FAQs - Mental Health

What are the criteria for a juvenile to be committed involuntarily for mental health treatment in Virginia?
A Juvenile Court judge may order the involuntary commitment of a minor to a mental health facility for treatment for a period not to exceed 90 days if the evidence shows, by clear and convincing evidence, that because of mental illness, the child (i) presents a serious danger to himself or others to the extent that severe or irremediable injury is likely to result, as evidenced by recent acts or threats or (ii) is experiencing a serious deterioration of his ability to care for himself in a developmentally age-appropriate manner, as evidenced by delusionary thinking or by a significant impairment of functioning in hydration, nutrition, self-protection, or self-control.

The Court must also determine that the minor is in need of compulsory treatment for a mental illness and is reasonably likely to benefit from the proposed treatment.

How does a parent petition the Juvenile Court for involuntary commitment of a juvenile for mental health services?
A petition for the involuntary commitment of a minor may be filed with the Juvenile and Domestic Relations District Court serving the jurisdiction in which the minor is located. The petition shall include the name and address of the petitioner and the minor and shall set forth in specific terms why the petitioner believes the minor meets the criteria for involuntary commitment.

I do not believe that my child needs to be involuntarily committed for mental health treatment. Does the Juvenile Court have jurisdiction to order local agencies to provide mental health treatment services for my child?
Under Virginia Code section 16.1-278, A Juvenile Court judge may order, after notice and opportunity to be heard, any state, county or municipal officer or employee or any governmental agency or other governmental institution to render only such information, assistance, services and cooperation as may be provided for by state or federal law or an ordinance of any city, county or town. The request to have the judge order such cooperation or services is initiated by a petition filed in the intake department of the Juvenile Court.

School officials are telling me that my child does not qualify for special education services, but rather my child's problems are related to mental health issues which are more appropriately addressed by community mental health services. Is my child prevented from getting special assistance in school for special education services?
This is a common dilemma faced by parents of special needs children. Each case should be reviewed carefully to determine whether or not a child is prevented from fully participating in the learning environment and obtain a meaningful educational benefit from the school curriculum due to mental health disorders. In such cases, children should be screened for eligibility for special education services as well as services within the community through the mental health services board or private providers. The primary criteria to determine special education services is whether the mental health disorder negatively impacts the child's ability to participate in the general curriculum at school. If so, the child may be eligible for special education services and also services through the local community services board.

I am the parent of a severely mentally ill child who requires residential treatment. I cannot afford to pay for residential care and my insurance will not cover the care required. I have been told that I must relinquish custody to the state Department of Social Services for residential services to be provided. I do not want to relinquish legal custody. Is this a legal requirement for state-funded residential treatment?
No, a parent is not legally required to give up legal custody as a prerequisite for state funding for residential treatment for severely mentally ill children. Such a suggestion raises serious constitutional and legal questions. If otherwise qualified, parents and children may legally access state and county agencies for appropriate mental health services without any requirement to relinquish or share legal custody with a state agency. If parents are told that they must relinquish legal custody, the parent should consult an attorney as soon as possible.

I am a therapist providing therapy to an adolescent patient. During the course of therapy, the patient has disclosed to me in confidence that she has been a victim of a criminal assault in the past by former friend. Am I obligated to report this fact to law-enforcement authorities or to the child's parents?
Unless provided otherwise in the therapy agreement with the child and the parents or a written confidentiality agreement or release with the child, there is no obligation on the part of the mental health provider to disclose this information to law-enforcement or the parent. However, if the event was an assault by a caretaker, a therapist in Virginia is a legally mandated reporter of child abuse and must report any suspicion of such abuse to the local child protective services agency. Whether or not there is a reporting requirement, therapists may help juvenile patients to appropriately disclose such information to parents if such a disclosure will be a therapeutic benefit to the child.

I am a psychologist who has been retained by parents in a custody dispute to conduct a forensic custody evaluation. Upon the completion of the evaluation, the parents followed my advice and entered into a consent custody order with the court. Later, the father asked if I would provide him therapy to help improve his parenting skills. Is this permissible?
Generally no. A mental health professional is ethically prohibited from acting both as an evaluator and as a therapist. These are distinct and separate roles with different confidentiality obligations to the parties. Under very exceptional circumstances with clear written releases and disclosures, this may be permitted. It is best to refer the father to another therapist. It is important to understand that custody cases may come back to court upon a showing of changed circumstances related to the best interests of the children. In a future modification issue, the forensic custody evaluator may be called to give court testimony.