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New law addresses temporary detention orders during mental health crises

‘A law like this was needed’ says woman who faced hospital stay

Jeremy M. Lazarus | 8/10/2023, 6 p.m.
A new state law might have prevented Jamisha L. Seward’s ordeal nearly a year ago when she was handcuffed and ...
Jamisha Seward says she was held in the emergency room of a Henrico County hospital for more than three days last September. A new state law allows a person to be released sooner than three days if an evaluation shows the individual is no longer a threat, suicidal and no longer needs hospitalization. Photo by Jeremy Lazarus/Richmond Free Press

A new state law might have prevented Jamisha L. Seward’s ordeal nearly a year ago when she was handcuffed and shackled by her leg to a hospital bed for more than 80 hours while a rotating shift of Henrico County police officers kept an eye on her.

Ms. Seward, a 40-year-old medical technician, was held in the emergency room of Henrico Parham Doctor’s Hospital under a three- day temporary detention order (TDO) alleging she was a danger to herself and others, according to documents in her case.

A new law that Gov. Glenn A. Youngkin recently signed will allow a person to be released sooner than three days if an evaluation shows the individual is no longer a threat or suicidal and no longer needs hospitalization.

New behavioral health language

Behavioral Health HB 1976/SB 1299. Temporary detention; release of detained individuals. The law permits the director of a facility where a person is awaiting transport to the facility of temporary detention pursuant to a temporary detention order to release the person if an employee or a designee of the local community services board, in consultation with the person’s treating physician, (i) conducts an evaluation of the person, (ii) determines that the person no longer meets the commitment criteria, (iii) authorizes the release of the person, and (iv) provides a discharge plan.

To view more 2023 changes to Virginia’s laws, visit https://dls.virgi...

“This is another step in reshaping our behavioral health system,” said Charlottesville state Sen. Creigh Deeds, who sponsored the Senate version of the bill that Republic Delegate Robert B. Bell patroned in the House.

The law went into effect July 1.

“I just wish this law had been in place so I wouldn’t have needed to go through what I did,” Ms. Seward said. “A law like this was needed. Of course you want to let people go when it is clear they don’t need to be in a hospital. That’s just common sense.

“But it certainly didn’t happen in my case, and if it takes a state law to make it happen, then I’m fine with that.”

Ms. Seward was released on the fourth day after her appointed attorney persuaded a Henrico County magistrate at a hearing that there was no evidence in her file to support sending her to a state hospital for a 30-day observation period as physicians at the hospital had recommended.

She was deemed no longer a patient at risk for violence within eight hours of her arrival at the hospital, according to hospital records that she obtained and shared with the Free Press.

While being held, Ms. Seward said she was not allowed to contact family and friends to let them know her situation that began Sept. 11, 2022.

The records also show that she generally was not provided with any of the prescription medicine she takes to control heart and stomach issues.

The doctors assigned to her at the hospital never consulted her primary care physician about the medications she might need or the therapist she has been seeing to treat the depression, anxiety and other neuroses, the Free Press confirmed.

The records also show the doctors assigned to her also refused to provide her with a CPAP machine, even though, she has been diagnosed with severe sleep apnea — or breathing disruption during sleep — and had been prescribed the continuous positive airway pressure equipment in order to prevent her from constantly waking up to reopen her airways.

“It was traumatizing and scary and continues to affect my everyday life,” said Ms. Seward, who works in the medical field as a medical technician and cares for an ill cousin in her Henrico County apartment.

The hospital did not respond to Free Press requests for comment on her case, though the records she provided confirm the general accuracy of Ms. Seward’s statements about how she was treated.

Overall, the hospital and its practitioners did not appear to have followed the patient care policy that the owner, HCA Health Services of Virginia, has issued. The policy promises that those who come will receive “quality, safe and professional care without discrimination and will be free of all forms of abuse and harassment.” The policy states that “consideration and respect” would be the norms in serving patients.

Ms. Seward has no criminal record and has not been diagnosed as having violent tendencies, according to a review of court and behavioral health records.

Her ordeal grew out a conflict with her daughter, who came to stat with her on Sept. 11, 2022, to avoid being homeless. The daughter has not been available for comment.

When the officers refused to remove the daughter because she had permission to be there, Ms. Seward made a decision that backfired.

She said she offered to go to a mental hospital so she could separate from her daughter, and then threatened to stab her daughter if police did not assist her to go to the hospital.

For the officers, that was enough for them to seek an emergency custody order and take her to Henrico Parham for further evaluation. As is department protocol, she was handcuffed for the trip.

Ms. Seward said she just spoke the words to get away from her daughter and had no intention of carrying out the threat. Then, she found out how unpleasant the situation could become.

She is not alone. Delegate Bell and Sen. Deeds both have said they proposed the legal change after learning the about the difficul- ties people have faced in gaining quicker release from a TDO.

Two lawyers, who represent patients under temporary detention orders and spoke on condition of anonymity, separately said that keeping mental patients in restraints is normal in emergency rooms while they await admission to a psychiatric ward in the hospital or at another location.

In Ms. Seward’s case, she remained in the emergency room when, the records show, no place was found in which to transfer her. The hospital did not admit her.

There has been plenty of concern about the current TDO system.

In December, Gov. Youngkin set up a task force to gain recommendations on ways to speed up the process of placing people who are suffering a mental health issue or crisis.

“The present TDO process has failed by not delivering care to patients when they need it most,” Gov. Youngkin’s administration stated in announcing the task force.

The new laws, such as the one allowing for early release from a TDO, represent efforts by the governor and the legislature to address known issues while the task force does its work.

When police bring patients such as Ms. Seward to an emergency room under an emergency custody order, they retain responsibility and can be tied up until the patient is admitted to a mental care facility, according to the Virginia Association of Chiefs of Police. The result, according to the association, is that it can take days for officers to be released back to duty.

For Ms. Seward, the worst part is that no one at the hospital would listen to her.

“They were so convinced I was the crazy one, they just did want they wanted,” she said. “It was so unfair. Everyone else was in control, and I had to accept that because it could only get worse.”