State aims to reduce transportation trauma for involuntary mental health detentions

When someone in Virginia has a mental health crisis and a magistrate issues a temporary detention order to involuntarily hold them for treatment, law enforcement must take them to an available hospital bed.

So the patient is put in the back of a police vehicle, often handcuffed even though the vast majority have not committed a crime, to travel to a psychiatric hospital that can be all the way across the state.

Mental health advocates argue that the practice deepens the trauma of the experience. And the state is in the process of instituting a new alternative transportation model that will shift the responsibility away from law enforcement.

The Department of Behavioral Health and Developmental Services announced Tuesday that it awarded a $7 million, two-year contract to G4S, a security company that operates in 90 countries, to implement new transportation services for people under a TDO.

The company will use “unarmed, specially trained drivers in secure, unmarked vehicles,” to transport the individuals, a DBHDS press release states. The new alternative transportation program will start in the summer, and the state estimates that G4S will transport 50 percent of all TDOs in Virginia during its contract, which has an option for extension.

In the 2018 fiscal year, more than 25,000 TDOs were issued in Virginia, “and it is estimated that law enforcement transported 99 percent of these individuals,” the release states.

“Ideally we would like for as many people as possible to be transported in a way that supports their dignity and hopefully their engagement in treatment,” Daniel Herr, deputy commissioner for facility services with DBHDS, said in an interview last month. “We will just see, over time, how that works and whether we’re able to actually transport more folks than we originally estimated.”

Law enforcement officers will still need to transport individuals who do not meet criteria for alternative transportation, though, such as if there is a safety concern.

Officers will also continue to transport minors, Herr said, until the program has gotten off the ground and specialized processes for children are developed, like potentially allowing a parent or legal guardian to accompany them to the hospital.

“For me, that was a particular pressure point because I’m so cognizant to what it would mean to a child or adolescent to be transported the way they are now,” Herr said. “It just felt like we would be able to make the largest impact the most quickly by starting with adults.”

The program will roll out gradually across the state, Herr said, and though every community is different, the goal is for the same process to apply everywhere.

“The level of collaboration that’s required for this to be successful is hard to overstate,” he said. “You have the law enforcement, you have the community services board clinicians, you have the emergency department, you have the magistrate and then the hospital providing the care, so you have a minimum of five different agencies and players that must all interact in a coordinated way and understanding the process for it to work well.”