Law enforcement continues to have problems with ECOs

HARRISONBURG, Va. (WHSV) - Around the Shenandoah Valley, law enforcement continues to deal with problems related to emergency custody orders when dealing with individuals in a mental health crisis. One of the biggest hurdles is a lack of open beds in state psychiatric hospitals.

An emergency custody order, or ECO, is when police take someone in crisis into custody because they may be a threat to themselves or others, but it is not an arrest.

After an initial evaluation period police take them to a hospital and stay with them for up to 72 hours while they wait to transfer them to a state facility if necessary, and that is where problems are arising.

“More times than not it takes the full 72 hours before a bed is made available and oftentimes, a bed is not available at which point we have to release the patient and let them walk out,” said Luray Police Chief C.S. “Bow” Cook.

These cases can put a strain on small police departments who have to take an officer off of patrol, sometimes for days, and have them monitor a patient who should be sent to a state facility.

“Another issue is most of the hospitals aren’t equipped for these types of patients whether they’re aggressive or deteriorating fairly quick. Just holding these patients in the hospital isn’t fair to the patient,” said Cook.

For state psychiatric facilities like Western State Hospital in Staunton, ECO patients are often unable to be admitted due to major understaffing.

“Our vacancy rates for the aids, who are the people on the floor working with the patients, it’s close to 60% vacancy. As you move down in the other positions, the LPNs (licensed practical nurse) we have a vacancy rate in the mid-40s, and for the RNs (registered nurse) we have vacancy rates around 30%,” said Dr. Jonathan Anderson, director of Western State Hospital.

The issue is occurring in state psychiatric hospitals across the commonwealth. One reason is that they’re losing employees to private hospitals.

“We’re losing a lot of RNs because the private hospitals have put a lot of their resources into salaries for RNs and it’s hard to compete against that so our staffing levels have gone down,” said Anderson.

Another broader problem is that there aren’t enough behavioral health professionals as it is.

“You don’t have enough psychiatrists. You don’t have enough psychologists. You don’t have enough licensed clinical social workers or counselors and part of that is because the jobs are dangerous and pay is not what it needs to be,” said 25th district State Senator Creigh Deeds.

Senator Deeds has spent years working to improve mental health resources in Virginia and hopes to continue to do so when the General Assembly takes up this year’s budget.

“I’ve got language in the budget, in the Senate version of the budget, to create more psychiatric residences in Virginia so we can train more people. I’ve also worked hard to increase funding for pay increases,” he said.

Stakeholders say one way to address the ongoing issues would be to increase funding to agencies like regional community service boards to provide more types of mental health resources, to hopefully limit the number of people in crisis.

“For rural Virginia, we need more funding. We don’t have the facilities that are in Northern Virginia and other places of facilities that you could go to for 24 hours, receive crisis care, and be released,” said New Market Police Chief Chris Rinker.

All of the officers in Rinker’s small department have been CIT trained (Crisis Intervention Team) which he said he believes has helped limit mental health crisis calls in New Market in recent years.

Police and community service boards have been working together to look for possible solutions because in many cases patients are being released without treatment once their 72 hour period of being held by police is up.

“Law only allows law enforcement to keep them in custody at the hospital for 72 hours, after that the patient is back on his own, and tragically things happen where the patient hurts themselves or doesn’t get the treatment he needs,” said Chief Cook.

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