The role of mental health crises in crime has Charlottesville city officials looking to create changes to how fire, medical and police respond to a crisis, but they say it won’t happen overnight.
The system would follow the Marcus Alert framework signed into law by former Virginia Governor Ralph Northam in December 2020. The system is a statewide framework intended to improve the response to mental and behavioral health crises in Virginia. Marcus Alert is designed to enhance services for people experiencing a crisis related to mental health, substance use, or developmental disability. It coordinates the local 911 center and regional crisis call centers while establishing a specialized behavioral health response from law enforcement responding to a behavioral health situation.
The bill was named for Marcus-David Peters, a Black man who was shot and killed by Richmond police in 2018 while having a mental health crisis. The city will be required to implement a Marcus Alert program by July 2026.
Charlottesville is also working to be in compliance with the National Suicide Hotline Designation Act of 2020 by creating a suicide prevention hotline and response effort by July.
Sonny Saxton, executive director of the Charlottesville-UVA-Albemarle County Emergency Communications Center, presented a report about the Marcus Alert to City Council during its Monday work session.
The center is the consolidated regional 911 dispatch center that connects fire, police and EMS. Currently, the center is working on implementing the Marcus Alert system through several programs, including the 988 suicide hotline program.
“What’s striking to me is that 10% of American adults will suffer from a depressive illness,” Saxton said, noting that they include major depression, bipolar disorder and dysthymia. “The time has long passed for us to start handling mental health emergencies effectively.”
This is why a thoughtfully implemented approach to mental health emergency response is necessary, Saxton said.
“Marcus Alert seeks to divert individuals needing behavioral health care from the criminal justice system,” Saxton said.
The goal of both the 988 hotline and Marcus Alert system is there will be “no wrong door,” Saxton said. There is an FCC mandate for the 988 hotline beyond the Virginia law. Telephone companies must set up 988 by July 2022.
Saxton said the goal is to create a set-up so that whether someone calls 988, 911 or a local hotline, the person gets connected with the correct mental health responders.
The program would be similar to existing dispatch protocols much like 911 emergency call creates a response from an ambulance or fire vehicle with transportation to an emergency department and relocation to an inpatient unit.
The model for behavioral or mental health response that parallels this would begin with a call to a crisis call center and response from a mobile crisis team, if the crisis can’t be resolved on the phone. A 23-hour stabilization period would follow for the person in crisis and then short-term inpatient stabilization, if required.
Saxton said the goal is to start implementing the program in July 2022. The state may provide support and require some localities to fully implement a Marcus Alert program in the next few months, Saxton said.
Currently five localities have been required to implement first and second steps in the program as pilot programs.
“I liken many of these things to when 911 was beginning. It took many steps and new technology to implement it. We’re going to see something similar to this,” Saxton said. “We’re likely not going to see a hard press on 988 until January 2023. Locally, the protocols are still in development. These things are going to take time.”
In the meantime, Saxton said Region 10 is working on a crisis response hub. Saxton said the Charlottesville region is not behind with the program but he said it is a large undertaking.
“There’s no lack of people who are intentional about this work. The staffing restraints are there. Our emergency departments may not be able to handle the load. These are tall orders,” Saxton said.
Councilor Michael Payne voiced his desire to be selected by the state as a Marcus Alert pilot program locality.
“We need to do anything we can as a City Council, a local government to support this,” Payne said.