Navigating Involuntary Holds in Virginia: A Guide for Patients, Friends, & Families
Facing a mental health crisis–whether it’s your own or a loved one’s–can be overwhelming. In some cases, a person may be placed under an involuntary psychiatric hold for their safety or the safety of others. This guide explains how the process works in Virginia, what you can expect, and how to navigate it with compassion and clarity.
What Happens During an Involuntary Psychiatric Hold?
An involuntary hold means a person is temporarily kept in a hospital or mental health facility against their will to ensure their safety. This typically lasts for a short period, often 72 hours or less, and is intended to allow doctors to assess the person’s mental health and determine the next steps.
During the hold, the individual will receive a psychiatric evaluation, and if needed, medication or treatment. Families may not always have access right away, but most facilities will communicate with loved ones when appropriate.
What is the Process for Initiating a Hold?
In Virginia, a hold usually starts following a mental health emergency, such as suicidal thoughts, threats of violence, or severe confusion. A family member, friend, police officer, or health provider can call for help and initiate the process.
A mental health professional will then assess the person. If they believe the person is a danger to themselves or others, they can request what’s called a Temporary Detention Order (TDO), authorizing the involuntary detention of the individual once issued by the court.
Legal Criteria for Involuntary Holds
Demonstration of a severe mental illness
Near-future likelihood of harm or neglect to self or others (e.g., suicidal behavior, violent threats, or inability to care for basic needs)
Unwillingness or inability to seek voluntary treatment
Potential Outcomes
Discharge: If the person is found to be stable, they may be released with a treatment plan or referrals.
Voluntary Admission: The patient agrees to stay in the hospital for treatment voluntarily. This can sometimes allow for less restrictive treatment options.
Involuntary commitment: A judge may order extended involuntary treatment if the patient continues to meet legal criteria for the hold and poses a significant risk without it.
State-Specific Laws
A person may be held up to 8 hours under an Emergency Custody Order (ECO) while being evaluated.
After this time, if needed, a court-issued Temporary Detention Order (TDO) allows the individual to be held for up to 72 hours, excluding weekends and holidays.
After that, a court hearing is held to decide if continued treatment is necessary. In Virginia, a court order may extend the hold by 90 days.
If a hospital bed isn’t available, Virginia has a bed registry to help find a space quickly, though delays can still occur.
CSBs (Community Services Boards) are central to the process. They coordinate evaluations and placements.
Tips and Guidance
Ask questions: Staff at hospitals or the CSB can explain the process and available options.
Know your rights: Patients have the right to legal representation and a hearing within 72 hours (excluding weekends and holidays) after a TDO is issued, and must be informed of the reason for the hold. Consider contacting a mental health attorney or patient advocate.
Request to view paperwork: Patients are entitled to see a copy of the TDO, which outlines why the detention is occurring and when the hearing will take place.
Communicate with the hospital: Family members can often provide valuable information to the treatment team. Ask how you can share relevant details while respecting patient privacy laws.
Prepare for discharge planning: If your loved one is released, ask about follow-up care and safety planning to support recovery.
Seek support: mental health crises affect everyone involved. Don’t hesitate to reach out to local support groups or mental health organizations for help and guidance.
Conclusion
Involuntary psychiatric holds are designed to protect individuals experiencing a serious mental health crisis, but the process can be confusing and emotional. Understanding your rights, asking questions, and seeking support can make this difficult situation more manageable. Whether you’re a patient or a concerned family member, compassionate care and legal protections are in place to guide you through this challenging time.
