Crisis Services
Behavioral health emergencies can be scary and confusing. They can seem hopeless. But they don’t have to be. We’re here to help.
We provide a variety of crisis services for people experiencing behavioral health emergencies in the greater Fredericksburg area.
This guide is here to help you navigate crisis services, to understand when and how to seek help.
FAQ
What is a behavioral emergency?
A mental health emergency is a situation where someone’s behavior, feelings or actions could cause harm to themselves or someone else or leave them unable to care for themselves.
What are signs of a behavioral health crisis?
Sometimes it can be hard to know when something reaches the crisis level. We encourage you to reach out and talk with an emergency services therapist, 540-373-6876.
Some signs that a behavioral health problem is an emergency include:
- Thoughts of self-harm or suicide
- Thoughts of harming someone else
- Inability to complete daily tasks such as bathing, eating, brushing teeth, dressing
- Hallucinations or delusions
- Extreme withdrawal
- Verbal or physical abuse
- Rapid or extreme mood changes
- Inability to recognize friends, family or familiar locations
What should I do in a behavioral health crisis?
Call us at 540-373-6876. You can also visit our emergency services therapists in person weekdays from 8 a.m. to 5 p.m. at 700 Kenmore Avenue in Fredericksburg.
What happens when I visit RACSB's emergency services?
A compassionate clinician will assess your situation and connect you with resources that you need. The emergency services therapist will work with you to develop a plan that will keep you safe.
What if I have a loved one who refuses to seek help?
If there is an immediate need for help, call 911 and request a Crisis Intervention Team officer. Explain your situation calmly and clearly.
There may be a need for an Emergency Custody Order (ECO), which is a legal court order that authorizes law enforcement to take a person into custody for a mental health evaluation. When a person is under an ECO, an emergency services therapist will evaluate them.
Does a behavioral health crisis require hospitalization?
Not necessarily. Emergency services therapists will assess the risks of the situation to determine what level of care is needed for safety.
We offer crisis stabilization services at the Sunshine Lady House for Mental Health Wellness & Recovery. This 12-bed residential facility serves individuals experiencing acute psychiatric crisis or who need a safe place to withdraw from alcohol, opioids, and benzodiazepines. Services are provided by a multidisciplinary team of psychiatrists, counselors, nurses, qualified mental health providers and contracted healthcare professionals.
Sometimes, a person can safely stay at home with a safety plan and natural supports in place.
What if hospitalization is needed?
Sometimes, a person needs to receive intensive behavioral healthcare in a hospital. An emergency services therapist will be able to determine if this level of care is needed.
Hospitalization could be voluntary or involuntary.
National Alliance on Mental Illness says, “Voluntary admission is always preferable. The immediate outlook is brighter for the person who understands the necessity and benefit of hospitalization and is willing to participate in a treatment plan.”
An emergency services therapist will help connect you with an inpatient program if hospitalization is needed.
What if hospitalization is needed but the person isn't willing to go?
If there is a risk of serious harm, a person could be hospitalized against their will. This happens only when other options have been exhausted or are not available or suitable. This is a serious step that is only taken if a person is likely to cause serious harm to themselves or others in the near future.
The process starts with a Temporary Detention Order (TDO), which is a court order issued by a magistrate requiring a person to be hospitalized for up to 72 hours*. This allows time for a commitment hearing, which will determine if the person needs more inpatient treatment.
*However, if the order expires on a weekend, holiday, or other day the court is closed, it can be extended to the next day the court is open.
What are the criteria for a temporary detention order?
- The person has a mental illness
- The person is a danger to themselves or others due to their mental illness
- The person is unable or unwilling to consent to treatment or hospitalization
- The person needs treatment or hospitalization
What happens once a TDO is issued?
Once the TDO is issued, a police officer will serve the TDO, take the individual into custody, and transport them to the hospital.
During transportation to the hospital, police officers usually place the person in handcuffs.
The individual will remain in custody until a court hearing is held to determine if involuntary admission is necessary. The hearing is usually held within 72 hours.
At the hearing, the individual will be given the opportunity to apply for voluntary admission. The court will also consider the clinical opinions of an emergency services clinician and an independent examiner. The court will then decide if the individual needs further treatment and if so, if it can be provided voluntarily or through mandatory outpatient treatment.
What is the difference between an ECO and a TDO?
In Virginia, an Emergency Custody Order (ECO) is typically the first step in the process of a potential Temporary Detention Order (TDO), which is a court order that allows for involuntary detention of someone who may be mentally ill.
What is a commitment hearing?
A commitment hearing in Virginia is a court process that determines if a person meets the criteria for involuntary commitment to a mental health facility. A special justice presides over the hearing.
The invidual receives a court-appointed attorney for this hearing or they could choose their own legal representation.
The hearing could have a few outcomes:
- The petition for involuntary admission could be dismissed.
- The person could voluntarily admit themselves to the hospital, and if they choose to do so, they must stay at least three days.
- The person could be committed to the hospital for up to 30 days.
- The person could be mandated to receive outpatient services.
What is someone has a developmental disability and a behavioral health crisis?
Virginia offers crisis services for individuals with developmental disability through the REACH program.
Adult Crisis Line #(855) 917-8278 Adult REACH
Children’s Crisis Line #(888) 908-0486 Children’s REACH
Learn more about crisis services for individuals with developmental disabilities here.
Tips for De-escalation
Emotions can run high when you’re dealing with a person having a behavioral health crisis. But there are some things you can do to try and de-escalate the situation:
Be empathetic: Try to understand the other person’s point of view and show that you respect them. Express concern and support.
Stay calm: Use a calm voice and non-threatening body language.
Use non-threatening body language: Maintain a relaxed posture, use calm gestures, and avoid crossing your arms or making aggressive eye contact.
Be flexible: Adapt your approach based on what’s happening.
Be patient: Don’t argue or try to reason with the person.
Create a safe space: Respect the other person’s personal space and boundaries. Also reduce stimulation as much as possible from bright lights, loud sounds, etc.
Give the other person time: Allow them to think about the situation and set the pace of the interaction.
Offer choices: If possible, give the other person options for how you can help.
Be clear: Gently announce your actions in advance.
Sunshine Lady House
We offer crisis stabilization services at The Sunshine Lady House for Mental Health Wellness and Recovery. This 12-bed residential facility serves individuals experiencing acute psychiatric crisis or who need a safe place to withdraw from alcohol, opioids, and benzodiazepines.