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In Arlington and across the state, hospital emergency rooms are filling up with people in mental health crises, often handcuffed to gurneys and attended by law enforcement officers.
People in these situations can’t walk around, save to go to the bathroom, and they can’t see their families. They may be calm or exhibiting aggressive behaviors; they might be hearing voices or may not have eaten in days because they believe their food is poisoned.
Whatever the case, they are in the emergency room because local clinicians determined they are a danger to themselves or others or unable to care for themselves, and need to be treated by specialized staff in a hospital.
Magistrates placed them under the civil custody of law enforcement officers, who have to stay with them until ER nurses can conduct a basic physical exam and clear them to go to that hospital’s behavioral health ward, where they will receive additional treatment.
That is how it should work.
But a statewide shortage of adult psychiatric beds means people in crisis — and under either an eight-hour emergency custody orders (ECOs) or 72-hour temporary detention orders (TDOs) — could wait hours under the eye of law enforcement for medical clearance while local social workers call every hospital in the state searching for beds. Once beds are located, police will drive their charges there — sometimes up to five hours away.
The shortage is straining Virginia’s mental health care system, which is held up by dwindling ranks of under-resourced clinicians, nurses and law enforcement working overtime.
“You do wonder, how much is this helping this person as opposed to hurting someone?” said police officer James Herring, who is running for Arlington County Sheriff. “This ‘help’ feels very, ‘One Flew Over the Cuckoo’s Nest.’ That’s not what any of us wants, but it’s the way the system has evolved.”
The current crisis is a result of the state’s decision in 2021 to close most state psychiatric hospitals, which were understaffed due to low wages, hazardous working conditions and Covid. This took some 260 psychiatric beds offline, resulting in people across the state being diverted to remaining state facilities, including Northern Virginia Mental Health Institute, where many Arlington patients go.
The bed shortage has prompted Arlington County law enforcement agencies, the Dept. of Human Services and Community Services Board and VHC Health — the new name of Virginia Hospital Center — to work together to move away from a system that they say causes trauma and pulls officers away from important duties and toward a community-based continuum of care.
Just yesterday (Tuesday), VHC announced it will be building a facility dedicated to behavioral health at its former urgent care facility at 601 S. Carlin Springs Road.
“The crisis with the state hospital beds has forced us, locally and regionally, to bust our butt to come up with [ways to] help people who are in crisis,” says Deborah Warren, the executive director of the Arlington Community Services Board and the DHS Deputy Director.
Other events threw these systemic issues into relief, too, Warren says. The Richmond police shooting of Marcus-David Peters, who was having a psychotic episode, demonstrated the risk of police responding to a behavioral health problem while pandemic-era isolation has made mental illnesses more acute.
“It’s true for every population and age band,” Warren said. “People aren’t doing well, post-pandemic… Anybody can go into a behavioral health crisis… It’s neurotypical people who are overwhelmed and overrun with feelings of anxiety and depression… People are more self-destructive. It’s gut-wrenching.”
Last year, the Virginia legislature directed the state Dept. of Behavioral Health and Developmental Services to discuss alternatives to police transportation, with stakeholders that included Arlington police, says ACPD spokeswoman Ashley Savage. The workgroup came up with the idea for the Prompt Placement Task Force, which brings together government agencies, public and private hospitals, law enforcement and community partners to address the crisis.
Gov. Glenn Youngkin announced the creation of this task force, of which Warren is a member, in December 2022. The goal is to come up with solutions that could be enacted this legislative session.
But the problem won’t get better until every locality has more services upstream, said state Sen. Barbara Favola, who noted Arlington has “more community-based care than most parts of the state.”
“Virginia has more people in psych beds than need to be there because we don’t have a community-based network to release them into care,” she said.
Getting by
Historically, Virginia mostly funded state facilities and wealthy jurisdictions in Northern Virginia, like Arlington County, applied local tax dollars to their community services boards, explains Warren. But as evidenced by the current crisis, even Arlington has room to improve.
“We have a long way to go, and the state has a long way to go,” she said.
VHC Health could break ground on a new mental health and rehabilitation facility at its old urgent care facility on S. Carlin Springs Road as soon as this year.
Arlington County and VHC Health — the new name of Virginia Hospital Center — announced a joint agreement this afternoon to expand behavioral health and rehab services through the proposed project at 601 S. Carlin Springs Road.
The new facility would have 72 beds dedicated to mental health and substance use recovery. This consists of a 24-bed adult unit, a 24-bed youth unit, a 24-bed “recovery and wellness unit” and five outpatient programs, according to a county announcement.
It will have 40 beds set aside for people with brain and spinal cord injuries, those recovering from strokes and those with neurological and other conditions. Currently, the main VHC campus has 20 beds for patients with these needs.
“We are grateful for our continued partnership with VHC Health in developing facilities to meet the healthcare needs of the Arlington community,” County Board Chair Christian Dorsey said in a statement. “With the growing demand, mental health services continue to be a priority. We remain committed to expanding capacity and offering services and support for individuals experiencing behavioral health challenges and their families.”
The chair of the VHC Health Board of Directors, Dr. Russell E. McWey, said this expansion of mental health services “has been a long-time priority for the Board and for VHC Health.”
“The Board is pleased to continue serving our community and to champion this facility and advocate for those who are in need in and around Arlington County,” he said in his statement.
The new S. Carlin Springs Road facility will house five programs: intensive outpatient programs for adults and children, a recovery and wellness intensive outpatient program, an adult partial hospitalization program and an outpatient behavioral health clinic.
VHC had originally intended to add a behavioral health unit to its main campus expansion, Deborah Warren, the executive director of the Arlington Community Services Board and the DHS Deputy Director, told ARLnow. Now, per the announcement, the hospital will instead build a 14-bed geriatric behavioral health unit.
The expansion comes as Arlington, Northern Virginia and Commonwealth as a whole are seeing two trends: deepening mental health needs and greater competition for limited healthcare resources.
Advocates have called the current state of mental health care in Virginia a crisis, one prompted by the state’s decision in 2021 to close most state psychiatric hospitals, which were understaffed due to low wages, hazardous working conditions and Covid.
The closures created a bottleneck at remaining facilities and forced private hospitals, including Virginia Hospital Center, to take in more patients. Sometimes, patients are brought to the hospital by law enforcement, and until they are able to be treated, are left to wait in the emergency room — handcuffed to a gurney under the watch of a law enforcement officer. This situation has contributed to burnout for county social workers and police officers.
In response, Virginia Gov. Glenn Youngkin announced late last year the formation of a task force to come up with ways to remove law enforcement from this process and ensure people get the help they need. VHC Health CEO and President Chris Lane lauded this move in today’s statement.
“VHC Health applauds the Governor and the General Assembly for their commitment to addressing Virginia’s behavioral health crisis and this joint venture will contribute to the Commonwealth’s objective of treating behavioral wellness,” Lane said. Read More
Update at 3:05 p.m. — Numerous small, scattered outages have been reported around Arlington. The number of Dominion customers in the dark is now down to just over 800, with the larger earlier outage since largely resolved.
Earlier: Today’s frigid wind storm is just getting underway — complete with a recent bout of snow flurries — but many are already without power in Arlington.
As of 10 a.m., more than 1,500 Dominion customers are in the cold, according to the power company’s website.
The following outages were reported on Dominion’s map.
- 718 customers, in Penrose and Lyon Park
- 715 customers, between Ballston and Westover
- 114 customers, in Glebewood
- At least two smaller outages in Bellevue Forest and Ashton Heights
The Penrose outage has closed Arlington’s Dept. of Human Services offices at Sequoia Plaza, the county announced this morning.
DHS is closed today. Due to a power outage at Sequoia Plaza, Dept. of Human Services offices are closed today. Client appts will be rescheduled. Sorry for the inconvenience. @ArlingtonVA
— Arlington County Department of Human Services (@ArlingtonDHS) December 23, 2022
“Dominion Energy continues to closely monitor the extremely cold, windy weather and its potential to impact our Virginia and North Carolina service territory,” the company said in a statement today. “Our crews are positioned and ready to respond to any damage or power outages that may be caused as a result of the ice storm.”
“If you experience a power outage, please make sure you report it to Dominion Energy immediately,” the company added. “Please stay at least 30 feet away from all downed wires and damaged equipment. If you need to report an emergency or a downed wire, please call us at 1-866-DOM-HELP (1-866-366-4357)… We appreciate your patience.”
The county is under both a Wind Advisory and a Wind Chill Advisory today. More outages are possible throughout the day, with 50 mph wind gusts expected.
A non-profit is teaming up with the county and schools to provide food assistance to students when classes start up again next week.
Food for Neighbors (FFN), the Department of Human Services (DHS), and Arlington Public Schools (APS) have announced a partnership where food, toiletries, and grocery gift cards will be collected and distributed to students in need on a weekly basis.
The Herndon-based Food for Neighbors has been partnering with Fairfax County and Loudoun County schools for the last five years, but the 2022-2023 school year will be the first working with APS.
FFN will work with students at three high schools initially — Wakefield High School, Arlington Community High School, and the Arlington Career Center — when classes start for the year this coming Monday (Aug. 29).
Renee Maxwell, Community Liaison for FFN, told ARLnow that a “rough estimate is that we’ll be providing consistent, regular support to 200-300 students” to start out. FFN works with the schools and staff to identify the students who are most in need.
The hope, though, is to expand to help more students at more schools soon.
“We’re thrilled to be working with the Arlington County Department of Human Services to bring our programming to Arlington Public Schools,” FFN founder and executive director Karen Joseph said in a press release. “Arlington is a highly diverse, vibrant area, and the expansion provides the opportunity for us to learn about and respond to the needs in the community, so that we may help even more students facing food insecurity.”
The main way FFN collects and distributes items is through its “Red Bag Program.”
That’s where volunteers shop for shelf-stable items, leave them in an FFN-supplied red bag on their doorstep, and other volunteers come pick it up, sort the food, and distribute it to local schools that same day.
The day-long collection event happens five times a school year. The first one to include Arlington is set to happen on October 29. Those who would like to volunteer to donate items are being asked to sign up “well ahead of time.”
Over 1,700 food donors and about 1,200 volunteers have signed up to help across Northern Virginia so far, per a press release.
FFN also provides shelving and cabinets to schools to store the extra food, as well as grocery gift cards and holiday meals.
During the 2021-2022 school year, FFN provided more than 88,000 pounds of food and toiletries to Fairfax and Loudoun County schools. Additionally, more than $105,000 in grocery gift cards were also donated so that students could have access to fresh fruits, vegetables, meats, and other perishables.
Food insecurity continues to be a major challenge in Arlington and across the region. Nearly 8% of Arlingtonians experienced food security recently, according to a report that was released earlier this year.
The rates were particularly high in certain neighborhoods including Glencarlyn, Buckingham, Ashton Heights, Pentagon City, Crystal City, Forest Glen, and Arlington Mill. All three of these high schools that will be served by FFN this coming year have students from these neighborhoods.
What’s more, the federal government ended the free meal program for all students earlier this summer. While students at several county elementary schools will still be able to receive free meals under the Community Eligibility Provision, the sunsetting of free meals nationally could leave some students wondering where their next meal might come from.
The hope is that Food for Neighbors could help fill some of those gaps.
“Through my previous work in Fairfax County, I have seen how influential a partnership with Food For Neighbors can be to address food security for middle and high school students,” DHS Food Security Coordinator Stephanie Hopkins said in a press release. “I know that Arlington community members have a very giving spirit, and I’m confident that they will come through to support the Red Bag Program by donating food and hands-on support.”
What can we do to help those in our community who are experiencing homelessness is a question Triina Van gets a lot.
Van has been Homeless Services Coordinator at Arlington County’s Department of Human Services for about a year and a half. But she has more than two decades of experience working in the field and thinking about this very question.
It’s a difficult one to answer, she says, because the issue of homelessness is “an incredibly complex one.”
ARLnow spoke with Van about how people can help, common misconceptions about those experiencing homelessness, and where people can turn if they need help.
This interview has been edited and condensed for clarity.
What are some of the most common reasons that people in our community experience homelessness?
I’d attribute that to a lot of different reasons. It’s compounded by issues of lack of affordable housing, rents increasing during lease renewals, and challenges associated with not having incomes that can really sustain the cost of living in our community. It can also certainly be compounded by mental health challenges and family violence. There’s also the much deeper systemic roots… woven into our systems with the historical context of our housing policies and how this country has been stood up.
They all contribute to housing loss, housing instability and homelessness.
You noted two different terms there — housing instability and homelessness — what’s the difference?
Yeah, generally when we speak about housing instability, we’re talking about folks who are at risk of experiencing homelessness. That could mean they are contributing over 30%, 40% of their monthly income to rent. Maybe they’re doubled up, living with other families and households to try to make ends meet.
When I’m speaking about homelessness, I’m really talking about people who are sleeping outside, sleeping in emergency shelters.
I think housing instability is a less visible challenge. Arlington is not alone, it’s a nationwide crisis. When they are challenged with this, people often turn to their networks of support like family, friends, congregations, and other communities of faith for assistance.
When people are facing house instability or are experiencing homelessness and need help beyond these networks, where can they turn?
If someone is experiencing homelessness or if you know someone who’s experiencing homelessness, you can call what we call the “1010 line” — that’s 703-228-1010. That’s our main shelter line and can reach someone 24/7, 365 days a year. It’s operated by the Community Assistance Bureau during normal business hours, but we also know homelessness can happen any time of the day. So, it’s also staffed by one of three shelter providers in Arlington who rotate that coverage throughout the non-business hours, overnight, and weekends.
That’s an immediate first step folks can take.
So, what happens after that first phone call?
Staff will complete an assessment to understand the different circumstances people are facing. They’ll look for creative solutions that can help people stay in their housing or find another option that prevents them from entering the homelessness system.
Sometimes, that could be providing temporary financial assistance or maybe negotiation with a landlord to try to prevent an eviction from happening. It could also be more long-term assistance depending on the personal family’s needs. It could also be helping find a new apartment. And, sometimes, people just need a security deposit or first month’s rent.
If the staff can’t assist directly, they have a deep knowledge of other community resources and can help people connect to other options.
Update at 4 p.m. on 3/15/22 — President Joe Biden has signed a $1.5 trillion spending bill with funding for three projects in Arlington.
In the 10 months it took for the funding to pass, Arlington County substantially completed two of the projects: repaving parts of the Bluemont Junction Trail and replacing a pedestrian bridge in Glencarlyn Park.
The county moved forward with them in the interim due to safety concerns and the uncertain nature of federal funding, Department of Parks and Recreation spokeswoman Susan Kalish told ARLnow on Tuesday.
The funding will pay for any remaining work and Rep. Don Beyer (D-Va.) is considering how to repurpose any unspent funds on similar projects, she said.
Earlier: A $1.5 trillion spending bill that cleared Congress on Friday has funding for three projects in Arlington.
The bill includes $13.6 billion in emergency aid for Ukraine’s fight against Russia and will fund the federal government through September, avoiding an impending government shutdown. Now the 2,741-page bill is headed to the desk of President Joe Biden, who is expected to sign it this week.
The bill also sends Arlington County more than $1.4 million to pay for a health initiative and two parks projects, for which Rep. Don Beyer (D-Va.) requested federal assistance last May. In total, the spending package has $5.4 million earmarked for 10 projects in Northern Virginia, at Beyer’s request.
“This funding will translate to significant, beneficial projects in Arlington, Alexandria, Falls Church and Fairfax County,” he said in a statement on Friday. “I am thankful to my colleagues who enacted the legislation to fund these initiatives, and to the local leaders who worked with me to identify and develop the initial requests. These projects will make a real, positive difference in our region.”
Arlington County’s Department of Human Services is getting $390,000 to purchase two medically equipped vehicles for a forthcoming mobile crisis response team. While not yet in existence, the team will be responsible for responding to behavioral health crises and providing on-site treatment.
The team was a recommendation of the Police Practices Group, which identified about 100 ways policing could be reformed in Arlington, including some ways the county could remove police officers from its mental health crisis response.
The county earmarked $574,000 in the current budget to staff the team with a physician’s assistant, nurse and clinician, and to buy a transport van and operating supplies.
DHS spokesman Kurt Larrick says the vehicles will be purchased once the County Board officially accepts and allocates the federal funding, which will take a couple of months. The mobile crisis response team, meanwhile, is “not up and running yet,” he said.
“County residents do have access to Community Regional Crisis Response services, however, which is a mobile crisis response,” he said. “And our Emergency Services staff can and do go into the community when need arises and staffing allows.”
The county will receive $325,000 to fund repaving and repairs for a segment of the Bluemont Junction Trail and adjacent connector paths. A 2018 trails assessment determined the Bluemont Junction Trail needed significant investments, as the condition of the asphalt is deteriorating in many sections.
The section paid for by the federal government spans the intersection of N. George Mason Drive and Wilson Blvd to the intersection of the trail with the Washington & Old Dominion Trail.
This project is divided into two phases, according to the county. The first phase, completed late last year, updated the main trail and most of its connecting paths. The second phase will update three remaining trail connectors, which need to be realigned to be compliant with the Americans with Disabilities Act. Phase two construction is expected to begin and end this spring and early summer.
Arlington budgeted $550,000 in its 2022-24 Capital Improvements Plan for the project.
The county will also receive $800,000 for the replacement of a pedestrian bridge in Glencarlyn Park. The bridge, lost during the July 2019 flash flooding, was recently installed. The project was part of the adopted 2021 Capital Improvements Plan.
Outside of Arlington, local earmarks in the bill will support storm sewer and climate resilience improvements in the City of Alexandria and Falls Church City and improve information technology services in Fairfax County. It will also support a pilot program for the deployment of body-worn cameras in the Alexandria Police Department and safety improvements to the GW Parkway.
Arlington County is developing an alert system aimed at improving its emergency response to behavioral health crises.
The aim of the system, dubbed the Marcus Alert, is to keep people in crisis — due to a mental illness, substance use disorder or intellectual and developmental disabilities — from being arrested and booked in jail.
It comes from the Marcus-David Peters Act, which was signed into law in late 2020 and is named for Marcus-David Peters, a 24-year-old biology teacher who was killed by a police officer in 2018 while experiencing a mental health crisis.
Once operational, the system would transfer people who call 911 or 988 — a new national suicide and mental health crisis hotline — to a regional call center where staff determine whether to de-escalate the situation over the phone, dispatch a mobile crisis unit or send specially trained law enforcement.
Last summer, Arlington began developing its Marcus Alert plan, a draft of which needs to be submitted to the state by May 22. It’s asking residents to share their experiences with the county’s current behavioral health crisis response via an anonymous and voluntary survey open through mid-March.
Locals can also email the county to sign up to participate in focus groups, which will convene in early- to mid-March.
State law requires that the county’s final plan be implemented by July 1.
“We are hopeful that with the Marcus Alert and increased community outreach and co-response, we will see a reduction in arrests of people with [serious mental illnesses],” Suzanne Somerville, the bureau director of residential and specialized clinical services for Arlington’s Department of Human Services, tells ARLnow. “The system is tremendously strained at this time and hospitalization for people that need it for psychiatric symptoms is not always easy to attain.”
DHS attributes the strain to COVID-19 and a lack of beds in state-run mental hospitals after the Commonwealth closed more than half of these hospitals to new admissions amid its own workforce crisis. This overwhelmed local hospitals and the Arlington County Police Department, and drove fatigued DHS clinicians and Arlington police officers to quit.
“Everyone is trying to do the right thing and get the client the services they need and deserve and we just don’t have the resources currently,” said Aubrey Graham, the behavioral health program manager for the Arlington County jail.
Bed shortages also impact court hearings, as many inmates with mental illnesses require competency restoration services to understand court proceedings and work with their defense attorney. Graham says inmates must go to Virginia Department of Behavioral Health and Developmental Services state hospitals, which limits beds even more.
Compared to other jurisdictions, Arlington sends proportionately more people to Western State Hospital for competency restoration, per data ARLnow requested from DBHDS. It also saw the greatest increase in admission rates between 2020 and 2021.
Graham says she doesn’t know of any studies that explain why Arlington sees so many individuals with serious mental illnesses, but geography plays a role, as about 70% of people sent to state hospitals come from D.C., Maryland and other parts of Virginia. Only about 30% of those sent to state hospitals from Arlington are actually Arlington residents.
“Although there are a high number of competency evaluations requested in Arlington courts, the referrals are entirely appropriate, and most are deemed incompetent to stand trial,” Graham said.
That’s why police should not arrest them in the first place, says Chief Public Defender Brad Haywood, adding that people with mental illnesses are over-represented in the county jail, which is seeing a continued inmate deaths and may not have the resources to treat the needs of the mentally ill.
A local pilot program to give up to 200 qualifying low-income residents $500 a month for two years, no strings attached, will move forward without any public funding.
For a few months last fall, Arlington County was poised to spend either federal or county money on “Arlington’s Guarantee,” a guaranteed income pilot program launched by nonprofit Arlington Community Foundation.
This commitment fell through, however, when the county and ACF realized any infusion of public funding would have put participants at risk of losing their government benefits, such as child care subsidies or food stamps.
“It would put them back instead of putting them forward,” says Anne Vor der Bruegge, ACF’s Director of Grants and Initiatives.
She and Department of Human Services spokesman Kurt Larrick call this income precipice the “benefits cliff.” The little additional income would make the fall particularly painful in Arlington given its high cost of living.
“The issue was that in order to give money to recipients and then not push them off the benefits cliff — where, for example, they lose SNAP because they make too much income — and to make the net effect of receiving the cash zero, we had to get a waiver from the Virginia Department of Social Services (VDSS),” Larrick said.
He added that with the waiver, the monthly stipend “would not count as income in the calculation of benefits, and no one who joined the program would lose benefits by being ‘over income.'”
But this waiver only works if the program is 100% privately funded. Last year, the county and ACF learned that neither the county’s original plan to use American Rescue Plan Act funding nor its revised plan to use unspent funds from the 2021 fiscal year would have worked.
“The County decided to rescind the plan to give ARPA money so as to not negatively impact the recipients,” he said. “Using closeout funds would have created the same issue.”
ACF’s wide donor base ensures this loss of funding won’t impact the program’s trajectory, says Vor der Bruegge, but it may slow it down slightly.
“We had intended all along for it to be privately funded from the get-go: that is, through individual people, philanthropic organizations and corporate dollars,” she said, adding that the ARPA funding “evolved as an opportunity we didn’t plan for or seek out.”
County contributions would have allowed ACF to enroll all 200 participants immediately, she says. Now, ACF will resume its plan to continue accepting donations until it reaches 200 participants.
So far, 105 residents are receiving money directly onto debit cards through the program. ACF will continue expanding enrollment in groups of 25, as funding becomes available, up to 200 people. Donations benefit participants directly, says Vor der Bruegge, as ACF obtained a grant to cover the program’s operating costs.
The “benefits cliff” issue is not exclusive to Arlington.
Vor der Bruegge says it hurt nascent guaranteed income programs across the state and nation that were counting on ARPA funding, she said. These programs are proliferating right now because federal stimulus checks normalized the idea of automatic payments to residents — and many were latching onto ARPA funding.
Now, they’re having to “go back to the drawing board,” she said, adding that some states are introducing legislation to override this unintended consequence.
“It is pretty prevalent across the country,” she said.
After Republican victories in Virginia last Tuesday, Arlington’s Democratic state legislators say their focus is preserving policy gains they made over the last few years.
Last week, Virginians elected Glenn Youngkin as Governor, Winsome Sears as Lieutenant Governor and Jason Miyares as Attorney General. Despite a slight shift right, Arlington overwhelmingly elected and re-elected all Democrat lawmakers.
Control of the Virginia House of Delegates also appears to shifting to the GOP, pending the outcome of two potential recounts.
“My top priorities are defense, defense and defense,” Rep. Rip Sullivan (D-48) told County Board members yesterday afternoon. “In light of last Tuesday, there are a lot of things that I’ll be interested in making sure we can preserve, in terms of things that have been accomplished over the last couple of years.”
County Board members met Tuesday with state lawmakers to outline the Board’s priorities for the upcoming legislative session — such as vehicle noise enforcement and virtual government meetings — and hear what legislators are focused on.
Among House representatives and state senators, there was an emphasis on preserving work done under outgoing Gov. Ralph Northam.
“In terms of playing defense, as whip for the House Democratic caucus, we are going to be incredibly vigilant in making sure that all of the progress we’ve made [is] not whittled away at the 11th hour, 59th minute, at 7 a.m. subcommittee meetings — that we are casting a very bright light on all the actions taken on the House floor so there’s a very clear record at the end of this long session that people know what they voted for,” said Del. Alfonso Lopez (D-49).
Looking to inject some optimism into the conversation, Board Member Christian Dorsey asked what areas could see bipartisan support. Legislators predicted bridging the aisle to reduce medical debt, expand broadband access, support small businesses, incentivize community college for in-demand jobs, fund mental health services and increase teacher pay.
More locally, the County Board and their state representatives had a number of overlapping priorities: allowing electronic meetings post-pandemic; improving access to childcare; firming up the rights of affordable housing tenants; and committing to environmental sustainability initiatives and teacher pay raises.
Top of mind for County Board members, however, is what they describe as an ongoing behavioral health crisis caused by the closure of most state psychiatric hospitals this summer and exacerbated by police and mental health services workforce shortages. The Board and county staff made the case for more state funding for community-based mental health services.
“This is very time sensitive and very important as we try to serve those most in need in Arlington,” Board Chair Matt de Ferranti said.
Without sufficient state beds to which to bring people in crisis, police have to detain people against their will in emergency rooms for multiple days while staff in the Department of Human Services make calls around the clock, searching for beds.
“They have no privacy, they’re in police custody day after day,” Arlington County Police Department Capt. Michael Rowling said. “I can’t imagine they’re getting better — they’re not getting treatment whatsoever.”
On a daily basis there are five to 10 individuals attended by police officers in the emergency department of Virginia Hospital Center waiting for a mental health bed, Human Services Deputy Director Deborah Warren said.
“It’s inhumane,” she said. “On the worst day of their lives, [people in crisis] are handcuffed to a gurney, under police supervision, agitated and maybe getting sedation.”
(Updated at 11:35 a.m.) Dozens of Arlington residents are now receiving a supplemental income through a new pilot program.
The nonprofit Arlington Community Foundation, which oversees the outreach, will unconditionally give $500 a month to 200 low-income households for two years. Fifty have been enrolled so far, chosen at random from current Arlington County housing grant recipients.
“This new initiative equips families with funds that can be used for whatever is needed most in real time — paying off debt, pursuing education or employment goals, college savings for kids, or allowing parents more time with their children and less time away from home in a second job,” the foundation said in a news release.
Housing grants from Arlington’s Department of Human Services, part of the criteria for eligibility for the pilot program, are restricted to two-person households earning $43,860 or less, three-person households earning $49,343 or less, and four-person households earning $54,825 or less.
The foundation says the pilot further restricts participants to those at or below 30% of the area median income, which is $38,700 for a family of four.
“One participant, a single mother who works full time, says this assistance will give her the much needed breathing room to finish her GED and attend nursing school,” the foundation says.
The county partnered with the foundation for the initiative, dubbed Arlington’s Guarantee. Participants will have access to one-on-one coaching, and a team of experts will be monitoring participants’ health, wellbeing and financial stability.
People can donate to the fund covering the pilot, which the foundation sees as a resource for future policy outreach and philanthropy.
“Arlington’s Guarantee is an opportunity for donors to support a pilot that holistically and unconditionally promotes power, dignity and belonging for families in Arlington,” the foundation said. All administrative costs have been covered by a grant from the Kresge Foundation, so 100% of what is contributed to this fund will go directly into the hands of people in our community who need it.”
More from the press release:
24,700 people, or about 10,000 households in Arlington, make under 30% of the area median income (AMI), or $38,700 for a family of four. These working low income families rely on a combination of earned income, public benefits, and community support to survive. With even a minor rise in earnings, these families can lose their eligibility for subsidies for health care, food, child care, transportation, and housing, meaning the worker has to refuse raises and promotions that could ultimately leave their family worse off. Arlington’s Guarantee has secured local and state agency commitments to ensure the monthly cash payments do not affect benefits and subsidies eligibility. In addition to $500/month and protection from benefits loss, Arlington Guarantee supports the participants with access to trained mobility teams and one-on-one coaching.
Similar tests of Universal Basic Income-like programs — though more targeted and on a smaller scale than UBI — have been rolling out elsewhere in the D.C. area and across the country. In nearby Alexandria, the city plans to use $3 million in American Rescue Plan money to provide $500 a month to 150 low-income households, starting on Nov. 1.
According to research conducted on a similar program in California, participants were more likely to land full-time jobs, pay down debt and report better emotional wellbeing.
Photo by Pepi Stojanovski on Unsplash
The police department is not the only county department with staffing reportedly in steep decline.
The number of emergency behavioral health clinicians in the Department of Human Services is also in free fall, as 13 members of the 26-person staff have departed in the last year, County Manager Mark Schwartz told the County Board during its Tuesday afternoon meeting. Existing staff cannot cover all the shifts and contractors are being used to fill in the gaps.
County officials say these clinical jobs are complex and demanding, have higher expectations and require significant training. In response, folks are leaving for jobs with better benefits and working conditions.
But they also pin this trend on a decision the Commonwealth made this summer to close more than half of its state-run mental hospitals to new admissions amid its own workforce crisis. Without these beds, people in crisis are “warehoused” at Virginia Hospital Center, and in some cases sedated and handcuffed to gurneys, Schwartz said, grimacing.
“We cannot afford not to take action,” said Director of Human Services Anita Friedman. “I have always viewed most of our clinicians, but especially our emergency clinicians, as non-uniformed public safety. They don’t wear badge, or a gun, but they are in as much danger, oftentimes, as public safety without really the same level of benefits. Without a strong emergency services staff, competent and equipped to deal with people, you’ll see an increase in suicide, homicide and all kinds of community problems.”
The short staffing hurts the Arlington County Police Department, as some officers end up spending most of their shifts in the hospital emergency room with these patients, reducing the officers available to respond to calls.
“I know I’m speaking in somewhat dire tones,” Schwartz said. “I feel like the situation is really critical.”
He asked the County Board to consider setting aside $3 million of American Rescue Plan Act funding — intended for Covid-related needs — for bonuses. Schwartz said he wanted to gauge the Board’s support before bringing forward a fully-baked plan.
“We’re fully with you on moving forward with this,” Board Chair Matt de Ferranti said. “Thank you for bringing this forward. While we want to understand the fiscal details, let’s move forward and address this. There’s a through-line between our police department and our mental health services, and with respect to staffing, that’s what we have to move quickly and the Board is ready to do that with you.”
This situation is coming to a head amid calls from the community and the County Board to transition police officers away from mental health calls. In the wake of the killing of George Floyd by police in Minnesota last year, Arlington County convened a Police Practices Group, which drafted about 100 ways to reform ACPD, including detangling officers from intervening in these cases.
The approved Fiscal Year 2022 budget even included funding for an enhanced mental health crisis response program.
But now, Police Chief Andy Penn says the police are more entangled with mental health calls than ever.
“We certainly supported where the police department should do less with mental health, but I think we’re doing more than we have in some time,” he said. “The need is to help people get the care and treatment they need, but it is a big, broad conversation that goes beyond the police department.”
In a statement provided to County Board members prior to the meeting, the Arlington Coalition of Police said officers overwhelmingly share the community’s desire to limit the interactions police have with those in mental crisis.
“But as is commonly the case, when the community has a problem few others want to address, it turns to the police,” the statement said.
