model.

On Thursday last week, three of the state’s mental hospitals were operating over capacity, including Catawba Hospital, Piedmont Geriatric Hospital and Southern Virginia Mental Health Institute, according to the census provided by the Department for Behavioral Health and Development Services. Most of the remaining hospitals were operating at 90 percent capacity or higher.

Sometimes staff at community services boards — which are located across Virginia and contract with the state to provide mental health care — must call up to 30 hospitals across the state before finding one with an available bed. They call private hospitals before public ones, due to the 2014 “bed of last resort” law.

The private hospitals are taking patients who are under a temporary detention order, but they’re also taking more self-admitted, private patients, said Bruce Cruser, executive director of Mental Health America of Virginia. So that means more often patients must turn to state hospitals for treatment instead.

The long term solution, Cruser said, isn’t adding more beds to the state but ensuring that there are supportive services for people to receive mental health treatment in community settings.

“We need more available options for people short of hospitalization,” he said, “so they don’t get to that point.”