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These days, calls to a Virginia 9-1-1 dispatcher bring behavioral health help in thousands more cases than when teacher Marcus-David Peters' 2018 mental health crisis ended when a Richmond police officer shot him dead.
Most such calls still bring police, even if the state's Marcus Alert system is meant to encourage an alternative, according to a report for the General Assembly's Behavioral Health Commission.
But the 22% of 9-1-1 calls involving Virginians in crisis last year that brought someone other than, or in addition to police officers, is more than double the level when the Marcus Alert system launched, in 2022.
"We're making progress but there's a long way to go," said state Sen. Creigh Deeds, D-Charlottesville, chair of the commission.
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Marcus Alert links 9-1-1 dispatchers with the call centers that handle 9-8-8 mental health crisis calls. Protocols say when the 9-8-8 range of services - from referrals to dispatch of mobile crisis - teams take charge, and when a situation is dangerous enough that police respond, ideally with support from behavioral health specialists.
Currently, 48 Virginia localities have implemented Marcus Alert, including Richmond, Chesterfield, Henrico and New Kent counties, as well as localities in the Roanoke Valley, and the Fredericksburg, Lynchburg and Bristol areas. An additional 36, including Hanover, Goochland and Powhatan counties, are slated to come online in 2026.
In addition to the 9-1-1 and 9-8-8 coordination, Marcus Alert requires databases where individuals can ask to be listed with basic information about their mental illnesses or developmental disabilities.
But the databases aren't widely used, commission analyst Claire Mairead said.
In addition only 7% of the least urgent 9-1-1 calls, the ones that are supposed to be transferred to 9-8-8 - are actually sent there.
Dispatchers shift only 1% of calls the next level up - for people who have an immediate need for someone to intervene - to 9-8-8. That is even though officials deem dispatch of a mobile crisis team as the best response.
Sometimes the low rate of transfers to 9-8-8 happens because a family member, rather than the person in crisis, is calling. This can make it harder to assess how imminent the risk is to life and safety, Mairead said.
Sometimes it is because 9-1-1 dispatchers feel a sense of responsibility to the caller and are not sure 9-8-8 will handle the call in the best way.
The moment of mental health crisis becomes a General Assembly priority
Coordination between 9-1-1 and 9-8-8 gets more challenging as the urgency of a response rises: for instance, when a person is talking about killing someone, or when individuals are actually planning suicide.
Here, either 9-1-1 or 9-8-8 should be thinking about an emergency custody order, and a response would require police or emergency medical technicians or a crisis team. Most of these calls get a response from police without behavioral health specialists.
Another challenge is that when localities adopt an option of setting up their own "community care teams" - police accompanied by behavioral health specialists or specialists without police - they're most often sent on the least urgent calls.
That means they are not always available in the most urgent cases - when life and safety are at immediately at risk.
Training is one big need, Mairead said.
And funding is a challenge as all localities except those with fewer than 40,000 residents are to have Marcus Alert operating by July 1 2028, Mairead said.
Keeping ahead of the need that Marcus Alert is meant to address is a worry because of federal cuts to Medicaid and social services programs that are likely to shift costs to the state, said Del. Rodney Willett, D-Henrico, a commission member.
"Absolutely, we would want to do more here to get this to the finish line," he said. "But the reality is, this is unprecedented dealing with these budget impacts."
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Family members, including Princess Blanding, center right, sister of Marcus-David Peters, her daughter, Tionna Blanding, 10, center left, cousin Rachel Melvin, right, and others pray after a march for Peters in front of Richmond Police Headquarters in Richmond on June 2, 2018. Peters was fatally shot by police.
DANIEL SANGJIB MIN, TIMES-DISPATCH
Marchers for Marcus-David Peters, including Jessica Moreno, center, shout, "Justice", as they head to Richmond Police Headquarters from VCU's Siegel Center in Richmond on Saturday, June 2, 2018. Peters was fatally shot by police.
DANIEL SANGJIB MIN/RTD
Marchers for Marcus-David Peters shout as they arrive at Richmond Police Headquarters from VCU's Siegel Center in Richmond, Va, on Saturday, June 2, 2018. Peters was fatally shot by police.
DANIEL SANGJIB MIN/RTD
A marcher holds a flower after walking to Richmond Police Headquarters from VCU's Siegel Center in Richmond, Va, on Saturday, June 2, 2018.
DANIEL SANGJIB MIN/RTD
Marchers hold photos of Marcus-David Peters as they head to Richmond Police Headquarters from VCU's Siegel Center in Richmond, Va, on Saturday, June 2, 2018. Peters was fatally shot by police.
DANIEL SANGJIB MIN/RTD PHOTOS: March for Marcus-David Peters
Family members, including Princess Blanding, center right, sister of Marcus-David Peters, her daughter, Tionna Blanding, 10, center left, cousin Rachel Melvin, right, and others pray after a march for Peters in front of Richmond Police Headquarters in Richmond on June 2, 2018. Peters was fatally shot by police.
DANIEL SANGJIB MIN, TIMES-DISPATCH
Marchers for Marcus-David Peters, including Jessica Moreno, center, shout, "Justice", as they head to Richmond Police Headquarters from VCU's Siegel Center in Richmond on Saturday, June 2, 2018. Peters was fatally shot by police.
DANIEL SANGJIB MIN/RTD
Marchers for Marcus-David Peters shout as they arrive at Richmond Police Headquarters from VCU's Siegel Center in Richmond, Va, on Saturday, June 2, 2018. Peters was fatally shot by police.
DANIEL SANGJIB MIN/RTD
A marcher holds a flower after walking to Richmond Police Headquarters from VCU's Siegel Center in Richmond, Va, on Saturday, June 2, 2018.
DANIEL SANGJIB MIN/RTD
Marchers hold photos of Marcus-David Peters as they head to Richmond Police Headquarters from VCU's Siegel Center in Richmond, Va, on Saturday, June 2, 2018. Peters was fatally shot by police.
DANIEL SANGJIB MIN/RTD
Dave Ress (804) 649-6948
dress@timesdispatch.com
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Dave Ress
State Politics / Growth and Development Reporter
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