Emergency Services provides 24-hour intervention for persons experiencing a mental health or substance use disorder related crisis. Licensed clinicians evaluate mental health and substance use disorder problems and provide help as needed over the phone or in person. 

Emergency Services responds to a variety of crises including stress, anxiety, depression, unusual thoughts or behaviors, thoughts about hurting one’s self or someone else, drug or alcohol problems, traumatic events and more.

In the case of a dangerous or life-threatening emergency, always call 911 immediately. 

To contact Emergency Services, call 703.746.3401 and ask to speak to an Emergency Services clinician. When calling after regular business hours, the call will be answered by an answering service and transferred immediately to an Emergency Services clinician.

Emergency Services responds to calls from individuals in crisis, family members, friends, professionals or other concerned individuals. When appropriate, clinicians can go to the location of a crisis within the City of Alexandria or offer a tele video evaluation..

Walk-in Emergency Services are available at 4850 Mark Center Drive, first floor, on Monday and Tuesday from 8 a.m. to 8 p.m., and Wednesday - Friday from 8 a.m. to 5 p.m. If staff are busy attending to other crises, there may be a wait, so it is helpful to call before coming when possible.

If someone calls with concerns about another person, the clinician will ask about the situation and how to contact the person of concern.  Individuals who call for themselves will be asked questions about the situation so that Emergency Services can decide how best to help. Sometimes talking to someone on the phone is enough.  Sometimes the Emergency Services clinician may ask that the caller to come to the CSB to talk in person, or would coordinate an evaluation in the community or a tele video meeting.  At other times the caller may be referred to another program or agency that can better meet the specific needs. 

If a person in crisis needs more support than is available in the community, the clinician might suggest going to the hospital and Emergency Services can make the necessary arrangements to facilitate admission. If the individual is under age 14, a parent or guardian must agree to hospitalization.  If the child is between the ages of 14 and 18, the child and the parent or guardian must agree. 

Emergency Custody Orders
An Emergency Custody Order or ECO can be issued by a magistrate or a law-enforcement officer if they believe that someone has a mental illness and there exists a substantial likelihood that, as a result of  the mental illness, the person will , in the near future , cause serious physical harm to self  or others or could suffer serious harm due to the lack of capacity to protect from harm or to provide for basic needs, and the individual is unwilling or incapable of volunteering for treatment. Under an ECO, an individual can be transported to the hospital to be evaluated by an Emergency Services clinician to determine the appropriate level of care.

When a TDO is Necessary
Sometimes the Emergency Services clinician believes that a person in crisis needs to be in a hospital to be safe, but the person does not agree or is unable to agree due to the severity of the crisis. In this situation, Emergency Services may request a Temporary Detention Order (TDO) from a City of Alexandria magistrate, which allows for involuntarily hospitalization of the person. Clinicians call the magistrate’s office to request a TDO, and if approved, the Alexandria Police will serve the order and take the person to the hospital.

Emergency Services obtains a TDO if, due to mental illness, there is a substantial likelihood that the person will cause serious harm to himself or others, or if the person could suffer serious harm due to lack of capacity to protect himself or provide for his basic needs. Clinicians consider all options for keeping a person safe before recommending hospitalization. 

Commitment Hearings 
Once admitted to the hospital by a TDO, the person remains there until a commitment hearing is held, which is usually within 72 hours.  Emergency Services will notify family members of the hearing.  Family members or significant others are encouraged to attend to provide support and speak before the judge. The person who has been hospitalized can bring an attorney or have one appointed by the court. 

The judge decides whether the individual will remain hospitalized or be discharged. The judge may allow the person to sign in to the hospital voluntarily; however; if the judge decides that ongoing hospitalization is necessary and the person will not agree to this, a commitment order is issued. The judge may also order mandatory outpatient treatment with monitoring by the CSB.  

Critical Incident Response Team
Emergency Services operates a Critical Incident Response Team that responds to small and large scale crises. The team consists of clinicians with different areas of specialization who are trained in crisis response.  They remain prepared to respond when groups of individuals are impacted by a critical incident.

Debriefing Following Traumatic Events
Emergency Services are not only for persons in crisis. The program also helps people to have healthy responses to traumatic events such as natural disasters, car accidents, a fire or a crime. Following a traumatic incident, a debriefing conversation with a therapist reduces the likelihood that mental health problems such as depression or post-traumatic stress disorder will occur in the future. Debriefing educates people about what to expect, such as difficulty sleeping, crying, agitation, reliving the event and loss of appetite, for how long these symptoms can be expected and when to seek additional help.

Cost of Emergency Services
The cost of services may be covered by Medicaid or by private insurance companies. If the person in need of services does not have insurance, fees will be arranged based on the person’s income. No one is denied services due to inability to pay. 

Eligibility
Emergency Services provides services to persons located in the City of Alexandria and will respond at locations within the City. Those who call to report a concern about someone else can call from any location; however, the person in need of assistance must be in the City of Alexandria.