A new study by the University of Virginia found that the number of civil commitments of people in mental distress rose last year, perhaps in response to changes enacted after the fatal encounter between Sen. R. Creigh Deeds and his mentally ill son.
“Roughly speaking, there’s been about a 10 percent increase,” said Richard J. Bonnie, director of the Institute of Law, Psychiatry and Public Policy at U-Va. and chairman of the state Supreme Court’s Commission on Mental Health Law Reform from 2006-2011.
Although Bonnie said further study is needed to explain the increase, there is speculation that the Deeds case sensitized the public and providers of mental health care to be more vigilant about committing people who appear to pose threats to themselves or others. “One possibility is that this is what we might call the ‘Deeds effect,’ ” he said.
The institute, in compiling annual statistics for the Virginia Department of Behavioral Health and Developmental Services, found that the total number of temporary detention orders rose from 19,971 in fiscal 2013 to 21,055 in fiscal 2014. The number of emergency custody orders — which authorize law enforcement officials to take a person into custody for evaluation or to keep a person in custody for evaluation — rose from 6,000 to 6,438.
The overall increase came after declines in civil commitments from 2011 to 2013, the report says. Using court data, it raised the question of whether the Deeds case and subsequent changes caused the increase, just as civil commitments had gone up after the April 2007 Virginia Tech massacre and ensuing reforms.
In November 2013, Austin “Gus” Deeds, 24, stabbed his father and then committed suicide hours after mental health officials said no psychiatric beds were available for him. Sen. Deeds had obtained an emergency custody order from a magistrate so that Gus Deeds, a William and Mary student who had volunteered on his father’s unsuccessful gubernatorial bid, could undergo a psychiatric evaluation. But time ran out on the order before a bed could be found. Sen. Deeds (D-Bath), who has served in the General Assembly since 1992, angrily declared that the state had failed his son and other mentally ill people.
In the General Assembly session following the tragedy, legislators voted to give officials more time to find psychiatric placements for people who had been the subject of emergency custody orders. If a placement cannot be found before such an order expires, the new law requires the state to provide a bed of last resort. It also compels the state to maintain a “real-time” online registry of available beds, a project that had been in the works for years but did not come about until after Gus Deeds’s death.
The changes also mandated tighter monitoring of court-ordered outpatient treatment and a four-year study of mental-health services to search for additional reforms. The reforms were enacted in April 2014 and took effect July 1, 2014.
Bonnie said the most interesting aspect of the data suggests that the increase — and later decrease — in emergency commitment orders from magistrates could have been caused by reforms that extended the time a person could be held for evaluation. There is speculation that permitting a person to be held longer allows emergency facilities to better stabilize the person before his or her release.
Deeds declined to comment Thursday, referring questions to state officials.
The report noted that the court statistics capture only a slice of the number of people in mental distress who are taken into emergency custody by law enforcement, usually voluntarily, because they appear to pose a threat to themselves or others. The report, citing a 2013 study of emergency evaluations conducted by Community Services Board personnel, found that more than half of the people taken into emergency police custody were being held temporarily, without an emergency custody order.
This year marked the first that state health officials began collecting information from Community Services Boards around the commonwealth on the number of emergency contacts and emergency mental health evaluations that were completed. The data will appear in future reports, the study says.