The Behavioral Health Commission met on October 1, devoting the majority of its meeting to a briefing by Commission staff on the question of how to minimize assaults on law enforcement officers by individuals experiencing a mental health crisis. This issue was referred to the Commission by the Disability Commission; legislation was considered in 2024 that would have established an affirmative defense to prosecution for assault and/or battery of certain individuals (including law enforcement officers) if a defendant could prove that his or her behavior was the result of a mental illness or neurocognitive disorder or neurodevelopmental disability, or that he or she met the criteria for issuance of an emergency custody order. This legislation was vetoed by the Governor, but secured substantial support in the General Assembly, and Behavioral Health Commission staff had suggested that additional research into other states’ statutes would be unlikely to change the outcome of legislation, proposing instead to determine to what extent law enforcement officers receive adequate training in interacting with individuals in crisis and what barriers might be impeding adequate training.
Commission staff found that most assaults on law enforcement did not involve injuries, but that major injuries occurred in about 2 to 3 percent of assaults, and that those injuries could have serious effects on officers. Based on the data available to staff, more than half of individuals with mental illness who assaulted a law enforcement officer were arrested; such negative interactions with law enforcement can have serious repercussions for those individuals, including psychological effects and disruptions to housing and employment. Law enforcement surveyed by Commission staff viewed Crisis Intervention Team (CIT) training as improving interactions between officers and individuals experiencing mental health crises; while most of the law enforcement agencies responding to the staff survey reported offering CIT training and having a trained officer on duty 24/7, officers reported an interest in receiving additional “refresher” CIT training opportunities. The Department of Criminal Justice Services was directed in 2020 legislation to develop new CIT training that would include recertification and advanced training; these new standards are awaiting completion as part of the regulatory process and staff recommended moving those standards forward to the next phase of regulatory development.
Law enforcement officers also reported an interest in having additional access to clinicians to respond to mental health crises. Some law enforcement agencies use a co-responder model, but deployment of these programs has been limited by funding and workforce availability. Staff included a suggested policy option for the legislature to consider funding co-response programs, especially in localities that have not yet implemented the Marcus Alert initiative, or in smaller localities that are not required to implement all of the Marcus Alert protocols.
Commission staff also documented an increased risk of assaults by individuals in crisis during lengthy waits for psychiatric hospital admissions. Staff noted that given the sometimes extensive delays in inpatient admissions and the lack of alternative options in some areas, some law enforcement officers may view jail as a faster option for securing treatment for an individual in crisis, despite the limitations on psychiatric services in jails. Staff suggested that the General Assembly consider providing additional funding to private psychiatric hospitals that agree to increase their acceptance of involuntary admissions. Staff also suggested that further research could be done to clarify law enforcement’s ability to defer arrest for certain alleged offenses by an individual involved in the civil commitment process until the individual is no longer subject to an emergency custody order, temporary detention order, or civil commitment order.
Commission members also received a briefing on an initiative recently begun by the Department of Medical Assistance Services (DMAS) to redesign certain community mental health services to be more evidence-based and trauma-informed, as directed by budget language. The new services are planned to be in place by summer 2026.
Two presentations focused on the state’s workforce development initiatives. Staff to the Joint Commission on Health Care presented the findings of the Commission’s recent study of health care workforce programs (discussed in a recent County Connections article), and the Virginia Health Workforce Development Authority presented updates on its efforts to match its programs with the health care needs of each region in the state. Commission members were concerned by reports on the state’s lackluster performance in retaining medical professionals who complete residency training in Virginia and the small percentage of providers who completed residency training in Virginia who practice in medically underserved areas. Although the most recent state budget added slots for residents in psychiatry, it appears that these slots are underused due to institutions’ lack of awareness of the program or perceived limitations on its use, or because the funded amount for each slot may be insufficient.
Commission members also received a presentation from the perspective of a peer in recovery on the importance of a recovery-oriented system of care that empowers individuals and avoids coercion in treatment.
The Commission’s next meeting is scheduled for November 12.
VACo Contact: Katie Boyle