Pillar #1: educate.

Most people with mental health conditions are no more likely to be violent than anyone else. In fact, people with severe mental illnesses are over 10 times more likely to be victims of a violent crime than the general population (SAMHSA.gov). At PLM Legacy Foundation, we use the term mental health “crisis”, which is different from a mental heath “disorder” like depression, anxiety and schizophrenia. See below.

Signs vary from person to person but often include:

• Withdrawal such as skipping social functions, missing work, losing interest in activities that used to bring joy, not wanting to leave home

• Poor lifestyle behaviors such as skipping meals, not sleeping, poor hygiene

• Sudden onset or increase in anxiety or depression symptoms

• Paranoia or hallucinations

• Panic attacks

Triggers may include:

• Significant personal tragedy, such as divorce, financial strain or grief

• Interpersonal/familial turmoil

• Ongoing work or school stress

• Chronic or worsening medical conditions

• Loss of sleep or inability to relax

(clevelandclinic.org)

Individuals are more likely to commit violent crime when they exhibit:

• Persecutory delusions and command hallucinations (hearing voices telling them to harm someone)

• Grandiosity, grandiose delusions, and mania

• Antisocial personality traits, including a history of conduct disorder or a diagnosis of antisocial personality disorder (APA.org)

Mass shooters often exhibit noticeable behavioral changes before an attack. Warning signs include:

• making threats or jokes about violent plans

• social isolation

• angry outbursts or increasing physical aggression

• experiencing an unusual difficulty coping with stress or daily tasks

• worsening work or school performance

• increasingly troublesome behaviors with others

• bizarre or unexpected change to appearance, like poor hygiene

• comments about hurting self or others

• reduced interest in hobbies or activities

• changes in vocabulary or behavior that align with violent extremist causes

• testing security of potential target location

• showing obsessive interest in previous mass attacks or perpetrators

  (FBI.gov)

Mental health professionals can:

• assess patients for risk of violence

• counsel about firearm safety

• help lessen symptoms of crisis

• guide the creation of policy that mitigate violence risk without stigmatizing people with mental illness (Rozel & Mulvey, 2018)

When a person is in crisis, family members and law enforcement are often the first to see the signs of potential harm to self or others. Extreme Risk laws allow law enforcement to petition a court for an order to temporarily prevent someone in crisis from accessing guns.

In Virginia, the law is called an Extreme Substantial Risk Order (ESROs) or Red Flag Law. In some states, the term Extreme Risk Protection Order (ERPO) is used.

These laws can help de-escalate emergency situations and are a proven way to intervene before gun violence - such as a gun suicide or mass shooting - takes more lives. (Evertytown.org)

While loved ones can’t currently petition the court directly in Virginia, they can and should engage law enforcement to do so. We strongly recommend documenting and sharing evidence of crisis to be presented to law enforcement and the court.

To learn more, visit: https://erpo.org/

In Virginia, an Emergency Custody Order (ECO) allows law enforcement to take a person experiencing a mental health crisis into custody for an immediate evaluation by mental health professionals. 

It gives professionals time (up to 8 hours) to assess the individual and determine if they need further hospitalization or treatment. 

If a person meets the criteria for detention, an ECO can lead to a Temporary Detention Order (TDO) for up to 72 hours of hospital care for stabilization. 

Family members can petition for an ECO. We strongly recommend documenting concerning behaviors to share with the court in case a petition is needed.

(NAMI Blue Ridge Charlottesville)