WINCHESTER — “The system is completely broken and we’re in a real crisis right now.”

That’s how Winchester Police Chief John Piper characterized the current availability of Virginia’s public mental health services during a presentation on Wednesday to City Council’s Public Health and Safety Committee.

“It’s affecting not only the Police Department and our community members,” Piper said, “but most importantly the people who are in dire need of mental health services.”

About five months ago, Virginia stopped accepting new admissions at five of its eight state-run psychiatric hospitals including Western State Hospital in Staunton, which is where police and social service agencies in the Northern Shenandoah Valley send people suffering from psychological crises. The restriction on new patients has since been lifted, but staffing shortages at the facilities continue to reduce the number of men and women who can be treated on a daily basis.

When the Winchester Police Department encounters someone experiencing a mental health crisis who poses a threat to their self or others, Piper said officers can issue an Emergency Custody Order (ECO) that gives them eight hours to have the person evaluated by a healthcare professional at Winchester Medical Center. If a determination is made that the subject requires more comprehensive treatment, a Temporary Detention Order (TDO) can be issued by a magistrate to admit the patient to a hospital for up to 72 hours for adults or 96 hours for juveniles.

If a bed isn’t available at Western State, or if the patient tests positive for COVID-19, he or she is kept at Winchester Medical Center. However, the local hospital has limited psychiatric services, so Piper said patients frequently stay in the emergency department under a police officer’s supervision for the entire duration of the TDO.

“They may get a visit once a day from a psychologist,” Piper said. “After the TDO expires, our legal authority to hold that person is gone. ... We’re either facilitating their return back to the environment from which they came or they’re just being released from Winchester Medical Center with little or no psychiatric care.”

To offer an example, Piper told the Public Health and Safety Committee about a recent episode involving an unnamed 15-year-old boy who was experiencing a mental health emergency and taken to Winchester Medical Center on an eight-hour ECO. A 96-hour TDO was subsequently issued, but neither the local hospital nor Western State could admit the teen for treatment.

“We sat with this young man for 96 hours — five days — in the emergency room of Winchester Medical Center,” Piper said. “He received little or no psychiatric care and the TDO expired.”

Police had no choice but to take the boy back to where he first experienced a psychological crisis. Within a few hours, Piper said, he was again being disruptive and violent, so officers returned him to the hospital under an ECO that evolved into a second TDO.

Piper said officers sat with him in Winchester Medical Center’s emergency department for another five days, which actually turned into six because a caveat of the TDO law allows a subject to be held for an extra day if their hospital stay occurs on a weekend.

“So in essence, we sat with this young man around the clock for 11 days in the emergency room at Winchester Medical Center,” Piper said. “You know what happened after those 11 days? He got released back to the same environment.”

Fortunately, Piper said he was able to work with the Winchester Department of Social Services to obtain alternate care for the boy. However, the incident exemplified the troubled state of Virginia’s mental health services and the tremendous burden the situation has put on law enforcement agencies.

From Jan. 1 through Sept. 30, Piper said the Winchester Police Department handled a total of 170 ECOs, 90 of which turned into TDOs.

In August alone, he said, “We had 120 officers utilized watching people in the emergency room. That’s 400 hours and over $14,800 spent on personnel costs.

“We’re averaging 19 ECOs and 11 TDOs every month,” Piper told the committee. “I would say, based on the wide category of mental health calls, 20% or more of our calls for service are dealing with people in [psychological] crisis.”

Winchester is not the only jurisdiction reeling due to the fallout of Virginia’s failure to treat mental health patients. Piper said it’s happening throughout the commonwealth, and the only way to stop it is to appeal to lawmakers in Richmond to provide more funding and support to the state’s mental hospitals and compel private hospitals to provide additional beds for patients experiencing psychiatric emergencies.

Another helpful option, he said, would be to create a regional crisis stabilization unit where police can take people in psychological distress. The unit would primarily be funded by the municipalities it serves and would give patients the opportunity to calm down for a few hours and, when applicable, receive medication. Piper said this approach could reduce the number of TDOs issued and would ensure that patients are spending time with medical personnel rather than police officers.

Ultimately, Piper said he would like to remove law enforcement as much as possible from the process of obtaining mental health care for people in crisis.

“But we’ve got to have the funding and the personnel and the willingness of others to step up into those roles and do it in a safe way,” he said. “We’ve got to get more creative.”

— Contact Brian Brehm at

bbrehm@winchesterstar.com

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