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This describes the steps you can take to help a friend or family member who is experiencing a psychiatric crisis and in need of help, primarily focusing on the civil commitment process in Virginia. A psychiatric crisis can include but is not limited to: suicidal or homicidal thinking and/or behavior, acute psychotic symptoms, increased drug or alcohol use, and sudden changes in mental status. The steps described in this guide progress from a person who is cooperative and voluntarily seeking help, to someone who is not seeking help on his or her own and may require mental health assistance via the civil commitment process. Please keep in mind that a psychiatric crisis and the commitment process, in particular, can be traumatic experiences for the individual. It is recommended to always encourage the individual to receive treatment voluntarily, as it will result in a better outcome for all involved. However, we know that at times seeking help through the commitment process is the safest course of action for the individual and his/her loved ones. 



The legal age of consent for hospitalization is 14 in Virginia. This means that if the individual is a minor between the ages of 14 and 18, he or she has the legal ability to voluntarily receive services, with or without parent consent, and will be asked to sign a consent form during the facility’s intake process. However, if the individual is younger than 14 years old, the processes of evaluation, admission and treatment are at the sole discretion of the parent(s)/guardian(s).




Commitment Hearing- a court process involving a special justice who hears evidence, and decides whether the person under consideration meets the criteria for involuntary commitment, and ultimately delivers the decision and plan that will be carried out by the CSB/BHA or other mental health care provider.


Community Services Board (CSB)/Behavioral Health Authority (BHA) Virginia’s publicly funded system of services for mental health, intellectual disability, and substance abuse. CSB/BHAs provide preadmission screening and crisis services 24hours per day, 7 days per week. Contact information is online and at the end of this guide.


Emergency Custody Order (ECO) a legal order by the court authorizing the law enforcement agency to take a person into custody for a mental health evaluation performed by a qualified mental health clinician through the local CSB/BHA.


Temporary Detention Order (TDO) a legal document requiring an individual to receive immediate hospitalization for further evaluation and stabilization, on an involuntary basis, until a commitment hearing can be arranged to determine their future treatment needs.


Magistrate a local, independent judicial officer who presides over hearings for minor criminal complaints and civil commitment cases. The magistrate is typically a lawyer.


Person/Individual under consideration the individual who is in crisis, the subject of the ECO, TDO, and/or commitment hearing.


Petitioner the individual who files or requests the ECO/TDO; this may also be the person under consideration, or a third party, such as a concerned family member, friend, neighbor, etc.


Psychiatric Crisis can include, but not limited to: suicidal or homicidal thinking and/or behavior, acute psychotic symptoms, increased drug/alcohol use, and sudden changes in mental status.


Special Justice the official who hears evidence during the commitment hearing, and decides whether the person under consideration meets the criteria for involuntary commitment, and delivers the decision and plan to be carried out by the CSB/BHA or other mental health care provider.                                   

Important Terms Defined

Guide to Psychiatric Crisis and Civil Commitment

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This information was taken from the NAMI Virginia website and does not constitute legal advice. NAMI Virginia tries to provide quality information but makes no claims, promises, or guarantees about the accuracy, completeness or adequacy of the information contained here. As legal advice must be tailored to the specific circumstances of each case, and laws are constantly changing, nothing provided herein should be used as a substitute for the advice of competent counsel.

This information was taken from the NAMI Virginia website and does not constitute legal advice. NAMI Virginia tries to provide quality information but makes no claims, promises, or guarantees about the accuracy, completeness or adequacy of the information contained here. As legal advice must be tailored to the specific circumstances of each case, and laws are constantly changing, nothing provided herein should be used as a substitute for the advice of competent counsel.