Your (Unofficial) Guide to State-Sponsored Therapy in Virginia
There’s a way to get affordable mental health care that you might not know about. That’s Virginia’s mental health system.
If you qualify, you can get mental health care at a community program for a small co-pay or a low sliding-scale fee. But even if you don’t qualify for state-funded services, the people who work in Virginia’s system can still give you information, local referrals to affordable providers, and other essential help for free.
If you’re in a hurry and want to get the most essential information about what’s available at your community mental health program and who it’s for, you can read our quick start guide below.
To learn more about public mental health services in Virginia, keep reading. We’ve done the research to uncover essential facts about who’s eligible, what services you can get, when to go, where to call, and how it works so you can decide if Virginia’s mental health system might be right for you.
Who Is Eligible?
You should consider reaching out to your local Virginia CSB if you (or a loved one) are having a mental health crisis, have a severe mental health condition, need specialty services, or have a limited income.
Everyone in Virginia can use the state-funded mental health emergency response system. If you or someone you love is in crisis, you can call your local crisis line to get the help you need, quickly.
Use the State System When You're in Crisis
Public mental health services are usually the best option if you’re having a mental health crisis and need help right away.
State mental health programs are required to provide mental health crisis response services and are one of the fastest ways to get care when you’re having a mental health emergency.
The people who answer local crisis lines can provide caring attention and support as they help you determine the best response to a crisis, whether it’s inpatient treatment or an appointment with a counselor.
Even if you’re not in crisis, you can call your local mental health hotline for information about affordable mental health services in your area. When you call, you can find out whether you might qualify for state-funded mental health services, schedule an assessment or intake appointment, or get free information about other affordable local providers.
Other parts of the system have stricter eligibility requirements. You need to have a serious mental health condition (a diagnosable condition that affects your daily functioning) to qualify for public outpatient mental health care at many Virginia CSBs.
However, more people have a qualifying condition than realize it. Don’t assume you’re not eligible!
Fast Facts About Eligibility in Virginia
Consider reaching out to your local Virginia CSB if you:
- Are having a mental health emergency
- Have Virginia Medicaid or Medicare or don’t have insurance
- Need to get information about affordable non-profit providers in your area
- Live in an area with limited mental health resources or long commutes to other providers
- Have a serious mental health condition like major depression, bipolar disorder, or schizophrenia
- Need specialty mental health care like day treatment, case management, wrap-around care, or home-based services
Eligibility criteria depend on the service you want and can vary from CSB to CSB, so it’s worth calling to confirm. To get started, you can go to a walk-in center or call a local mental health hotline. To find your local contact information, scroll to the directory below.
One of the most important requirements you need to meet to get services at a Virginia CSB is to be a resident of the area it serves. Some CSBs serve one specific county or city, while others serve a larger “catchment area” of multiple counties. You can find out which CSB serves your area by scrolling to the directory below.
Services at a CSB are a great option if you’re a local resident with a public insurance plan. All Virginia CSBs accept Medicaid (most also accept Medicare), and it can be hard to find other providers who do. Many Virginia CSBs also accept other insurance plans and offer low sliding-scale fees if you don’t have insurance.
Virginia CSBs focus on serving people with severe mental health conditions. So, if you have a serious mental health condition that affects your functioning or safety on a day-to-day basis, you should look into getting services at your local Virginia CSB. You may also qualify for services if you belong to a special eligibility group.
Special Eligibility Groups
While there is some variation from CSB to CSB, the basic eligibility requirements for public mental health care in Virginia are that you need to be:
- A resident of the area the program serves and either
- Are in crisis and need emergency mental health services or
- Have a severe mental health condition that affects your ability to function.
You can also qualify for services if you belong to a special eligibility group. For example, you are probably eligible for CSB services if you:
- Are a woman who is pregnant and using opioid drugs
- Are or were recently homeless (or at risk of homelessness)
- Qualify for disability income or status due to a mental illness
- Have co-occurring mental health and substance use disorders
- Have recently been discharged from an inpatient psychiatric facility
- Are involved in the criminal justice system or are on probation or parole
This doesn’t mean you can’t get services at your local CSB if you’re not a member of one of these groups. New funding sources can add new programs or expand access to existing ones, so it’s a good idea to call before you assume you’re not eligible.
If you’ve recently been hospitalized for mental health reasons or are unemployed or homeless because of a mental health condition, you should definitely call your local CSB. Also call if you’re concerned that you’re at risk of hospitalization, homelessness, or incarceration due to a mental illness.
Virginia CSBs have specialized services designed to help you address these challenges and get the support you need to regain stability while living at home in your local community.
Check Out the State System If You Need Specialized Services
Community service boards in Virginia are great places to find specialized and intensive mental health services like case management and day treatment that can be hard to find anywhere else. These specialty programs can give you extra help when you’re dealing with severe symptoms.
You can also usually find affordable therapy and other basic outpatient mental health services like medication management at Virginia CSBs. Whether you need a severe mental health condition or to meet other requirements to get these services depends on the funding and policies of your local CSB.
Note, however, that not all CSBs provide individual therapy, so you should ask if they do over the phone before investing time and money in an in-person assessment if you’re looking for therapy. You should also ask if the CSB charges a fee for an assessment even if you find out you’re not eligible for services.
If the assessment is free or inexpensive, it’s probably worth it. Intake workers can help you clarify what you need and give you referrals to other providers if CSB services aren’t right for you. (If they do charge for in-person assessments, you may be able to get free referral information over the phone.)
Check with Your CSB for Accurate Local Eligibility Information
One of the most important things to know about the Virginia public mental health system is that every CSB is different. While Virginia funds mental health programs using state revenue, each CSB administers its own program separately.
This means that which services you can get through the state system and whether you’re eligible depends on where you live. So, it’s important to check with your local CSB to find out what they offer.
Even if you’re not eligible, or if the CSB doesn’t offer the service you want, they can probably still help you. People who work at Virginia CSBs are knowledgeable about local resources and will often give you free information or even referrals to other affordable providers nearby, including local non-profits that provide free or low-cost counseling to people who don’t qualify for CSB services.
Where Do You Call to Get Started?
The easiest way to learn more about state mental healthcare in Virginia is to call your local mental health hotline. To find your local number, scroll to the CSB directory in the next section. You can also call one of the following statewide numbers for general help or information.
Important Numbers in Virginia
The statewide Virginia mental health crisis hotline is 988.
The Crisis Text Line for the state of Virginia is 741741.
You can reach the Virginia National Alliance on Mental Illness (NAMI) Helpline by calling 1-888-486-8264, extension 202.
The number for the Virginia Department of Behavioral Health and Developmental Services is (804) 786-3921.
Public mental health services in Virginia are managed on the state level by the Virginia Department of Behavioral Health and Developmental Services. For general information about Virginia’s system, you can contact their main office by calling (804) 786-3921.
However, you’ll probably get the best results by calling your local CSB directly. You can find your local number in the directory below.
Virginia CSB Directory
Virginia has 40 CSBs, many of which have multiple offices and service locations. Each CSB has a number you can call to get information about mental health services or to get help in a crisis.
Many CSBs can give you basic information over the phone, including other local providers you can contact if you don’t meet requirements for their services.
You can also often find information on your CSB’s website about the services they offer and who qualifies for them. Most also explain where their walk-in assessment centers are located.
You can find listings for all Virginia CSBs, crisis and information lines, and local offices below.
Most crisis lines also often serve as general information lines for people seeking local mental health care. Some CSBs have dedicated information, access, or referral lines in addition to crisis lines. Some have one 24-hour crisis line, while some have different daytime and after-hours crisis lines.
If you need information after hours or aren’t sure whether you’re experiencing a mental health crisis, it’s okay to call a crisis line for help. The staff who answer are trained to quickly figure out what you need and can tell you what steps you need to take to connect with the right services.
Also Consider: Federally Qualified Health Centers
Federally qualified health centers (FQHCs) are another great way to get affordable publicly-funded mental health services in Virginia.
These federally-funded programs provide cutting-edge care in places where good primary healthcare was once hard to find. Most provide integrated care, meaning you can get primary medical and mental health services at the same location.
Each FQHC accepts Medicaid and Medicare and offers low sliding-scale fees if you don’t have insurance. Eligibility requirements at FQHCs are usually less strict than at CSBs.
You can search for FQHCs near you by using the online search tool on the U.S. Health Resources and Services Administration website.
The state mental health system is complicated and can be confusing to navigate. If you’re having any issues, we’re here to help. Here are some of our solutions to common problems you might experience.
If you’ve run into a problem that we haven’t addressed, don’t give up. Call someone at your CSB and tell them what’s going on.
You’re much more likely to get the help you need when you advocate for yourself and are persistent. Tell the person you talk to what you need or what problem you’re having.
If they don’t help the first time, call them back and tell them. If you keep calling and keep calm and focused, you should eventually get through to someone who can help you.
Deep Dive: How Does the System Work?
To understand Virginia’s mental health system, it helps to understand how it started and how it’s changed since then.
Public mental health services have been around for a surprisingly long time. But for over a hundred years in America, the only way to get them was in a psychiatric hospital.
For More Information
To learn more about what the public mental health system was like in the early days—and how psychiatric inpatient care has evolved since then—you can read our article “Do Insane Asylums Still Exist? The Surprising Past and Present.”
To learn more about what inpatient mental health treatment is like now, and the differences between how it works in general hospitals and specialized psychiatric facilities, you can read our article “How Inpatient Mental Health Treatment Works.”
In the 1960s, Americans started thinking differently about mental health care. Conditions in psychiatric hospitals were getting worse and new medications made it possible to provide mental health treatment on an outpatient basis.
In response, new laws were passed that required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. The most important was the Community Mental Health Act, which President John F. Kennedy signed into law in 1963.
What Is the Purpose of Virginia Mental Heath System?
A community services board (CSB) is a publicly-funded community mental health program in the state of Virginia. The purpose of a CSB is to function as a mental health safety net and to provide mental health services to people regardless of their ability to pay.
Other important functions of CSBs are to provide a single point of entry for mental health services and to enable people with serious mental health conditions to live in the least restrictive setting possible in the community.
Many state mental health programs trace their origins back to the 1960s when these important changes started to happen. Virginia is no exception.
The CSB system was established in 1968 after Virginia Code 37.2-500 was passed. This law requires every county or city in Virginia to establish a public agency that serves “as the single point of entry into publicly funded mental health, developmental, and substance abuse services.”
Virginia has continued to update its system ever since to meet the needs of its residents. In March 2019, Virginia Governor Ralph Northam announced that all 40 Virginia CSBs now provide same-day access to services. This means any person needing a mental health assessment can receive one right away instead of waiting weeks for an appointment. People who are eligible for services are scheduled to begin treatment within seven to ten days.
The Continuum of Care in the Virginia Mental Health System
Virginia state law requires every CSB to provide emergency and case management services for adults and children.
Other services provided by CSBs can include inpatient, outpatient, day support, residential, prevention, and early intervention services.
The type and extent of services offered depends on each specific CSB. Some CSBs serve more highly populated counties and cities and therefore have more funding to provide more services. Many CSBs offer outpatient counseling and therapy, though these departments are often small due to budget limitations.
State law requires every county to have its own CSB or to be part of one that’s shared among other cities and counties.
Each CSB runs a little differently. Some have more restrictive eligibility criteria than others, and some provide services others don’t. Some focus more on basic outpatient services while others focus on providing specialty services.
The best way to find out if your local CSB offers what you need is to call your local mental health hotline. They know how the system works and will help you get where you need to go.
According to the Substance Abuse and Mental Health Services Administration, only 45 percent of people in Virginia who have mental health conditions get treatment for them. Many of them qualify for public mental health services but don’t know about them.
You can make a difference by reaching out and connecting with local mental health resources to get the care you need. If you’re not sure whether you qualify for Virginia state mental health services, call your local CSB or crisis line. You may find out you can get mental health services through your CSB or that there’s another affordable option nearby.
The most important thing is to get started—the help you need may be only a call or click away.