Crisis Services
Service Overview
Region Ten Crisis Services support individuals who are in acute mental distress and in need of immediate help. Services are provided 24 hours a day, seven days a week in a variety of capacities throughout the agency. Crisis services are designed to meet a person’s immediate needs, assure their safety, and connect them to appropriate and timely interventions in the least restrictive environments. This includes rapid telephone consultation and in-person crisis assessments if necessary. Crisis counseling is also available at scheduled times in a variety of Region Ten sites.
Region Ten’s acute teams and programs provide supportive counseling, assessment, stabilization services, as well as acute intervention and safety planning. In accordance with legal and ethical best practices, Region Ten collaborates with a wide variety of community partners including mental health providers, law enforcement agencies, family members, and the individuals themselves, to assure interactions within crisis situations are handled in a safe, respectful, and person-centered way.
FAQs
You can find answers to our most frequently asked questions about this service here. If you’ve got a question we haven’t covered, please don’t hesitate to get in touch.
What happens when someone contacts Region Ten in an acute psychiatric crisis? When you encounter Crisis Services, you can expect to meet with a clinician who will assess the risk of your situation and help you get the services you need. This may include supportive counseling, referral to a higher level of care or another provider; or even, in some cases, hospitalization at an inpatient facility. For individuals already receiving services at Region Ten, the Crisis Services staff can provide consultation, information, assistance, and support to assure de-escalation and safety and referral to other behavioral healthcare partners as needed.
What is an Emergency Custody Order (ECO)? In Virginia, an Emergency Custody Order (ECO) is a court order that authorizes law enforcement to take a person into custody for up to 8 hours for an emergency mental health evaluation. It can be issued by the magistrate or initiated by a law enforcement officer in the field. Criteria for an ECO: the person has a mental illness and as a result of that mental illness they are in crisis, posing a substantial, immediate risk of harming themselves or others, or incapable of self-care. A magistrate will take testimony and issue an ECO if the criteria are met. Police then would be dispatched to serve the order and take the person into custody for the evaluation at a designated safe location. This could be the emergency department or CITAC. Region Ten-certified pre-screeners are required to evaluate any person in custody under an ECO. If the evaluators find that the only way to ensure safety is admission to the hospital, they will petition the magistrate for a temporary detention order (TDO).
What is a Temporary Detention Order (TDO)? This order will admit the person for inpatient behavioral health treatment at UVa or another psychiatric hospital. After approximately three days, during which the person undergoes a psychiatric assessment, a special justice hears evidence in a commitment hearing held at the admitting hospital.
What is a Civil Commitment? At the commitment hearing, the special justice decides, based on evidence presented by the treating psychiatrist, an independent evaluator, and a representative from the community services board, if the person meets legal criteria to remain in the hospital for ongoing treatment. The legal criteria is always the same four questions:
- Is the person experiencing a mental illness?
- Are they at risk of harm to self/others because of that illness?
- Is hospitalization or treatment the only way to reduce that risk?
- Is the person unwilling or unable to agree to the treatment?
If the answer to any of the questions becomes “no,” the person can agree to voluntary treatment or be discharged.
Will I get a bill for crisis services? Region Ten bills for face-to-face evaluation services. No one is refused services if they cannot afford to pay. A sliding scale is available. We accept reimbursement from many health insurance plans, as well as Medicaid.