Pillar #3: activate.

Let’s get real for a second: Access to mental health care in our community is limited. You are going to have to be prepared for a long road and you are going to have to commit to staying the course until your loved one is better. They need you.

• If you or someone you know is in urgent crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988 or visiting 988lifeline.org. If you are trying to reach a 988 call center in Virginia using an out-of-state area code, you can call 703-752-5263. If your loved one is a Veteran, text 838255 for support OR call 988 and select 1 for the Veterans Crisis Line.

• Call 911 for urgent help or the non-emergency number if it isn’t urgent. In In a situation where it is urgent but you are not safe to speak, such as a domestic abuse situation, text 911. Mention that your loved one is in crisis and ask for the Crisis Intervention Team (called HART and ANCHOR in Albemarle County and Charlottesville City). These professionals are part of the first response team, are trained in de-escalation and, while they can’t diagnose and treat, they can help you navigate treatment resources. We know this route can be scary for some and you may not want your loved one to have a record with law enforcement. However, they are there to help and they will need a record of these behaviors should future legal action (e.g., Custody or Risk Orders) be needed.

• Go to the emergency room. UVA emergency department established a new psych care department. It will likely be a long wait in the waiting room. However, once in, trained professionals can assess your needs, determine whether in patient care and/or medication is appropriate and direct you to therapists and community services that can support you in your journey. This option will also provide documentation you made need to petition for an Emergency Custody Order or an Emergency Substantial Risk Order in the future, if needed.

• Need affordable care? Contact Region 10.When scheduling, make sure you use the word “crisis” so the urgency is well-understood and care can be expedited. They also have social workers who can help with longer term needs, such as housing and food.

• Visit the Mental Health America of Virginia (MHAV)website for resources and information, or call their peer-run warm line at 1-866-400-MHAV for support. Note: Research suggests peers (i.e., those who have experienced mental health crises, serious mental illnesses and/or substance use disorder) are effective at de-escalating crises and helping patients navigate care and community services. However, they cannot and should not provide diagnostics, advise you on a treatment plan or whether, or help determine whether Emergency Custody Order (ECO) or Emergency Substantial Risk Order (ESRO/ERPO) is appropriate.

• For longer-term treatment, visit the 2-1-1 VIRGINIAwebsite or dial 2-1-1 to find local mental health service providers by zip code or region OR use a treatment locator at https://findtreatment.gov/ or Psychology Today. You can also contact your insurance provider.

• KEEP DETAILED RECORDS. A “crisis” is defined as a change in behavior and mental state. This means it’s up to you to observe and record trends that may be needed to inform an appropriate treatment plan. Also, you may need to petition for a Emergency Custody Order (ECO) or request an Emergency Substantial Risk Order (ESRO/ERPO) in the future. This is a legal process. As such, magistrates and judges require evidence of crisis and danger to self or others. Don’t get to this stage without documentation- your petition will fail.

This journey will be particularly difficult because you will likely face issues accessing care in addition to resistance from your loved one. However, for your safety, their safety and the safety of the community, you must act now and stay the course. Lives may depend on it.

• Call 911, mention that your loved one is in crisis and ask for the Crisis Intervention Team (called HART and ANCHOR in Albemarle County and Charlottesville City). These professionals are part of the first response team, are trained in de-escalation and, while they can’t diagnose and treat, they can help you navigate treatment resources. We know this route can be scary for some and you may not want your loved one to have a record with law enforcement. However, they are there to help and they will need a record of these behaviors should future legal action (e.g., Emergency Custody Orders or Emergency Substantive Risk Orders) be needed - which is more likely in your situation given your loved ones resistance to treatment.

• If you aren’t yet ready to contact 911 but need urgent help: Contact the 988 Suicide and Crisis Lifeline by calling or texting 988 or visiting 988lifeline.org. If you are trying to reach a 988 call center in Virginia using an out-of-state area code, you can call 703-752-5263. If your loved one is a Veteran, text 838255 for support OR call 988 and select 1 for the Veterans Crisis Line.

• KEEP DETAILED RECORDS (video, audio, notes, clinician records, school records). A “crisis” is defined as a change in behavior and mental state. This means it’s up to you to observe and record trends that may be needed to inform an appropriate treatment plan. Also, you may need to petition for a Emergency Custody Order (ECO) or request an Emergency Substantial Risk Order (ESRO/ERPO) in the future. This is a legal process. As such, magistrates and judges require evidence of crisis and danger to self or others. Don’t get to this stage without documentation- your petition will fail.

• Follow the law in your record-keeping. You can generally video without consent in public places where there is no reasonable expectation of privacy, but you cannot record in a state of undress (i.e., when someone is not fully clothed). While Virginia is a one-party consent state for recording conversations, meaning you can record if you are a party to it, using hidden cameras that record both audio and video is generally illegal. ACLU of VA.

• Petition the court for an Emergency Custody Order (ECO) yourself. In Virginia, an ECO for a mental health crisis is a temporary court order authorizing law enforcement to take someone into custody and transport them for a clinical evaluation by a mental health professional. It is issued by a magistrate when there is probable cause to believe the person has a mental illness and, due to that illness, is likely to cause or suffer serious harm in the near future, and is unwilling or unable to volunteer for treatment. Custody is temporary. The maximum time limit is 8 hours from the moment law enforcement takes custody (or 4 hours if the ECO is issued by law enforcement directly). During this window, the individual must be transported to a facility for evaluation by a CSB crisis worker (Virginia ECO Code). Here are your next steps to follow: 1) Locate the nearest magistrate's office. You must go to the magistrate's office in person, as public citizens cannot request an ECO over the phone. You can call ahead to learn their hours and address.; 2) File a sworn petition. You will need to provide a sworn testimony detailing recent behaviors that demonstrate a substantial likelihood that the person will harm themselves or others due to mental illness, or will suffer serious harm due to their inability to care for themselves. A "responsible person," which can include a family member, clinician, or other credible individual, can submit this petition.; 3) Receive the ECO. If the magistrate finds probable cause, they will issue an ECO. This order authorizes law enforcement to take the person into custody for an emergency mental health evaluation. 4) Work with the CSB crisis worker to start transport. Once the ECO is served, the person must be transported for evaluation by a CSB crisis worker or law enforcement officer within eight hours. 

• Contact your local Community Service Board (in our community, this is Region Ten) to help file an ECO. CSBs offer pre-admission screenings and crisis services 24 hours a day, 7 days a week. Request an evaluation. A CSB crisis worker can conduct an evaluation, and if they determine it is necessary, they can initiate the ECO process with a magistrate. 

• You got an ECO for your loved one, now what? If, after evaluation, the crisis worker finds that someone poses a serious risk to themselves or others due to mental illness, they may recommend a Temporary Detention Order (TDO). Unlike an ECO, which is short-term, a TDO provides up to 72 hours of hospitalization for a thorough psychiatric evaluation and stabilization (Virginia TDO Code).

We get it. Nobody wants to be the squeaky wheel. However, our Law Enforcement and Judicial systems are designed to help us and they can’t help unless they are contacted. Act now. Lives may depend on it.

• Call 911 if urgent help is required (e.g., someone is in immediate danger) OR Text-to-911 if you are in a situation where it is not safe or possible to speak. Provide your location, note that a person is likely in crisis, and request the Crisis Intervention Team. These professionals are are trained in de-escalation and, while they can’t diagnose and treat, they can help the person navigate treatment resources.

• If it isn’t urgent and you live in Albemarle County, call the Non-Emergency line at 434-977-9041. If it isn’t urgent and you live in Charlottesville City, call their Non-Emergency line at 434- 970-3280. Again, use the term crisis in your incident description.

• KEEP RECORDS. A “crisis” is defined as a change in behavior and mental state. This means we, ideally, want to show evidence of behavioral trends over time to inform next steps. Also, a responsible party or law enforcement officer may want to petition for a Emergency Custody Order (ECO) or request an Emergency Substantial Risk Order (ESRO/ERPO) in the future. This is a legal process. As such, magistrates and judges require evidence of crisis and danger to self or others.

• Follow the law in your record-keeping. You can generally video without consent in public places where there is no reasonable expectation of privacy, but you cannot record in a state of undress (i.e., when someone is not fully clothed). While Virginia is a one-party consent state for recording conversations, meaning you can record if you are a party to it, using hidden cameras that record both audio and video is generally illegal (ACLU of VA).

• You have rights too! Public safety: While Virginia doesn't have a broad constitutional "right to live in a safe environment," it does have laws that provide certain protections, including victims' rights to protection from harm and notice of proceedings. The Commonwealth also mandates that localities take measures to preserve public safety (Virginia Code). If you feel unsafe in your home or community, contact the police.

• You have rights too! Workplace safety: The February 17th shooter reportedly harassed and stalked staff members of a local business for months - even causing notable property damage in the process. According to staff statements, they followed business protocol and alerted management. At no point was law enforcement engaged. While OSHA does not have a specific standard for harassment and stalking, it does require employers to provide a workplace free from recognized hazards under the General Duty Clause. In Virginia, a recent bill (HB 1919) passed by the House of Delegates requires large employers to implement workplace violence prevention policies by 2027, which includes harassment and threats (OSHA). In the meantime, it is up to employees to speak up when they feel their rights are being violated. If illegal and threatening activities persist, please engage law enforcement yourself- for your safety and the safety of those around you.

• Determine whether the person is barred from having guns under Federal Law: A person is barred from having guns if they are: a convicted felon, a fugitive, an unlawful user of controlled substances, adjudicated as mentally defective, involuntarily committed to a mental institution, an illegal alien (or someone who renounced U.S. citizenship), dishonorably discharged from the military, subject to qualifying domestic violence restraining orders, and/or have been convicted of a misdemeanor domestic violence crime. If you know the person in crisis fits that criteria, call local law enforcement. (ATF)

• Familiarize yourself with Emergency Substantive Risk Orders (ESRO/ERPO). A person who displays warning signs of a future suicide or a violent act, but who is not prohibited under federal law, can legally buy and possess guns. However, ESROs protect public safety by temporarily removing weapons from people in crisis while they obtain the help they need. Go to John’s Hopkins National Extreme Risk Protection Order (ERPO) Resource Center for details. Note: “Emergency Substantial Risk Order “ (ESRO) is the term used in Virginia. “Extreme Risk Protection Order “ (ERPO) is the term used in many states and by Hopkins.

• COLLECT EVIDENCE of crisis and threat. This could include, but is not limited to:

  • Recent acts or threats of violence towards self or others

  • A history of threatening or dangerous behavior

  • A history of, or current, risky alcohol or controlled substance use

  • A recent violation of a domestic violence protective order

  • Unlawful or reckless use, display, or brandishing of a firearm

  • Cruelty to animals

    (Johns Hopkins)

• Contact Law Enforcement. Currently in Virginia, only law enforcement, judicial officers and attorneys can petition for a risk order. As a result, you will need to contact law enforcement (911 if it is an emergency or your local non-emergency number if it isn’t). In Albemarle County, the Non-Emergency line is 434-977-9041. In Charlottesville City, the Non-Emergency line is 434- 970-3280.

• Present your evidence. Officers, or the attorneys petitioning on their behalf, will need to include this in their request. Communicate the perceived threat clearly. For example, you may say “They threatened to use the gun on me” or “They said they are going to take their own life”. Don’t leave room for misinterpretation. The more evidence, the better your chances are of success.

• Know the process: 1) The petitioner files a temporary ERSO petition under the penalty of perjury to a local judicial officer (typically a magistrate); 2) The judicial officer will approve or deny the petition; 3) If the order is issued, officers will present it to the individual in crisis (i.e., the “respondent'“). Ideally, firearms are surrendered or removed at that time. The order will then be entered into the background check system to prevent gun purchases during the duration of the order. 4) An ESRO hearing is held where the respondent and petitioner will testify and present evidence. A judge or judicial officer will then determine if there is sufficient evidence for an ESRO. 5) Firearms will be seized for up to 14 days before a final hearing and up to 180 days for a final order, with the possibility of extensions. 6) After an ESRO expires or the underlying final order is dissolved, law enforcement can dispose of the firearm if the owner does not request its return in writing within 120 days. 

• What if the responding officers refuse to move a petition forward? If a clear threat exists, don’t give up! You have options: 1) Reach out directly to your local police chief. In Albemarle County, this is Sean Reeves at 434-296-5807. In Charlottesville City, this is Michael Kochis at 434-970-3288. 2) Contact your local Commonwealth’s Attorneys. In Albemarle County, call 434-972-4072. In Charlottesville City, call 434-970-3176.

• What if the petition is rejected? Collect more evidence and try again, starting with a call to your local police department. The law is designed to protect Due Process and ensure weapons aren’t unlawfully removed. Evidence is a critical component of the process.