Fairfax County, Va. Leaders Continue To Push For Better Mental Health and Substance Abuse Care

Judge Tina Snee of the Fairfax County General District Court. “Graduation” for defendants who successfully completed requirements on the Fairfax County Mental Health Docket.

(12-1-21) I am delighted that the Fairfax County Board of Supervisors is continuing to focus on decriminalizing mental illnesses and treating substance abuse.

Earlier this month, General District Court Judge Tina L. Snee held yet another graduation ceremony for individuals who’d completed requirements set through her mental health docket. (In Virginia, there are no mental health courts, only dockets.) Judge Snee has been a champion in overseeing this important tool in our county’s jail diversion efforts. Circuit Court Chief Justice Penney S. Azcarate first opened the door by establishing a veterans’ docket. Both should be commended.

Jeffrey C. McKay, chair of the Board of Supervisors, recently highlighted other steps the country is taking to improve mental health and substance abuse services. (See below) McKay has done a masterful job in building on a foundation that his predecessors, Chair Sharon Bulova and Supervisor John C. Cook, established.

Not surprisingly, Sheriff Stacey A. Kincaid continues to be a driving force in pushing the county forward. She was a crucial in launching the county’s Diversion First program, is nationally recognized as a proponent of the Stepping Up Initiative, and has implemented dozens of meaningful changes at the adult detention center, such as offering tele-psychiatry services in the jail. She changed the jail’s long standing policy of releasing inmates at 12:01 a.m., shifting discharge to 8 a.m., a time when transportation, shelter, medical care and other community resources are more readily available. Since 2016, she has invited NAMI support groups into the jail six times a year. She routinely talks to parents and spouses who are concerned about an incarcerated loved one with a mental illness and/or substance abuse problem.

Those of us who live in Fairfax County should be grateful for Chair McKay, the board, Judges Snee and Azcarate, the CSB’s Daryl Washington, and especially Sheriff Kincaid.

Now, if we can only do something about securing affordable housing and increasing access to treatment beds.

Here is Chair McKay’s recent press release.

I want to share some of the Board’s work decriminalizing and treating mental health and substance abuse. Due to the pandemic, many of us have faced isolation, anxiety, and uncertainty, and it takes a toll on our wellbeing. (You can find general mental health resources here.) This increase in mental health problems combined with less access to services, has partly led to a record high number of deaths in the US caused by drug overdoses. We have seen sadly similar trends in Fairfax County:
  • Following a significant decrease in the number of fatal opioid overdoses in the Fairfax Health District from 2017 to 2019, unfortunately in 2020, the number of fatal opioid overdoses increased to 94 (most of these involved fentanyl which is 50-100 times more powerful than morphine).
  • Statewide from 2019 to 2020, there has been a 47% increase in fatal opioid overdoses and about 87% involved fentanyl.
  • The number of emergency department visits for heroin and non-heroin opioid overdoses also was significantly higher in the state and the Fairfax Health District in 2020 relative to 2019. The data available for 2021 so far is trending higher than the same time period in 2020.
The Board and Fairfax County are committed to making accessible resources for mental health treatment. Recently, the Board acted on a settlement agreement with Attorney General Mark Herring to hold pharmaceutical companies responsible for the opioid crisis that enabled this surge in 2020 to occur. This money will continue to help abate the harmful impacts of the opioid crisis.
To further our work, we know how crucial it is the invest in our Community Services Board that provides services to people with mental illness. That’s why in FY2017 for example, we devoted more funding (over $113 million) to our CSB than Arlington, Loudoun, Alexandria, Virginia Beach, and Prince William counties combined.
Below, I outline some programs we have in Fairfax County that work to divert mental illness away from the criminal justice system and additionally our work to reduce drug overdoses.
Diversion First Background:
  • In Fairfax County, we are committed to treating behavioral health and getting to the root causes of problems, not criminalizing it. Not only does Diversion First allow people to take control of their lives and recover, it’s less costly for people to receive treatment instead of spending time in jail. For every person held in our jail, it costs the tax payer $358.98 each day.
  • This is why in 2016, the Board of Supervisors launched the countywide Diversion First program, which provides alternatives to arrest and incarceration for people with mental illness, co-occurring substance use disorders and/or developmental disabilities.
  • This initiative involves collaboration among multiple health and human services and public safety agencies and the courts.
  • The Sequential Intercept Model below outlines and informs points of intervention and the resources needed.
Diversion First Programs:
In May 2021, I addressed the graduates of the Mental Health Docket.
Diversion First by the numbers:
  • To date, there have been over 11,000 transports for services at the Merrifield Crisis Response Center by law enforcement officers, and over 2,500 diversions from potential arrest.
  • There has been a 28% decrease in the behavioral health population in jail for misdemeanors (from 2015-2020).
  • There has been a 21% increase in the number of inmates referred to jail-based behavioral health services (from 2015-2020).
  • Over 2,000 individuals with behavioral health issues have been served through Court Services Pre-Trial services since 2017.
  • 90% of those in Diversion First housing have maintained stable housing
  • Over 1,000 law enforcement officers throughout Fairfax County have received Crisis Intervention Team training.
Opioid and Substance Use Task Force
  • Fairfax County’s Opioid and Substance Use Task Force, created by the Board of Supervisors in 2017, is a collaborative, cross-systems approach to reduce the number of opioid-related deaths and overdoses in the Fairfax community.
  • Addressing the opioid epidemic’s impact on the Fairfax community has been a longstanding Board priority. The FY2022 County Budget adopted by the Board includes additional resources to expand services for incarcerated individuals and pregnant women and ensures sufficient residential treatment and detoxification capacity.
  • These services are part of the Task Force’s strategy, guided by the FY 2021 and FY 2022 work plan, to combat the opioid epidemic through activities in the following five areas: education, prevention, and collaboration; early intervention and treatment; enforcement and criminal justice; data and monitoring; and harm reduction.
  • Over 30 activities are currently underway or in development, including:
  • The CSB provides Virtual REVIVE! Training classes on how to recognize the signs and symptoms of an opioid overdose and administer naloxone nasal spray to potentially reverse the effects of an opioid overdose.
  • Because most fatal overdoses in Fairfax in 2020 involved fentanyl, the CSB now provides fentanyl test strips. Illicitly made fentanyl can be found in cocaine, methamphetamine, heroin, ketamine, synthetic cannabinoids, and counterfeit pills.  FTS can be used to determine if drugs have been mixed or cut with fentanyl.
  • The Substance Abuse Prevention program provides substance use prevention, assessments and treatment to adolescents who are at risk of or who are actively using substances.
  • Launched in July 2020, a medication-assisted treatment program in the Adult Detention Center is seeing early success with former inmates staying engaged and successfully connecting in unprecedented numbers to CSB’s Addiction Medicine Clinic, which provides outpatient medication-assisted treatment.
  • The 4Recovery (Rapid Referrals and Resources for Recovery) Project, initially launched in October 2020, connects individuals experiencing a non-fatal overdose who encounter a member of our public safety team with the CSB Peer Outreach Response Team (PORT). The PORT team follows up with those individuals to offer support toward recovery.
  • If the situation is immediately life-threatening, call 911. Fairfax County Fire and Rescue personnel carry medication that can prevent deaths from opioid overdose.
  • If it’s after business hours, call CSB Emergency Services at 703-573-5679  or the Fairfax Detoxification Center at 703-502-7000; available 24/7
  • For other CSB services (including medication-assisted treatment and residential treatment), call CSB Entry & Referral 703-383-8500   TTY 711 Monday-Friday, 9am-5pm.
  • PORT provides outreach, engagement and resource navigation to individuals who have serious opioid and other substance use challenges. If you or someone you know could benefit from PORT services, call PORT today at 703-559-3199.
Recovery and Support Groups
  • Heads Up and Talk it Out for teens between the ages of 14-17 who are working through emotional, mental health or substance use challenges.
  • Fairfax County Juvenile and Domestic Relations Court offers a Virtual Parent Support Group for parents & custodians of adolescents (court involved or not).
  • Medication Assisted Peer Support (MAPS) is a free support group especially for people who are using prescribed medications to help in their recovery from substance use/addiction.
About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.