Involuntary Treatment in Virginia: Understanding Commitment Laws and the Recovery Process

This article provides a broad overview of the involuntary commitment process in Virginia and should not be considered legal counsel. If you are facing this situation, contact an attorney or your local Community Services Board to learn what options are available.

To watch someone you love resist treatment during a severe mental health episode or while actively addicted is frightening. You naturally want to know if there’s something you can do to intervene when someone cannot or will not receive the help they need.

An involuntary treatment option does exist for these types of situations; however, it’s only used in extreme cases where a person poses a significant threat to either themselves or other people. The state of Virginia has developed a well-defined legal process to ensure both public safety and citizens’ civil liberties. Understanding how this process works can provide families with greater peace of mind if they were to need to use this process in the future.

What is Involuntary Treatment in Virginia?

Involuntary treatment is a legal term describing psychiatric treatment ordered by a judge for someone who has not consented to treatment, usually because a mental illness has made them a danger to themselves or others.[1] The involuntary commitment process in Virginia is intended to serve as a last resort in these situations and requires the court to consider less restrictive treatment options before ordering involuntary admission.[2] When possible, voluntary hospitalization is preferable, as it allows for a patient’s cooperation with treatment and leads to more positive results for long-term recovery.

It’s essential to recognize that involuntary commitment mental health laws in Virginia and substance abuse treatment are not synonymous. While addiction is certainly taken into consideration within the context of involuntary commitment proceedings in Virginia, especially when the addiction is related to a pre-existing mental illness, a diagnosis of substance dependency is not sufficient to support involuntary commitment on its own.

When Can Someone Be Involuntarily Committed in Virginia?

Virginia statute sets a high bar for involuntary commitment. To qualify, someone must have  a mental health condition and demonstrate at least one of the following:

• That there is a reasonable likelihood that, unless appropriate treatment is received, they will cause serious physical harm to themselves.
• That there is a reasonable likelihood that, unless appropriate treatment is received, they will inflict serious physical harm to others.
• That they are so disabled that they cannot take care of their basic needs, such as food, shelter, or safety, without treatment.

Typically, someone struggling with addiction will not be considered a candidate for involuntary commitment unless they have a diagnosable mental illness and meet one of the above three standards.

How Does the Involuntary Treatment Process Work in Virginia?

The process of involuntary treatment in Virginia follows these stages. Each stage differs in how it helps protect the rights of people with mental illness, and in what it does to help them get the treatment they need.

1. Emergency Custody Order (ECO)

An Emergency Custody Order allows law enforcement to take someone into custody for an emergency evaluation

If a clinician, family member, or magistrate believes that someone meets the requirements listed above, they can request an ECO. Once issued, a law enforcement officer will take the person into custody and transport them to a designated location, where they will be evaluated by a certified prescreener, typically through a local Community Services Board (CSB). The certified prescreener will perform a preliminary evaluation to determine if further intervention is warranted. An Emergency Custody Order generally expires within 8 hours; however, this timeframe may extend depending on the situation.

2. Temporary Detention Order (TDO)

Following an evaluation that indicates the presence of a serious mental disorder or a substantial risk of physical harm to self or others, a magistrate may issue a Temporary Detention Order.

A Temporary Detention Order allows for temporary hospitalization at a psychiatric facility. While hospitalized, the person continues to retain all of their rights, including the right to be treated with dignity and to consult with an attorney. Generally, a TDO is valid for only a few days, which permits sufficient time for a comprehensive evaluation and preparation of a preadmission screening report ahead of a formal commitment hearing.

3. Commitment Hearing

The final stage of the process is a commitment hearing, typically heard by either a Special Justice or a district court judge.

At this point, an independent evaluator, such as a psychiatrist or clinical psychologist, prepares a clinical evaluation of the person. The judge also hears evidence from family members or other professionals associated with the local Community Services Board. Clear and convincing evidence is required prior to ordering commitment. Possible outcomes include committing someone involuntarily to an inpatient treatment program, placing them under Mandatory Outpatient Treatment (MOT) in the community, or releasing them if the requirements aren’t met.

What Laws Govern Involuntary Commitment in Virginia?

The laws governing civil commitments in Virginia are located in Title 37.2, Chapter 8 of the Code of Virginia, which governs emergency custody and voluntary and involuntary civil admissions.[3]

Title 37.2 outlines the conditions under which someone may be committed, describes the procedures related to Emergency Custody Orders and Temporary Detentions, and establishes procedures for both involuntary inpatient treatment and mandatory outpatient treatment when a less restrictive alternative exists.[4]

Title 37.2 is meant to safeguard the rights of people with mental illness throughout the entire process and because of this, it requires independent evaluations and a formal court hearing before allowing a single person to commit another.[5]

Can Someone Be Forced Into Substance Abuse Treatment in Virginia?

Families commonly ask about the possibility of forcing someone into substance abuse treatment in Virginia. The answer is complex.

The involuntary commitment process in Virginia is primarily based on mental illness, not drug or alcohol use disorders alone.[6] However, substance use disorders often co-occur alongside mental illness, and courts may consider involuntary evaluation when substance use is tied to mental illness and the danger or basic needs criteria are met. Voluntary treatment is normally considered the preferred method for addressing substance use disorders alone.

Rather than waiting until a crisis occurs and meets legal criteria for involuntary treatment, encouraging your loved one toward voluntary detoxification or residential treatment may be the best course of action when possible.

What Rights Does a Person Have During the Commitment Process?

People undergoing Virginia’s involuntary commitment process possess certain legal protections, including:

• The right to a court-appointed attorney if one is not retained
• The right to an independent clinical evaluation
• The right to a hearing prior to a commitment order being issued by a judge or special justice
• The right to receive treatment using the least restrictive options available
• The right to provide evidence and testimony during their hearing
• Appeal rights applicable in certain circumstances

Benefits and Challenges of Involuntary Treatment

While involuntary treatment may not be ideal for everyone, it can indeed save lives. It affords an immediate, safe environment during a psychiatric crisis, an opportunity to stabilize an emergency, and protection from immediate harm. It also provides an opportunity for someone who could not otherwise pursue treatment to start receiving services, ultimately connecting them with long-term behavioral health care that could serve as the starting point for recovering from mental illness.

However, involuntary treatment is not a total fix on its own. There are many people who struggle with mental illness who do not meet the legal criteria for involuntary treatment. The process can also be emotionally taxing on families seeking it. Once someone has been placed in an inpatient hospital setting due to an involuntary commitment order, there are limits on how long they can remain, and recovery from mental illness requires continued active participation after hospitalization. A family’s relationship with their loved one may also be strained by the nature of the involuntary treatment process, which is why having a plan for aftercare support following discharge is so critical.

Alternatives to Involuntary Commitment

Before a situation reaches the point of involuntary commitment, several alternatives are worth exploring:

• Crisis intervention services and mobile crisis teams
• Local Community Services Boards (CSBs)
• Voluntary detox and residential treatment
• Intensive outpatient treatment
• Family intervention
• Peer recovery support

How Families Can Help Before a Crisis Develops

Recognizing warning signs early and having open conversations about issues before they become emergencies can greatly improve outcomes.

There are ways to encourage your loved one to seek voluntary treatment, create a crisis plan before one is needed, and know what local crisis resources are available to you, so that if a crisis emerges, you’ll be able to respond with knowledge and calm rather than panic.

Knowing when to call for emergency services, instead of trying to manage things on your own, is important for everyone’s safety.

Professional Treatment After Stabilization

Once someone is stabilized, either voluntarily or involuntarily, how the next steps are handled can be just as important as the crisis itself.

Typically, this includes detoxification if necessary, residential treatment, dual diagnosis care for co-occurring mental health conditions and substance use disorders, medication management, therapy, and aftercare planning that connects your loved one to recovery support groups in the community.

Compassionate Treatment Before a Crisis Escalates

While involuntary treatment provides critical intervention during a mental health emergency, many people find more success in recovery when they receive treatment before it becomes necessary.

At Alpas Virginia, we help families seeking treatment for addiction and co-occurring mental health disorders in Virginia find a suitable treatment option and begin the journey toward sustainable recovery.

Reach out to our admissions team today to see what treatment could look like for you or someone you love.