Virginia must do more to ensure that people who call for help in a mental health crisis receive treatment with the best chance of a good outcome.
When someone calls 911 or 988, the mental health crisis number, about an emergency involving behavioral health, there’s a somewhat better chance these days that the response will come from people trained to deal with their particular emergency.
But the odds of a behavioral health crisis being dealt with by trained clinicians are improving more slowly than commonwealth officials envisioned in 2020, when the General Assembly passed the Marcus-Davis Peters Act. That law created the Marcus Alert system, intended to send behavioral health clinicians and other experts to someone in a mental-health crisis instead of — or, if necessary, in addition to — law enforcement officers.
Last year, the number of behavioral health calls to 911 receiving an appropriate response rose from 10% to 22%. Meanwhile, many 988 calls involving someone in crisis involving mental health, substance abuse or developmental disability are still handled by law enforcement. While it’s good that the numbers are improving, change is not happening as efficiently as state leaders intended.
That’s a serious problem for at least two important reasons. Experience and research make it clear that dispatching a team trained to deal with behavioral health crises, rather than law enforcement, is more likely to help — and even save the life of — the person in distress. The Marcus Alert system grew out of such a situation, when Marcus-David Peters, a 24-year-old, unarmed, Black high school teacher in a mental health crisis was fatally shot by Richmond police.
And, especially in rural areas with stretched-thin sheriff’s departments and small-town police departments, sending officers to deal with behavioral health emergencies means law enforcement officers are not available to help if the sorts of crises they are trained to deal with should arise.
There are several reasons for the slow progress. One is the staggered rollout of the system. The Marcus Alert system is being implemented across Virginia by community service boards (CSBs), which may include several localities and agencies. All 40 CSBs across Virginia are supposed to implement the system by July 2028. So far, 17 have, including the Virginia Beach, Hampton-Newport News and Western Tidewater CSBs.
For the deadline to be met, Virginia will need to provide adequate funding. Officials are realizing that it may be necessary to amend the funding process, which allocates $600,000 to each CSB the year before the system takes effect — even though statewide, CSBs vary greatly in the number of people they serve.
More also needs to be done to smooth the implementation and encourage people to trust the new system. There is no statewide training on the Marcus Alert system for CSBs, emergency dispatchers and law enforcement.
The legislation provides a triage framework for dispatchers handling calls to 911 or 988, with guidelines about who should respond to various levels of urgency and threat to life — whether law officers are needed in addition to or instead of behavioral health clinicians. But that framework isn’t always followed. It’s important that operators answering 911 and 988 calls know what to do, and that callers can trust their decisions.
Gov. Glenn Youngkin, who commendably has made mental health care a priority, recently announced a pilot project in Winchester that uses Special Conservators of the Peace (SCOPS), professionals authorized to carry out some law-enforcement duties. The pilot, part of Youngkin’s “Right Help, Right Now” initiative, credentials hospital employees to escort people in crisis to a hospital in a way that doesn’t further agitate them, rather than relying on law enforcement.
Overall, the Marcus Alert system is the state’s best bet for reducing the chances that a behavioral health crisis will spiral out of control. Virginia must do what it takes to hasten the time when the system will be fully implemented and working as it should be. The next governor and legislature must continue to build on what has been started.