Virginia’s Involuntary Commitment System Is Failing

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New Report by disAbility Law Center of Virginia Exposes Systemic Failures and Rights Violations in State’s Involuntary Commitment Process

Media Contact

Colleen Miller, Executive Director
Colleen.Miller@dLCV.org | (804) 225-2042

RICHMOND, VA — The disAbility Law Center of Virginia (dLCV) has released a comprehensive new report, “Between Custody and Care: The Flawed Involuntary Commitment System in Virginia,” detailing a traumatic and disorganized system that often prioritizes restraint over recovery. Based on a statewide survey of individuals who recently navigated the Emergency Custody Order (ECO) and Temporary Detention Order (TDO) processes, the findings reveal a systemic failure to protect the civil liberties of Virginians in mental health crisis.

Disturbing Trends in Custody and Restraint

The report highlights a “sprawling, complicated path” where thousands of Virginians must navigate a system that lacks instructions, clarity, and even basic data collection and assessment. Key findings include:

  • Routine Use of Restraints: Rather than being used as a last resort, handcuffs and physical restraints appear to be routine practice.
  • Prolonged Restraint: Individuals reported remaining handcuffed for hours or even days while in police custody.
  • Lack of Accommodation: People with physical and developmental disabilities reported a significant lack of effective communication and accommodation, particularly from law enforcement. One deaf individual reported being handcuffed to a bed, despite it preventing them from using sign language to communicate.

A Breakdown of Due Process

The survey results suggest that most Virginians entering this process are never properly informed of their rights.

  • Voluntary Admission Denied: 65% of respondents who met with a pre-screener reported that the option of voluntary hospitalization was never discussed.
  • Legal Representation Failures: Respondents’ extreme dissatisfaction with their court-appointed attorneys, describing them as “rubber stamps” or “just there as a formality”.
  • Inaccessible Appeals: While individuals under a TDO have a legal right to appeal, the process is frequently inaccessible due to sedation, misinformation, or the inability to contact their attorneys. Only one out of 79 respondents successfully appealed their commitment.



“I felt left out of the process, even though I was an integral part of it.”

— S., Survey Respondent

Urgent Recommendations for Reform

To transition from a system of control to a system of care, dLCV recommends the following systemic actions:

  1. Statewide Restraint Standards: Amend the Virginia code to limit handcuffs and restraints to true emergencies involving real and imminent danger.
  2. Mandatory Training: Require initial and periodic training for law enforcement, pre-screeners, and attorneys on disability rights, accessibility, and accommodations.
  3. Plain-Language Materials: Develop protocols to ensure patients are adequately informed of the process and their right to appeal using accessible, plain-language formats.
  4. Improved Data Collection: Require state agencies to track and report data on the use of “paperless” ECOs and the duration and type of restraints used during the process.



“These findings show that restraints, lack of information, and exclusion from decision-making are not isolated incidents but patterns that strip people of autonomy and deepen trauma,” the report concludes.

About the disAbility Law Center of Virginia (dLCV):

The dLCV is the Commonwealth’s Protection and Advocacy Program, tasked with providing a wide range of services to Virginians with disabilities. dLCV’s is to advance independence, choice and self-determination; protect legal, human and civil rights; and eliminate abuse, neglect and discrimination of people with disabilities through zealous and uncompromising legal advocacy and representation.

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